Is Tough Love Effective in Treating Addiction?

Tough love is a common expression used to describe any behavior that is a firm, sometimes cold, approach to handling another person's actions. It is somewhat controversial, particularly when used in the treatment of certain disorders, such as drug addiction or other addictive behaviors. 

This article discusses how tough love works and whether this approach is effective. It also discusses how tough love differs from setting healthy boundaries and some alternative approaches that can be more effective.

What Is Tough Love?

Author Bill Milliken first introduced the expression "tough love" in his book, Tough Love, published in 1968.

There are several ways that tough love is used in everyday language. Most commonly, it is used to describe any type of parenting in which a child experiences some negative emotions as part of a learning process.

Tough love can also refer to a positive approach to parenting in which the child learns valuable lessons in a way that is supportive and preserves the dignity of the child. This can include a healthy set of firm boundaries, common in authoritative parenting styles.

It can also refer to abusive parenting styles in which humiliation, belittling or physical violence are used to control the child.

For instance, a parent may use tough love against their adult child who has not gotten a job. The parents practicing tough love would withhold paying bills and would let the child deal with the consequences, such as late payments or bill collection, rather than swooping in and fixing the problem.

In a harmful example of tough love, a parent would belittle or physically injure a child for failing to get a good grade or complete their chores. Having consequences can change behavior, but this is an extreme example that can have long-lasting negative repercussions. 

Examples of Tough Love for Addiction

Tough love often involves withholding assistance when a person is using a substance. It can also involve demanding that the other person enter compulsory treatment. Examples of tough love might include:

• Confronting the person and insisting that they enter treatment or face serious consequences, such as the termination of the relationship
• Kicking someone out of their home if they refuse to go to rehab
• Not answering calls or texts when it seems like the individual is high or inebriated
• Refusing to pick someone up if they need a ride home because they are intoxicated

While such actions may be rooted in a desire to get the other person to get help, they are also likely to backfire and potentially contribute to further problems.

Does Tough Love Work?

Research suggests that compulsory drug treatment may not improve outcomes. Approaches that encourage voluntary treatment may be more effective in getting people to initiate and maintain abstinence.

For example, one study found that confrontational approaches such as tough love are often viewed as unhelpful by people who are experiencing addiction. Instead, interventions that focus on offering practical support tend to be more effective.

Tough love can have its place in addiction treatment, but it should not be used without input from a physician or therapist. If you have a child or loved one struggling with addiction, seek out an addiction therapist for a consultation on how you can help your loved one. A therapist can advise you on the best approaches and boundaries to help your loved one recover in a sustainable way. 

Tough Love vs. Setting Boundaries

Instead of tough love, healthy boundaries are often a more effective and sustainable solution. Your boundaries are the limits to what you are willing to accept in a relationship. 

Healthy boundaries should be clearly communicated. It is also essential to maintain these boundaries by following through with consequences. Examples of boundaries for dealing with addiction include:

• Not allowing drugs or alcohol in your home
• Not giving another person money to pay for drugs or alcohol
• Prohibiting driving under the influence of drugs or alcohol
• Refusing to make excuses for another person's actions

Explain these boundaries to the individual. Using "I feel" statements can help express your feelings without being confrontational or accusatory.

Alternatives to Tough Love

While tough love can sometimes force people with substance and alcohol use disorders into treatment, research suggests that more empathetic, voluntary approaches are more effective.

For example, studies have shown that a program known as Community Reinforcement and Family Training (CRAFT) can help people encourage their loved ones to seek treatment. The program uses behavioral principles to reduce substance use, encourage treatment, and reduce the stress felt by the individual's loved ones.

Using the CRAFT approach, loved ones reinforce positive behaviors and avoid reinforcing negative behaviors. The approach is not only more compassionate, it also tends to be much more effective.

While it may take time to get the individual to voluntarily seek treatment, research suggests that it is often effective. In one study, 74% of participants were able to eventually get their loved one to enter addiction treatment.

A Word From Verywell

While tough love is often rooted in a desire to help, it is often applied in an ineffective or even harmful way. Rather than responding with actions that are overly harsh, authoritative, or uncaring, empathetic approaches tend to be more effective. 

Establishing healthy boundaries can be a way to avoid enabling addiction while also encouraging your loved one to get the help they need. Also consider talking to your healthcare provider about the CRAFT approach, which teaches family members how to use behavioral strategies to reduce substance use and encourage treatment.