Tough Love – good or bad?

The basic definition of tough love is “the promotion of a person’s welfare, especially that of an addict, child, or criminal, by enforcing certain constraints on them, or requiring them to take responsibility for their actions.”

The Term Tough Love

The term tough love was first used in 1968 by Bill Milliken when he wrote the book “Tough Love”, and has been used by numerous authors since then.

Tough love is used to describe a firm and unyielding approach to handling someone’s actions or behaviour. Initially viewed as the answer to a variety of problems, it has since become a rather controversial treatment when applied to certain disorders, such as drug addiction or other addictive behaviours.

In everyday use, it may be applied by parents to manage the negative emotions experienced by children as part of a learning process. This can vary from the healthy setting of firm boundaries, common in authoritative parenting styles, to abusive parenting styles in which humiliation, belittling or physical violence are used to control the child. It is this fine line between using the approach in the correct manner or allowing it to become an abusive tool which has raised so many questions as to its effectiveness, and even more so, its dangers.

One example is where a parent may use tough love against an adult child who has purposefully remained unemployed whilst still living at home. In keeping with the principles of tough love, the parent would then withhold the paying of bills, and instead allow the child to deal with the consequences of non-payment, such as the damage to the child’s financial credibility. One may then ask how this motivates the adult child in any way to secure employment.

The term tough love has become very popular and is easily bandied about as the answer to managing difficult or unwanted behaviour, but it has since become apparent that tough love cannot be used effectively in all situations, including addiction.

In particular, tough love has been ridiculed as a dangerous technique in handling teens or adults struggling with addictions, especially those who engage in substance abuse. Some treatment centres use the term tough love to refer to a harsh approach that breaks down the will of the person. While it may appear to be effective in the short-term, it can actually worsen the condition and lead to dangerous relapses later on.

Tough love can have its place in addiction treatment, but it should not be engaged in without input from a doctor or therapist who fully understand how and when the treatment should be applied.

I am familiar with the tough love approach based on my own personal experiences but decided to keep an open mind and see what came up in the extensive research I do for each and every blog.  From the many reports, studies, and the personal experiences of others who shared their stories, I can conclude that without a doubt, the tough love approach is now viewed as a rather flawed method of trying to adjust someone’s actions or behaviour. There are the die-hards who still believe that with perseverance, this approach achieves the desired results, but the evidence to the contrary is overwhelming. Especially when one takes the view that addiction is a legitimate medical illness marked by observable brain changes that cause escalating drug use, and that tough love does not change the structure or behaviour of one’s brain, nor does it cure psychiatric illness. The research and addicts themselves tell us that tough love addiction treatment doesn’t work.

Journalist and author of the book Unbroken Brain, Maia Szalavitz writes:

“The trouble with tough love is twofold. First, the underlying philosophy – that pain produces growth – lends itself to abuse of power. Second, and more important, toughness doesn’t begin to address the real problem. Addicts aren’t usually ‘spoiled brats’ who ‘just need to be taught respect.’ Like me, they most often go wrong because they hurt, not because they don’t want to do the right thing.”

Numerous studies show how positive encouragement stimulates the part of the brain which enhances mental abilities, such as creative thinking, cognitive flexibility, and the processing of information. These are the very mental capacities most needed for people to come up with solutions to their own problems. However, messages that are consistently negative and focus on someone’s faults and flaws are only likely to increase feelings of stress, fear and anxiety. These feelings of inadequacy may further restrict the possibilities for addicts trying to break out of the often strongly ingrained patterns of predictably harmful behaviours.

Tough Love Addiction Treatment

“Tough love addiction treatment has long predominated the recovery community, to the detriment of addicts and their families. But the tough love approach is fundamentally antithetical to the reality of addiction and fails to recognise addiction as a brain disorder and psychological symptom. If your loved one is struggling with addiction, knowing what to look for in addiction treatment and steering clear of damaging treatment approaches could mean the difference between recovery and relapse” – Alta Mira

The belief is growing that tough love addiction treatment not only doesn’t work, it actually feeds into the pain and shame that are driving addiction in the first place. Professionals are becoming more aware of the failings of tough love addiction treatment and now see the need for effective, evidence-based alternatives that recognise addiction for what it is – an illness. Not a choice, not a moral shortcoming, and most certainly not something that can be shamed out of you.

Forget the tough love and get back to the basics of real love.

Karen P

 

David is the Clinical and Development Director of Twin Rivers Rehab in South Africa and a UK Accredited Addictions Therapist with the Federation of Drug and Alcohol Professionals UK. Articles/Blogs are written with the assistance of researchers and other specialists in the field of addiction and the recovery process