Behavior Modification

Tough Love – Is it Effective or Not

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Addiction has been present among humans from the beginning.

There is no such a thing as Tough Love being effective or useful in combating addiction. References about addiction have been written about in the Bible:

“At last it (alcohol) bites like a serpent and stings like an adder. Your eyes will see strange things,
and your mind utter perverse things (Proverbs 23:32-33)”.

The great philosopher, Plato was concerned about children under 18 drinking.

Over the course of history, society has struggled with how to approach this issue; and across the course of history people have been receiving absolutely ridiculous advice on how to handle addiction.

From William Miller and Kathleen Carroll’s book Rethinking Substance Abuse:

“For as long as there have been written records, people have been searching for what to do about the troublesome use of psychoactive drugs. Ancient Greek remedies for excessive alcohol use included placing an eel at the bottom of the unfortunate drinker’s generous goblet of red wine. Historically, problem drinkers have been whipped, dunked, shocked, poisoned with potions, chained, dialyzed, terrorized, and drugged with hallucinogens”.

Problematic and Ineffective

The war on drugs for example has been a war on people and completely ineffective.

Yet it remains our first line of defense and most well-funded response to this issue. We have been prescribed one size fits all services and everyday seems to bring more controversy and disagreement on the “solution”.

People with a substance use disorder are subject to the most outrageous of advice, and the instant experts are everywhere. Family members are also subject to this same type of misguided advice.

One could argue that the common direction given to family members is just as problematic as whipping, shocking or dialyzing an active addict.

Love Your Child to Death

This is most pronounced where parents are concerned. Parents are told they are “loving their child to death” and they frequently arrive to our programs beaten down and self-critical.

One of the most common introductions used by family members new to our group is: “My name is Mr. Jones and I am the poster child for enabling” followed by hanging of the head and body language that reflects a hopeless self-concept where parenting is concerned.

One of the most problematic things I have ever heard came from a person who described himself as a professional in the field. I had the unfortunate opportunity to witness him admonish a group of parents about “enabling” and instructed the entire group (with no real knowledge of the individual family situations) to detach, kick the kid out of the house, stop all contact with the person and “not even give him a baloney sandwich.

We could write an entire blog post on the sad reality of this person’s behavior.

Fortunately, this man may be an outlier (I hope) and most professionals or helpers would avoid going to that extreme.

However, one glance at the unethical, illegal and exploitative A&E television show Intervention will tell you the “kick the bum out” mentality still carries the day.

Guide by Clichés

Clichés tend to guide much of what happens in addiction treatment/recovery services.

There are several that have become universally accepted as guiding principles. Some of these clichés are useful and some are destructive.

“The most troublesome of these is the term Tough Love.”

It is most troubling because it is the most universally recognized of family recovery principles despite the fact it has been shown to be dangerous at worse; ineffective at best.

What Exactly is Tough Love?

We throw the term tough love around like it is the gospel truth.

However, do we have a generally agreed upon definition of Tough Love?

A simple search reveals the following definition:

• Tough love is an expression used when someone treats another person harshly or sternly with the intent to help them in the long run. … In most uses, there must be some actual love or feeling of affection behind the harsh or stern treatment to be defined as tough love. (Wikipedia)

• Love or affectionate concern expressed in a stern or unsentimental manner (as through discipline) especially to promote responsible behavior (Webster’s dictionary)

Harshly or Sternly

Pretty obvious right! The key terms and principles stand out clearly: “harshly or sternly”; “stern and unsentimental manner”; to promote responsible behavior over the long term.

Tough love sits comfortably under the umbrella of confrontation and punishment that guided the majority of the treatment and recovery programs over the past 40 years. Fortunately, that philosophy is being challenged.

But it is easy to see that tough love is part of that tradition. To get a better sense of tough love let’s look at the origins of this principle.

Where Did The Idea of “Tough Love” Come From?

As stated above the concept of tough love is rooted in the tradition of confrontation and punishment that has been such an integral part of addiction treatment and recovery services. Tough love has been the preferred advice given to family and friends as they struggle with a loved one’s addiction.

It made perfect sense given the default approach with addicts: confront, berate and belittle until they admit defeat.

At which point we can build them back up in a more acceptable manner. The tough love approach became mainstream as younger and younger people needed support.

It was a mainstay of the youth treatment movement (boarding schools, therapeutic schools, wilderness camps, behavioral camps etc…). Many kids were subject to these re-education efforts.

Many times, the treatment was horrific. Programs like “Straight Recovery” took tough love to an entirely new level. They are a great example of how good intentions can go horribly wrong.

Most of the time these abusive programs would claim anecdotal stories of “success” (not empirical) as justification for the misguided approach. Fortunately, there is an effort to clean up these abusive practices and much progress has been made where teen treatment is concerned.

Mother Jones Is Telling the Truth!

The online news media website Mother Jones describes the origin of tough love and teens in the following manner: “This harsh approach to helping troubled teens has a long and disturbing history. No fewer than 50 teen programs… can trace their treatment philosophy, directly or indirectly, to an antidrug cult called Synanon.

Founded in 1958, Synanon sold itself as a cure for hardcore heroin addicts who could help each other by:

“breaking new initiates with isolation, humiliation, hard labor, and sleep deprivation”

The connection between Synanon and tough love is important. Synanon was notorious for its abusive practices. The people running Synanon were open about the philosophy.

We could spend a great deal of time exploring the psychological pathologies of the founder-Bill Dietrich-but for the time being it is important to focus on the tough love connection.

Treatment Model for Thousands

As the 1970’s progressed Synanon became the model for thousands of treatment programs across America. Although these programs were not as intense and abusive as Synanon, the culture of confrontation, punishment and belittling carried the day in many of these programs. It became the norm and tough love was launched into the mainstream.

Never Studied or Validated

Please NOTE: Like most other addiction treatment practices; tough love was never studied or validated as an effective approach. It was simply “declared effective” by the founders of these programs.

The other 2 factors that promulgated the universal acceptance of tough love:

1). The culture of the times and the psychological establishment’s pre-occupation with law and order and ensuring the maintenance of the proper middle-class family (post WW II mentality).

If the addict was an embarrassment and causing problems a punishing approach seemed most conducive to promoting “middle class decorum and material comfort”. Families wanted everything to look appropriate and polished. And tough love fits in well with that model.

2). The popular media thrives on confrontation and drama. Tough love provides that.

Being patient and using connection, family therapy and a measured/rational approach doesn’t play well in terms of ratings. A&E needs drama and confrontation to sell the show. They don’t want clinically sound interventions.

Unchallenged for 40 Years

When you put all of this together you get “tough love” as an unquestioned rule of thumb.

Tough love has remained unchallenged for 40 years. We are fortunate, however, to be living in this time. Today, tough love is being re-evaluated and looked at.

It has been found invalid and many new ideas are being put forward. Many will criticize this movement away from tough love as an “easier and softer way”. Well to that I say…thank you for the complement.

We Do Not Need Tough Love

We do not need TOUGH love. What we do  need the appropriate expression of love.

In reality, however, we know that addiction is a family disease and impacts everyone. We also know that family and friends are more impactful than professionals; when it comes to changing outcomes related to addiction.

Therefore, it will be necessary for parents to change their behaviors.

As parents change their behaviors the child becomes more likely to change his behavior. But rather than tough love, think of it as the appropriate expression of love.

Love is an action word and setting limits and boundaries is part of the action of love.

Many times, saying no is an act of love. We can not just stand by and allow our child to self-destruct.

HOWEVER, we do not need to be “tough” while setting these boundaries.

We do not need to be “harsh” or “unsentimental” or “mean” when we set these boundaries. You do not need to completely detach and never talk your loved one.  We can buy our kids lunch.

“We can certainly make them a baloney sandwich.”

Setting boundaries is the most important aspect of the process. Setting boundaries takes practice.

Please check out my post on boundaries – MEAN WHAT YOU SAY

Final Words

Be kind to yourself. You are not a bad parent. You are not the “world’s worst enabler”.

Beware of toxic people with toxic advice. They come in all shapes and sizes and sometimes will even disguise themselves as “experts”.