How do you rescue a loved one from a powerful and destructive addiction to alcohol, drugs or even food? If the answer was obvious many of us wouldn’t be pulling our hair out trying to come up with the magic solution to the problem, and few people would be stuck in the throes of an addiction.
Treatment approaches vary, but one of the most popular and pervasive ideas about the treatment of addiction is that people need to hit “rock bottom” to see the light and, for that to happen, the people around them need to practice tough love.
Dr. Gabor Mate, a Vancouver-based addictions specialist and author of In the Realm of Hungry Ghosts: Close Encounters with Addiction, strongly disagrees with that approach, however. In an interview with Time magazine’s Maia Szalavitz, Mate outlines the reasons why tough love isn't an effective method for treating addiction.
In the interview, Mate says that “rock bottom” is a meaningless concept that doesn’t take into account the realities of most addicts’ lives. He draws on his own experiences working in the notorious Eastside of Vancouver for 12 years. Says Mate: “People live there in the street with HIV and hepatitis and festering wounds: what more of a bottom can they hit? If hitting bottom helped people, there would be no addicts at all in the Downtown Eastside.”
The doctor argues that punishing people for their problems isn't a wise approach if you want to create positive change, “People don’t need more negative things to happen to them to give it up,” explained Mate. “They need more positive things to happen. In 12 years of work on the Downtown Eastside, I didn’t meet an [addicted] woman who was not sexually abused as a child.”
One of the reasons people may choose to take the tough love approach, however, is because of the anger we feel when people continually make bad choices, choices that can negatively affect our lives too. In a sense tough love is cathartic, it “.. gives a kind of emotional relief because people feel a lot of hostility towards addicts. Seeing someone jailed certainly provides some satisfaction and relief, but it’s not an evidence-based [treatment].”
So, what is an “evidence-based treatment for addiction”? There doesn’t seem to be an easy answer to that question just yet. But for Mate, if there are no clear solutions to the problem of addiction, there are wiser, more humane methods of dealing with people who are struggling.
He also believes in preventive care, which may start with offering greater support for both women and children at the pre-natal stage. He also argues that addicts are, at the root, people dealing with some form of trauma, and as such they need to be handled with care, “In term of addictions, first of all recognize that these people are traumatized and what they need is not more trauma and punishment but more compassion.”
Has addiction ever impacted your life? What did you do to get help or help a loved one?
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