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Addiction: Caregiving and “Unhealthy Helping and Giving”

There is nothing pretty about living with an addiction to alcohol and/or drugs. There is also nothing pretty about being the caregiver for someone who has an addiction. It may be that this is a concurrent disorder (that is, the person you are caring for has an addiction as well as a mental health condition or disorder at the same time) or the person may also have some other physical injury, illness, or disease in addition to the addiction. Substances may have been used to “self-medicate” or manage physical and/or mental and emotional pain.

Substance use and abuse can be concurrent with PTSD, traumatic brain injury, and chronic pain to name a few.

It is important for the person to seek medical help. All of these conditions need to be treated by a health care professional. It is an understatement to say that drug and alcohol addictions bring much pain and suffering for all involved. The relationship dynamics are undoubtedly complicated.

What are the consequences for you as a caregiver?

At the very least, there is additional stress and anxiety. You may be wondering whether recovery is even possible. The short answer is: yes, but it can be a long haul before recovery is sought by the person with the addiction and the truth is that there is no guarantee they will ever begin the recovery process. You have probably already figured out that you can’t make a person seek treatment. In fact, you may have already worn yourself ragged trying to micromanage the person’s life.

When the person you are caring for has an addiction, there is a risk of crossing a line and instead of supporting the person, you may actually be enabling the person. This is related to the concept of codependency. This term was first used in the 1950s when therapists treating clients with addictions to alcohol noticed that a partner or spouse sometimes helped to maintain the addictive behaviour by enabling the person with the addiction. To date, there is no agreement about the definition or diagnosis of codependency and it has become so popularized and overused to the point that the act of caregiving can lead to a label of “codependency!” A less judgmental and more fruitful way to explore the ideas embedded in codependency is through the lens of what makes up “healthy and unhealthy helping and giving.”* Dr. Shawn Meghan Burn describes some classic patterns of “unhealthy helping and giving.”

“Unhealthy Helping and Giving”

  • “Bearing others’ negative consequences”

This is when we bail others out of the trouble they brought on themselves. This prevents the person from fully experiencing the results or the consequences of their behaviour. Examples may include paying fines, court costs, increased insurance costs, etc.

  • “Accepting others’ bogus excuses “

This is when we accept the person’s justifications and rationalizations for the behaviour. This may be done to keep the peace because questioning the reason for the behaviour may result in the person questioning your love or loyalty.

  • “Making bogus excuses for others”

Similar to the point above, this is when you defend the person in your care in order to justify their behaviour. Again, like accepting excuses, making excuses is often seen by caregivers as an expression of loyalty.

  • “Covering for others by lying for them or doing their work”

This one is pretty straightforward. Do you have a pattern of covering up or lying for the person with the addiction?

  • “Overlooking violated boundaries and agreements”

In dysfunctional helping and giving relationships, the caregiver sets  boundaries (for example, “if I come home from work and find you drunk, I am leaving you”) and/or the person with the addiction makes agreements (for example, “I’m going to get help tomorrow”) but there is no follow-through.

  • “Accommodating others’ unhealthy behaviours”

Dr. Burn describes this as catering to “manufactured needs” which are needs that would be non-existent if the person sought treatment or stuck to a treatment plan (so while this includes addictions, it is also applicable to poorly managed mental and physical illnesses, injuries, or diseases). Accommodations would include such things as stocking the home or driving the person to pick up their drugs or alcohol.

To sum up, enabling is about propping up or reinforcing the addiction. Without consequences, the motivation or incentive to get help with the addiction is reduced. Caring for someone with an addiction can be draining and is likely having an impact on your own mental and physical health. You may have been trying to control and manage the addiction at the expense of your own health and wellbeing.

So, now what?

It is really important to look at your own behaviour as a caregiver with non-judgmental eyes. Think about how a kind and loving aunt, uncle, or dear friend would react to your behaviour as a caregiver. These are complicated relationships and if you suspect or know that you have been enabling the addiction, it is not because you are fatefully a “codependent.” This label is only helpful, as Dr. Burn points out, if it empowers you to “understand and change your unhealthy behaviour and choices.”

Please also keep in mind your original intention to support and care for someone. The fact that you may have crossed a line from “healthy helping and giving” to “unhealthy helping and giving” or from supporting to enabling does not change your good intentions. You may not have known how to behave or react any differently.

You may already know that simply reading an article will be insufficient and you will need professional help and support to make healthier choices when it comes to caring for someone with an addiction.

*If you are interested in learning more about why it can be so challenging to set limits or boundaries and you would like more strategies and suggestions for how you can practice this limit setting, consider reading Dr. Burn’s book:

Unhealthy Helping: A Psychological Guide to Overcoming Codependence, Enabling & Other Dysfunctional Giving, 2016.