psychotherapy

ENABLING IS TOXIC.

People typically seek therapy for themselves or their children to find relief for emotional distress or improve behavior or habits. Therapy can be useful for personal and family insight, growth, and empowerment. However if therapy becomes a place for a person or family to simply confide and vent without any actual relief or improvement, then it may not be helpful.

In my work with patients, I advocate that one of the goals of therapy can and should be to not need it anymore. And this means that the therapeutic work by nature should involve understanding of thoughts and feelings as well as behavior change. One of my jobs is to listen to patients in a non-judgemental way, but if I do not use therapeutic techniques to point out how patients may be perpetuating patterns or not allowing themselves to make emotional gains, than I would be allowing them to stay in the sick role. This is called enabling. It is something I will not do. And by being aware of this potential therapeutic hazard and drawing firm boundaries against it, I can give patients and families opportunities to seek true improvement though it is difficult.


Enabling is toxic. The enabler (the person—a health professional, partner, family, or friend—trying to help) usually has good intentions but without expectations for the enabled (the person in need of help who is likely stuck in a cycle of poor decisions and distress) to make behavior change, he or she is only allowing or fostering the dysfunction to continue. The enabler thinks they are helping but the truth is they are scared and trying to control the situation that the enabled is not yet willing to fully address.

As long as the enabler keeps enabling, the enabled will never get a chance to make positive change. And this is what differentiates enabling from healthy, appropriate help. The healthy, appropriate helping approach allows for the control and decision making to be put in the correct, albeit unpracticed, hands.