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Kind Love vs. Tough Love – What’s A Parent To Do? A Q&A with Maia Szalavitz, Part I

Tuesday, April 2nd, 2013


Maia Szalavitz is an award-winning journalist who covers the addiction field, health, science and public policy. She is co-author (with leading child trauma expert Bruce D. Perry, MD, PhD) of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

I recently had the opportunity to speak with Ms. Szalavitz about her work. Following is the first in a four-part series. Here, Ms. Szalavitz shares her insights into how parents can better deal with their teens’ and young adults’ drug and alcohol abuse problems.

***

JERRY OTERO: In your latest book, Born for Love: Why Empathy Is Essential — and Endangered ,you explore empathy’s startling importance in human evolution and its significance for our children and our society. Why is empathy essential, and how can parents help to instill it in their children? Are there any lessons here to learn for parents who are struggling to make sense of their teenagers and young adult children’s drug abuse issues?

MAIA SZALAVITZ: Empathy is critical for having a happy, healthy life because it affects all of our relationships and our health — physical and mental — to an enormous degree is determined by our ability to form strong bonds with others.  The best way to teach empathy is to behave kindly:  as one expert put it, empathy can’t be taught, but it can be caught.  However, kids need to learn to understand their own feelings well before they can understand those of others:  good ways of helping them learn this are reading to them and asking them explicit questions about their own and other people’s thoughts and feelings in various situations.

Empathy is also important for preventing and treating drug problems.  In terms of prevention, schools with warm atmospheres where kids feel part of a community have less drug use and less bullying, for one.

Also, part of the reason I got interested in the subject was that I saw how unkind so many counselors and treatment programs were to people with addictions.  And there are all kinds of people out there advocating that being cruel is the only way to help.  The data just doesn’t support that — empathetic treatment is the most effective.  And harsh treatment drives people away from seeking help.

JERRY OTERO:  “Kind Love” vs. “Tough Love”, what’s a parent to do about a teenager’s or young adult’s substance use?

MAIA SZALAVITZ: There is no evidence that “tough love” does anything useful.  Of course, you shouldn’t buy drugs for your children or do things that will help them use easily and if they are a danger to you or your other children, you may have to have them live elsewhere — but don’t put a child on the street with the aim of helping him stop using.  It might do that — but it also might make a temporary problem into a permanent one by entrenching the street lifestyle and putting the child at greater risk for overdose, suicide and disease.  If you need to cut a child out of your life, in other words, do it to protect yourself or others, not to help them.  There’s no evidence that it does help and all of the evidence on treatment and intervention shows that kind, supportive, gradual approaches are more effective than abrupt, harsh, confrontational ones.

This goes back to empathy:  if you want to help your child quit, you need to understand why they use and help them find other ways of getting those needs met.  If the child believes you are on their side and will not place them in an awful place they can’t escape and want them to feel good, not control them, you will be much more successful in motivating change.  It’s a lot easier for a kid to say yes to treatment if he knows his parents will back him up if it’s not right for him; a trial of antidepressants is much more easily done if the teen sees this as a way for her to feel better, not a way for her to be made compliant.

Check back next week for Part 2 of our Q&A, “Finding Treatment for Your Teen.”

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz.  In addition to the books mentioned above, Ms. Szalavitz previously co-authored The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000).

Posted by  |  Filed under Books about addiction, Dealing with an Addicted Child, Drugs, getting help, parenting, Substance Abuse, tough love, Writing About Addiction



6 Comments on “Kind Love vs. Tough Love – What’s A Parent To Do? A Q&A with Maia Szalavitz, Part I”

Edwin Rutsch says:
April 2nd, 2013 at 9:15 pm

May I suggest a further resource to learn more about empathy and compassion, The Center for Building a Culture of Empathy
The Culture of Empathy website is the largest internet portal for resources and information about the values of empathy and compassion. It contains articles, conferences, definitions, experts, history, interviews,  videos, science and much more about empathy and compassion.
http://CultureOfEmpathy.com
also here is my interview with MAia http://bit.ly/mDhQpl



steve castleman says:
April 3rd, 2013 at 3:42 pm

Successful treatment for the addicts in recovery I’ve known depended a their being part of a caring therapeutic community, whether a formal one likme rehab or an informal one like 12-step programs or alternates like S.O.S. or SMART recovery. That was also my experience.

Too often when “tough love” is employed the addict reacts extremely negatively to the “tough” part and misses the “love” part altogether, feeding a sense that no one understand or cares and playing into the addict’s view of him or herself as a victim.

All of the successfuil interventions I’ve been involved with have led with love, not anger or disappointment. Those dealing with addicts have to learn to distinguish between the diseas eand the diseased.

Addiction is a chronic, progressive brain disease. It’s treatable. Perhaps not as successfully as one might like, but on a par with other chronic diseases that require substantial behavioral change, like diabetes and hypertension.

Unfortunately, many people still don’t believe addiction is a disease. That’s why science-based education is so important.

For a not-for-profit website that discusses the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don’t; how treatment works; how well treatment works; why relapse is common; what family and friends can do; etc.) please click on http://www.AddictScience.com.



Dorothy Brown says:
April 6th, 2013 at 3:05 pm

I feel parents are their kids worst enemies. I work with people with addiction so many times I hear My mom gives me Xanax when I am not feeling well,or they drink with their parents. I have parents that have adults in there homes who used and abuse. The parents enable them so badly that the adult children can not function on their own. I say it is the parents fault because they allow their children to continue to use in their home without consquences



Barbara says:
April 8th, 2013 at 3:18 am

My daughter has been dating a guy for 6 yrs and in a permeant long term 4. (him trying to get her a ring they have talked marriage) I know my daughter is 22 and knows how to make up her on mind. He stole drugs from my own home that… I have to have 2 months ago and lied about it. Since taking it to the next step from pills to shooting up he could have died 1 week ago she never knew he was doing this. She kept telling him you have one more chance and if I told you how many times I have heard her say that I’m running out of patience. My daughter is in her last yr. of college with a 4.0. I thought she had more sense. I guess as a parent I don’t know what to do and how to handle it or help or tell her kick him to the curb. He also has a felony.And as you know will never get a good job. OH BTW he dropped out of college. My daughter has a bright future ahead of her with a great degree that she has worked hard for, but I am so scared with him in the picture he will just bring her down. She thinks now that he is in a 30 day rehab that he will get better and stop (I’m not saying that can’t happen. But for a girlfriend to not even pick up that he was shooting up I’m scared she is got the “LOVE SYNDROME” and her street smarts went out the window. I even asked her if this was one of your friends what advice would you give….”get rid of him” I asked why not the same for her. “I can’t see myself with anybody else”. My daughter will not even take advil. She hates medication and is not a drinker. He is that also. I need HELP!!!!Hope you have some advice.
A VERY LOVING MOM



Dohn Witte says:
April 13th, 2013 at 3:56 pm

Im totally confused. On one hand “Intervene” publishes a letter from a parent about their son Alex, in which drastic measures were taken (tough love)to stop enabling his addictions. Then “Intervene” publishes the comments of Maia Szalavitz, who basically contradicts the father of Alex. she stated that tough love does nothing useful. Why then when a person attends meetings such as alanon, do they stress the need to let the person feel the consequences of their actions. Doesnt a person just have to stand a side and let the addict hit bottom. That is tough to do, yet may be the loving thing to do. Sounds like tough love to me. I know empathy and compassion are important. But to mollycoddle an addict gets nobody anywhere. Of course it stands to reason that when a person has made up their own mind to change, who wouldnt support that? At any rate INTERVENE, please publish material that is consistent with your mission and purpose.



Patti Herndon says:
April 27th, 2013 at 3:28 am

An Intervention on behalf of the Intervene Community. We needed it. Thank you again, Ms. Szalavitz!

Edwin: Thank you for the links! Please keep coming back. We need your positive spirit and insights.

Mr. Witte: Encouraging you to please take note of Ms. Szalavitz credentials/expertise in this field. And, just in case your inclined to confusion about empathy: Empathy is NOT to be confused with “mollycoddling”….or ‘enabling’… or ‘weakness’.

Empathy is ‘empathy’. And…It’s required for ANY genuinely healthy/productive relationship/relational dynamic. It’s often missing from the relational dynamic where there is substance use disorder…But, we can work to be more conscious of this and improve our ability to demonstrate empathy.

That said…The blog above is EXACTLY the kind of information that will help you cultivate appropriate, balanced perspectives about how best to support a son/daughter (or other loved one, who has a substance use disorder)into and through recovery.

The mission and purpose, here, is to support/educate parents about addiction and provide tools that will help all us parents cope increasingly better with the challenges we face, so that we can be the best possible advocates on behalf of our individual circumstances/our individual son/daughters needs and strengths. And…we’re gonna need ‘empathy’ to do that ;-) .

What you are witnessing here, on Intervene, is evolution, Dohn. I’ve been an active participant in this community for about 4 years. I’ve read just about every blog, and just about every comment/response to the blogs, on this Intervene site. And…I am thrilled to see what I am seeing here more recently!

I have been commenting/writing about the same things Ms. Szalavitz mentions in this series of blogs since I first ‘met’ Intervene, several years ago ;-)

I want to continue to see these kinds of blogs. So…Keep up the good work Intervene!

There will always be some amount of a gap between what our culture/society is socially cued to practice as ‘the accepted approach’… and what has ‘actually’ been studied and proven to ‘genuinely’ help people with substance use disorder gain recovery.

The goal is to support/encourage an individual toward healthy change/recovery…not intimidate, or shame, or confront, or ignore, or otherwise ‘coerce’ …because ‘those’ are the methods of approach that have been shown, in more recent decades, (remember there’s a gap), to not “get nobody anywhere”.

Many ‘traditional methods’ of treatment serve in opposition of recovery. They actually diminish our sense of self efficacy/hope. People don’t gain recovery without self efficacy and hope.

Spirits of approach that are based on notions of ‘tough love/confrontation/let em’ hit bottom/kick ‘em out of the house/’there’s always the ‘homeless shelter’ waiting for ‘em/let ‘em suffer the consequence’ etc.. I mean,just notice the hostility in those commonly used terms/phrases? Let’s review: There’s ‘tough’, ‘hit’, ‘kick’ and ‘suffer’ just glarin’ at us, right there!

And, we wonder why addiction is so stigmatized? And we wonder why ‘those addicts can’t just ‘stop their drug use’, and straighten up and fly right’… (News Flash: It ain’t because they are ‘selfish’, and they ‘lack humility’, and they won’t ‘admit’ they are ‘an addict’, and they have a ‘spiritual deficit’ *sigh*)…And, we wonder why individuals with substance use disorder often express feeling so marginalized, rejected, scapegoated, stereotyped and isolated? And, then, imagine being a teen and feeling ‘all that’.

These, mostly, ineffective, mostly hostile… and, definitely, empathy-lacking approaches are increasingly being traded in for strategies/methods that reflect more CURRENT, EVIDENCE-BASED research. Menu of options: MI,(motivational Interviewing), ACT, (acceptance and commitment therapy), REBT (rational emotive behavioral therapy,)CBT (cognitive behavioral therapy) and others.

This ‘gap’ exists mostly because folks don’t cotton to change. There are a lot of people, (clinicians, as well as other advocates included), who have a really difficult time considering that the way they have been doin’ it, thinkin’ about it, approaching it, all this time, has been shown to be, well…’wrong’ -At least, wrong for a large percentage of those with substance use disorder.

Great resourse for family and friends of loved ones with a substance use disorder. Please google SMART Recovery friends and family. (Self Managment and Recovery training). It’s an easily accessible, free peer support resource based on current, evidence-based methods of Motivational Interviewing,(MI) and CRAFT (Community Reinforcement and Family Training). No ‘traditional’ stuff.

These resources/tools are designed to support you in building your coping muscles, move anger/blaming/fear/resentments out of the mix so to improve your interactions/communication skill set with your son/daughter…all toward the goal of effectively encouraging your son/daughter, or other addiction-challenged loved one, to make their own arguments for change -which, will be the only way they will achieve healthy change/sustainable recovery.

Important to remember that people gain momentum in recovery every day….achieve recovery and healthy change every day. Every individual with a substance use disorder has the innate ability to problem solve for their circumstances. It’s a process. It takes time. It’s critical that individuals with a substance use disorder/co-occurring disorder have the appropriate support from family and other advocates. And appropriate support includes demonstrating empathy.

Remember parents: Because you choose to recognize the importance of demonstrating empathy in your interactions/your approach in responding to your son/daughter’s challenge/substance use disorder, that does not equate to your ‘being weak’, or that you are ‘co dependent’, or that you’re ignoring healthy boundaries…It doesn’t mean that you’re ‘in denial’, or that you’re ‘enabling’. It’s just ‘empathy’. And, it’s necessary for creating a spirit of recovery purposed thoughts and actions onto recovery.

This series with Ms. Szalavitz is the example of the appropriate spirit of approach -collaborative/empathy based.

Wishing all us parents increasing peace, continued enlightenments and Godspeed.




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