Chapter 4: Understanding Enabling Behavior and How to Address It 2 CE Hours By: Wade Lijewski, Ph.D. Learning objectives Explain the definition of enabling behavior and give five examples Explain techniques to address and stop enabling behavior (from the and research on codependency. perspective of a counselor dealing with addiction and enabling and Summarize the elements of enabling behavior. the perspective of the person who is enabling a loved one). Discuss current strategies related to behavior change. Describe existing myths about enabling behavior and the myths Review and discuss family dynamics related to enabling behavior. about therapy. Identify the elements of confrontation and explain how to use them. OVERVIEW In the world of psychology, the term “enable” is used in both a positive Understanding the enabler’s role and how it can be reversed is critical and a negative sense. It is used by psychologists in a positive light to for anyone who wants to permanently break the cycle of drug abuse, describe the empowerment of others as well as the implementation of alcoholism and addiction. positive resources to address a problem. However, enabling is also used To enable the individual with the addiction, the mutually dependent as a term to describe approaches by individuals that are intended to help person makes excuses and lies for the addict, which enables the but in fact may perpetuate a problem. addiction to continue. Codependency is reinforced by a person’s need A common theme of enabling in the latter sense is that third parties take to be needed. The enabler thinks unreasonably by believing he can responsibility, blame, or make accommodations for a person’s harmful maintain healthy relationships through manipulation and control. He conduct. They often have the best of intentions, but become an element believes he can do this by avoiding conflict and nurturing dependency. that needs to be addressed when counseling individuals and families on Is it normal for people to think that they can maintain a healthy addiction. relationship when they do not address problems and lie to protect others Enabling is a term that is frequently used in 12-step recovery programs from their responsibilities? The way a codependent person can continue to describe the behavior of family members or other loved ones who to foster this dependency from others is by controlling situations and rescue an alcoholic or drug addict from the consequences of his or her the people around them. The codependent family is trapped in a pattern own self-destructive behavior. It also includes rescuing anyone who of conflict while attempting to hide problems and make excuses for the is caught up in any of the compulsive or addictive self-destructive addict’s self destructive behavior that also harms the family (Classen, behaviors that are symptoms of codependency, such as: 2015). ● Gambling. Why does enabling cause so much hurt in a relationship? The power ● Spending. afforded to the mutually dependent person in a relationship supports his ● Eating disorders. need for control, even if he uses inappropriate means to fulfill that need. ● Sexual or relationship addictions. A second and overlooked reason centers on the contradictory messages ● Inability to hold a job. and unclear expectations presented by someone who is codependent. Enabling comes in many forms, such as giving addicts whatever they These characteristics lead to a relationship filled with irrational thoughts want. This deprives them of learning how to build self-esteem, which you and behavior. This kind of relationship has no clear rules to right and build by doing esteem able acts, such as going to work every day, going wrong behavior. The unhealthy patterns a person enables may be one or to school, being productive, and building a life and healthy relationships. more of these behaviors: Another example of enabling is setting boundaries but failing to uphold ● Drinking too much. them when the time comes. An addict/alcoholic must understand the ● Spending too much. consequences of his or her actions or will most likely continue with the ● Overdrawing bank accounts and bouncing checks. same behavior; this responsibility lies with the family. ● Gambling too much. ● Getting into trouble with loan sharks and check cashing agencies. Another common example of enabling can be seen in the relationship ● Working too much or not enough. between alcoholics/addicts and their codependent spouses. The spouses ● Maxing out credit cards. often believe incorrectly that they are helping alcoholics by calling into ● Abusing drugs (prescription or street drugs). work for them, making excuses that prevent others from holding them ● Getting arrested (the enabler must bail him or her out). accountable, and generally cleaning up the mess that occurs in the wake ● Any of a number of other unhealthy behaviors and patterns of of the alcoholic’s impaired judgment. In reality, what those spouses are addiction. doing is hurting, not helping. Enabling prevents psychological growth in the person being enabled and can contribute to negative symptoms in Any time people help or allow another person to continue their the enabler. unproductive, unhealthy, addictive behavior, whether actively or passively, they are enabling. Even when they say nothing, they are Many people who are drug abusers and addicts recognize that they can’t enabling the behavior to continue. Sometimes people say nothing out stop using on their own. Likewise, a large number of these same people of fear – fear of reprisal; fear of the other person hurting, hating or not literally wouldn’t be able to continue to use on their own if an enabler liking them; or fear of butting in where they don’t think they belong. wasn’t helping them. From covering up lies and criminal activity Perhaps they even fear being hit or worse. to making excuses to other family members, enablers often make a person’s substance abuse and addiction possible. However, the reality of Enablers often participate in such behavior because of their own low the matter is that enablers are doing the addict great harm, and in some self-esteem. They haven’t gained the ability to say no without fear of ways are just as responsible for their behavior as the addicts themselves. losing the love or caring of that other person. People who learn tough love have to learn that their former behaviors have been enabling and Page 84 Counselors.EliteCME.com that to continue in them would represent allowing the other person’s A major source of information on substance use, abuse, and dependence pattern of behavior to continue and to worsen. among Americans age 12 and older is the annual National Survey on Because enabling behavior is most often discussed in substance abuse Drug Use and Health (NSDUH, 2015) conducted by the Substance issues, it is interesting to note the prevalence of this issue and its impact Abuse and Mental Health Services Administration. The following on society. are facts and statistics on substance use in America from 2014 and published in 2015, the most recent year for which NSDUH survey data have been analyzed. Illicit drug use Illicit drug use in America has been increasing. In 2014, 27.0 million Women are the fastest-growing segment of drug users in the United people aged 12 or older used an illicit drug in the past 30 days, which States. In fact, 3.5 million misuse prescription drugs, and 3.1 million corresponds to about 1 in 10 Americans (10.2 percent). This percentage regularly use illicit drugs. Women are less likely to misuse or abuse pain in 2014 was higher than those in every year from 2002 through 2013. medication. Four million women report past-year misuse of prescription The illicit drug use estimate for 2014 continues to be driven primarily pain medicines. Five million men report past-year misuse. Women by marijuana use and the non-medical use of prescription pain relievers, are more likely to seek treatment for misuse of barbiturates. Fifty- with 22.2 million current marijuana users aged 12 or older (i.e., users in five percent of past-year treatment admissions for barbiturate misuse the past 30 days) and 4.3 million people aged 12 or older who reported are women. Forty-five percent of past-year treatment admissions for current non-medical use of prescription pain relievers. The percent barbiturate misuse are men. The percentage of people aged 12 or older of persons 12 years of age and over with any nonmedical use of a in 2014 who were current heroin users was higher than the percentages psychotherapeutic drug in the past month was 2.5% for 2014. in most years from 2002 to 2013. Alcohol use Alcohol is the most commonly used addictive substance in the United Alcoholism is the 3rd leading lifestyle-related cause of death in the States: 17.6 million people, or one in every 12 adults, suffer from nation. Up to 40% of all hospital beds in the United States (except for alcohol abuse or dependence along with several million more who those being used by maternity and intensive care patients) are being engage in risky, binge drinking patterns that could lead to alcohol used to treat health conditions that are related to alcohol consumption. problems. More than half of all adults have a family history of There were 139.7 million past month alcohol drinkers aged 12 or older alcoholism or problem drinking, and more than 7 million children in 2014, including 60.9 million who were binge alcohol users and live in a household where at least one parent is dependent on or has 16.3 million who were heavy alcohol users. In 2014, the percentage abused alcohol. Alcohol abuse and alcoholism can affect all aspects of people aged 12 or older who were past month alcohol users (52.7 of a person’s life.