Supporting the patient without enabling

Supporting the Person
Without Enabling
Instructor: Dr. Dawn-Elise Snipes
Executive Director: AllCEUs Counselor Continuing Education
Podcast host: Counselor Toolbox and Happiness Isn’t Brain Surgery
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89 1

Objectives
 Explore how a person becomes an enabler
 Define enabling
 Examine the consequences of enabling
 Learn about the connection between enabling and co-
dependency
 Define characteristics of codependency and how they
may develop from being in an enabling relationship
 Examine practical strategies to provide support and
encouragement to the loved one without enabling.

What Makes an Enabler
 A person that you love who is in trouble or experiencing pain
 An addicted person
 A person with mental health issue
 A person with chronic pain
 A child
 A sense of responsibility for the problem (If I would have been
more aware…, If I had…)
 Denial that there is a problem requiring professional help
(initially)
 Once you have “helped” once it is hard to stop
 Emotional manipulation to maintain the behavior
AllCEUs Unlimited CEUs $59 | Addiction Counselor Certificate Training $149 | Specialty Certificates $89
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What is Enabling
 Enabling behavior:
 Protects the person from the natural consequences of his behavior
 Keeps secrets about the person’s behavior from others in order to
keep peace
 Makes excuses for the person’s behavior (with teachers, friends,
legal authorities, employers, and other family members)
 Bails the person out of trouble (pays debts, fixes tickets, hires
lawyers, and provides jobs)
 Blames others for the person's behaviors (friends, teachers,
employers, family, and self)
 Sees "the problem" as the result of something else (shyness,
adolescence, loneliness, broken home, ADHD, or another illness)
 Avoids the person in order to keep peace (out of sight, out of mind)
 Gives help that is undeserved, unearned or unappreciated
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What is Enabling
 Enabling behavior:
 Attempts to control the other person by planning activities,
choosing friends, and getting them jobs and doctor appointments
 Makes threats that have no follow-through or consistency
 "Care takes" the person by doing what she/he is expected to do
for herself/himself
 Ignoring the person’s negative or potentially dangerous behavior
 Difficulty expressing emotions –especially if there are negative
repercussions for doing so
 Prioritizing the needs of the person with the addiction before their
own
 Acting out of fear – Since addiction can cause frightening events,
the enabler will do whatever it takes to avoid such situations
 Resenting the person with the addiction

What Does Enabling Look Like
 “He’s so irresponsible with money, he could never make it on his own. If I
kicked him out, he would be homeless. What else can I do?”
 “Every time I’ve tried to talk to her about her addiction, she’s gone on an
even worse binge, and I’m afraid she will overdose.”
 “I know I shouldn’t have paid for his lawyer after the third DUI, but if he
went to jail, he would lose his job, and we rely on his income.”
 “Every time she and her boyfriend fight, she crashes here. I let her because
I know he can be violent, and I don’t want her to be hurt.”
 “If I don’t get the emails, he will miss them and lose his scholarship.”
 “It is my fault she is in pain, so I must do whatever she wants.”
 “If I can’t change what he did, at least I can limit the damage.”
 “Maybe he will wake up and come to his senses.”
 “Maybe I just need to find the right treatment for him.”
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Consequences of Enabling
 Enablers detest the behaviors of the enabled, but fear the
consequences of those behaviors even more.
 They are locked into a lose-lose position in the family. Setting
boundaries feels like a punishment or abandonment of the
person they love.
 Enablers may struggle with the guilt they would feel if the
person they’re enabling were hurt by the real consequences of
their actions.
 Enablers are also protecting themselves and/or children from
those consequences
 Enabling means that someone else will always fix, solve, or
make the consequences go away.

Consequences of Enabling
 Enabled persons will come to expect that their behaviors
have no consequences or negative outcomes.
 Enablers may become “emotional hostages” as the person
learns to manipulate them in order to ensure that the
help and support keep coming.
 The enabler is desperate to prevent one enormous crisis,
but winds up experiencing a constant state of stress
 The enabled person and the enabler become stuck in a
role in which they feel incompetent, incapable,
disempowered and ineffectual.
 They may gradually accept a self-concept that includes these
negative traits, destroying self-esteem and leading to co-
dependency

Characteristics of the Co-Dependent Person
 The person had someone they loved and…
 Failed to “fix” them. The loved one “chose” another behavior over the
relationship---impacting self-esteem, self-efficacy and abandonment anxiety.
 Believes it is his or her responsibility to care-take the other person
 An exaggerated sense of responsibility for the actions of others
 A tendency to confuse love and pity, with the tendency to “love”
people they can pity and rescue
 A willingness do anything to hold on to a relationship; to avoid the
feeling of abandonment
 An extreme need for approval and recognition
 A sense of guilt when asserting themselves/setting boundaries
 A tendency to do more than their share and become hurt when people
don’t recognize their efforts
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Characteristics of the Co-Dependent Person
 A compelling need to control others
 Lack of trust in self and/or others
 Difficulty identifying feelings
 Rigidity/difficulty adjusting to change
 Problems with intimacy/boundaries
 Chronic anger
 Lying/dishonesty
 Poor communications
 Difficulty making decisions (Don’t talk, don’t trust, don’t
feel)

What to Do
 Learn about addiction and any co-occurring issues the
person may have.
 Get help and support from others.
 Calmly let your loved one know that you are aware of
their problem, that you will not tolerate that
continued behavior, and that you are willing and able
to support them on the road to full recovery.
 This should include explaining that you will be withdrawing
financial and other support should they choose to refuse
your help--which means that you will not enable them, but
only support them on the path to recovery.

What to Do
 Healthy help involves providing information,
encouragement, and coaching to your loved one.
 Give the person contact information for doctors, counselors,
lawyers, or rehabilitation programs, without feeling the
need to force him or her to accept this help.
 Discuss with the person what the possible consequences of
actions might be, without feeling as if you must make sure
they make the choice you want them to make.
 Foster hope, for you and the person.
 Sometimes people refuse to get help, only to turn around
and ask for help a short time later. (control)
 By refusing to tolerate or enable the addiction related
behavior, but being willing to fully support their recovery,
you can foster hope that can grow and catch on.

Practical Strategies
 Take care of yourself
 Sleep
 Nutrition
 Exercise
 Emotions
 Social relationships and activities
 Awareness of what is truly important to you
 When you’re together, remember not to helicopter
 Don’t obsess or worry about him or her.

 Example thoughts
 I have to….or he will…
 If I truly loved her, I would…
 If she chooses that behavior, it means I am a failure and unlovable
 Handling thoughts
 Unhook from thoughts.
 I am having the thought that…
 Challenging Questions
 What is the evidence for and against this?
 What parts of this are my responsibility?
 Play it through to the end… If I do this it will…
 Which important things does this help me move toward? Away from?
 Which values does doing this support? Undermine?
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 Don’t judge them. (It is what it is.)
 Don’t have expectations of others; instead, meet
expectations of yourself.
 Remember that you didn’t cause someone else’s behavior.
You are only responsible for yours.
 You cannot change or “fix” someone else.
 Before engaging in enabling behavior, weigh your options
for short-term and long-term pain
 Write about your feelings in a journal.
 Pursue your own interests and have fun.

 Set Boundaries
 Part of your recovery is to get very clear about your
boundaries.
 What do you expect from your partner?
 What behaviors are acceptable and what will you no
longer tolerate.
What will happen if there is a relapse?
 What do you need to feel safe and secure?
 Learn how to say no and mean it.
 Learn how to ask for help and get it.

 Take a time out when you get emotional. Practice distress
tolerance and get into your wise mind.
 Each day, identify 3 things you did well or like about yourself, and
write them in your awesomeness journal.
 Take the labels off (good/bad, should). When it comes to
expectations, assumptions and excuses, ask yourself how you
would treat the other person if he or she wasn’t your loved one.
 When you’re tempted to think or worry about someone else, turn
your attention back to you.
 Pay attention to how you talk to and treat yourself. Silence the
inner critic. Be compassionate.

 Have some fun. Pursue hobbies and interests.
 Spend time alone with yourself.
 Start looking for the positive in your life and add to your
gratitude list each day
 Stand-up for yourself if someone criticizes, undermines,
or tries to control you.
 Practice mindfulness and radical acceptance to deal with
worry
 Let go of control and the need to manage other people. Remember
the saying, “Live and let live.”
 Accept yourself. You don’t have to be perfect.
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 Get in touch with your feelings. Don’t judge them.
Feelings just are. They’re not logical or right or wrong.
 Express yourself honestly with everyone. Say what you
think and what you feel. Ask for what you need.
 Reach out for help when you feel bad. Don’t fall into the
trap of thinking you should be able to manage alone.
That’s a symptom of codependency, too.

 Encourage and Support Recovery Activities
(Avoiding the dry drunk)
 You can’t be your partner’s only support.
 You can encourage and support by helping to arrange
time in the family schedule and budget and providing
emotional support or transportation.
 Encouraging doesn’t mean forcing, manipulating,
making ultimatums, or nagging.
 Engage in your own recovery activities

 Restore Balance
 Stop making excuses, minimizing or avoiding problems,
and simply doing things that s/he can do for
him/herself.
 Leave the person to clean up the messes she makes
while engaging in the destructive behavior.
 Don’t allow the person to put you in situations which
may endanger yourself or others
 Follow through with plans even if the person refuses to
participate

Summary
 Enabling behaviors can occur with anyone, not
just people who are addicted.
 Most of the time people do not start out enabling,
they often feel responsible in some way and are
trying to make things better
 Supporting without enabling means
 Getting clear about your wants and needs
 Setting boundaries (emotional, physical, financial…)
 Learning how to say “no”
 Being willing to encourage and support healthy
behaviors

Supporting the patient without enabling

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Supporting the patient without enabling