Danger Assessment Screening Tool | Clinicians can download a PDF version of this assessment, which helps predict the level of danger in an abusive relationship; this screening tool was developed to predict violence and homicide.
Self-care is not a luxury; it’s necessary for survival when your loved one has a substance use disorder. By taking care of yourself, you gain the energy and patience to cope with your problems. Self-care promotes wellness and emotional intelligence; it puts you in a better space to interact with your loved one. Strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers.
By Cassie Jewell, M.Ed., LPC, LSATP
When your loved one has a substance use disorder (SUD), it can be overwhelming, distressing, and all-consuming. When we’re stressed, we forget to practice basic self-care, which in turn makes us even less equipped to cope with the emotional chaos addiction generates.
(Side note: I strongly recommend reading Beyond Addiction if your loved one has an SUD or if you work in the field. This book will increase your understanding of addiction and teach you how to cope with and positively impact your loved one’s SUD by using a motivational approach. This is one of the best resources I’ve come across, especially for family members/significant others.)
Based on the premise that your actions affect your loved one’s motivation, taking care of yourself is not only modeling healthy behaviors, it’s putting you in a better space to interact with your loved one. Chronic stress and worry make it difficult to practice self-care. Self-care may even seem selfish. However, by taking care of yourself and thus reducing suffering, you gain the energy and patience to cope with your problems (and feel better too). Furthermore, you reduce the level of pain and tension in your relationships with others, including your loved one with a SUD.
Self-care strategies include developing/building resilience, practicing distress tolerance, keeping perspective, and recognizing/managing your triggers. Therapy and/or support groups are additional options.
“An empty lantern provides no light. Self-care is the fuel that allows your light to shine brightly.”
Self-Care Strategies When Your Loved One Has an Addiction
The definition of resilience is “the capacity to recover quickly from difficulties” (Oxford Dictionary). Doctors Foote, Wilkens, and Kosanke wrote that having resilience is a way to “systematically reduce your vulnerability to bad moods, lost tempers, and meltdowns.” While you cannot “mood-proof” yourself entirely, resilience helps when facing life’s challenges, setbacks, and disappointments. To maintain resilience, one must practice at least the most basic self care practices, which are as follows:
Self-care is not something you can push in to the future. Don’t wait until you have more time or fewer obligations. Self-care is not a luxury; it’s a necessity. The authors of Beyond Addiction pointed out that self-care is something you have control over when other parts of your life are out of control. If you find it challenging to implement self-care practices, tap into your motivations, problem-solve, get support, and most of all, be patient and kind with yourself.
“Taking care of yourself is the most powerful way to begin to take care of others.”
On tolerance, Doctors Foote, Wilkens, and Kosanke suggested that it is “acceptance over time, and it is a cornerstone of self-care.” Tolerance is not an inherent characteristic; it is a skill. And like most skills, it requires practice. However, it’s wholly worth the effort as it reduces suffering. By not tolerating the things you cannot change (such as a loved one’s SUD), you’re fighting reality and adding to the anguish.
Techniques for distress tolerance include distracting yourself, relaxing, self-soothing, taking a break, and creating positive experiences. (The following skills are also taught in dialectical behavior therapy (DBT), an evidence-based practice that combines cognitive behavioral therapy techniques and mindfulness. For additional resources, visit The Linehan Institute or Behavioral Tech.)
Switch the focus of your thoughts. The possibilities are endless; for you, this could mean reading a magazine, calling a friend, walking the dog, etc. The authors of Beyond Addiction suggested making a list of ideas for changing your thoughts (and keeping it handy).
Switch the focus of your emotions. Steer your emotions in a happier direction by watching corgi puppies on YouTube, reading an inspirational poem, or viewing funny Facebook memes. The writers of Beyond Addiction suggested bookmarking sites in your Internet browser that you know will cheer you up.
Switch the focus of your senses. This could mean taking a hot shower, jumping into a cold pool, holding an ice cube in your hand, walking from a dark room to one that’s brightly lit, looking at bright colors, listening to loud rock music, etc. Also, simply walking away from a distressing situation may help.
Do something generous. Donate to your favorite charity, pass out sandwiches to the homeless, visit a nursing home and spend time with the residents, express genuine thanks to cashier or server, etc. By redirecting attention away from yourself (and directing energy toward positive goals), you’ll feel better. In Beyond Addiction, it’s noted that this skill is especially helpful for individuals who tend to ruminate. Also, it’s important to brainstorm activities that are accessible in the moment (i.e. texting a friend to let them know you’re thinking about them) that don’t take multiple steps (such as volunteering).
“Body tells mind tells body…” Relaxing your body helps to relax your mind. It also focuses your thoughts on relaxing (instead of your loved one’s addiction). What helps you to relax? Yoga? A hot bath? Mindful meditation? (I recommend doing a mindful body scan; it’s simple and effective, even for the tensest of the tense, i.e. me.)
In Beyond Addiction, self-soothing is described as “making a gentle, comforting appeal to any of your five senses.” A hot beverage. Nature sounds. A cozy blanket. A scenic painting. Essential oils. A cool breeze. A warm compress. A massage. Your favorite song. Find what works for you, make a list, and utilize as needed. Seemingly small techniques can make a big difference in your life by creating comfort and reducing out-of-control emotions.
Take A Break
“Taking a break” doesn’t mean giving up; it’s a timeout for when you’re emotionally exhausted. Learn to recognize when you need to step away from a situation or from your own thoughts. Find a way to shift your focus to something pleasant (i.e. a romantic movie, a nature walk, a day trip to the beach, playing golf for a few hours, traveling to a different country, etc.)
Create a Positive Experience
Doctors Foote, Wilkens, and Kosanke refer to this as “making it better,” not in the sense that you’re fixing the problem (or your loved one), but that you’re making the moment better by transforming a negative moment into a positive one. Suggested techniques include the following:
Half-smile. Another mind-body technique, half-smiling tricks your brain into feeling happier.
Meditate or pray. As explained in Beyond Addiction, “meditation or pray is another word for – and effective channel to – awareness and acceptance. Either one can open doors to different states of mind and act as an emotional or spiritual salve in trying moments.”
Move. By moving, you’re shifting your focus and releasing energy. Stretch, run, play volleyball, chop wood, move furniture, etc.
Find meaning. The authors of Beyond Addiction wrote, “Suffering can make people more compassionate toward others. Having lived through pain, sometimes people are better able to appreciate moments of peace and joy.” Suffering can also inspire meaningful action. What can you do to find meaning?
Borrow some perspective. How do your problems look from a different viewpoint? Ask a trusted friend. You may find that your perspective is causing more harm than good.
Perspective is “an understanding of a situation and your reactions to it that allows you to step back and keep your options open… [it’s] seeing patterns, options, and a path forward” (Beyond Addiction).
When Trish married Dave nearly 20 years ago, he rarely drank: maybe an occasional beer over the weekend or a glass of wine at dinner. After their fist daughter was born, his drinking increased to a few beers most nights. Dave said it helped him relax and manage the stress of being a new parent. By the time their second daughter was born several years later, his drinking had progressed to a six-pack of beer every evening (and more on weekends). Currently, Dave drinks at least a 12-pack of beer on weeknights; if it’s the weekend, his drinking starts Friday after work and doesn’t stop until late Sunday night.
Dave no longer helps Trish with household chores or yardwork as he did early in their marriage. He rarely dines with the family and won’t assist with the cooking/cleanup; he typically eats in front of the TV. Dave occasionally engages with his daughters, but Trish can’t recall the last time they went on a family outing, and it’s been years since they went on a date. Dave struggles to get out of bed in the mornings and is frequently late to work; Trish is worried he’ll get fired. They frequently argue about this. Dave is irritable much of the time, or angry. Most nights, he doesn’t move from his armchair (except to get another beer) until he passes out with the television blaring.
Trish is frustrated; she believes Dave is lazy and lacks self-control. When she nags about his drinking, he promises he’ll cut back, but never follows through. Trish thinks he’s not trying hard enough. She can’t understand why he’d choose booze over her and the kids; sometimes she wonders if it’s because she’s not good enough… maybe he would stop if she was thinner or funnier or more interesting? At times she feels helpless and hopeless and others, mad and resentful; she frequently yells at Dave. She wonders if things are ever going to change.
A different perspective would be to recognize that Dave has an alcohol use disorder. He feels ill most of the time, which affects his mood, energy level, and motivation. He wants to cut back, but fails when he tries, which leads to guilt and shame. To feel better, he drinks. It’s a self-destructive cycle. If Trish understood this, she could learn to not take his drinking personally or question herself. Her current reactions, nagging and yelling, only increase defensiveness and harm Dave’s sense of self-worth. Alternative options for Trish might include learning more about addiction and the reasons Dave drinks, bolstering his confidence, and/or creating a supportive and loving environment to enhance motivation.
In recovery language, a “trigger” is anything (person, place, or thing) that prompts a person with SUD to drink or use; it activates certain parts of the brain associated with use. For instance, seeing a commercial for beer could be triggering for a person with an alcohol use disorder.
You have triggers too. For example, if your loved one is in recovery for heroin, and you notice that a bottle of opioid painkillers is missing from the medicine cabinet, it could trigger a flood of emotions: fear, that your loved one relapsed; sadness, when you remember the agony addiction brings; hopelessness, that they’ll never recover. It’s crucial to recognize what triggers you and have a plan to cope when it happens.
Therapy and Support Groups
Lastly, therapy and/or support groups can be a valuable addition to your self-care regime. Seeing a therapist can strengthen your resilience and distress tolerance skills. Therapy may provide an additional avenue for perspective. (Side note: A good therapist is supportive and will provide you with tools for effective problem-solving and communication, coping with grief and loss, building self-esteem, making difficult choices, managing stress, overcoming obstacles, improving social skills/emotional intelligence, and better understanding yourself. A good therapist empowers you. A bad therapist, on the other hand, will offer advice and/or tell you what to do, disempowering you.)
Regarding support groups, there are many options for family members, friends, and significant others with a loved one who has a SUD, including Al-Anon, Nar-Anon, and Families Anonymous. Support groups provide the opportunity to share in a safe space and to receive feedback, suggestions, and/or encouragement from others who relate.
“I have come to believe that caring for myself is not self indulgent. Caring for myself is an act of survival.”
In sum, self-care is not optional; it’s essential for surviving the addiction of a loved one. Self-care enhances both overall wellness and your ability to help your loved one; in order words, take responsibility for your health and happiness by taking care of yourself.
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.
By Cassie Jewell, M.Ed., LPC, LSATP
Recently, an acquaintance told me about breaking up with his 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!)
(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. 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