The recently released film 6 Balloons highlights the challenging relationship between protagonist Katie (Abbi Jacobson) and her brother Seth (Dave Franco), who is struggling with a heroin addiction. Through Katie’s attempts to help her brother get into rehab, she ends up ultimately helping him, with his child in tow, get his next fix. The film has sparked a discussion about “enabling” and the role of loved ones in supporting friends and family dealing with addiction.
The “Cycle of Enabling” typically refers to a complicated relationship between family/friends and the people they love who are struggling with addiction or other problematic behaviors. In the process of trying to help, caregivers’ actions sometimes result in maintaining or escalating the very behaviors that are causing everybody harm.
However, there’s a problem with labeling caregivers as “enablers.”
Often the idea of “enabling” comes with an implicit prescription. The family member or loved one just needs to show some “tough love” and follow through with their ultimatums. The logic is that if the threat of being cut off is real, it can compel a person dealing with an addiction to shape up.
In reality, “tough love” just doesn’t work. Analysis of over 40 years of research on addiction treatment (White & Miller) found that not a single study supported confrontational approaches as better than kinder and less harmful treatments.
Instead, research on family interventions that focus on providing support to the person dealing with addiction, like Community Reinforcement and Family Training (CRAFT), have been shown to be extremely effective.
So, how can caregivers help friends or family with addiction issues?
Caregivers can support their friends and family by being compassionate and by reinforcing positive behavior. Some parts of this process might include:
1. Understand your loved one’s behavior.
Addiction is a coping mechanism in response to pain - whether it’s trauma, abuse, isolation, or just having a tough time. A first step is for friends or family members to get to the bottom of the pain and to understand what drives their loved one to repeatedly use this type of behavior despite negative consequences. This can open up possibilities for ways to support. You might ask - What do they really need?
2. Have “courageous conversations.”
It feels like a risk to have difficult conversations, but these are what will make a difference. In approaching a loved one, it’s important for caregivers to be honest AND compassionate. They should focus their feedback on how their loved one’s actions affects them personally.
3. Get support for yourself.
In a moment of crisis, a caregiver might think it’s appropriate to put their wellbeing on the back burner. However, a caregiver’s ability to take care of themselves will determine how effective they are. They will also likely find that they need to do some introspective work. They might have to think about how their own actions are contributing to the problem. It’s important to create a network of support from people who can understand the fears and complexity of supporting someone who is going through a tough time.
C.E. Grella and J.A. Stein, “Remission from Substance Dependence: Differences Between Individuals in a General Population Longitudinal Survey Who Do and Do Not Seek Help,” Drug and Alcohol Dependence 133, no.1 (2013): 146-53.
White, W. & Miller, W. (2007). "The use of confrontation in addiction treatment: History, science and time for change." Counselor, 8(4), 12-30.
Roberts, Amy. (April 6, 2018). “Love gone too far: What ‘6 Balloons’ gets right about enabling an addict.” Film Daily.