Addictive relationships: Are therapists enablers?

Author, trainer, and therapist, John Bradshaw, speaks of addictive relationships during his presentation on the topic: Healing The Shame that Binds You. This presentation was made during his promotion of his book by the same title and was recorded by KUHT-TV in Houston.

During his talk, John Bradshaw defines an addictive relationships as: “any pathological relationship with a mood-altering substance or activity that has life-damaging consequences.” I have come to conclude that therapists see some mood-altering relationships and activities more clearly than others, and this selective focus does a disservice to therapy clients and to those who pay for their care.

In my experience, therapists tend to see substance-dependency clearly. Examples of dependency-prone substances are cocaine, alcohol, heroin, tobacco, methamphetamine, and para-prescriptive drugs. They also tend to see dependency-prone behavior clearly when the activities involve gambling, pornography, rageaholism, workaholism, and codependency. In my personal experience, many therapists seem to encourage dependency on various welfare programs and support political figures who view the welfare-dependent and members of the helping industry as special interest groups, whose votes can swing an election.

These therapists seem to think kindly of themselves with respect to their own enabling tendencies when it comes to clients, who are, arguably, in developmental arrest with respect to their own dependency upon food stamps, Section 8 Housing, Medicaid healthcare, Medicaid transportation, free and reduced-price school lunch, free health clinics, disability benefits for the non-disabled, and other charitable ventures that may be well-intentioned but misguided. Perhaps dependency upon therapists belongs in the mix.

In the world of physical medicine, we use the word iatrogenics in talking about the illness caused by the physician – such as the sponge or clamp left in the patient’s abdomen during surgery. Perhaps therapists are vulnerable to charges of iatrogenic behavior, when we see one type of dependency so clearly and another type of dependency poorly if at all.

If we, as therapists, are committed to helping our patients overcome dependency, whatever form it takes, a discussion involving welfare-dependency belongs in the mix. In my opinion, such a discussion is long overdue.

Andrew J. Billups, PsyD

About ajb

I am clinical psychologist and academic coach with more than twenty years of psychotherapy, academic coaching, and training experience. I operate from my base camp in the Chesapeake Bay Country of Tidewater Virginia. I have a long-term interest in the relationship among public policy, education, mental health, poverty, and change language.
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