21. Psych Central Network Blogs | A list of mental health blogs by experts, professionals, and ordinary people who share their insights on a variety of mental health topics
22. Psychology Today Blogs | A large collection of blogs on psychology-related topics, including creativity, intelligence, memory, parenting, and more
23. SAMHSA Blog | “A place where up-to-date information including articles from SAMHSA staff, announcements of new programs, links to reports, grant opportunities, and ways to connect to other resources are located”
24. A Splintered Mind | A blog by Douglas Scootey about “overcoming ADHD and depression with lots of humor and attitude”
Janaburson’s Blog | A blog created to help people better understand the medication-assisted treatment of opioid addiction using either buprenorphine (Suboxone) or methadone from a physician, board-certified in Internal Medicine and Addiction Medicine
If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity.” When applied to substance use, it means a person in active addiction is provided with the means to continue to use. With substance use disorders, how can you know the difference between helping and enabling? This post explains how to tell the difference and provides 7 tips for helping a loved one who struggles with addiction.
With substance use disorders, how can you know the difference between helping and enabling? I’ve worked with family members who inadvertently fueled their loved one’s addiction. They “helped” by bailing them out of jail, giving them money, etc., which only permitted the individual to continue to get high. It’s hard for family members to differentiate between behaviors that help versus enable.
If you’re unfamiliar with the term “enable,” it means “to provide with the means or opportunity” or “to make possible, practical, or easy” (according to Merriam-Webster). When applied to substance use, it means a person in active addiction is provided with the means to continue to use.
When I worked at a substance use treatment center, I taught families and loved ones that helping a person in active addiction means supporting their basic needs, such as food, water, shelter, and clothing. (If someone is in jail or treatment, their basic needs are met; therefore, bailing them out would be enabling.) Thinking in terms of “needs vs. wants” helps you to recognize enabling.
Distancing yourself (or setting a boundary) with your daughter will be difficult because you want to help. In the past, by “helping” her, you’ve enabled her addiction (which hurts her in the long run) and leaves you emotionally depleted. There’s a very fine line between helping and enabling; it’s not clear-cut. (Plus, it can be counterintuitive for a parent whose job has always been to protect your child.)
When a parent has a son or daughter with an addiction, it’s especially difficult to make the distinction between helping and enabling. A parent’s natural inclination is to nurture and protect from harm. It’s heart-wrenching to see your child in pain. But if a parent doesn’t set (and adhere to) healthy boundaries, they will quickly become emotionally drained (as they enable their child’s addiction).
Here are some suggestions for helping (instead of enabling) a loved one who’s actively using:
1. Never (ever) offer money.
If asked for cash for food, for example, buy groceries instead (or offer to take them to lunch). I worked with a father who bought a bag of groceries for his son, who struggled with severe alcoholism and was homeless, on a weekly basis. This is an excellent example of helping a loved one versus enabling their addiction.
2. If asked for help paying bills, say no.
If your loved one doesn’t have to pay the electric bill, they’ll spend the money on drugs or alcohol. Furthermore, if you protect them from the consequences of not paying bills (i.e. having the power shut off), your loved one is less likely to see a need for change. (People don’t change when they’re comfortable.)
If you’re unsure where local trainings are offered, a Google search for “Narcan training” or “opioid reversal training” will link you to resources in your area. Most trainings are free. Keep a Narcan kit on your person at all times. Provide your loved one with a kit (or two) as well. This is not enabling. This is potentially saving a life and offering an opportunity for recovery. (A dead opioid-user will never recover.)
4. Offer to help them get into treatment.
Become familiar with the different treatment options in your area. Don’t give ultimatums (i.e. “If you don’t get treatment, I’ll divorce you”) or make threats (especially if you’re not willing to follow through).
Be supportive, not judgmental. Be patient; when your loved one is emotionally and physically drained from addiction’s painful consequences (or when they hit “rock bottom”), they may decide it’s time to get help. And you’ll be ready.
5. Recognize that your loved one is not the same person they were before addiction.
Substance use disorder is a debilitating disease that damages the brain; it changes how a person feels and thinks. With addiction, the brain’s reward center is rewired, resulting in a biological “need” for drugs/alcohol. (Compare this to your need for food or water or air.)
Recognize that your loved one’s addiction will lie to you. They will do whatever it takes to get their “needs” met. Your loved one’s addiction will steal from you. (Lock up your valuables if they have access to your home… and even if they don’t. I’ve worked with more than a few individuals who have broken into their parents’ home for either money for drugs or valuables to pawn for money for drugs.) Your loved one’s addiction will betray you. Accepting the nature of addiction allows you to set healthy boundaries.
By engaging with others with similar struggles, you’ll learn more about supporting your loved one (without enabling their addiction). You’ll also build a supportive network by connecting with others, strengthening your emotional health.
7. When in doubt, try asking yourself one (or all) of the following questions:
Will my actions allow my loved one to continue to drink or use? Is this a “want” versus a basic need? Will my actions prevent them from experiencing a natural consequence? If the answer is yes, it’s probably enabling.
Addiction is a devastating, but treatable, disease. The road to recovery is difficult and long (with many detours).
If your loved one has a substance use disorder, be kind and compassionate; they’re in an unthinkable amount of pain. They didn’t choose addiction. The best way to support them is by setting healthy boundaries to ensure you’re not enabling continued use. Boundaries allow you to help them without furthering their addiction. Boundaries also serve as protection for you and your emotional health; you’re in no position to help if you’re emotionally, financially, and spiritually depleted.
Please share in a comment your suggestions for helping a loved one with addiction.
(Updated 1/20/21) Free PDF and interactive online assessment tools for addiction, mental illness, boundaries/attachment styles, relationships/communication, anger, self-esteem, suicide risk/self-injury, personality, and more. This list includes both self-assessments and screening tools for clinicians to administer and score.
This is a list of free online assessment screenings for clinical use and for self-help purposes. While an assessment cannot take the place of a diagnosis, it can give you a better idea if what you’re experiencing is “normal.”
Substance Abuse History Interview | (Source: University of Washington Center for Behavioral Technology) The SAHI is an interview to assess periods of drug use (by drug), alcohol use, and abstinence in a client’s life over a desired period of time. The SAHI combines the drug and alcohol use items from the Addiction Severity Index (ASI) and the Time Line Follow-back Assessment Method to collect information about the quantity, frequency, and quantity X frequency of alcohol and drug consumption. Citations: McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168, 26-33.
PDF and interactive online assessment tools for anxiety, depression, and bipolar disorders
ADAA Screening Tools | The Anxiety and Depression Association of America provides links to both printable and interactive tests for depression, generalized anxiety disorder, OCD, panic disorder, PTSD, social anxiety disorder, and specific phobias. This site does not provide test results. (It’s recommended that you print your results to discuss with a mental health practitioner.) This is an excellent resource for clinicians to print and administer to clients.
Classroom Anxiety Measure | Printable scale with scoring instructions (Source: Richmond, V. P., Wrench, J. S., & Gorham, J.(2001). Communication, affect, and learning in the classroom. Acton, MA: Tapestry Press).
DBSA Mental Health Screening Center | The Depression and Bipolar Support Alliance offers screening tools for both children and adults (including versions for parents to answers questions about their child’s symptoms). Take an online assessment for depression, mania, and/or anxiety.
Depression Self-Assessment | A simple self-assessment tool from Kaiser. Results are provided on a spectrum, ranging from “None” to “Severe” depression.
Fear of Physician (FOP) | Printable scale with scoring instructions (Source: Richmond, V. P., Smith, R. S., Heisel, A. M., & McCroskey, J. C. (1998). The impact of communication apprehension and fear of talking with a physician and perceived medical outcomes. Communication Research Reports, 15, 344-353).
Shyness Scale | Printable scale with scoring instructions (Source: McCroskey, J. C., & Richmond, V. P. (1982). Communication apprehension and shyness: Conceptual and operational distinctions. Central States Speech Journal, 33, 458-468).
Trauma, Stress, & Related Disorders Online Assessment Tools
ACE Questionnaire | Adverse childhood experiences (ACEs) are associated with a variety of health (both physical and mental) conditions in adults. To find your ACE score, take an interactive quiz. Learn more about ACEs on the CDC’s violence prevention webpage. You can also download the international version (PDF) from the World Health Organization’s Violence and Injury Prevention webpage.
Kessler Psychological Distress Scale (K10) | Source: Kessler, R. C., Barker, P.R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi E., et al. (2003). Screening for serious mental illness in the general population. Arch Gen Psychiatry, 60(2), 184-9. 🆕
Borderline Symptom List and Scoring Instructions | (Source: University of Washington Center for Behavioral Technology) Citations: Bohus M., Limberger, M. F., Frank, U., Chapman, A. L., Kuhler, T., Stieglitz, R. D. (2007). Psychometric Properties of the Borderline Symptom List (BSL). Psychopahology, 40, 126-132.
Original Attachment Three-Category Measure | PDF assessment (Reference: Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524).
Learn Your Love Language | Choose your version: Couples, Children’s Quiz, Teens, or Singles. An online assessment to determine your primary love language. (You are required to enter your information to get quiz results.)
Danger Assessment Screening Tool | Clinicians can download this PDF version of the assessment, which helps predict the level of danger in an abusive relationship; this screening tool was developed to predict violence and homicide.
Lifetime – Suicide Attempt Self-Injury Count (L-SASI)InstructionsScoring | (Source: University of Washington Center for Behavioral Technology) The L-SASI is an interview to obtain a detailed lifetime history of non-suicidal self-injury and suicidal behavior. Citations: Linehan, M. M. &, Comtois, K. (1996). Lifetime Parasuicide History. University of Washington, Seattle, WA, Unpublished work.
Lineham Risk Assessment and Management Protocol | (Source: University of Washington Center for Behavioral Technology) Linehan, M. M. (2009). University of Washington Risk Assessment Action Protocol: UWRAMP, University of WA, Unpublished work.
Non-Suicidal Self-Injury Assessment Tool Brief Version | Full Version | Assessment tool created by Cornell Research Program on Self-Injury and Recovery
NSSI Severity Assessment | A PDF assessment tool from the Cornell Research Program on Self-Injury and Recovery to assess the severity of non-suicidal self-injury
Suicidal Behaviors Questionnaire | SBQ with Variable Labels | SBQ Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SBQ is a self-report questionnaire designed to assess suicidal ideation, suicide expectancies, suicide threats and communications, and suicidal behavior. Citations: Addis, M. & Linehan, M. M. (1989). Predicting suicidal behavior: Psychometric properties of the Suicidal Behaviors Questionnaire. Poster presented at the Annual Meeting of the Association for the Advancement Behavior Therapy, Washington, DC.
Suicide Attempt Self-Injury Interview (SASII) SASII Instructions For Published SASII | SASII Standard Short Form with Supplemental Questions | SASII Short Form with Variable Labels | SASII Scoring Syntax | Detailed Explanation of SPSS Scoring Syntax | (Source: University of Washington Center for Behavioral Technology) The SASII (formerly the PHI) is an interview to collect details of the topography, intent, medical severity, social context, precipitating and concurrent events, and outcomes of non-suicidal self-injury and suicidal behavior during a target time period. Major SASII outcome variables are the frequency of self-injurious and suicidal behaviors, the medical risk of such behaviors, suicide intent, a risk/rescue score, instrumental intent, and impulsiveness. Citations: Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., Wagner, A. (2006). Suicide Attempt Self-Injury Interview (SASII): Development, Reliability, and Validity of a Scale to Assess Suicide Attempts and Intentional Self-Injury. Psychological Assessment, 18(3), 303-312.
University of WA Suicide Risk/Distress Assessment Protocol | (Source: University of Washington Center for Behavioral Technology) Reynolds, S. K., Lindenboim, N., Comtois, K. A., Murray, A., & Linehan, M. M. (2006). Risky Assessments: Participant Suicidality and Distress Associated with Research Assessments in a Treatment Study of Suicidal Behavior. Suicide and Life-Threatening Behavior (36)1, 19-33. Linehan, M. M., Comtois, K. A., &, Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232.
Jung Typology Test | Interactive assessment based on Carl Jung’s and Isabel Briggs Myers’ personality type theory
Keirsey | Take this interactive assessment to learn your temperament. (There are four temperaments: Artisan, Guardian, Idealist, and Rational.) My results were consistent with my Myers-Brigg personality type. (Note: You must create an account and enter a password to view your results.)
The SAPA Project | SAPA stands for “Synthetic Aperture Personality Assessment.” This online personality assessment scores you on 27 “narrow traits,” such as order, impulsivity, and creativity in addition to the “Big Five” (Agreeableness, Conscientiousness, Extraversion, Neuroticism, and Openness). You’re also scored on cognitive ability. This test takes 20-30 minutes to complete and you will receive a full report when finished.
DBT-WCCL Scale and Scoring | (Source: University of Washington Center for Behavioral Technology) Citations: Neacsiu, A. D., Rizvi, S. L., Vitaliano, P. P., Lynch, T. R., & Linehan, M. M. (2010). The Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL).: Development and Psychometric Properties. Journal of Clinical Psychology, 66(61), 1-20.
Demographic Data Scale | (Source: University of Washington Center for Behavioral Technology) A self-report questionnaire used to gather extensive demographic information from the client. Citations: Linehan, M. M. (1982). Demographic Data Schedule (DDS). University of Washington, Seattle, WA, Unpublished work.
Focus on Emotions | PDF assessment instruments for children and adolescents from 9 to 15 years. Includes Empathy Questionnaire (EmQue), Mood List, Alexithymia Questionnaire for Children, Emotion Awareness Questionnaire (EAQ), BARQ, Behavioral Anger Response Questionnaire, Worry / Rumination, Somatic Complaint List, Instrument for Reactive and Proactive Aggression (IRPA) Self-Report, Brief Shame and Guilt Questionnaire for Children, Coping Scale, and Social-Emotional Development Tasks
Library of Scales (from Outcome Tracker) | 25 psychiatric scales (PDF documents) to be used by mental health practitioners in clinical practice. Includes Frequency, Intensity, and Burden of Side Effects Ratings; Fagerstrom Test for Nicotine Dependence; Fear Questionnaire; Massachusetts General Hospital Hair Pulling Scale; and more. (Note: Some of the assessments have copyright restrictions for use.)
Mental Health Screening Tools | Online screenings for depression, anxiety, bipolar, psychosis, eating disorders, PTSD, and addiction. You can also take a parent test (for a parent to assess their child’s symptoms), a youth test (for a youth to report his/her symptoms), or a workplace health test. The site includes resources and self-help tools.
Open Source Psychometrics Project | This site provides a collection of interactive personality and other tests, including the Open Extended Jungian Type Scales, the Evaluations of Attractiveness Scales, and the Rosenberg Self-Esteem Scale.
Parental Affect Test | (Source: University of Washington Center for Behavioral Technology) The Linehan Parental Affect Test is a self-report questionnaire that assesses parent responses to typical child behaviors. Citations: Linehan, M. M., Paul, E., & Egan, K. J. (1983). The Parent Affect Test – Development, Validity and Reliability. Journal of Clinical Child Psychology, 12, 161-166.
Patient Health Questionnaire Screeners | This is a great diagnostic tool for clinicians. Use the drop down arrow to choose a PHQ or GAD screener (which assesses mood, anxiety, eating, sleep, and somatic concerns). The site generates a PDF printable; you can also access the instruction manual. No permission is required to reproduce, translate, display or distribute the screeners.
Project Implicit | A variety of interactive assessments that measures your hidden biases
Social History Interview (SHI) | (Source: University of Washington Center for Behavioral Technology) The SHI is an interview to gather information about a client’s significant life events over a desired period of time. The SHI was developed by adapting and modifying the psychosocial functioning portion of both the Social Adjustment Scale-Self Report (SAS-SR) and the Longitudinal Interview Follow-up Evaluation Base Schedule (LIFE) to assess a variety of events (e.g., jobs, moves, relationship endings, jail) during the target timeframe. Using the LIFE, functioning is rated in each of 10 areas (e.g., work, household, social interpersonal relations, global social adjustment) for the worst week in each of the preceding four months and for the best week overall. Self-report ratings using the SAS-SR are used to corroborate interview ratings. Citations: Weissman, M. M., & Bothwell, S. (1976). Assessment of social adjustment by patient self-report. Archives of General Psychiatry, 33, 1111-1115. Keller, M. B., Lavori, P. W., Friedman, B., Nielsen, E. C., Endicott, J., McDonald-Scott, P., & Andreasen, N. C. (1987). The longitudinal interval follow-up evaluation: A comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry, 44, 540-548.
Therapist Interview | (Source: University of Washington Center for Behavioral Technology) The TI is an interview to gather information from a therapist about their treatment for a specific client. Citations: Linehan, M. M. (1987). Therapist Interview. University of Washington, Seattle, WA, Unpublished work.
Treatment History Interview | Appendices | (Source: University of Washington Center for Behavioral Technology) The THI is an interview to gather detailed information about a client’s psychiatric and medical treatment over a desired period of time. Section 1 assesses the client’s utilization of professional psychotherapy, comprehensive treatment programs (e.g., substance abuse programs, day treatment), case management, self-help groups, and other non-professional forms of treatment. Section 2 assesses the client’s utilization of inpatient units (psychiatric and medical), emergency treatment (e.g., emergency room visits, paramedics visits, police wellness checks), and medical treatment (e.g., physician and clinic visits). Section 3 assesses the use of psychotropic and non-psychotropic medications. Citations: Linehan, M. M. &, Heard, H. L. (1987). Treatment history interview (THI). University of Washington, Seattle, WA, Unpublished work. Therapy and Risk Notes – do not use without citation. For clarity of how to implement these items, please see Cognitive-Behavioral Treatment of Borderline Personality Book, Chapter 15.
Individuals with “big picture” styles of reasoning make better decisions. Learn four strategies for “big picture” thinking to get optimal results.
A recent study found that a “big picture” style of thinking led to better decision-making. (“Better” decisions were defined as those resulting in maximum benefits.)
If you took the Myers-Briggs (a personality assessment), and fell on the “Intuition” side of the spectrum (like me!), it’s likely you’re already a “big picture” thinker. If you’re on the “Sensing” side, you’re more apt to examine individual facts before considering the sum of all parts.
“Big picture” thinking is a practical and balanced method of reasoning. It suggests taking a step back (zoom out!)… and looking to see how all pieces fit together for more effective decision-making.
The following strategies promote “big picture” thinking for better decision-making:
Research indicates that when weighing out options, it’s ideal to take small breaks. For more effective decision-making, don’t deliberate for long periods of time or you’ll start to lose focus. If things become fuzzy, you won’t see the big picture.
Ask around to learn how others’ view your situation. Every perspective you collect is another piece of the “big picture” puzzle.
Seek opinions from those you trust (only those who have your best interests in mind). Make sure you ask a variety of people (especially those with whom you typically disagree). The end result is a broader and more comprehensive awareness of what you’re facing.
Employ all four strategies to optimize your thinking style and decision-making skills!
Berman, M. G., Kross, E., Krpan, K. M., Askren, M. K., Burson, A., Deldin, P. J., Kaplan, S., Sherdell, L., Gotlib, I. H., & Jonides, J. (2012). Interacting with nature improves cognition and affect for individuals with depression. Journal of Affective Disorders, DOI: 10.1016/j.jad.2012.03.012
Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances. JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2014.8081
Curry, O., Rowland, L., Zlotowitz, S., McAlaney, J., & Whitehouse, H. (2016). Happy to help? A systematic review and meta-analysis of the effects of performing acts of kindness on the well-being of the actor. Open Science Framework
Demsky, C. A. et al. (2018). Workplace incivility and employee sleep: The role of rumination and recovery experiences. Journal of Occupational Health Psychology, DOI: 10.1037/ocp0000116
Labroo, A., Patrick, V., & Deighton, J. served as editor and Luce, M. F. served as associate editor for this article. (2009). Psychological distancing: Why happiness helps you see the big picture. Journal of Consumer Research,35(5), 800-809. DOI: 10.1086/593683
Northwestern University. (2017, July 10). Purpose in life by day linked to better sleep at night: Older adults whose lives have meaning enjoy better sleep quality, less sleep apnea, restless leg syndrome. ScienceDaily. Retrieved July 18, 2018 from http://www.sciencedaily.com/releases/2017/07/170710091734.htm
Spira, A. P. (2015). Being mindful of later-life sleep quality and its potential role in prevention. JAMA Internal Medicine, DOI: 10.1001/jamainternmed.2014.8093
Stillman, P. E., Fujita, K., Sheldon, O., & Trope, Y. (2018). From “me” to “we”: The role of construal level in promoting maximized joint outcomes. Organizational Behavior and Human Decision Processes, 147(16), DOI: 10.1016/j.obhdp.2018.05.004
Turner, A. D., Smith, C. E., & Ong, J. C. (2017). Is purpose in life associated with less sleep disturbance in older adults? Sleep Science and Practice, 1(1), DOI: 10.1186/s41606-017-0015-6
Why do we keep toxic people in our lives? Despite the emotional costs, many people chose to remain in toxic relationships. This post explores the emotional reasoning behind not letting go.
Recently, an acquaintance told me about breaking up with his toxic girlfriend. Listening to his story, I both cringed and laughed at the sheer ridiculousness of it. (Think The Break-Up meets Fatal Attraction.) His humorously-told narrative left me wondering, how on earth did it get to that?
It began when his at-the-time girlfriend “secretly” moved in with him. At first, she’d stay for a night or two, which eventually turned into weeks at a time, until all her stuff was there and my friend found himself with a live-in girlfriend. (It’s worth mentioning he’d seen a few “red flags” early on, but chose to ignore them… as we often do under the spell of infatuation.) Now living with her, he couldn’t turn a blind eye to the fact that she had some serious mental health and interpersonal issues. Furthermore, the relationship had taken a turn for the worse; they were constantly fighting.
So, my friend (wisely) broke up with her and told her to get out. And… she refused. (Really??) She claimed there was a law permitting her to stay since she’d been there for X amount of time. (Note: This is also when he found out she was homeless.)
He kicked her out of the bedroom (and she slept on the couch). To “encourage” her to leave, he took her parking pass, along with her new iPhone (which he undoubtedly bought in a more amiable era). To further “motivate,” he even shut off her cell service.
Despite his efforts, weeks stretched on; she continued to live (rent-free) on his couch.
To make a long story short… she eventually left. (Otherwise, I wouldn’t be writing this blog post) … but not until the apartment manager and police got involved. (It turned out her tenant rights claim, while valid, was not actually applicable to her situation.)
My initial reaction to the whole fiasco was incredulity – Seriously, how could he let it go that far? – but after reflecting on past relationships… it was suddenly very easy to understand. (I’ve made my fair share of relationship mistakes.)
The reality is, it’s never as simple as “it’s over, get out.” Relationships require a certain level of emotional investment and commitment. Plus, there are multiple factors (such as debt, illness, or infidelity) that contribute to a relationship’s complexity.
Back to my friend… to be fair, the reason he remained in a toxic relationship was her refusal to vacate the apartment; his options were limited… but, instead of allowing it drag on, he could have taken action earlier. Anyway, the story has a happy(ish) ending (for my friend, probably not his ex). He has his place back (hopefully a lesson learned) and I got free blog inspiration. This post is 100% inspired by my friend’s toxic relationship. (Thank you for letting me share!)
3 Reasons We Keep Toxic People in Our Lives
(Apart from “tenant rights”) what are reasons we allow toxic or difficult people (friends, family, and/or romantic partners) to remain in our lives? Why is it so hard to let go?
1. Either You Need Them (or You Can’t Ignore Them)
A recent study suggests we keep toxic people around simply because their lives are intertwined with ours. For example, your aging mother-in-law, who degrades and insults you, lives at your home, despite the negative impact this has on your life. Your options are limited because your husband is unwilling to put her in a nursing home (and you may also depend on her for things, like childcare or help with the bills).
Another example would be toxic co-workers; you don’t have a lot of choice when it comes to your boss or colleagues, and you can’t entirely avoid them or refuse to talk about work-related stuff (unless you’re okay with losing your job). If pursing a new position isn’t practical, your next best option is to find a way to effectively deal with workplace toxicity.
That being said, you don’t have the power to change anyone else. To manage your reactions and interactions with toxic people, acknowledge the need for self-adjustment, including attitude and role. Examine your personal views. Lower expectations for others; accept that people will do and say things you don’t agree with… and it’s not something you can control. Once you’ve reached the point of radical acceptance, follow guidelines for effective communication (i.e. active listening, avoiding blame, being aware of tone and body language, reflecting for clarity, etc.) in conversations with toxic people, whether it’s your mother-in-law or your boss. By being proactive, you’re doing your part to avoid getting caught up in others’ toxicity.
In the face of unavoidable toxicity, I find switching to a “counselor role” to be a tremendous asset; I set aside my personal viewpoint, opening myself to alternative views, while seeking to understand (not judge) behavior. (You don’t have to be a counselor to do this!) I view individuals in terms of “what happened to you?” instead of assuming they’re malicious or intentional. (People act the way they do for some reason.) I don’t know what’s happening in a “toxic” person’s life or what they’ve been through. (Maybe that snarky co-worker is in an abusive relationship and lives in fear. Or maybe her son is in the hospital with brain cancer. Or, it’s possible she grew up in a home where her parents yelled and disrespected each other, shaping her view of relationships. The snarky attitude makes sense when viewed through different lenses.) While it’s never okay to be an asshole, I can understand why people are jerks. Somehow, this knowledge serves as an immunity when encountering a toxic person. Their behavior is the result of something bad that happened to them; it has nothing to do with me and I can choose whether or not to engage. They don’t have power to negatively impact me unless I give it up.
2. Toxic Love: It Feels Better to Stay
When Joe Strummer of the Clash sang the question, “Should I stay or should I go now?”; he knew the answer. (Note: Firm boundaries and healthy decisions aren’t the stuff of chart-topping hits.) We stay in unhealthy relationships or continue to hang out with toxic friends because it feels good (at times, at least). The boyfriend who yells at you can also be incredibly sweet and caring. Or your gossipy friend who talks about you behind your back also happens to be the most fun person you know. Despite the sense that it’s unhealthy, you (like Strummer) can’t resist. And like my friend, you ignore the red flags because you crave the rush or the intensity… or maybe what you desire most is the feeling of being wanted. (Despite the toxicity, it’s worth it, just to feel wanted… or is it?)
Beyond just feeling good, it’s entirely possible to deeply love a toxic person (no matter how wrong they are for you). You don’t want to give up on the person they could be; maybe you’re in love with their potential (or an idea of what the relationship could be). You believe it’s better to sacrifice your happiness (your dignity, your well-being, your independence) than to be without the person you love.
On the flip side, some people stay in toxic relationships because deep down, they believe they can’t do any better and/or the abuse is a preferable alternative to being alone. It could also mean they believe they deserve to be punished (which sometimes happens when a person remains in an abusive relationship for a long time). Or, they may reason that it’s better to hang out with a “mean girl” than sit and stare at the walls on a Friday night (with only the cat for company).
If you can relate to staying in a toxic relationship because it feels good or are afraid of being alone, carefully consider and weigh out the long-term costs of a toxic relationship. There are far worse and more damaging things than being alone. If the idea of being alone terrifies you, maybe it’s an indication that something’s not right… that you’re not okay. It could be a sign of low self-worth or could point to an intense fear of abandonment. It may also signify a lack of understanding of what it means to be in a healthy relationship. Lastly, an intense fear of being alone is associated with some of the personality disorders and/or could be the result of trauma.
3. It’s (So Much) Easier to Stay
Breaking up is messy and uncomfortable. In my experience, most people avoid conflict when possible. Despite conflict being a natural, everyday occurrence, it can feel unpleasant, even for those with expert conflict resolution skills. However, avoiding conflict in relationships does more harm than good. In a healthy relationship, it’s necessary to address problems in order to resolve them, thereby strengthening the relationship.
In a toxic relationship, conflict should not be avoided, but for different reasons. It may be easier to ignore the reality of your situation than to get honest, but this is detrimental (not only to you, but to your partner, who will never have the opportunity to change so long as you enable the toxicity to continue).
You may wish to avoid the emotional drain that accompanies confrontation, but in the long run, you’ll lose more emotional energy if you remain in a toxic relationship. (A steep, one-time payment is preferable to the ongoing, daily emotional sacrifices/abuses associated with toxicity; you’re slowly poisoned as time goes on.)
If you choose to end a toxic relationship, be realistic; it’s not going to be easy… and it’s going to hurt. A lot. You may love this person a great deal (and maybe you’ve long held on to the hope they’d change). Go into it with low (or no) expectations. When things feel unbearable, remember that the easy things in life matter little; the difficult stuff is what leads to personal growth, success, and resilience.
In closing, I’m sure there are multitudes of reasons people have for staying in toxic relationships; this post is by no means comprehensive. I’m also certain, whatever the reason, it seems justifiable to them. People don’t choose toxicity without some sort of justification (if not for others, than at least for themselves). Unfortunately, rationalizations don’t offer protection from harm. No matter the reason for remaining in a toxic relationship, it’s not worth the cost.
What are other reasons people have for staying in a toxic relationship? Why is letting go so hard? Share your thoughts in a comment!
Offer, S., & Fischer, C.S. (2017). Difficult people: Who is perceived to be demanding in personal networks and why are they there? American Sociological Review, 000312241773795, DOI: 10.1177/0003122417737951