Anna, the mom at the blog Let Go, Hang On wondered in a recent post whether or not she should rent a room in a rooming house so that her mentally ill and addicted daughter would have a safer place to live.
This, of course, resulted in a flurry of comments warning her about the dangers of enabling. Here is my take on the question:
You do not have the ability to end your daughter’s addiction, or stop your daughter from using by withholding supports.
You do have the ability to make your daughter safer by providing appropriate supports.
I would encourage people to step back and consider the reason that sobriety is desirable in the first place. Because it keeps people safe from drug-related harm.
This is why I advocate a focus on safety.
Some things are worse than continued use. Death, rape, prostitution, violence, HIV, and Hepatitis C, for example, are not an improvement over continued use.
Many people withhold support with the intent that this will constitute an end to the enabling that they believe is somehow the reason use has continued.
Withholding support is the extent of many people’s recovery plan for their loved one, and it is an ineffective plan.
Sobriety is a means to an end…freedom from harm. Something is wrong when we become so obsessed and hyper-vigilant about avoiding enabling that we lose site of this. Especially when you are talking about somebody who is disabled and has had multiple treatment attempts.
Too often, withholding support out of fear of enabling isn’t about setting appropriate boundaries. Instead it’s about trying to control an addict’s behavior –while claiming powerlessness over the addict and the addiction, and claiming that only the addict can make a change.
I agree with NAMI (and federal housing programs for mentally ill and addicted homeless people like Shelter Plus Care which uses a “housing first” model) that withholding housing supports is not a safe or effective way to support treatment or recovery. This is especially true for people with both major mental illness and addiction.
You might check and see if there is a Shelter Plus Care housing program in your area. Pathways to Housing is one organization that operates this type of program in several parts of the country (there is one near me and I think they are great!).
Your daughter may be eligible for a housing voucher and professional supports from a case manager, nurse and others on a support team. This would allow you to conserve your resources and allow them to grow (increasing your ability to help in the future if needed).
If there is not a program like that where you live, or she is not eligible, then it seems to me it would be reasonable for you to try your plan and see how it goes. In the big picture, you will be making her more safe and not less safe.
I spend my days along with my staff helping people who are opiate dependent get housing, get food, get jobs, get medical care, get dental care, get mental health care, get drug treament and on and on. And my program offers the same supports whether or not somebody is currently using. Some would say I’m a full time enabler!
The funny thing is, 100 percent of our case-managed clients participated in treatment last year. Turns out, this is a great way to help people transition from use to recovery. How is that for an intervention?
We don’t require a goal of abstinence, but virtually all have this goal for themselves and consider themselves to be in recovery. Most are successfully abstinent…not because we would withhold basic needs support from them otherwise, but because the unconditional support has created the conditions for positive change.
Many have mental health issues in addition to the addiction issue, but we use this approach with everybody. So while I think a “housing first” model which provides housing before mental health and addiction recovery is achieved makes sense for people who are mentally disabled, I also think it makes sense for everyone else too.
You have more power to help your daughter by providing appropriate supports than you have power to hurt your daughter by so-called enabling. So don’t be too worried.
Please allow me to repeat, you don’t have the power to end your daughter’s addiction by withholding supports. You do have the power to keep her safer by providing appropriate supports.
{ 4 comments… read them below or add one }
Tom,
While I don’t totally disagree with your philosophies, I believe that the reason you have success with these kind of programs (providing housing, etc.) is because it is a “program”. Kids tend to take advantage of their parents, especially addict kids. It is possible that they respect “strangers” more and therefore you are able to help more successfully than parents can. Just a thought.
Thanks Helga. I agree with you that the parent/child relationship is very different than the counselor/client relationship. You make a valid point.
At the same time, I wouldn’t dismiss the idea that the approach also matters, and can help parents understand a better approach for themselves.
Many counselors/treatment providers (like many parents) are unsuccessful at engaging and retaining clients in treatment. The average number of times a counselor meets with a client is once! Many providers rely on captive (residential) or coerced (corrections mandated) clients to make a living.
In other words, the approach matters too.
In my opinion, the issue isn’t that parents need to stop “enabling.” The issue is that parents need to learn how to both set appropriate boundaries AND provide appropriate supports.
And they need to learn enough about recovery to either help their son or daughter create a realistic treatment plan that is both effective and acceptable to the addicted person, or find somebody who can (not an easy task either since most providers only focus on their own treatment modality and have no concept of how to create a comprehensive, long term and effective treatment plan).
On the issue of respecting parents versus respecting strangers, I don’t “demand” much respect from clients. You can be late, you can no show, you can swear, you can answer your cellphone in the middle of our meeting, and you can get away with almost anything short of violence. I’m not there to teach etiquette, enforce rules, teach discipline or responsibility. I keep my eye on the prize. Yet I get the kind of respect I really want…they keep coming back, keep trying, believe I care about them, and consider what I say and often act on it.
I get that respect because I care more about supporting them than I care about controlling them. That feels rare in their world.
I suggest that parents decide to focus less on controlling use (especially controlling by withholding communication or support), and more on setting appropriate personal boundaries and providing appropriate support that is consistent with personal boundaries.
Thanks for your comment!
I was thinking about this tonight. My brother is mentally ill and often verbally abusive to my parents. (The police have even been called) My parents have an alcoholic/codependent relationship where they are usually yelling and belittling each other. I was thinking my brother needs to get out of there and could my parents pay for him to do so and would it be right? He can’t work so doesn’t have money to get a place of his own. He won’t go on disability or his (not sure what it’s called) stuff from the marines b/c of his conspiracy concerns. I pray for the day he gets better and they can all find and experience peace.
God bless.
Heather’s Mom, It might make sense to start having conversations with your parents and brother separately about whether or not they are satisfied with the current living arrangements, and whether or not they would consider it a good thing for your brother to live some place else. I suspect they all may like that, but have concerns and anxiety around making a change. If you can get them to give you permission to explore options, it will help when you start finding other options. It may be a process to get your brother to agree to paperwork, assessments, and appointments that may need to happen. But if he is interested in the goal, it will be easier.
You may be able to find housing options via programs for the homeless, vets, or people who are mentally ill. You may be able to put things in terms of helping your parents financially. He may feel bad about not being able to pay his own way, and if you put it in terms of the government or a program giving his parents money instead of him money it may help. It would probably be better for your parents to be his benefits payee instead of having him control his own money anyway.
Under many programs, the definition of homeless includes people who are “marginally housed.” It sounds like your brother would be homeless if your parents did not let him stay with them, so he may meet requirements under these programs.
I would start exploring housing programs (such as those mentioned in the post above), veterans benefits and disability benefits and explain to people the issue with his refusal to apply because of his mental illness. There may be reasonable accommodations that programs will (and may have to under federal law) make under the circumstances.
I’m not sure how old your parents are, but it would be wise to start some planning now anyway, because your parents may not be able to sustain this situation in the long term.
Consider contacting mental health, veterans or other advocacy organizations if needed. You could also contact your federal legislators’ offices. They have staff who will help address your concerns with performance of federal agencies.
I’d start slow with brief, informal conversations and see how things go. In the mean time, you could spend some time exploring options on your own.
I have not worked with anyone in this situation before and don’t have a lot of the facts, so these are just suggested starting points. Hope they help, and best of luck to you and your family.