Tough Love or Tough Luck?

One of the main reasons I wanted to write about empathy was my experience of the *lack* of empathy we show towards people with addiction. As a former heroin and cocaine addict, I was horrified by what I learned about treatment before I sought help: the idea was that addiction is cured by "tough love," by breaking people in order to fix them.

ABC World News with Diane Sawyer featured me (briefly!) last night in a segment about tough love. While the academic experts in the piece noted that the research shows that "exactly the opposite" of tough love is what works in treatment, the question of what parents should do is difficult.

Some parents-like those of Laura Franklin who appear on ABC -take a tough approach that helps their child get into treatment. But when George McGovern and Robert "Woody" Johnson and their wives cut all ties with their daughters, the daughters wound up dead.

As I said last night, it may sometimes be necessary for parents to reduce or even cut contact with a child. For example, if other children at home need protection or the addict is stealing or otherwise harming family members. However, as the stories of Casey Johnson and Terry McGovern show, it's a gamble as to whether this will help the addict-or simply speed her self-destruction.

And it's a gamble parents don't have to take if the addicted person is not harming anyone other than herself. There are empathetic and supportive ways to get addicts into treatment: one that has been shown to be twice as effective as the confrontational "intervention" is called Community Reinforcement and Family Therapy (CRAFT).

A book by the designers of that therapy shows parents how to help while reducing the risk of harm.

I'll have a lot more to say about the destructive notion of "tough love" and how it has torn many families apart on the blog here, but the main point I want to make today is that whenever empathetic and supportive approaches to the treatment of addiction have been compared to tough love, empathy always wins-and by a large margin.