August 20, 2025 • 56 mins
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When does our help cross the line from supportive to harmful for our loved ones with mental health challenges? In this episode we dive deep into the complex dynamics of "unintentional reinforcement," a less judgmental term for "enabling" that acknowledges how our best intentions can sometimes backfire.
Drawing from personal experiences with addiction, depression, and avoidance behaviors, we explore how our actions sometimes shield our loved ones from the very consequences that might motivate change. Whether it's financially supporting a partner who refuses to work, making excuses for someone's alcohol abuse, or accommodating anxiety-driven avoidance, these patterns can gradually trap both parties in cycles that feel impossible to break.
What makes these situations particularly challenging is when we feel stuck between either "enabling" destructive behaviors or dealing with other consequences. When we point out the problem, they often retreat further into problematic behaviors. Through practical examples and psychological insights, we discuss strategies for shifting these dynamics without abandoning those we love.
We highlight that boundaries aren't selfish- they're necessary. By intentionally encouraging healthy behaviors while allowing natural consequences for unhealthy ones, we can boost motivation for positive change. And by recognizing when our own needs for caretaking or control might be part of the problem, we gain the clarity to make difficult but loving choices.
Ready to transform your relationship with someone struggling with mental health or addiction? Check out KulaMind, our community support platform where we're learning together how to break free from unhealthy patterns and set boundaries that stick.
Resources:
- If you're navigating someone's mental health or emotional issues, join KulaMind, our community and support platform. In KulaMind, we'll help you set healthy boundaries, advocate for yourself, and support your loved one.
- Follow @kulamind on Instagram for podcast updates and science-backed insights on staying sane while loving someone emotionally explosive.
- For more info about this podcast, check out: www.alittlehelpforourfriends.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Jacqueline Trumbull (00:00):
Hey guys, welcome to A Little Help
for Our Friends, the podcast forpeople with loved ones
struggling with mental health.
Hey Little Helpers, welcomeback.
Today we are going to do atopic that I think can sometimes
have like a pejorativeconnotation, but so many of us
(00:21):
do it kind of from a good place,and that is enabling.
Um, enabling can look reallydifferent, I think, depending on
what the disorder is and whereit comes from, but, um, kibbe's
actually been doing a trainingon this, so she's got a lot to
share.
It's also something that we'vetalked about at the va in
reference to, like you know,spouses or or loved ones of
(00:46):
people with PTSD.
So, kibbe, this is superrelevant to Cool Mind, so tell
us about what you've got goingon and then explain to us what
enabling is.
Dr. Kibby McMahon (00:55):
Yeah, just for any of you who have loved
ones with addiction or otherkinds of mental health symptoms
and you kind of feel like you'restuck in negative cycles, like
you don't really know how tohelp without making it worse,
and maybe you are overextendingyourself, you're burning out and
you want to change but have ahard time figuring out how cool
(01:18):
a mind is.
We've been talking about it,it's been.
It's been so great so far.
I've really loved it.
It's our community and supportplatform for people with mental
health and addiction issues andtheir loved ones.
So basically, what we're doingnow is that we're learning how
to set boundaries, how toidentify boundaries, how to
identify when we're enabling wecall it something else, but
(01:40):
we'll get to that in a littlebit and then how to actually set
boundaries that stick.
So, for example, we're doingthat now and all of our
community members are workingtogether, sharing what struggles
and patterns that they're stuckin, and we're all supporting
each other and learning how tobreak free from those unhealthy
habits.
So if that sounds likesomething that you'd be
(02:01):
interested in, just go tocoolamindcom, k-u-l-a-m-i-n-dcom
or the link in the show notes.
Amazing Well, how would youdefine enabling?
Yeah, so I'm also forbackground, I'm also doing a
training right now on craft,community reinforcement and
(02:21):
family training craft yeah,that's right Specifically for
loved ones of people withaddiction, and so we're really
talking a lot about this and theword enabling is so common, but
it is.
It's pretty negative, as youwere saying, because it makes it
seem like, um, you know, it'skind of mixed in with the words
codependent or it kind of soundslike you're causing or helping
(02:49):
your loved one be addicted, soit really has kind of like a
blamey and judgy word, right.
Dr. Jacqueline Trumbull (02:57):
Some people do it on purpose to gain
control, but the vast majorityof people do it for
well-intentioned reasons.
Dr. Kibby McMahon (03:03):
Yeah, the other words for it in the OCD
world is called accommodationand in general it just describes
actions that loved ones take tomaybe solve a problem in the
short term or relieve distress,like make things easier in the
(03:23):
short term but actually make theaddiction or other mental
health symptoms more likely.
Sometimes we also say thatenabling is doing an action that
makes it easier for the lovedone to drink or avoid something
hard that actually maintainstheir disorder in the long run.
So, as you were saying, it'sreally coming from
(03:44):
well-intentioned places.
Right, and it's so easy fromthe outside to be like don't
help your loved one drink.
That's crazy.
Why would you do that?
Right, that's the thing that'scausing you and them pain.
But in the moment when you'rewith your husband and he is so
drunk and so sick and you'rejust like, oh my God, my kids
(04:08):
are going to be upset.
You know this is going to be amess, he's going to hurt himself
, so I'll just clean up afterhim, I'll take off his shoes,
I'll put him into bed and maybeI'll even call his boss in the
morning and say that he's notfeeling well and I'll tell the
kids it's okay.
You know this is not, you know,daddy's just not feeling well,
right?
So all of all of those kind ofbehaviors are just to try to
(04:31):
make the situation better.
But what it might actually dois one add some kind of
reinforcement, and we'll talkabout that, but add some kind of
reward or good thing around thedrinking behavior and it also
shields them from theconsequences of their actions,
right?
Dr. Jacqueline Trumbull (04:50):
yeah, yeah, I mean, I've seen nailing
come in a lot of different forms.
So, like you know, with, like,when my sister was married, her
husband like refused to removethe alcohol from the house and
was like actively drinkingaround her, and that's a form of
(05:11):
enabling.
But on the other hand, I've had, like I know a couple where, um
, they're both doctors the samekind of doctor and they work in
the same hospital, and she wouldget wasted while on call and he
would have to take her call,meaning like when she was at
home, not while she was at work.
(05:31):
Well, yeah, yeah, and he wouldhave to take her call.
Technically that's enabling,because it'll it reinforces her
ability to say well, anytime I'moverwhelmed, I'll just get
drunk, because I know that myhusband is capable of taking
this over.
Um, but it's hard to say thathe's in the wrong, because it's
(05:51):
not like he wants her to loseher livelihood.
Dr. Kibby McMahon (05:53):
They're married, you know or he doesn't
want those patients to gowithout help, right, there's
like so many totally reasonablereasons why he would do that.
Um, I enabled so much and youknow it really does.
Let's, let's, let's actuallyshift the word to the word that
we prefer which isunintentionally reinforced I
(06:15):
know that's actually more of amouthful, but I think it it
takes enabling sounds so likeyou did it and unintentionally
reinforced.
It's like I accidentally, youknow, I don't know, you know,
made it easier or made it better, right, I remember, oh, there's
(06:37):
so many.
Even I'm just like looking backon what I did and it's like so
shameful.
One of the bigger ways I enabledmy ex-husband was I completely
shielded him from, I protectedhim from the consequences of not
working.
(06:57):
I mean, I blame myself a lotfor it and got caught in the
cycle, and it's crazy because,if there you might, it's a weird
thing to feel like that you aremaking it easier for people to
do the thing that hurts you themost or that you're most
frustrated with.
So you're like, oh, it's myfault, I'm not my own worst
enemy, but don't they have achoice?
Right, and um, I've talkedabout this before in previous
(07:18):
episodes, but my ex-husbanddecided to stop working and find
himself.
But finding himself usuallymeant smoking weed in our
basement for a day and likedreaming about the things that
he wants to do, and then openingup tabs of job applications.
Um, and I know that because I'dbe like are you looking for a
(07:39):
job?
He's like, yeah, I have so manytabs open.
So I was was like, oh, here yougo, done Um, just accept the
offers as I come in.
But, um, he, he would then getanxious and then he would smoke
and and in normal life andnormal world, um, that wouldn't
(08:00):
work right, like if he goeswithout a job for too long, he's
not going to have a house, he'snot going to have food, he's
going to have to figure it outand go through the discomfort
and anxiety of I have to applyfor a job.
It's not going to be great, youknow, go through all that
hardship.
And yet I was still paying thebills.
Right, I was still.
I didn't kick him out, I wasstill paying our house bills.
(08:27):
I mean it was weird because itfelt like I'm just paying for
the house bills that I alwaysdid and he just like moved in
and benefited for that.
So it didn't feel like I wasdoing, adding anything.
I was just frustrated by hispresence and how he was
responding to it, but it wasunintentionally reinforcing,
right.
It's like he didn't.
He felt the anxiety of oh no, Ihave to look for a job and I,
(08:48):
you know, don't know where tostart.
I feel ashamed, I feel lost,anxiety, anxiety oh phew, weed
makes me feel better.
And then I could go a couplemore weeks like that and just
pretend that you know this is afuture me problem and there's no
consequence.
Dr. Jacqueline Trumbull (09:06):
Right, there's no, except the
consequence was just me beingupset, which is probably just
wasn't, as strong as feelingreally yeah, no I think what I'm
struggling with with you knowyou saying that you feel shame
around this and you know youshouldn't have done these things
.
It's like I don't know how toput this exactly but at what
(09:29):
point do we need to step in andbe our partner's therapist, like
, be our partner's behavioralplans?
Um, you know it's, it's a bitunfair on the partner now.
Now, now, fairness doesn'treally matter, right, because
you have to do what's effectiveif you want to get ahead, like
fairness.
But I think it is hard to knowwhen it's really on you to
(09:55):
basically say you know I need totake away my support or I need
to figure out how to let youfeel the natural consequences of
your behavior, because youwon't do it, because caring
about me and what I want isn'tenough, like that's a hard
(10:15):
choice to make yeah, I mean.
Dr. Kibby McMahon (10:21):
I think that I mean this is what we're doing
at Cool of Mine right now isidentifying those when, when
you're like, oh okay, I'm, I'm,I'm at capacity, because
sometimes these patterns happengradually and then suddenly
you're stuck Right and thensuddenly you're like, oh my gosh
, I think I'm even making itworse and it is tough to then
(10:45):
change right.
Then it's tough to be like waita minute, I was okay paying
your bills before and now I'mnot right.
It's just like a weird thing tointroduce.
And before I go further and Ijust want to clarify for people
who don't know, when we sayreinforce, that basically means
that a reinforcement is anythingthat makes a behavior more
(11:07):
likely, and this is in humans,this is in animals, this is in
all sorts of things.
But it's like whatever ismaking the thing do something
more in the future.
It could be negative.
Positive reinforcement, whichis a reward, like they get money
, they get treats, they get agood feeling, they get attention
, they get, you know, love.
(11:27):
Like that you get somethinggood or negative reinforcement
means taking away something badanxiety relief, relief of
responsibilities, right?
Or you know that beeping noisewhen you don't put on your
seatbelt and then, as soon asyou put on your seatbelt, it
turns off, right.
So it's just adding, you know,like either something good or
(11:52):
less bad, and that makes thebehavior more likely.
And, as I was saying, that couldchange over time.
Right, I might've been okaywith paying the bills for the
first few months and then, afterfour years, you know, my
boundaries have changed, mylimits have changed, so, but I
don't know.
I think I, I really I was inthat position.
(12:15):
I was desperate for someoneelse to come in and say this is
wrong.
Um, I wanted I get in mydeepest fantasies.
I wanted someone to recognizelike me as a hero, like oh,
kibbe's doing this anyway andyou're taking advantage of it,
or you know you should make adifferent choice and get a job,
(12:37):
right.
So I that's what I fantasizedthat someone would see how I
feel like I was enabling, andyet I felt powerless to break
out of it.
Dr. Jacqueline Trumbull (12:49):
Right, well, I mean it often confers a
negative outcome in the shortterm on the partner who has to
stop enabling I mean like one, Imean like in the example I gave
about the two doctors right,like he's, he's risking one half
(13:09):
of his family's income there.
A lot of times it's risking thewrath of your partner.
It may be, you know, you haveto stop drinking yourself or you
have to change your socialworld and, like the way that
you've always operated becauseyou don't want you know your
behavior to like enable yourpartners In the world of PTSD.
(13:31):
A lot of times enabling lookslike you know the person with
PTSD is going to want to startavoiding a lot of things
Avoiding going out, avoidingcrowds, avoiding a lot of noises
and that's actually it's reallyfrustrating for the partner
because they want to be livingtheir lives right, but in order
(13:54):
to, in order to not enable, itfeels like they have to like I
just put up a huge fight, likedrag their partner to this thing
and then watch them be scaredand uncomfortable and angry.
You know that's a lot to ask ofa person.
Dr. Kibby McMahon (14:11):
Yeah, I mean going through not enabling, like
stopping the enabling, likethat could lead to so much
headache, so much argument, somuch like distress and chaos
that you know, people might justbe like I just, I just don't
want to deal with that, like Ijust don't have the strength.
I'll just, you know, make thiseasier and do it.
(14:32):
I mean to that point.
I remember when, before my exand I lived together, um, he was
finishing his residency, um, uh, and got in trouble and they
were punishing him and they said, you know, you might not be
(14:52):
able to get your license as adoctor.
And he had called me up andsaid I, you know so upset, like,
oh, how could they do this?
This is so terrible, I feel sobad.
But you know, so upset, like,oh, how could they do this?
This is so terrible, I feel sobad.
But you know what I don't makesme think that I don't want to
be a doctor after all.
I just want to find myself and,you know, do other things.
(15:14):
And I remember, um, he was goingto move into my house and we
had made an agreement Like Italked about this explicitly
that we would split the bills,we would split the contributions
.
And I remember at the time whenwe had that conversation, he
was like why would you even, whywould you even question that
I'm going to be a doctor?
Like how could you even thinkthat I wouldn't contribute?
(15:35):
I probably would contributewhatever.
And then when he was like I'mgoing to, I'm going to leave
medicine, I don't want to be adoctor, I'm going to do medicine
, I don't want to be a doctor,I'm going to do something else,
I was like oh, okay, well, Ilike what, what are you going to
do for a job?
Because you have to get a jobwhen you come here like or you
gotta, you know, carry your ownweight.
(15:55):
And he was like how could youdo this to me?
No, I, I have you not heard me?
I need to figure it out.
Don't pressure me to be adoctor.
And I was like, okay, well then, maybe we shouldn't move in
together.
And that caused so much fightsthat eventually I was like okay,
we can't move in together, wecan't.
I don't know if we could followthrough this relationship.
(16:15):
And he spent three days callingme, crying, screaming at me,
being like I can't believe youdid this to me, you're
abandoning me at the worst time.
Um, he was like you're abusive,like, just because I won't, I
don't not going to be a doctor,you, you know, you're taking
everything away.
How can you do this?
(16:36):
And I mean, I felt awful, likeI, I just felt, I was like I
felt so guilty and I was likeyou're right, he's right.
Like what, what's the harm inletting him hang out and live
with me while we can continueour relationship and he could
figure himself out?
You know, like what?
What am I being a stickler for?
Dr. Jacqueline Trumbull (16:57):
I guess I had a reason?
Dr. Kibby McMahon (16:58):
because, yeah , because I, you know, he moved
in, didn't get a job for betterpart of four years and it drove
me nuts when, especially olderpeople.
But people were like, well,what do you expect?
You didn't make him get a job,you let him stay at your house
and let him move in without ajob and without paying the bills
(17:21):
.
And I was like, okay, so Ieither, you know, risk our
relationship or get yelled at,you know?
So like it really feels likeyou're stuck between a rock and
a hard place.
Dr. Jacqueline Trumbull (17:33):
Yeah, yeah that story is really
upsetting.
Dr. Kibby McMahon (17:39):
That bastard when I think about it.
I haven't talked about him in along time, but whenever I do,
I'm just like what?
What was I thinking?
What was I?
And I, you know, like I just it.
Especially, I think it's whenwe talk in these vague terms of
case, cases, examples it'sreally easy to picture the
(18:02):
alcoholic or the, you know, thenarcissist or whatever whoever
we talk about, as this, liketerrible person, and we're like
cowering in fear.
But often no, often these lovedones are vulnerable and they're
soft and they're like tryingand they are sorry and they
don't want to be like this andthey don't want to hurt you,
(18:23):
right, and so when he was thatremorseful and that vulnerable,
I was like how could I?
Okay, fine, it's just easier.
Dr. Jacqueline Trumbull (18:30):
All right, I'll keep paying the
bills, all right, just this,just this month because like it
is valid to when somebody'sreally struggling, throw them a
life raft, you know, like thatmakes sense.
That's not always a bad idea.
It's just if they, you know,build a house on that life raft
then and like move in and decideto live there for four years,
(18:51):
then it's a problem.
But it's hard to know at whatpoint.
I mean you don't literally seethem building, you know building
the house there, so it's hardto know at what point you have
to cut off support.
Yeah, and it can feel likesometimes it's too deep you know
, I mean with PTSD, it's reallyhard because it's like are you
(19:13):
like?
Okay, like, let's say, I wasmarried to somebody with PTSD?
Everybody knows how importantdates are to me.
Well, dates stop being fun ifyour husband is scanning the
crowd and looking at the doorthe entire time and not being
able to concentrate on you and,you know, put up a fight going.
So it's kind of like, okay,yeah, I'm gonna make him go on
(19:35):
this date, but for what purpose?
And neither of us is going toenjoy it.
Like so, how do you?
So?
Where do you start?
What do you do?
Dr. Kibby McMahon (19:50):
I don't know.
I mean, I think you start whenI think for most people they're
going to spot their enabling,unintentional reinforcement
patterns when either they arelosing capacity to keep offering
(20:13):
that support Like it's draining, to keep doing that, like I got
to the point where I had nomore money.
That was the point.
I was like you know, I can'tkeep you know supporting you,
point, and I was like you know Ican't keep you know supporting
you, um, or when the resentmentbuilds, when you kind of feel
like you know, I feel like I've,I've extended myself past my
limits, or um.
(20:34):
Another thing is like when younotice that the problematic
behavior, whether it's drinkingor not getting a job, avoidance
or whatever is getting worse.
Right, I think that's that'swhen.
That's when usually it's, it'slike, oh my gosh, we need to get
this person help in general,let's get them to treatment,
(20:55):
let's get them to therapy.
This has to change.
And then you know, then, likesubtly, the loved ones need to
change their um reinforcementpatterns, right so it's like you
know.
Then, like, subtly, the lovedones need to change their
reinforcement patterns, right?
So it's like you know, when younotice that either the
avoidance is just staying thesame for years and years or
getting worse, they're avoidingmore things.
Dr. Jacqueline Trumbull (21:19):
I mean, yeah, like if there's a
behavior that's really unhealthyor a behavior that's really
unattractive or something thatyou just don't want to put up
with and you're on a timeline,right like, there's got to be
some comfort in saying, I mean,I think it's tough, you know,
between saying what am I goingto have to accept of this
(21:39):
behavior and what do I trulyneed to change?
Um, somebody with PTSD isprobably never going to love a
firework show.
I'm going to combat PTSD person.
Uh, is that that big of a deal?
I don't know.
So, you know, it could be likeit could be a situation of
saying we need to work on someof this.
(22:00):
I can have acceptance aroundsome things.
I can have acceptance aroundthe fact that you struggle and
maybe you're not going to enjoythe same things that I do or be
able to, you know, live the lifeI wish you could.
Dr. Kibby McMahon (22:18):
But we're suffering here, yeah, and that
that those limits can change,right, like you could be fine
with it for a while.
And then one day you're likeyou know what I'm done.
You know, yeah, and that thatthose limits can change, right,
like you could be fine with itfor a while.
And then one day you're likeyou know what I'm done.
You know, yeah, have you didyou find yourself reinforcing
your exes?
Dr. Jacqueline Trumbull (22:34):
Yeah, I mean, I'm trying to.
I think that's so complicated,is that it's kind of like, well,
what can you considerreinforcing?
You know, because you could saythat me working on my thesis
constantly was enabling, becauseit left him to his own devices
(22:57):
all the time and, you know,allowed him to do his first
choice activity, which was drugs.
But would you really really saythat's his first choice
activity, which was drugs, butwould you really really say
that's enabled?
You know what I mean.
Like I, that I'm not likedirectly making it, like I'm not
necessarily directlyreinforcing it, um, you know, I
(23:18):
mean I suppose, like he, I wouldsay, had an alcohol problem
maybe, um, and we had a bit of aparty house, you know, and so
you could say that me, um,participating in the very like
social events that we had, maybelike reinforced it, um, um,
(23:47):
yeah, I don't know.
Dr. Kibby McMahon (24:13):
I've been hearing, especially like
partners or parents of peoplewith severe addiction that maybe
, or like emotion dysregulationthat ended up in the hospital
and they'll be like they'll sayto themselves, like did I do
this?
Is this my fault?
Oh, I should have taken awaythe bottle.
Or like I shouldn't have donethat, right, they really want to
blame themselves, just becauseit feels like there's something
that they can do and they couldhave done differently.
But, as you're highlighting,like it's, these behaviors are
(24:37):
being reinforced by a bunch ofstuff, not just you, right, like
even in that picture of himdrinking and other stuff, he,
you know it would be.
What's probably reinforcing arethe feelings that he got right,
like the good feelings ofgetting drunk or high, having
fun with friends, like beingseen as social, being seen as
(25:01):
fun, probably decrease in socialanxiety and then you, you know,
got to enjoy that partyatmosphere, right.
So there's like severaldifferent things that are
reinforcing there and maybe ifyou had done anything
differently, it wouldn't havechanged, like the equation of
how much is being reinforced,right, you know.
Dr. Jacqueline Trumbull (25:23):
I mean, I think that's the problem, you
know, like he wasn't interestedin changing.
And so you know, like with mysister it was clear she was an
alcoholic and it was clear shewas destroying her life and her
husband's choice to keep up thealcoholic environment was quite
(25:46):
questionable because she wasvery clearly suffering.
Um, she was very clearlyputting a lot of things at risk
and it was very dangerous and hehated it.
Um, it's, you know, with my exlike he didn't really have an
interest in changing and itwasn't actually clear that there
(26:08):
were massive consequences tothe drinking.
And so it can kind of beunclear when to say I am going
to tell you that you have aproblem and I'm going to change
my behavior to no longerreinforce you when you are
actually not interested in doingthat.
I'm not saying that that's awrong thing to do, it's just,
(26:29):
that's just another complicationthat that's a wrong thing to do
.
Dr. Kibby McMahon (26:34):
It's just, that's just another complication
, yeah, yeah, and I think that'sthe tough part, because we
ideally would love for yourpreferences and your feelings to
matter a lot, and sometimesthey do, um, sometimes they
don't, and that that's a reallypainful reality.
When you go up to your lovedone partner, whatever, and say
reality.
When you go up to your lovedone partner, whatever, and say,
(26:54):
hey, you know you're, you'regetting highs, like I would like
you to stop, it's getting to bea problem.
I'm really worried, blah, blah,blah.
And for that it's kind ofadding punishment, it's adding
that negative Like I feel bad, I, I'm going to, I'm upset with
you because you're doing this.
So they go.
Oh okay, you know, it would benice if your feelings would be
(27:16):
the thing that they go.
You know what?
I'm not going to.
I'm not going to.
I don't want her to be upset.
I'm going to stop this.
Dr. Jacqueline Trumbull (27:21):
Yeah, it wouldn't be nice.
And I mean, I think the otherlike paradox is that sometimes
you getting upset with them justdrives them to the behavior
more, because now they feelnegative and so they go for
their avoidance, calledsubstitute avoidance.
They substitute their badfeelings with something that
will hurt the bad feelings,right?
So you know he drank a lot morewhen we fought, you know?
(27:44):
So it's not like.
It's not like expressing myselfworked.
Dr. Kibby McMahon (27:51):
Yeah, yeah, and, and it might even be like a
little bit of a rebellion tolike a little bit of a power,
right, if I tell you, no, youknow, I say you know, don't
drink.
Oh well, if I stopped drinking,like basically I'm just saying
yes to whatever you want, right,like sometimes my accent became
like I would talk to him aboutjob and it'd be like, oh well,
(28:12):
I'm not going to be a doctorjust because you want, I'm like
what?
So just, sometimes it's, it's alittle bit of a power struggle
when you, when you have to talkof, like you know, your behavior
is bad or whatever yeah, I meanit's different for different
things.
Dr. Jacqueline Trumbull (28:29):
Right, like alcohol.
I mean it's different fordifferent things right, Like
alcohol, if somebody is actuallyinterested in changing.
I think that conversationaround enabling is different.
So, like you know, with PTSD um, I ran like a family group for
a hot second and one of thethings was talking about to
(28:52):
spouses and you know, in ourcase they were.
They're all women because mostveterans are men, so the spouses
, we don't really think women.
Um, and it was mainly talkingabout, like, how their spouses
were going to want to avoid,like avoid traumas, and one of
the things we would suggest ishaving a talk with them about
(29:14):
coping ahead, like look, youknow, I'm unwilling to let our
lives shrink to the size of apea because of your avoidance,
and I know that you know you'restruggling with this too.
So let's, you know, let's planto go and do some of these
things that we've been avoiding,but we don't have to like go in
with our fingers crossed.
(29:35):
We can go in with a plan, youknow, like what can we do if you
get anxious?
What can we do if there's aloud noise?
Is there a signal you can getme that says that you're
overwhelmed and you need to takea break?
You know, is there a code wordwe can use when you really
actually have to get out, likefor real, this time, you know,
(29:55):
um, what kinds of skills can weuse if the anxiety goes up?
So all of these things can bedone and it's a great approach.
Dr. Kibby McMahon (30:03):
It's just that it it entails cooperation,
yeah, yeah yeah, and entailshaving to, uh, be on a team and
being on the same page with,like um, you know what, what
you're describing as shaping.
It's like we're doing a little,we're we're.
It's not all or nothing, it'snot like I'm staying home
forever or I'm going out to likeconcerts all the time, but it's
(30:27):
like, okay, can we, can we trygoing to these places and then
having ways that I could signalthat I need to take a step, step
back right, so right, or that'swhat I got from that.
Dr. Jacqueline Trumbull (30:38):
It's like baby steps, baby steps
towards um opening up your lifea little bit more yeah, I mean,
if you're gonna think aboutpushing your kid in a pool, it
can be helpful to discuss itwith them maybe not a child, but
like, if you're about to gointo something terrifying, then
it's usually going to feelbetter if you have somebody say
(30:58):
like okay, like let's, let'stalk about what it's going to be
like when you, when youremotions get really big because
they're going to yeah they'revery likely to, and I'll jump in
.
It doesn't mean that you have tosplash around in the pool
drowning until you're dead.
Right, like there are thingsthat we can do.
Addiction is just so hardbecause it's so.
(31:20):
It serves such a strong purposeand and it rewires your brain,
you know.
So it's so tough because you'reyou're fighting in two battles
or more, and so it's it's likemaybe sort of less likely that
(31:40):
you're going to get thatcollaboration.
That's obviously many, manypeople who are addicted want to
get better and will collaborate.
But it's just a really it's anuphill battle and I think
especially in the stages wherethey're in that
pre-contemplation mode, they'renot really sure that they are
want to admit that they have aproblem or want to change.
Then there's a lot ofdefensiveness and lying that
comes up around it.
Dr. Kibby McMahon (32:01):
Yeah, yeah, it's, it's.
It's kind of relieving and sadto hear that addiction and the
substances I mean they rewire,like.
When we talk aboutreinforcement, we're talking
about the reward system.
How do we do stuff and then geta reward and what does that
feel like?
And keep going right andsubstances change all that they
(32:22):
make.
It hijacks the brain so thatyou just want that reinforcement
of the drug, you just want thatlike it's.
It's like almost tunnel visionand so your partner, your loved
ones, like please, for you know,get help, and stuff like that
kind of like fade in thedistance and they may want to
(32:44):
make you happy, they might besad that they're making, they're
hurting you, but their brain islike I have to, the only reward
that matters is getting highyeah, yeah, I know it's such a
tough one.
Dr. Jacqueline Trumbull (32:57):
I mean it looked like I've, I've.
It's hard to think.
There's so many times when mysister, during her quote-unquote
sobriety, has been like askedme for just a sip of my drink,
um, like at family functions orwhatever.
It's really, it's really hardto be like no, oh I've given in.
Dr. Kibby McMahon (33:20):
Yeah, I don't think there's any good way, you
know.
No, you know, be the keeper ofher sobriety, I mean.
Dr. Jacqueline Trumbull (33:26):
But yeah, oh, that's tricky, it's so
tricky yeah, I'm trying tothink if anything from like mi
can be helpful.
Um, you know, I think, liketrying to resist power struggles
is is going to be helpful.
(33:47):
There's like there's an, youknow, an element of dropping the
rope and just trying to reflecttheir own motivation for things
to change without trying to.
There's something called thewriting reflex where, if they
take a position, anybody who'strying to get better but isn't
(34:13):
anybody who's trying to getbetter but isn't is struggling
with ambivalence.
Typically, when people arecompletely committed to
something, the needle will move,unless it's completely out of
their control.
Right?
But you know, often when we'redealing with this ambivalence,
you know I might talk on hereall the time about how I want to
lose 10 pounds.
(34:33):
If I were fully committed tothat, I would probably have lost
10 pounds, because there are alot of ways to go about that.
But the fact is I'm actuallyambivalent because of the
behavior change it would take.
It would mean me drinking less,eating less, eating different
foods, uh, moving more, doingthings I don't like, and so the
problem is that ambivalencemeans you're basically like
(34:54):
teetering on a seesaw, and ifyou, as the loved one, come in
and step on one end of theseesaw by taking a certain
position, especially a firmposition, then they will run on
over to the other side of theseesaw because that maintains
(35:15):
the ambivalence.
We've got both arguments beingstated out loud and I think that
this is a problem that lovedones run into because they're
like well, I have to make andyou know, sometimes you do have
to make your position no, youknow, you do have to say like I
need you to get sober, so I'mgonna work.
(35:36):
But convincing them is usuallygoing to backfire so make them
more stubborn on the other side,yeah yeah so instead you know
trying to have like an exploringmindset of you know like okay,
well, what does alcohol do foryou?
(35:57):
You know like what, what haveyou noticed about it?
And they'll say some goodthings.
But then you know, I might saysome bad things too.
And you can even say somethinglike well, how you know?
Like, how confident are youthat you can change this?
And if they're like well, alittle bit, but not really, you
can even say like well, okay,why, but why didn't you say
(36:18):
you're not at all confident?
You know what makes you alittle bit confident.
Oftentimes what we want to sayis like why aren't you
completely confident?
And that's when they're goingto start coming in with saying
well, because it's really hardand I don't know if I want to
and I don't have to make bigchanges.
I don't really want to make.
But if you, if you can, if youcould actually say you know well
(36:39):
, why aren't you actually lessconfident?
Then it gives them a chance tosay well, you know, I've done
hard things in the past and I'vebeen able to go a few days
without alcohol, and you know.
So there are some likemotivational interviewing
techniques you can do, butgenerally, you know, trying to
like have an a curious kind oflike open stance for them to
(37:00):
explore their ambivalence, but,like you know, trying to help
them give voice to their reasonsfor change is helpful, but it's
kind of a you know it takeslike a lot of finesse.
I mean, I'm not sure that I, Idon't, I don't have it down as a
therapist.
Dr. Kibby McMahon (37:20):
But at least avoiding certain traps can be
helpful.
Yeah, yeah, that's hard for theloved one who has, like you
know, skin in the game.
Right, it's like as a therapist, it's a little easier to be.
Like why would you want to quitdrinking, why would you want to
keep drinking?
But the wife was likeeverything is bad when you drink
.
It's a little harder to be thatneutral.
But even when you just saidwhat are the reasons for
(37:42):
changing, that is something thatchanging, enabling or
reinforcement patterns might do.
I think that when you're a lovedone, you're of someone with we
keep talking about addiction andyou know we, we can talk about
the supplies across the mental,mental illnesses, but if you're
a loved one and go well, I'mgoing to have to just wait till
(38:06):
they hit rock bottom.
Right, that's like kind of this, the old method of, like you
know, take away your health,take away support, let them fall
right, let them feel how badthings are, and then that would
make them want to change.
And it's true, the reason whypeople change either get therapy
or quit substance, whatever isbecause that the the cons
(38:34):
outweigh the pluses.
Right, it's no longer beingreinforced as strongly, right,
because it's costing so much,right, you might get a little
high, but then your whole lifeis a mess, right, and especially
when that person is sacrificingthe things that really matter
to them, which is infuriatingfor a loved one.
Because if I'm like, I reallywant a supportive partner who
(38:57):
contributes to the bills, likethat matters to me, not to him.
Like he, he cared about otherthings, right, which is why we
broke up, but um, he, just whatwould have tipped the scales
into motivating him or anyoneelse it would be if he was like,
(39:17):
oh, the things that I love todo I couldn't do, right, like,
sometimes, you know, the thingthat would get through to him
was I.
He hid from his friends a lot.
He like literally didn't seethem, didn't tell them what's
going on and withdrew, and hewas a very social guy.
So sacrificing his connectionto the community, his friends,
was really hard.
(39:38):
Um and that was way moremotivating than, like me, being
mad, right.
So I think when when we'retalking about, like you know,
having a conversation of whatare your reasons for changing,
you can add to that feeling, tothat by you don't have to let
them do rock bottom right.
You can add to that feeling, tothat by you don't have to let
them do rock bottom right.
You don't have to like takeaway everything until it's
(39:59):
dangerous, but you can take awaysome of the good stuff that you
unintentionally add to theproblematic behavior.
Right Like walking away ortaking a time out or I know that
we in craft are learning how tolike figuring out what to
change, what reinforces tochange, adding reinforcement to
(40:24):
healthy behaviors when they'resober or healthy, and then
withdrawing or taking time outfrom reinforcing unhealthy
behaviors.
For example, like just addingcompliments, acknowledging their
efforts, spending quality timewith them doing something that
they love.
Right Like easy, cheap, funthings that you can do that you
(40:47):
can add in right away.
You see them come home fromtheir night out with their
friends, sober, no-transcript,healthy behaviors that when
(41:22):
they're sober, or whatever youwant, yeah yeah I mean figuring
out how to let them experiencethe consequence, the natural
consequences, of their behavior,in ways that are not actively
dangerous, I suppose.
Dr. Jacqueline Trumbull (41:37):
But I like that idea of putting more
marbles in the incentive tochange column and removing them
from the incentives to stay thesame column to stay the same
column.
Dr. Kibby McMahon (41:57):
Yeah, I think of it like this, with the with,
you know, reinforcement, orenabling, where, if we're like,
oh, did we make them drink ornot drink do we?
How much power and control dowe have?
It's like I said this in theclient community.
I said, um, let's say you'rewalking with your loved one,
you're hiking in a forest, forsome, reason.
And you really want them to goleft.
(42:17):
You think that going right isreally dangerous.
So I'm going to clear the path,I'm going to chop down the
trees and remove the rocks,maybe pave the way, maybe look
at that nice view.
And then I say, hey, you know,I think that the left path is
like really nice.
And then I say, hey, you know,I think that the left path is
like really nice.
And then you let them choose.
(42:39):
You let them go left or right.
Well, I'm making it easier, I'mreinforcing the left, but they
have a choice.
Right, they might think thatthe right has so many cool
things over there that's goingto totally outweigh your nice
paved road.
And you might be like, wait,but you're going to get hurt in
the right side.
And they could choose.
(42:59):
They could choose Do they likeyour lovely path?
Or they could choose the rightpath, the right right, not the
correct one, the right one.
But that's how I think about it.
It's like making the path alittle nicer on the side that
you want them to go.
Dr. Jacqueline Trumbull (43:12):
Yeah, yeah, oh God, I mean I also.
Just part of me is like if youknow, if you don't want to do
this, then that's okay too.
Yeah, because one of thenatural consequences of that
behavior might be losing you,and that sucks.
Dr. Kibby McMahon (43:29):
Yeah, I, we talk about how don't throw
around ultimatums.
I mean the important part ofall this reinforcing like, let's
say, you take away thereinforcer on the unhealthy
behavior, add it to the healthybehavior and that's like a
boundary or that's you just likechanging your behavior the
(43:49):
important part is to be reallyconsistent, right, like,
reinforce the good stuffconsistently, don't reinforce
the best of consistently.
But people don't always followthrough right and they go.
I'm gonna leave you if we'redone, if you're gonna be, if
this is gonna happen and we'redone.
And then, unless it's real,unless you're saying like from a
(44:10):
real like, I'm gonna let youknow that I this is
unsustainable.
If this keeps going on, I'mgoing to have to, you know, take
space or like I'm going to haveto leave.
That's different than using theultimatum to like control their
behavior out of fear, right?
Dr. Jacqueline Trumbull (44:25):
So so many times, I mean in multiple
relationships.
You know um and um.
It's tough because as soon asyou threaten to leave but don't,
then they're they actually getreinforced to keep doing the
stuff that they're doing becausethey've learned that you're not
(44:48):
serious.
But the thing is you actuallymight be pretty fucking serious
and it's just that they wereable to reel you back in that
one time and so that, like in mycase, you know, I made that
threat many times and I I meantit, but the more times I didn't
go through with it.
He was like she doesn't reallyneed it, yeah, until one day,
(45:14):
you know, he called the wrongbluff.
Dr. Kibby McMahon (45:20):
Yeah, I've been there too.
It's tricky.
All this like boundaries andchanging reinforcement is really
tough when that person does ahealthy behavior and behaves and
listens, just enough for you tobe like, ah, good, right, like
my ex would start pulling upthose tabs, those job, the job
(45:41):
search tabs, and then I'd belike, okay, good.
And then we'd go back, I'dstill pay for things, because
I'm like, okay, I'm, you know,we're on the way out of this
hole, right.
But then, and for you, you, youknow, there might be an apology,
there might be a makeup, theremight be some closeness, right.
And then you might be like, oh,okay, good, the bad stuff is
over.
And then they do it again,right.
(46:04):
And then you're like, oh, whydidn't I just leave?
I knew this would happen, butyou gotta have some forgiveness
for when you have hope and whenyou believe in them and believe
that things change.
But I guess then you might haveto change the reinforcement to
seeing sustained changes, right,that was the thing that I
(46:24):
messed up on, where you know youcould reinforce like, oh, yeah,
they're trying, they're doingit.
But then I'm going to reallyreinforce you if you keep this
up for six months, if you staysober for longer than just like
a week, you know.
Dr. Jacqueline Trumbull (46:39):
Yeah, you didn't mess up on anything,
though, because you were in amarriage and it was his job to
respect his wife's wishes.
I'm just saying that because Idon't want you or anybody else
to feel like, if they aren't,you know perfectly reinforcing
their partner or whoever, thatthey're messing it up, right?
(47:02):
I mean, ultimately, it's likethis is we do what we can, and
if we want to put in the work totry to change their behavior,
then, like, we try and we giveit an effort, but it's not our
disease, it's not our disorder,um, and they have to be the one
who wants it enough, and all wecan do is try to make them want
(47:26):
it a little bit more throughsneaky means, I guess yeah I
also have been thinking aboutthis more with um.
Dr. Kibby McMahon (47:34):
It it comes up with addiction, but it's also
when someone's depressed oravoidant in general.
There's there.
There seems to be like talkingto all these loved ones through
Cool of Mind.
There seems to be this feelingof like um, my, my, my loved one
with an illness is like a baby,like hasn't grown up right.
(47:54):
There's something quitereinforcing to being completely
incapacitated to be completelydrunk, to be completely so
depressed.
You can't get out of bed andthe loved one takes on like a
parental caretaker role right.
And so everyone's upset, likeeven the person with the illness
is like embarrassed thatthey're living with their mom's
house or you know not, not youknow getting up and getting a
(48:17):
job.
However, the urge to be takencare of like a baby might be so
strong, especially when, like,you're going through something
hard, that that that could justbe reinforcing right.
Even if you're arguing andupset, it still kind of feels
like you're being like likesometimes, like there's so much
(48:40):
psychoanalysis that could bedone.
Like drinking a bottle you knowwhat I mean.
Like you're drinking, it's apoint where you're like you're
being taken care of by a mommy.
Right, there's something soreinforcing about like being
mommied.
Dr. Jacqueline Trumbull (49:00):
Well, I think that's why sometimes
enabling can actually be adevious and insidious behavior
that is done on purpose.
I've seen multiple men takeadvantage of my sister in this
way, like you know, making hermore vulnerable, setting her up
to be more vulnerable, becausewhen she's more vulnerable, they
have more power yeah, andthat's extremely scary to watch.
Um, and you know so, if youfeel as though somebody in your
life is enabling you not becauseit's just too difficult or
(49:25):
confusing for them to fight tobattle your disorder, but
because they're actually puttingyou in situations to weaken you
, like by removing your supportsystems, like by giving you like
a lot of, maybe, love andattention when you're
incapacitated, maybe by removingyour financial means, always
(49:54):
being the one who wants torescue right?
Like, I think it's justsomething to think about.
You know, like, is your, isyour disorder really putting you
at relational risk and issomebody manipulating that?
Dr. Kibby McMahon (50:07):
Yeah, yeah.
It's just like such a familysystems approach and all the
stuff that we talk about abouthow mental illness and addiction
aren't just one personillnesses.
It's like the system is sick.
The disease is in the system.
How do you get care?
How do you get attention foryour pain?
What does someone like to do tofeel valuable and helpful in
(50:30):
your life and take care of you?
Right, feel valuable andhelpful in your life and take
care of you, Right, Like, um, I,you know, I will admit that I
that there was somethingreinforcing to me about being
the one who can fix everything,who can handle it all.
Right, there was something likethat was part of my identity,
is like, well, I have a husbandwho's you know like not working
and I have to do everythingmyself.
(50:51):
Like, really, there wassomething about it that felt I
wouldn't say good, but it feltpurposeful or it felt like it
was something.
Dr. Jacqueline Trumbull (51:06):
I don't know.
Yeah, it's tough becausesometimes your person, your
loved one, will, you know, willpull for your affection,
attention that can make you feelimportant and valuable.
You just want to make sureyou're not getting high on that,
because it really shouldn't bea good thing if your partner or
(51:32):
whoever is incapacitated in someway yeah and you know if that's
a time when you feel mostconnected to them.
But that's something to examine.
It might not mean something.
Is, you know, psycho in you?
It.
It might mean that, like youcome from a background where it
was really hard to get softnessand attention and your loved one
giving that to you when they'remost vulnerable feels like the
(51:55):
only way you can get it.
You know, I mean that's likethat's very valid, but it set
both of you up for misery it'snot interesting.
Dr. Kibby McMahon (52:06):
We're talking about like reinforcing, like
drinking or mental health, youknow, or unhealthy behaviors,
but it's like now we're talkingabout reinforcing for us, right,
like what's reinforcing in thisdynamic?
Interesting yeah.
Dr. Jacqueline Trumbull (52:20):
Well, I mean because I think, because
we've talked about, I mean,enabling is such a it's such a
wide behavioral, you know,paradigm or whatever, like it
can include so many just benignthings, but sometimes it is on
purpose and sometimes it's notnecessarily on purpose, but it
is clearly problematic.
(52:40):
I mean, all of the times weenable it's because it does
something for us, right, like ifit didn't do something for us
we wouldn't be doing it.
And so usually what it's doingfor us is helping us avoid
conflict or avoiding a headacheor something.
Dr. Kibby McMahon (52:56):
but sometimes like reducing their distress,
right, like keeping therelationship, like preventing
them from leaving you, or evenjust like avoiding danger.
I mean, I will say that thewhole rock bot like let your
loved one hit rock bottom andwithdraw all your support really
got questioned as less popularwhen the opioid crisis has swept
(53:20):
the nation.
Right, because with alcohol, ifyou cut off contact, stop
paying the bills.
Like let them live on thestreets, like maybe they'll be
okay.
With opioid addiction, youstepping away and letting them
experience a consequence as well, it's really deadly.
Yeah, I mean, I think it is alladdiction.
Dr. Jacqueline Trumbull (53:40):
I mean, how many rock bottoms has my
sister hit at this point?
She lost her marriage, she losther kids, she lost her job, she
lost her medical license.
All she has to do is slam hercar into another car and she's
dead or suicide, right.
I mean, I've had theseconversations with her too.
So it is very, very scary.
Dr. Kibby McMahon (53:57):
Yeah to to let them hit rock bottom, and
maybe it is better to driveyourself crazy trying to keep
them from that than to to letthat happen yeah I'm not gonna
make a call on that, you knowlike yeah, in craft they say you
know if it's really going torisk their safety or your safety
, don't do it.
Um try, try changing other waysof reinforcing, like adding
(54:20):
more good stuff to when they'resober and I know that's hard,
but it may point your brain toseeing other things that you can
control besides the big thing,right Besides, for, like, should
I pay for their rent or leavethem homeless?
It's like, well, maybe that'snot the thing that you change
right now, cause that would betoo risky and too uncomfortable.
(54:43):
Maybe do other things likequality time, compliments, um
some other kind of reward in themeantime.
But it's tough.
Dr. Jacqueline Trumbull (54:52):
Yeah, there's no, there's no right
answer, unfortunately it's justI.
But it's tough.
Yeah, there's no, there's noright answer, unfortunately it's
just.
I think it's something to kindof explore and think about and
try to get some I don't knowsome perspective on.
Like I think a lot of timesit's very hard for people to set
boundaries and they feel likethey're hurting other people
when they do it, but sometimesit's the best thing you can do
for another person and foryourself.
(55:12):
So it's definitely a long gameand it entails some short-term
discomfort.
That's very legit, all right.
Well, guys, if you want toenable us to keep doing this
podcast, you know what to do.
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Hey guys, welcome to A Little Help
for Our Friends, the podcast forpeople with loved ones
struggling with mental health.
Hey Little Helpers, welcomeback.
Today we are going to do atopic that I think can sometimes
have like a pejorativeconnotation, but so many of us
(00:21):
do it kind of from a good place,and that is enabling.
Um, enabling can look reallydifferent, I think, depending on
what the disorder is and whereit comes from, but, um, kibbe's
actually been doing a trainingon this, so she's got a lot to
share.
It's also something that we'vetalked about at the va in
reference to, like you know,spouses or or loved ones of
(00:46):
people with PTSD.
So, kibbe, this is superrelevant to Cool Mind, so tell
us about what you've got goingon and then explain to us what
enabling is.
Dr. Kibby McMahon (00:55):
Yeah, just for any of you who have loved
ones with addiction or otherkinds of mental health symptoms
and you kind of feel like you'restuck in negative cycles, like
you don't really know how tohelp without making it worse,
and maybe you are overextendingyourself, you're burning out and
you want to change but have ahard time figuring out how cool
(01:18):
a mind is.
We've been talking about it,it's been.
It's been so great so far.
I've really loved it.
It's our community and supportplatform for people with mental
health and addiction issues andtheir loved ones.
So basically, what we're doingnow is that we're learning how
to set boundaries, how toidentify boundaries, how to
identify when we're enabling wecall it something else, but
(01:40):
we'll get to that in a littlebit and then how to actually set
boundaries that stick.
So, for example, we're doingthat now and all of our
community members are workingtogether, sharing what struggles
and patterns that they're stuckin, and we're all supporting
each other and learning how tobreak free from those unhealthy
habits.
So if that sounds likesomething that you'd be
(02:01):
interested in, just go tocoolamindcom, k-u-l-a-m-i-n-dcom
or the link in the show notes.
Amazing Well, how would youdefine enabling?
Yeah, so I'm also forbackground, I'm also doing a
training right now on craft,community reinforcement and
(02:21):
family training craft yeah,that's right Specifically for
loved ones of people withaddiction, and so we're really
talking a lot about this and theword enabling is so common, but
it is.
It's pretty negative, as youwere saying, because it makes it
seem like, um, you know, it'skind of mixed in with the words
codependent or it kind of soundslike you're causing or helping
(02:49):
your loved one be addicted, soit really has kind of like a
blamey and judgy word, right.
Dr. Jacqueline Trumbull (02:57):
Some people do it on purpose to gain
control, but the vast majorityof people do it for
well-intentioned reasons.
Dr. Kibby McMahon (03:03):
Yeah, the other words for it in the OCD
world is called accommodationand in general it just describes
actions that loved ones take tomaybe solve a problem in the
short term or relieve distress,like make things easier in the
(03:23):
short term but actually make theaddiction or other mental
health symptoms more likely.
Sometimes we also say thatenabling is doing an action that
makes it easier for the lovedone to drink or avoid something
hard that actually maintainstheir disorder in the long run.
So, as you were saying, it'sreally coming from
(03:44):
well-intentioned places.
Right, and it's so easy fromthe outside to be like don't
help your loved one drink.
That's crazy.
Why would you do that?
Right, that's the thing that'scausing you and them pain.
But in the moment when you'rewith your husband and he is so
drunk and so sick and you'rejust like, oh my God, my kids
(04:08):
are going to be upset.
You know this is going to be amess, he's going to hurt himself
, so I'll just clean up afterhim, I'll take off his shoes,
I'll put him into bed and maybeI'll even call his boss in the
morning and say that he's notfeeling well and I'll tell the
kids it's okay.
You know this is not, you know,daddy's just not feeling well,
right?
So all of all of those kind ofbehaviors are just to try to
(04:31):
make the situation better.
But what it might actually dois one add some kind of
reinforcement, and we'll talkabout that, but add some kind of
reward or good thing around thedrinking behavior and it also
shields them from theconsequences of their actions,
right?
Dr. Jacqueline Trumbull (04:50):
yeah, yeah, I mean, I've seen nailing
come in a lot of different forms.
So, like you know, with, like,when my sister was married, her
husband like refused to removethe alcohol from the house and
was like actively drinkingaround her, and that's a form of
(05:11):
enabling.
But on the other hand, I've had, like I know a couple where, um
, they're both doctors the samekind of doctor and they work in
the same hospital, and she wouldget wasted while on call and he
would have to take her call,meaning like when she was at
home, not while she was at work.
(05:31):
Well, yeah, yeah, and he wouldhave to take her call.
Technically that's enabling,because it'll it reinforces her
ability to say well, anytime I'moverwhelmed, I'll just get
drunk, because I know that myhusband is capable of taking
this over.
Um, but it's hard to say thathe's in the wrong, because it's
(05:51):
not like he wants her to loseher livelihood.
Dr. Kibby McMahon (05:53):
They're married, you know or he doesn't
want those patients to gowithout help, right, there's
like so many totally reasonablereasons why he would do that.
Um, I enabled so much and youknow it really does.
Let's, let's, let's actuallyshift the word to the word that
we prefer which isunintentionally reinforced I
(06:15):
know that's actually more of amouthful, but I think it it
takes enabling sounds so likeyou did it and unintentionally
reinforced.
It's like I accidentally, youknow, I don't know, you know,
made it easier or made it better, right, I remember, oh, there's
(06:37):
so many.
Even I'm just like looking backon what I did and it's like so
shameful.
One of the bigger ways I enabledmy ex-husband was I completely
shielded him from, I protectedhim from the consequences of not
working.
(06:57):
I mean, I blame myself a lotfor it and got caught in the
cycle, and it's crazy because,if there you might, it's a weird
thing to feel like that you aremaking it easier for people to
do the thing that hurts you themost or that you're most
frustrated with.
So you're like, oh, it's myfault, I'm not my own worst
enemy, but don't they have achoice?
Right, and um, I've talkedabout this before in previous
(07:18):
episodes, but my ex-husbanddecided to stop working and find
himself.
But finding himself usuallymeant smoking weed in our
basement for a day and likedreaming about the things that
he wants to do, and then openingup tabs of job applications.
Um, and I know that because I'dbe like are you looking for a
(07:39):
job?
He's like, yeah, I have so manytabs open.
So I was was like, oh, here yougo, done Um, just accept the
offers as I come in.
But, um, he, he would then getanxious and then he would smoke
and and in normal life andnormal world, um, that wouldn't
(08:00):
work right, like if he goeswithout a job for too long, he's
not going to have a house, he'snot going to have food, he's
going to have to figure it outand go through the discomfort
and anxiety of I have to applyfor a job.
It's not going to be great, youknow, go through all that
hardship.
And yet I was still paying thebills.
Right, I was still.
I didn't kick him out, I wasstill paying our house bills.
(08:27):
I mean it was weird because itfelt like I'm just paying for
the house bills that I alwaysdid and he just like moved in
and benefited for that.
So it didn't feel like I wasdoing, adding anything.
I was just frustrated by hispresence and how he was
responding to it, but it wasunintentionally reinforcing,
right.
It's like he didn't.
He felt the anxiety of oh no, Ihave to look for a job and I,
(08:48):
you know, don't know where tostart.
I feel ashamed, I feel lost,anxiety, anxiety oh phew, weed
makes me feel better.
And then I could go a couplemore weeks like that and just
pretend that you know this is afuture me problem and there's no
consequence.
Dr. Jacqueline Trumbull (09:06):
Right, there's no, except the
consequence was just me beingupset, which is probably just
wasn't, as strong as feelingreally yeah, no I think what I'm
struggling with with you knowyou saying that you feel shame
around this and you know youshouldn't have done these things
.
It's like I don't know how toput this exactly but at what
(09:29):
point do we need to step in andbe our partner's therapist, like
, be our partner's behavioralplans?
Um, you know it's, it's a bitunfair on the partner now.
Now, now, fairness doesn'treally matter, right, because
you have to do what's effectiveif you want to get ahead, like
fairness.
But I think it is hard to knowwhen it's really on you to
(09:55):
basically say you know I need totake away my support or I need
to figure out how to let youfeel the natural consequences of
your behavior, because youwon't do it, because caring
about me and what I want isn'tenough, like that's a hard
(10:15):
choice to make yeah, I mean.
Dr. Kibby McMahon (10:21):
I think that I mean this is what we're doing
at Cool of Mine right now isidentifying those when, when
you're like, oh okay, I'm, I'm,I'm at capacity, because
sometimes these patterns happengradually and then suddenly
you're stuck Right and thensuddenly you're like, oh my gosh
, I think I'm even making itworse and it is tough to then
(10:45):
change right.
Then it's tough to be like waita minute, I was okay paying
your bills before and now I'mnot right.
It's just like a weird thing tointroduce.
And before I go further and Ijust want to clarify for people
who don't know, when we sayreinforce, that basically means
that a reinforcement is anythingthat makes a behavior more
(11:07):
likely, and this is in humans,this is in animals, this is in
all sorts of things.
But it's like whatever ismaking the thing do something
more in the future.
It could be negative.
Positive reinforcement, whichis a reward, like they get money
, they get treats, they get agood feeling, they get attention
, they get, you know, love.
(11:27):
Like that you get somethinggood or negative reinforcement
means taking away something badanxiety relief, relief of
responsibilities, right?
Or you know that beeping noisewhen you don't put on your
seatbelt and then, as soon asyou put on your seatbelt, it
turns off, right.
So it's just adding, you know,like either something good or
(11:52):
less bad, and that makes thebehavior more likely.
And, as I was saying, that couldchange over time.
Right, I might've been okaywith paying the bills for the
first few months and then, afterfour years, you know, my
boundaries have changed, mylimits have changed, so, but I
don't know.
I think I, I really I was inthat position.
(12:15):
I was desperate for someoneelse to come in and say this is
wrong.
Um, I wanted I get in mydeepest fantasies.
I wanted someone to recognizelike me as a hero, like oh,
kibbe's doing this anyway andyou're taking advantage of it,
or you know you should make adifferent choice and get a job,
(12:37):
right.
So I that's what I fantasizedthat someone would see how I
feel like I was enabling, andyet I felt powerless to break
out of it.
Dr. Jacqueline Trumbull (12:49):
Right, well, I mean it often confers a
negative outcome in the shortterm on the partner who has to
stop enabling I mean like one, Imean like in the example I gave
about the two doctors right,like he's, he's risking one half
(13:09):
of his family's income there.
A lot of times it's risking thewrath of your partner.
It may be, you know, you haveto stop drinking yourself or you
have to change your socialworld and, like the way that
you've always operated becauseyou don't want you know your
behavior to like enable yourpartners In the world of PTSD.
(13:31):
A lot of times enabling lookslike you know the person with
PTSD is going to want to startavoiding a lot of things
Avoiding going out, avoidingcrowds, avoiding a lot of noises
and that's actually it's reallyfrustrating for the partner
because they want to be livingtheir lives right, but in order
(13:54):
to, in order to not enable, itfeels like they have to like I
just put up a huge fight, likedrag their partner to this thing
and then watch them be scaredand uncomfortable and angry.
You know that's a lot to ask ofa person.
Dr. Kibby McMahon (14:11):
Yeah, I mean going through not enabling, like
stopping the enabling, likethat could lead to so much
headache, so much argument, somuch like distress and chaos
that you know, people might justbe like I just, I just don't
want to deal with that, like Ijust don't have the strength.
I'll just, you know, make thiseasier and do it.
(14:32):
I mean to that point.
I remember when, before my exand I lived together, um, he was
finishing his residency, um, uh, and got in trouble and they
were punishing him and they said, you know, you might not be
(14:52):
able to get your license as adoctor.
And he had called me up andsaid I, you know so upset, like,
oh, how could they do this?
This is so terrible, I feel sobad.
But you know, so upset, like,oh, how could they do this?
This is so terrible, I feel sobad.
But you know what I don't makesme think that I don't want to
be a doctor after all.
I just want to find myself and,you know, do other things.
(15:14):
And I remember, um, he was goingto move into my house and we
had made an agreement Like Italked about this explicitly
that we would split the bills,we would split the contributions
.
And I remember at the time whenwe had that conversation, he
was like why would you even, whywould you even question that
I'm going to be a doctor?
Like how could you even thinkthat I wouldn't contribute?
(15:35):
I probably would contributewhatever.
And then when he was like I'mgoing to, I'm going to leave
medicine, I don't want to be adoctor, I'm going to do medicine
, I don't want to be a doctor,I'm going to do something else,
I was like oh, okay, well, Ilike what, what are you going to
do for a job?
Because you have to get a jobwhen you come here like or you
gotta, you know, carry your ownweight.
(15:55):
And he was like how could youdo this to me?
No, I, I have you not heard me?
I need to figure it out.
Don't pressure me to be adoctor.
And I was like, okay, well then, maybe we shouldn't move in
together.
And that caused so much fightsthat eventually I was like okay,
we can't move in together, wecan't.
I don't know if we could followthrough this relationship.
(16:15):
And he spent three days callingme, crying, screaming at me,
being like I can't believe youdid this to me, you're
abandoning me at the worst time.
Um, he was like you're abusive,like, just because I won't, I
don't not going to be a doctor,you, you know, you're taking
everything away.
How can you do this?
(16:36):
And I mean, I felt awful, likeI, I just felt, I was like I
felt so guilty and I was likeyou're right, he's right.
Like what, what's the harm inletting him hang out and live
with me while we can continueour relationship and he could
figure himself out?
You know, like what?
What am I being a stickler for?
Dr. Jacqueline Trumbull (16:57):
I guess I had a reason?
Dr. Kibby McMahon (16:58):
because, yeah , because I, you know, he moved
in, didn't get a job for betterpart of four years and it drove
me nuts when, especially olderpeople.
But people were like, well,what do you expect?
You didn't make him get a job,you let him stay at your house
and let him move in without ajob and without paying the bills
(17:21):
.
And I was like, okay, so Ieither, you know, risk our
relationship or get yelled at,you know?
So like it really feels likeyou're stuck between a rock and
a hard place.
Dr. Jacqueline Trumbull (17:33):
Yeah, yeah that story is really
upsetting.
Dr. Kibby McMahon (17:39):
That bastard when I think about it.
I haven't talked about him in along time, but whenever I do,
I'm just like what?
What was I thinking?
What was I?
And I, you know, like I just it.
Especially, I think it's whenwe talk in these vague terms of
case, cases, examples it'sreally easy to picture the
(18:02):
alcoholic or the, you know, thenarcissist or whatever whoever
we talk about, as this, liketerrible person, and we're like
cowering in fear.
But often no, often these lovedones are vulnerable and they're
soft and they're like tryingand they are sorry and they
don't want to be like this andthey don't want to hurt you,
(18:23):
right, and so when he was thatremorseful and that vulnerable,
I was like how could I?
Okay, fine, it's just easier.
Dr. Jacqueline Trumbull (18:30):
All right, I'll keep paying the
bills, all right, just this,just this month because like it
is valid to when somebody'sreally struggling, throw them a
life raft, you know, like thatmakes sense.
That's not always a bad idea.
It's just if they, you know,build a house on that life raft
then and like move in and decideto live there for four years,
(18:51):
then it's a problem.
But it's hard to know at whatpoint.
I mean you don't literally seethem building, you know building
the house there, so it's hardto know at what point you have
to cut off support.
Yeah, and it can feel likesometimes it's too deep you know
, I mean with PTSD, it's reallyhard because it's like are you
(19:13):
like?
Okay, like, let's say, I wasmarried to somebody with PTSD?
Everybody knows how importantdates are to me.
Well, dates stop being fun ifyour husband is scanning the
crowd and looking at the doorthe entire time and not being
able to concentrate on you and,you know, put up a fight going.
So it's kind of like, okay,yeah, I'm gonna make him go on
(19:35):
this date, but for what purpose?
And neither of us is going toenjoy it.
Like so, how do you?
So?
Where do you start?
What do you do?
Dr. Kibby McMahon (19:50):
I don't know.
I mean, I think you start whenI think for most people they're
going to spot their enabling,unintentional reinforcement
patterns when either they arelosing capacity to keep offering
(20:13):
that support Like it's draining, to keep doing that, like I got
to the point where I had nomore money.
That was the point.
I was like you know, I can'tkeep you know supporting you,
point, and I was like you know Ican't keep you know supporting
you, um, or when the resentmentbuilds, when you kind of feel
like you know, I feel like I've,I've extended myself past my
limits, or um.
(20:34):
Another thing is like when younotice that the problematic
behavior, whether it's drinkingor not getting a job, avoidance
or whatever is getting worse.
Right, I think that's that'swhen.
That's when usually it's, it'slike, oh my gosh, we need to get
this person help in general,let's get them to treatment,
(20:55):
let's get them to therapy.
This has to change.
And then you know, then, likesubtly, the loved ones need to
change their um reinforcementpatterns, right so it's like you
know.
Then, like, subtly, the lovedones need to change their
reinforcement patterns, right?
So it's like you know, when younotice that either the
avoidance is just staying thesame for years and years or
getting worse, they're avoidingmore things.
Dr. Jacqueline Trumbull (21:19):
I mean, yeah, like if there's a
behavior that's really unhealthyor a behavior that's really
unattractive or something thatyou just don't want to put up
with and you're on a timeline,right like, there's got to be
some comfort in saying, I mean,I think it's tough, you know,
between saying what am I goingto have to accept of this
(21:39):
behavior and what do I trulyneed to change?
Um, somebody with PTSD isprobably never going to love a
firework show.
I'm going to combat PTSD person.
Uh, is that that big of a deal?
I don't know.
So, you know, it could be likeit could be a situation of
saying we need to work on someof this.
(22:00):
I can have acceptance aroundsome things.
I can have acceptance aroundthe fact that you struggle and
maybe you're not going to enjoythe same things that I do or be
able to, you know, live the lifeI wish you could.
Dr. Kibby McMahon (22:18):
But we're suffering here, yeah, and that
that those limits can change,right, like you could be fine
with it for a while.
And then one day you're likeyou know what I'm done.
You know, yeah, and that thatthose limits can change, right,
like you could be fine with itfor a while.
And then one day you're likeyou know what I'm done.
You know, yeah, have you didyou find yourself reinforcing
your exes?
Dr. Jacqueline Trumbull (22:34):
Yeah, I mean, I'm trying to.
I think that's so complicated,is that it's kind of like, well,
what can you considerreinforcing?
You know, because you could saythat me working on my thesis
constantly was enabling, becauseit left him to his own devices
(22:57):
all the time and, you know,allowed him to do his first
choice activity, which was drugs.
But would you really really saythat's his first choice
activity, which was drugs, butwould you really really say
that's enabled?
You know what I mean.
Like I, that I'm not likedirectly making it, like I'm not
necessarily directlyreinforcing it, um, you know, I
(23:18):
mean I suppose, like he, I wouldsay, had an alcohol problem
maybe, um, and we had a bit of aparty house, you know, and so
you could say that me, um,participating in the very like
social events that we had, maybelike reinforced it, um, um,
(23:47):
yeah, I don't know.
Dr. Kibby McMahon (24:13):
I've been hearing, especially like
partners or parents of peoplewith severe addiction that maybe
, or like emotion dysregulationthat ended up in the hospital
and they'll be like they'll sayto themselves, like did I do
this?
Is this my fault?
Oh, I should have taken awaythe bottle.
Or like I shouldn't have donethat, right, they really want to
blame themselves, just becauseit feels like there's something
that they can do and they couldhave done differently.
But, as you're highlighting,like it's, these behaviors are
(24:37):
being reinforced by a bunch ofstuff, not just you, right, like
even in that picture of himdrinking and other stuff, he,
you know it would be.
What's probably reinforcing arethe feelings that he got right,
like the good feelings ofgetting drunk or high, having
fun with friends, like beingseen as social, being seen as
(25:01):
fun, probably decrease in socialanxiety and then you, you know,
got to enjoy that partyatmosphere, right.
So there's like severaldifferent things that are
reinforcing there and maybe ifyou had done anything
differently, it wouldn't havechanged, like the equation of
how much is being reinforced,right, you know.
Dr. Jacqueline Trumbull (25:23):
I mean, I think that's the problem, you
know, like he wasn't interestedin changing.
And so you know, like with mysister it was clear she was an
alcoholic and it was clear shewas destroying her life and her
husband's choice to keep up thealcoholic environment was quite
(25:46):
questionable because she wasvery clearly suffering.
Um, she was very clearlyputting a lot of things at risk
and it was very dangerous and hehated it.
Um, it's, you know, with my exlike he didn't really have an
interest in changing and itwasn't actually clear that there
(26:08):
were massive consequences tothe drinking.
And so it can kind of beunclear when to say I am going
to tell you that you have aproblem and I'm going to change
my behavior to no longerreinforce you when you are
actually not interested in doingthat.
I'm not saying that that's awrong thing to do, it's just,
(26:29):
that's just another complicationthat that's a wrong thing to do
.
Dr. Kibby McMahon (26:34):
It's just, that's just another complication
, yeah, yeah, and I think that'sthe tough part, because we
ideally would love for yourpreferences and your feelings to
matter a lot, and sometimesthey do, um, sometimes they
don't, and that that's a reallypainful reality.
When you go up to your lovedone partner, whatever, and say
reality.
When you go up to your lovedone partner, whatever, and say,
(26:54):
hey, you know you're, you'regetting highs, like I would like
you to stop, it's getting to bea problem.
I'm really worried, blah, blah,blah.
And for that it's kind ofadding punishment, it's adding
that negative Like I feel bad, I, I'm going to, I'm upset with
you because you're doing this.
So they go.
Oh okay, you know, it would benice if your feelings would be
(27:16):
the thing that they go.
You know what?
I'm not going to.
I'm not going to.
I don't want her to be upset.
I'm going to stop this.
Dr. Jacqueline Trumbull (27:21):
Yeah, it wouldn't be nice.
And I mean, I think the otherlike paradox is that sometimes
you getting upset with them justdrives them to the behavior
more, because now they feelnegative and so they go for
their avoidance, calledsubstitute avoidance.
They substitute their badfeelings with something that
will hurt the bad feelings,right?
So you know he drank a lot morewhen we fought, you know?
(27:44):
So it's not like.
It's not like expressing myselfworked.
Dr. Kibby McMahon (27:51):
Yeah, yeah, and, and it might even be like a
little bit of a rebellion tolike a little bit of a power,
right, if I tell you, no, youknow, I say you know, don't
drink.
Oh well, if I stopped drinking,like basically I'm just saying
yes to whatever you want, right,like sometimes my accent became
like I would talk to him aboutjob and it'd be like, oh well,
(28:12):
I'm not going to be a doctorjust because you want, I'm like
what?
So just, sometimes it's, it's alittle bit of a power struggle
when you, when you have to talkof, like you know, your behavior
is bad or whatever yeah, I meanit's different for different
things.
Dr. Jacqueline Trumbull (28:29):
Right, like alcohol.
I mean it's different fordifferent things right, Like
alcohol, if somebody is actuallyinterested in changing.
I think that conversationaround enabling is different.
So, like you know, with PTSD um, I ran like a family group for
a hot second and one of thethings was talking about to
(28:52):
spouses and you know, in ourcase they were.
They're all women because mostveterans are men, so the spouses
, we don't really think women.
Um, and it was mainly talkingabout, like, how their spouses
were going to want to avoid,like avoid traumas, and one of
the things we would suggest ishaving a talk with them about
(29:14):
coping ahead, like look, youknow, I'm unwilling to let our
lives shrink to the size of apea because of your avoidance,
and I know that you know you'restruggling with this too.
So let's, you know, let's planto go and do some of these
things that we've been avoiding,but we don't have to like go in
with our fingers crossed.
(29:35):
We can go in with a plan, youknow, like what can we do if you
get anxious?
What can we do if there's aloud noise?
Is there a signal you can getme that says that you're
overwhelmed and you need to takea break?
You know, is there a code wordwe can use when you really
actually have to get out, likefor real, this time, you know,
(29:55):
um, what kinds of skills can weuse if the anxiety goes up?
So all of these things can bedone and it's a great approach.
Dr. Kibby McMahon (30:03):
It's just that it it entails cooperation,
yeah, yeah yeah, and entailshaving to, uh, be on a team and
being on the same page with,like um, you know what, what
you're describing as shaping.
It's like we're doing a little,we're we're.
It's not all or nothing, it'snot like I'm staying home
forever or I'm going out to likeconcerts all the time, but it's
(30:27):
like, okay, can we, can we trygoing to these places and then
having ways that I could signalthat I need to take a step, step
back right, so right, or that'swhat I got from that.
Dr. Jacqueline Trumbull (30:38):
It's like baby steps, baby steps
towards um opening up your lifea little bit more yeah, I mean,
if you're gonna think aboutpushing your kid in a pool, it
can be helpful to discuss itwith them maybe not a child, but
like, if you're about to gointo something terrifying, then
it's usually going to feelbetter if you have somebody say
(30:58):
like okay, like let's, let'stalk about what it's going to be
like when you, when youremotions get really big because
they're going to yeah they'revery likely to, and I'll jump in
.
It doesn't mean that you have tosplash around in the pool
drowning until you're dead.
Right, like there are thingsthat we can do.
Addiction is just so hardbecause it's so.
(31:20):
It serves such a strong purposeand and it rewires your brain,
you know.
So it's so tough because you'reyou're fighting in two battles
or more, and so it's it's likemaybe sort of less likely that
(31:40):
you're going to get thatcollaboration.
That's obviously many, manypeople who are addicted want to
get better and will collaborate.
But it's just a really it's anuphill battle and I think
especially in the stages wherethey're in that
pre-contemplation mode, they'renot really sure that they are
want to admit that they have aproblem or want to change.
Then there's a lot ofdefensiveness and lying that
comes up around it.
Dr. Kibby McMahon (32:01):
Yeah, yeah, it's, it's.
It's kind of relieving and sadto hear that addiction and the
substances I mean they rewire,like.
When we talk aboutreinforcement, we're talking
about the reward system.
How do we do stuff and then geta reward and what does that
feel like?
And keep going right andsubstances change all that they
(32:22):
make.
It hijacks the brain so thatyou just want that reinforcement
of the drug, you just want thatlike it's.
It's like almost tunnel visionand so your partner, your loved
ones, like please, for you know,get help, and stuff like that
kind of like fade in thedistance and they may want to
(32:44):
make you happy, they might besad that they're making, they're
hurting you, but their brain islike I have to, the only reward
that matters is getting highyeah, yeah, I know it's such a
tough one.
Dr. Jacqueline Trumbull (32:57):
I mean it looked like I've, I've.
It's hard to think.
There's so many times when mysister, during her quote-unquote
sobriety, has been like askedme for just a sip of my drink,
um, like at family functions orwhatever.
It's really, it's really hardto be like no, oh I've given in.
Dr. Kibby McMahon (33:20):
Yeah, I don't think there's any good way, you
know.
No, you know, be the keeper ofher sobriety, I mean.
Dr. Jacqueline Trumbull (33:26):
But yeah, oh, that's tricky, it's so
tricky yeah, I'm trying tothink if anything from like mi
can be helpful.
Um, you know, I think, liketrying to resist power struggles
is is going to be helpful.
(33:47):
There's like there's an, youknow, an element of dropping the
rope and just trying to reflecttheir own motivation for things
to change without trying to.
There's something called thewriting reflex where, if they
take a position, anybody who'strying to get better but isn't
(34:13):
anybody who's trying to getbetter but isn't is struggling
with ambivalence.
Typically, when people arecompletely committed to
something, the needle will move,unless it's completely out of
their control.
Right?
But you know, often when we'redealing with this ambivalence,
you know I might talk on hereall the time about how I want to
lose 10 pounds.
(34:33):
If I were fully committed tothat, I would probably have lost
10 pounds, because there are alot of ways to go about that.
But the fact is I'm actuallyambivalent because of the
behavior change it would take.
It would mean me drinking less,eating less, eating different
foods, uh, moving more, doingthings I don't like, and so the
problem is that ambivalencemeans you're basically like
(34:54):
teetering on a seesaw, and ifyou, as the loved one, come in
and step on one end of theseesaw by taking a certain
position, especially a firmposition, then they will run on
over to the other side of theseesaw because that maintains
(35:15):
the ambivalence.
We've got both arguments beingstated out loud and I think that
this is a problem that lovedones run into because they're
like well, I have to make andyou know, sometimes you do have
to make your position no, youknow, you do have to say like I
need you to get sober, so I'mgonna work.
(35:36):
But convincing them is usuallygoing to backfire so make them
more stubborn on the other side,yeah yeah so instead you know
trying to have like an exploringmindset of you know like okay,
well, what does alcohol do foryou?
(35:57):
You know like what, what haveyou noticed about it?
And they'll say some goodthings.
But then you know, I might saysome bad things too.
And you can even say somethinglike well, how you know?
Like, how confident are youthat you can change this?
And if they're like well, alittle bit, but not really, you
can even say like well, okay,why, but why didn't you say
(36:18):
you're not at all confident?
You know what makes you alittle bit confident.
Oftentimes what we want to sayis like why aren't you
completely confident?
And that's when they're goingto start coming in with saying
well, because it's really hardand I don't know if I want to
and I don't have to make bigchanges.
I don't really want to make.
But if you, if you can, if youcould actually say you know well
(36:39):
, why aren't you actually lessconfident?
Then it gives them a chance tosay well, you know, I've done
hard things in the past and I'vebeen able to go a few days
without alcohol, and you know.
So there are some likemotivational interviewing
techniques you can do, butgenerally, you know, trying to
like have an a curious kind oflike open stance for them to
(37:00):
explore their ambivalence, but,like you know, trying to help
them give voice to their reasonsfor change is helpful, but it's
kind of a you know it takeslike a lot of finesse.
I mean, I'm not sure that I, Idon't, I don't have it down as a
therapist.
Dr. Kibby McMahon (37:20):
But at least avoiding certain traps can be
helpful.
Yeah, yeah, that's hard for theloved one who has, like you
know, skin in the game.
Right, it's like as a therapist, it's a little easier to be.
Like why would you want to quitdrinking, why would you want to
keep drinking?
But the wife was likeeverything is bad when you drink
.
It's a little harder to be thatneutral.
But even when you just saidwhat are the reasons for
(37:42):
changing, that is something thatchanging, enabling or
reinforcement patterns might do.
I think that when you're a lovedone, you're of someone with we
keep talking about addiction andyou know we, we can talk about
the supplies across the mental,mental illnesses, but if you're
a loved one and go well, I'mgoing to have to just wait till
(38:06):
they hit rock bottom.
Right, that's like kind of this, the old method of, like you
know, take away your health,take away support, let them fall
right, let them feel how badthings are, and then that would
make them want to change.
And it's true, the reason whypeople change either get therapy
or quit substance, whatever isbecause that the the cons
(38:34):
outweigh the pluses.
Right, it's no longer beingreinforced as strongly, right,
because it's costing so much,right, you might get a little
high, but then your whole lifeis a mess, right, and especially
when that person is sacrificingthe things that really matter
to them, which is infuriatingfor a loved one.
Because if I'm like, I reallywant a supportive partner who
(38:57):
contributes to the bills, likethat matters to me, not to him.
Like he, he cared about otherthings, right, which is why we
broke up, but um, he, just whatwould have tipped the scales
into motivating him or anyoneelse it would be if he was like,
(39:17):
oh, the things that I love todo I couldn't do, right, like,
sometimes, you know, the thingthat would get through to him
was I.
He hid from his friends a lot.
He like literally didn't seethem, didn't tell them what's
going on and withdrew, and hewas a very social guy.
So sacrificing his connectionto the community, his friends,
was really hard.
(39:38):
Um and that was way moremotivating than, like me, being
mad, right.
So I think when when we'retalking about, like you know,
having a conversation of whatare your reasons for changing,
you can add to that feeling, tothat by you don't have to let
them do rock bottom right.
You can add to that feeling, tothat by you don't have to let
them do rock bottom right.
You don't have to like takeaway everything until it's
(39:59):
dangerous, but you can take awaysome of the good stuff that you
unintentionally add to theproblematic behavior.
Right Like walking away ortaking a time out or I know that
we in craft are learning how tolike figuring out what to
change, what reinforces tochange, adding reinforcement to
(40:24):
healthy behaviors when they'resober or healthy, and then
withdrawing or taking time outfrom reinforcing unhealthy
behaviors.
For example, like just addingcompliments, acknowledging their
efforts, spending quality timewith them doing something that
they love.
Right Like easy, cheap, funthings that you can do that you
(40:47):
can add in right away.
You see them come home fromtheir night out with their
friends, sober, no-transcript,healthy behaviors that when
(41:22):
they're sober, or whatever youwant, yeah yeah I mean figuring
out how to let them experiencethe consequence, the natural
consequences, of their behavior,in ways that are not actively
dangerous, I suppose.
Dr. Jacqueline Trumbull (41:37):
But I like that idea of putting more
marbles in the incentive tochange column and removing them
from the incentives to stay thesame column to stay the same
column.
Dr. Kibby McMahon (41:57):
Yeah, I think of it like this, with the with,
you know, reinforcement, orenabling, where, if we're like,
oh, did we make them drink ornot drink do we?
How much power and control dowe have?
It's like I said this in theclient community.
I said, um, let's say you'rewalking with your loved one,
you're hiking in a forest, forsome, reason.
And you really want them to goleft.
(42:17):
You think that going right isreally dangerous.
So I'm going to clear the path,I'm going to chop down the
trees and remove the rocks,maybe pave the way, maybe look
at that nice view.
And then I say, hey, you know,I think that the left path is
like really nice.
And then I say, hey, you know,I think that the left path is
like really nice.
And then you let them choose.
(42:39):
You let them go left or right.
Well, I'm making it easier, I'mreinforcing the left, but they
have a choice.
Right, they might think thatthe right has so many cool
things over there that's goingto totally outweigh your nice
paved road.
And you might be like, wait,but you're going to get hurt in
the right side.
And they could choose.
(42:59):
They could choose Do they likeyour lovely path?
Or they could choose the rightpath, the right right, not the
correct one, the right one.
But that's how I think about it.
It's like making the path alittle nicer on the side that
you want them to go.
Dr. Jacqueline Trumbull (43:12):
Yeah, yeah, oh God, I mean I also.
Just part of me is like if youknow, if you don't want to do
this, then that's okay too.
Yeah, because one of thenatural consequences of that
behavior might be losing you,and that sucks.
Dr. Kibby McMahon (43:29):
Yeah, I, we talk about how don't throw
around ultimatums.
I mean the important part ofall this reinforcing like, let's
say, you take away thereinforcer on the unhealthy
behavior, add it to the healthybehavior and that's like a
boundary or that's you just likechanging your behavior the
(43:49):
important part is to be reallyconsistent, right, like,
reinforce the good stuffconsistently, don't reinforce
the best of consistently.
But people don't always followthrough right and they go.
I'm gonna leave you if we'redone, if you're gonna be, if
this is gonna happen and we'redone.
And then, unless it's real,unless you're saying like from a
(44:10):
real like, I'm gonna let youknow that I this is
unsustainable.
If this keeps going on, I'mgoing to have to, you know, take
space or like I'm going to haveto leave.
That's different than using theultimatum to like control their
behavior out of fear, right?
Dr. Jacqueline Trumbull (44:25):
So so many times, I mean in multiple
relationships.
You know um and um.
It's tough because as soon asyou threaten to leave but don't,
then they're they actually getreinforced to keep doing the
stuff that they're doing becausethey've learned that you're not
(44:48):
serious.
But the thing is you actuallymight be pretty fucking serious
and it's just that they wereable to reel you back in that
one time and so that, like in mycase, you know, I made that
threat many times and I I meantit, but the more times I didn't
go through with it.
He was like she doesn't reallyneed it, yeah, until one day,
(45:14):
you know, he called the wrongbluff.
Dr. Kibby McMahon (45:20):
Yeah, I've been there too.
It's tricky.
All this like boundaries andchanging reinforcement is really
tough when that person does ahealthy behavior and behaves and
listens, just enough for you tobe like, ah, good, right, like
my ex would start pulling upthose tabs, those job, the job
(45:41):
search tabs, and then I'd belike, okay, good.
And then we'd go back, I'dstill pay for things, because
I'm like, okay, I'm, you know,we're on the way out of this
hole, right.
But then, and for you, you, youknow, there might be an apology,
there might be a makeup, theremight be some closeness, right.
And then you might be like, oh,okay, good, the bad stuff is
over.
And then they do it again,right.
(46:04):
And then you're like, oh, whydidn't I just leave?
I knew this would happen, butyou gotta have some forgiveness
for when you have hope and whenyou believe in them and believe
that things change.
But I guess then you might haveto change the reinforcement to
seeing sustained changes, right,that was the thing that I
(46:24):
messed up on, where you know youcould reinforce like, oh, yeah,
they're trying, they're doingit.
But then I'm going to reallyreinforce you if you keep this
up for six months, if you staysober for longer than just like
a week, you know.
Dr. Jacqueline Trumbull (46:39):
Yeah, you didn't mess up on anything,
though, because you were in amarriage and it was his job to
respect his wife's wishes.
I'm just saying that because Idon't want you or anybody else
to feel like, if they aren't,you know perfectly reinforcing
their partner or whoever, thatthey're messing it up, right?
(47:02):
I mean, ultimately, it's likethis is we do what we can, and
if we want to put in the work totry to change their behavior,
then, like, we try and we giveit an effort, but it's not our
disease, it's not our disorder,um, and they have to be the one
who wants it enough, and all wecan do is try to make them want
(47:26):
it a little bit more throughsneaky means, I guess yeah I
also have been thinking aboutthis more with um.
Dr. Kibby McMahon (47:34):
It it comes up with addiction, but it's also
when someone's depressed oravoidant in general.
There's there.
There seems to be like talkingto all these loved ones through
Cool of Mind.
There seems to be this feelingof like um, my, my, my loved one
with an illness is like a baby,like hasn't grown up right.
(47:54):
There's something quitereinforcing to being completely
incapacitated to be completelydrunk, to be completely so
depressed.
You can't get out of bed andthe loved one takes on like a
parental caretaker role right.
And so everyone's upset, likeeven the person with the illness
is like embarrassed thatthey're living with their mom's
house or you know not, not youknow getting up and getting a
(48:17):
job.
However, the urge to be takencare of like a baby might be so
strong, especially when, like,you're going through something
hard, that that that could justbe reinforcing right.
Even if you're arguing andupset, it still kind of feels
like you're being like likesometimes, like there's so much
(48:40):
psychoanalysis that could bedone.
Like drinking a bottle you knowwhat I mean.
Like you're drinking, it's apoint where you're like you're
being taken care of by a mommy.
Right, there's something soreinforcing about like being
mommied.
Dr. Jacqueline Trumbull (49:00):
Well, I think that's why sometimes
enabling can actually be adevious and insidious behavior
that is done on purpose.
I've seen multiple men takeadvantage of my sister in this
way, like you know, making hermore vulnerable, setting her up
to be more vulnerable, becausewhen she's more vulnerable, they
have more power yeah, andthat's extremely scary to watch.
Um, and you know so, if youfeel as though somebody in your
life is enabling you not becauseit's just too difficult or
(49:25):
confusing for them to fight tobattle your disorder, but
because they're actually puttingyou in situations to weaken you
, like by removing your supportsystems, like by giving you like
a lot of, maybe, love andattention when you're
incapacitated, maybe by removingyour financial means, always
(49:54):
being the one who wants torescue right?
Like, I think it's justsomething to think about.
You know, like, is your, isyour disorder really putting you
at relational risk and issomebody manipulating that?
Dr. Kibby McMahon (50:07):
Yeah, yeah.
It's just like such a familysystems approach and all the
stuff that we talk about abouthow mental illness and addiction
aren't just one personillnesses.
It's like the system is sick.
The disease is in the system.
How do you get care?
How do you get attention foryour pain?
What does someone like to do tofeel valuable and helpful in
(50:30):
your life and take care of you?
Right, feel valuable andhelpful in your life and take
care of you, Right, Like, um, I,you know, I will admit that I
that there was somethingreinforcing to me about being
the one who can fix everything,who can handle it all.
Right, there was something likethat was part of my identity,
is like, well, I have a husbandwho's you know like not working
and I have to do everythingmyself.
(50:51):
Like, really, there wassomething about it that felt I
wouldn't say good, but it feltpurposeful or it felt like it
was something.
Dr. Jacqueline Trumbull (51:06):
I don't know.
Yeah, it's tough becausesometimes your person, your
loved one, will, you know, willpull for your affection,
attention that can make you feelimportant and valuable.
You just want to make sureyou're not getting high on that,
because it really shouldn't bea good thing if your partner or
(51:32):
whoever is incapacitated in someway yeah and you know if that's
a time when you feel mostconnected to them.
But that's something to examine.
It might not mean something.
Is, you know, psycho in you?
It.
It might mean that, like youcome from a background where it
was really hard to get softnessand attention and your loved one
giving that to you when they'remost vulnerable feels like the
(51:55):
only way you can get it.
You know, I mean that's likethat's very valid, but it set
both of you up for misery it'snot interesting.
Dr. Kibby McMahon (52:06):
We're talking about like reinforcing, like
drinking or mental health, youknow, or unhealthy behaviors,
but it's like now we're talkingabout reinforcing for us, right,
like what's reinforcing in thisdynamic?
Interesting yeah.
Dr. Jacqueline Trumbull (52:20):
Well, I mean because I think, because
we've talked about, I mean,enabling is such a it's such a
wide behavioral, you know,paradigm or whatever, like it
can include so many just benignthings, but sometimes it is on
purpose and sometimes it's notnecessarily on purpose, but it
is clearly problematic.
(52:40):
I mean, all of the times weenable it's because it does
something for us, right, like ifit didn't do something for us
we wouldn't be doing it.
And so usually what it's doingfor us is helping us avoid
conflict or avoiding a headacheor something.
Dr. Kibby McMahon (52:56):
but sometimes like reducing their distress,
right, like keeping therelationship, like preventing
them from leaving you, or evenjust like avoiding danger.
I mean, I will say that thewhole rock bot like let your
loved one hit rock bottom andwithdraw all your support really
got questioned as less popularwhen the opioid crisis has swept
(53:20):
the nation.
Right, because with alcohol, ifyou cut off contact, stop
paying the bills.
Like let them live on thestreets, like maybe they'll be
okay.
With opioid addiction, youstepping away and letting them
experience a consequence as well, it's really deadly.
Yeah, I mean, I think it is alladdiction.
Dr. Jacqueline Trumbull (53:40):
I mean, how many rock bottoms has my
sister hit at this point?
She lost her marriage, she losther kids, she lost her job, she
lost her medical license.
All she has to do is slam hercar into another car and she's
dead or suicide, right.
I mean, I've had theseconversations with her too.
So it is very, very scary.
Dr. Kibby McMahon (53:57):
Yeah to to let them hit rock bottom, and
maybe it is better to driveyourself crazy trying to keep
them from that than to to letthat happen yeah I'm not gonna
make a call on that, you knowlike yeah, in craft they say you
know if it's really going torisk their safety or your safety
, don't do it.
Um try, try changing other waysof reinforcing, like adding
(54:20):
more good stuff to when they'resober and I know that's hard,
but it may point your brain toseeing other things that you can
control besides the big thing,right Besides, for, like, should
I pay for their rent or leavethem homeless?
It's like, well, maybe that'snot the thing that you change
right now, cause that would betoo risky and too uncomfortable.
(54:43):
Maybe do other things likequality time, compliments, um
some other kind of reward in themeantime.
But it's tough.
Dr. Jacqueline Trumbull (54:52):
Yeah, there's no, there's no right
answer, unfortunately it's justI.
But it's tough.
Yeah, there's no, there's noright answer, unfortunately it's
just.
I think it's something to kindof explore and think about and
try to get some I don't knowsome perspective on.
Like I think a lot of timesit's very hard for people to set
boundaries and they feel likethey're hurting other people
when they do it, but sometimesit's the best thing you can do
for another person and foryourself.
(55:12):
So it's definitely a long gameand it entails some short-term
discomfort.
That's very legit, all right.
Well, guys, if you want toenable us to keep doing this
podcast, you know what to do.
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We'll see you next week.
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