The Truth About Tough Love

Families seeking treatment often have the idea that the way to deal with addiction is through “tough love,” which seems harsh, unkind, and merciless. What we learn, though, in treating families with addiction, treatment isn’t about tough love at all - it is about healing, and the process of healing can often be very tough.

The key question we ask families to consider: Is the way they currently provide love -- tough or otherwise -- helping the person they love while working for the family as a whole? If not, then we must help the family make a change in the way they provide or express love. This expression of love might look different, but it’s still love.

What about unconditional love?

Sometimes, when I’m having this conversation about tough love with a family, I get questions about unconditional love. “You’ll never tell me not to love them,” I’m told, or, “I’ll always love them unconditionally.” Yes, unconditional love is something that helps all of us feel secure. It’s a necessary part of human development, knowing that we will be loved no matter what and valued for who we are. Treatment is about healing, including healing the family. To achieve healing, we help families define the difference between unconditional love and an unconditional relationship.

Unconditional relationships are inherently unhealthy. The only time unconditional relationships are appropriate is between parent and infant, because parents are 100 percent responsible for every aspect of an infant’s needs. Once we leave infancy, there are always conditions in our relationships. We have conditions in our marriages for how we expect our spouses to act. We have conditions with our children when we tell them there’s no TV tonight if they don’t clean their rooms. Values and boundaries are a healthy part of all relationships.

During active addiction, things have often broken down for families because of a key factor: Fear. If a family is sending a loved one to treatment with us, it’s likely because they’ve watched them engage in life-threatening behaviors. Drugs (illegal or over-the-counter drugs), alcohol, eating disorders, sexually acting out, relationship challenges, criminal behavior – these can all be life-or-death propositions. Families know the stakes, but they don’t know what to do. For many families, the level of fear is so bad that all they want is for their loved one to come home alive. That fear, and lowering of expectations as a result, is understandable. Ultimately, it is not a healthy relationship, and the goal in treatment is to help everyone in the family move beyond that.

Achieving a healthy relationship

To help families understand what behaviors need to change to achieve healthy relationships, we start by asking them to give us an understanding of the lens they view the world through. This involves some background on their own families of origin and the strategies and behaviors they learned. We then ask them to evaluate their own behavior patterns. For example, how did they respond each time their son took the car and had a car accident, how did they respond when he returned home? What was the follow-up to that? How did he behave as a result? And how did it feel for the family as those things happened? We’re asking families to look not only at what the patient did, but also at the pattern of response from others in the family, always from the point of view of, is it working? If not, then we start anew in searching for something more effective.

As part of treatment, families also need to give up the belief that they can control the patient’s behavior. It’s an illusion to think we can ever control another human being. Once families understand that they can’t control their loved one, it becomes a question of engaging in this relationship in a way where they are comfortable and know they’ve done the best that they can for their loved one and for themselves.

This means expressing love differently at a particular time. We talk a lot with families about how boundaries fit into the healing process. Saying no, or I won’t help you with that, or you’re going to need to figure that out on your own – sounds like tough love, but, in reality, these statements are simply indicative of a family creating an opportunity for their loved one to grow and get better.

Tough love doesn’t exist; there’s simply love, conveyed in different ways. The key question is: Is the way you’re conveying your love working? And, the follow-up question to that is, what type of relationship do you want?

We work to help families find a new set of actions to take, ones that often feel counter-intuitive. There must be space we can allow our loved one to grow. We have the data to prove that if you step back in an intentional and healthy way with the guidance of an expert, you allow your loved one to grow and move forward. And that has to be done with love.