Enablers compound the problem

By Michael G. Brock

This article was initially written in 2009, then revised in 2011.  Last week I received a call informing me that the client mentioned in this piece has been involved in another accident. I don’t know if he was intoxicated at the time, but apparently he tried to make a lane between two trucks where there was no lane.  His passenger was killed in the crash and he is awaiting trial.
In the movie, “Remember the Titans,” Denzel Washington plays a football coach with the thankless task of taking over the head-coaching job of a high school that has been recently integrated. It’s a good story about race relations, but like any worthwhile story dealing with race, it is about more than race, and includes some important observations about the human condition. 

Washington’s white assistant coach seems to have something of a social worker mentality, and seeks to soften the blows of the head coach’s strict discipline. Once, after the assistant coach gives a player an assignment on his defensive squad when Washington has removed him from the offense for lack of effort, the head coach tell his subordinate, “You think you are helping these kids when you do that, but you’re not. You’re crippling them; you’re crippling them for life.” And so he was.

Everyone likes to be helpful, or at least likes to believe they have done more good than harm in their lives. Even more so, we all like to believe we are good parents. One wonders then why some parents never seem to learn that enabling their children is not helpful to them, but only postpones the inevitable time when they will have to face reality, and increases the likelihood that when that time comes they will be totally incapable of doing so.

I received a call some time back from an attorney about pretty nice kid who had gotten himself into trouble by driving drunk, having an accident, and then leaving the scene to get another car to pull that car out of a ditch.  The lawyer had done a pretty good job of minimizing the damage, and the young man was referred to me for substance abuse evaluation and therapy. 

This was part of the terms of probation, but the client did not complete therapy within the probationary period. He really made no effort.  Instead, his mother phoned me to say she didn’t see why he should have to complete therapy and why couldn’t I just write a letter releasing him? I refused. She tried to pressure me. I told her the court had given the kid a substantial break and I thought her son should comply with the court’s orders.  Moreover, he had issues that needed to be addressed.

The lawyer called me and I explained the situation.  He said the terms of probation were the terms of probation, and that was that. Probation was extended six months, during which time the young man completed therapy.  He said that he had changed his lifestyle and his friends; he was in college full time and active in sports. He seemed to be back on the path to a bright future.

Some time later the lawyer called again regarding another case, but he also mentioned that this young man had been involved in another accident involving unlawful use of alcohol. We agreed you really hate to see this sort of thing happen; a young person digging himself a hole it will be next to impossible to crawl out of. At the very least, it will take a long time and plans will have to be put on hold. At worst, the person will become discouraged and give up. 

But why do they give up? Because their enabling parents have consistently told them that life should be easy, and that they should never have to experience the consequences of their behavior. 

It is part of life, however, that each of us has to someday experience the consequences of his or her actions, and the sooner we learn this lesson and take responsibility for our behavior, the sooner we become functional, productive adults. The longer young people are allowed to put off assuming responsibility, the more likely it is that they will never learn to accept it, never grow up, and never learn to live in the real world.

Although abuse by parents is a serious problem and warrants the attention it receives, and though parents can sometimes demand too much of their children, it is my belief that more children have had their lives ruined by being indulged than by being abused. This is because, too often, enabling is seen as “love,” and the opposite of abuse. Sometimes the enabling is done by the same parent who was abusive or neglectful earlier in the child’s life in an attempt to ameliorate the effects of the abuse, but, whatever the motive, it merely compounds the problem. 

It is not love to shield our children (or anyone else for that matter) to such an extent that they are totally incapable of functioning in the real world. To do so is to cripple them, to “cripple them for life.”
Feeling the Loss
On a somewhat different topic, but still related to the issue of substance abuse, this has been a tough year for recovering alcoholics/addicts in Hollywood, with the loss of Phillip Seymour-Hoffman and Robin Williams. Both of these gifted men had been sober over 20 years before relapsing back into active substance use. In the case of Seymour-Hoffman, death was directly due to addiction and was the result of a heroin overdose. But Williams relapsed in 2003, after having been sober 20 years, then reestablished sobriety in 2006. According to his wife, his sobriety was “intact” at the time of his suicide.

When Hoffman died there was a short article in Time by a friend of his who was also in recovery. The person quoted Hoffman as saying that if he were to die by overdose it might serve as a deterrent to others who were inclined to abuse substances. As much as I admire Hoffman’s work, I thought the comment was both dangerous and stupid. (After basketball player Len Bias died of an overdose the drug dealers began advertising their wares as “Len Bias” cocaine on the street the next day.)

Hoffman’s comments might go to show how seriously convoluted is the mind of someone in the grip of addiction to a powerful drug, but I am inclined to paraphrase Gen. George Patton that, “No poor dumb SOB ever got anyone sober by dying of an overdose; he did it by staying sober and being the message he hoped to carry.”

As unfortunate and wasteful and Hoffman’s death was, I find Williams’ case more distressing, both because it was deliberate, and because he was apparently sober. It is also a concern because, though he was trying to get help, he may not have sought the right help. 

Shortly before his suicide he had checked into Hazelden treatment center, a facility for addiction treatment utilizing the 12-Step approach. The notion that mental health conditions will inevitably respond to the same treatment as addiction is dangerously inaccurate. It may be easy to say in retrospect, but Williams needed inpatient hospitalization, appropriate non-addictive medication, and therapy tailored to his condition. An aftercare self-help group like the one set up by Abraham Low might also have helped his chances of survival, but that program, unfortunately, never caught on.

Psychology Today ran an article on its blog, August 14, 2014 by David Sack M.D., called, Tough Truths You Should Know About Addiction, Depression, How do we deal with Robin Williams’ suicide? The article cites research findings that both depression and addiction have suicide rates of around 10%. However, when combined (what are commonly called “dual diagnosis” patients) the suicide rate jumps to 25%. This was the first time I had heard these figures.  However, it is self-evident to anyone in the treatment community that dual diagnosis poses a unique challenge to both patients and treatment professionals. 

From time to time there is news about this person or that who has a new approach to treating addiction that is supposedly an improvement, or at least an alternative to the quasi-religious approach of AA. Recently, Harvard psychiatry professor emeritus Lance Dodes published a book called, “The Sober Truth,” in which he reviews the literature and concludes that the science supporting the effectiveness of 12-step groups is poor. This may be so, but he goes on to conclude that this method really isn’t very effective, and that abstinence isn’t a realistic goal.  If an alcoholic drinks less often, this should be seen as improvement; it is wrong to insist on abstinence.

Both Hoffman and Williams had two decades of sobriety before relapsing. Williams spoke of the powerful impact of his drug of choice when he took the first drink after twenty years of sobriety; it was like he never left. Over the decades I have been doing treatment, I have observed how hard it is for those who relapse after long-term sobriety to reestablish permanent abstinence and quality of life. I don’t know that I’ve seen anyone do it successfully.  Even if they manage to quit using their substance, the positive mental state is hard to regain.  To me, it certainly makes the case that abstinence is the only realistic choice. But Williams’ death also underscores the importance of effective treatment for co-occurring conditions.
Michael G. Brock, MA, LLP, LMSW, is a forensic mental health professional in private practice at Counseling and Evaluation Services in Wyandotte, Michigan. He has worked in the mental health field since 1974, and has been in full-time private practice since 1985. The majority of his practice in recent years relates to driver license restoration and substance abuse evaluation. He may be contacted at Michael G. Brock, Counseling and Evaluation Services, 2514 Biddle, Wyandotte, 48192; 313-802-0863, fax/phone 734-692-1082; e-mail, michaelgbrock@ comcast.net; website, michaelgbrock.com.