What is "enabling"?

Enabling is an often misunderstood concept. Originally stemming from the substance abuse field, specifically the field of alcoholism, it refers to behaviors by family members (or professional counselors) that facilitate or help the chemically dependent person continue to drink. Family members enable alcoholism, for example, by making alibis that cover up the drinking, by taking over responsibilities that the person should maintain, and by accepting the alcoholic's rules docilely rather than rock the boat.

The wife who calls her husband's boss on Monday morning and tells him that her husband has the flu (when in fact he is too hung over to go to work) enables the husband to continue to drink, because she prevents him from having to face the consequences of his drinking. Generally, enabling results from doing the wrong things for the right reasons, namely protecting everyone in the family.

An unconscious process, enabling, however, protects the addict from the consequences of his or her behavior, "enabling" the person to continue to drink. The primary cause of enabling is denial, fear, or ignorance. It stems from denial of the illness or problem, denial of the impact on others, and denial of the nature of the treatment and recovery. These actions may be defended on the grounds of love, loyalty, or family honor, but their effect is to prevent the crises that can offer the dependent the motivation for change.

But there is a much more insidious type of enabling, one in which alcohol and other drugs are not necessarily present, but one in which family members unwittingly allow a member to evade, avoid, deny, minimize, and otherwise not be responsible and accountable for his or her behavior.

Consider the following three examples. The first two are relatively straightforward, while the third is much more insidious and seductive. All three are often staples in families under the influence of major adversity.

Tom is a 17-year-old boy diagnosed with schizophrenia. When he decided to suddenly go off his anti-psychotic medication, his parents were upset but they allowed him to do so, rather than engage in a fight they thought they would loose, especially since he was to turn 18 in three weeks. All parties, including Tom, agreed he would be responsible for his actions to his parents and therapists, and built in a program of strict accountability, since a general pharmacological rule states that when one suddenly goes off meds, there can be a psychotic spike, or exacerbation of symptoms. 

When Tom without explanation called his therapist and psychiatrist, both of whom he trusted, and refused to come for treatment anymore, his parents acquiesced, stating they were at a loss of what to do, because Tom had turned 18 and they couldn't force him. His parents were asked to continue the treatment process and seek help for themselves now. Initially they refused, arguing Tom was the problem and stating they need not come if he didn't. However, Tom's once-controlled psychotic symptoms re-emerged quickly. 

The family therapist pointed out to the parents that they were "enabling" their son's psychosis to reign over the family by terminating a process that was beneficial to all members. The parents reassumed treatment, learned strategies to deal with their son's active psychotic symptoms, used his turning 18 as financial leverage, and found that their son soon agreed to go back on medication in exchange for room and board and other amenities. Their tough love, non-enabling posture forced Tom to face the consequences of his behavior if he were to remain at home. 

In the case of obsessive-compulsive disorder (OCD), enabling includes any and all behaviors by family members, loved ones, friends, and even professionals that encourage the OCD. Enabling includes participating in the loved one's obsessions and rituals--e.g., "cooperating" by checking appliances, answering repetitive questions, keeping objects perfectly aligned, submitting to washing behaviors yourself, and not making any requests of sufferers that ask them to be accountable. 

Enabling also includes failing to confront the presence of the OCD in loved ones as well as blocking treatment, recovery, and behaviors like shaming or dumping on the primary sufferer. Not wanting loved ones to suffer, family members try to remove or avoid those things that will disturb them, not realizing that these are the very behaviors that the person needs to engage in to get better. 

The most flagrant example of enabling OCD that I have heard is the husband who awoke to his wife's continually washing the germs off him. When asked why he didn't confront his wife, he said, "I didn't want to upset her." She continued to wake him up and wash him until one day he refused. This marked the beginning of her recovery. 

The next example is much more common and much more subtle. Al and Kathy came to counseling because their daughter had a severe and chronic physical illness. Because they often differed about how to deal with the illness, there was ongoing strain between them. Kathy typically was protective, often seeking the help of a multitude of healers, many of whom Al thought were quacks. He was much more laissez-faire, preferring to leave their daughter to fend for herself, which he explained as teaching her to cope. 

After years of arguing, Al withdrew more and more in the face of Kathy's perceived demands, and Kathy felt more and more unloved and uncared for when he would ignore her. Every time he withdrew, she reacted with anger, which only fed his withdrawal, creating a very vicious and destructive cycle between them. They were caught in this pattern, each believing the other was at fault, each believing the other must change. 

Knowing the long-term impact of adversities such as this one, their therapist proceeded to offer them an explanation that could move them forward, rather than keep them stuck in a vicious cycle. Using the language of enabling as well as relevant terms from the traumatic stress literature, he described their self-defeating behavior to them in the following way. Kathy's reaction could be seen as a type of "kindling" reaction, that is one in which a part of a traumatic stimulus brings forth an entire traumatic response. In other words, the moment she detected any sign of Al's withdrawal, for which she now had a hair trigger, she exploded with rage because his withdrawal re-stimulated her fears of abandonment, which stemmed from the desertion by her father when she was a child. 

Because she constantly rejected and criticized virtually all of his suggestions, Al, in turn, felt helpless and hopeless, believing nothing he said or did mattered. In the language of traumatic stress, he had learned the "silence" reaction. That is a reaction akin to learned helplessness in which the person, in order to protect himself or herself, stops talking and starts avoiding, minimizing, denying, placating, faking interest, becoming angry and showing boredom in any conversations that resemble a high-conflict situation. 

Viewed in this manner, Kathy "enabled" Al's silence by constantly criticizing him, and Al "enabled" Kathy's anger by his silence and withdrawal. Only when each person learned to stop enabling the other's maladaptive behaviors could their marriage heal and their parenting become more effective. In many ways, this type of enabling is much more difficult to deal with because it requires a higher level of recovery and responsibility. 

As with all cases of enabling, the bottom line is that enabling keeps the status quo and prevents everyone in the family from growth, development, and healing. You don't have to be a saint to stop enabling, but you do need to stop, inquire, be curious about YOUR behavior, and become more objective and learn to take things less personally. Hence, non-enabling behaviors are those that characterize the later stages of healing. The person must be well along the path of healing in order to stop the behaviors that facilitate or help another person stay stuck in his or her dysfunctional behaviors. 

In order to stop this kind of enabling, the person must have the relevant information and education, the needed skills such as conflict negotiation or assertiveness, and social support in order to no longer react to the unhealthy behaviors of the loved one. What is required in order to stop enabling is learning that the other person's behavior is not personal, even though you are personally impacted. The person must master the kindling and silence reactions. And the person must feel good about himself or herself.

In essence, to no longer enable in the above-described ways, the person needs to have a life. And to have a life, the person needs to be trained, not blamed. The person must have a story large enough to hold all the elements of his or her circumstance. The person must go on the journey of a lifetime. Perhaps this is why relationship is often called the highest spiritual path; it requires everything of us because relationships push all of our buttons.


The following two self-help assessment measures or guides can help you understand your current situation more clearly. They can increase your ability to be proactive, and therefore less reactive, so that you will be in the best position to facilitate your loved one's healing and well-being as well as your own. They can help give you a better sense of how deeply you are under the spell—or under the influence—of your loved one's illness, addiction, or trauma. 

The first is a guide to point to where you are stuck. It can indicate where your thinking might get you into slight, moderate, or serious trouble. The second is a measure of how much danger or trouble you may actually be in right now. Be as truthful as you can in order to give yourself the clearest picture of where you are functioning now. Both assessment measures are to be answered with a simple "yes" or "no." When you are not sure or are in doubt about the answer to a particular question, the answer in my experience most likely is "yes." Please note that these self-help assessment tools can be very useful, but they are not a substitute for an evaluation by a qualified professional; they are simply guidelines. They are not formal assessment procedures; rather, they are more like informal screening tests that are intended to raise awareness. If you have any doubts whatsoever, please consult a qualified mental health professional. And if you are dealing with violence, suicidal threats, or alcohol and other drugs, it is imperative that you do not waste any time. Consult a professional immediately. There may be little time to waste!

The Most Common Errors in Thinking by Family Members Under the Influence of Mental Illness

1. I am responsible for all the problems in this relationship/family. 

2. The actions of the person with any serious, chronic and recurrent illness, trauma, or addiction are directly influenced by me. 

3. It's my responsibility to solve this person's problems. 

4. If I can't help, no one else can. 

5. If I can convince the person with a serious, chronic and recurrent illness, trauma, or addiction that I am right, his or her problems will disappear. 

6. If you really love someone, you should take his or her physical or emotional abuse. 

7. Your loved one can't help having a serious, chronic and recurrent illness, trauma, or addiction, so I should not hold the person accountable for her or his behavior. 

8. Setting limits hurts the person with any serious, chronic and recurrent illness, trauma, or addiction and is wrong. 

9. No matter what the person under the influence of illness, trauma, or addiction does, I should offer them my love, understanding, support, and unconditional acceptance. 

10. If I ignore the warning signs, everything will be all right. 

11. If I just work hard enough, try enough, am smart enough, am pretty/handsome enough, etc., then my ill family member will be okay. 

12. No one can really understand what I/we am/are going through. 

13. I am alone. 

14. No help is available. 

15. Any serious, chronic and recurrent illness, trauma, or addiction is untreatable. 

16. A serious, chronic and recurrent illness, trauma, or addiction is a character flaw. 

17. If I am good enough, the person with a serious, chronic and recurrent illness, trauma, or addiction will be okay. 

18. Effective treatment for the person with any serious, chronic and recurrent illness, trauma, or addiction consists of having the person understand how irrational and illogical his or her thoughts, feelings, and behaviors are. 

19. Medication is for weaklings. 

20. I don't have a problem; it is just my family member or other loved one who does. 

21. My loved one is just lazy. 

22. I can't ever burden my loved one with my problems because his or hers are so much more serious. 

23. Life is a drag and then you die. 

24. There are no escaping life's burdens and responsibilities. 

25. There is no one I can really trust or depend on. 

26. My loved one can/will never learn to be different. 

27. If people really knew what was happening, they would reject me/my loved one. 

28. I have to sacrifice my life if my loved one is to recover. 

29. Others will always understand my situation if I explain it clearly. 

30. People with a serious, chronic and recurrent illness, trauma, or addiction shouldn't work, be employed, or be responsible. 

31. Others will like me if I always say positive things. 

32. Others always have my best interests at heart. 

33. I need to do things I don't like to do so others will like me. 

34. It is selfish to put my needs ahead of satisfying another's needs or desires some of the time. 

35. I must be agreeable for others to like me. 

36. It is not possible to love if I voice a different perspective or opinion. 

37. A good parent, spouse, sibling, etc., is responsible for the emotional and physical health of others. 

38. I can feel worthwhile only if I have someone to love me. 

39. I must stay alert to insure that I do not say something that might upset my loved one. 

40. I must avoid conflict at all costs.

ANSWER KEY:If you answered two or more questions with a yes, YOU may have a problem.

If you answered three or more questions with a yes, YOU probably do have a problem.

If you answered four or more questions with a yes, YOU have a problem.

If you answered more than five questions with a yes, get help immediately.

Danger Signs for Family Members Under the Influence of Mental Illness

1. Do others like family, friends, or significant people in your life tell you they don't understand why you are putting up with your loved one's behavior? 

2. Do you try to avoid contact with these people? 

3. Do you feel the need to hide or cover up your family member or loved one's behavior? 

4. Does the thought of spending time with the person give you unpleasant physical sensations? 

5. Are you becoming clinically depressed? Do you experience less interest in normal activities or have less pleasure; have you gained or lost more than twenty-five pounds in the last six months; had or have thoughts of suicide or feelings of worthlessness; have trouble concentrating; or experience mood swings? (Count each yes as one point) 

6. Have you acted in ways that go against your fundamental values and beliefs? 

7. Are you no longer able to take a stand for what you believe? 

8. Are you concerned about the effects of your loved one's behavior on other family members? 

9. Have you ever had to intercede on behalf of a family member? 

10. Have you ever felt or have actually been in physical danger with a loved one? (Count each yes as one point) 

11. Is there or has there been violence by any family member? 

12. Are you not sure about whether there is family violence? 

13. Are you making decisions mainly out of fear, obligation, and guilt? 

14. Are you taking non-prescription drugs to cope with or ward off depression or anxiety? 

15. Do you regularly read self-help books about (or for) your loved ones?  16. Do you think about/worry about your loved one more than one hour per day? 

17. Are you putting your life on hold? 

18. Are you participating in your loved one's serious, chronic and recurrent illness, trauma, or addiction? 

19. Do you think you might be participating in your loved one's illness, addiction, or trauma? (Subtract one for a yes response) 

20. Do you believe your loved one has a character flaw, is weak-willed, or is malingering? (Count one for each yes) 

21. Do you not have someone you can call any time of the day or night for any reason? 

22. Do you not have something to be very passionate about? 

23. Do you feel unloved? Unappreciated? Unneeded? (Count each yes as one point) 

24. Do you have difficulty falling or staying asleep? 

25. Do you startle easily? 

26. Have you thought that you need more friends? 

27. Do you feel trapped? 

28. Are you too sensitive a person? 

29. Have you suddenly and involuntarily recalled a frightening experience of your loved one while doing something else? 

30. Do you think that you work too hard for your own good? 

31. Do you get thoughts in your head that you neither want nor can control?

32. Do you have a problem with your eating? 

33. Do you see or hear things others don't? 

34. Have you ever thought of suicide? 

35. Had a suicide plan? (Count having a plan as three yes answers) 

36. Have you become a cynic? 

37. If you have answered any of the above questions with a yes, are you not getting help? 

38. If I disagree with my loved one, I will lose my relationship. 

39. I think triumph and adversity have little in common. 

40. I think fear and courage have little in common.

ANSWER KEY:If you answered one or more questions with a yes, YOU might have a problem.

If you answered two or more questions with a yes, YOU probably do have a problem and YOU should seek help.

If you answered three or more questions with a yes, you may have a major problem and YOU should seek professional help immediately.