Addiction catches up to us all in the end does it not?. In a single weekend, I lost my career, and my family. Shortly thereafter, I entered a pay for service rehab in a very depressed mood. Among the things I recalled from this facility was a strong warning that drug use while in treatment would result in instant discharge. I clearly remember thinking “Yeah, I doubt that.” I doubted them because I knew that our insurance companies were paying the facility hundreds of dollar a day for each client. I cynically believed the rehab would never willingly cast aside so much profit over a little thing like relapse.
A recovering alcoholic befriended me and taught me how to get along in rehab, and what it means to “really work the steps.” A week later my friend left on a day-pass to look for work. He returned drunk. The counselors let him use the phone, packed his belongings and drove him to the bus stop.
I was furious. The staff had taught me addiction was a disease. Now if that is true, how was it fair to kick someone out for relapsing? After all, I reasoned, a hospital would never kick out a cancer patient because the cancer returned. How could such a practice in substance abuse treatment be justified? I’ve come to recognize the simple answer is that one cannot help a cancer patient by removing the patient from treatment. However one might, as a last ditch effort, help a relapsing addict precisely by not helping. Let me explain.
In 1968 a psychiatrist named Steve Karpman developed a way of understanding dysfunctional relationships. This understanding rest upon a diagram often called the Drama Triangle. The three points of the Triangle represent three roles people often play in relationships. Persecutor, Rescuer, and Victim.
This diagram does not describe legitimate actions of rescue such as fire fighters pulling a victim from a burning car; rather, it describes dysfunction that arises when people seek to play roles that have personal “pay offs” at the expense of others. All three roles are dysfunctionally related and each role seeks a selfish end. The rescuer gets to feel needed; the victim gets to feel valued, and the persecutor gets to feel in control. The triangle has proven to be a very useful thought construct for therapists. For nearly half a century, it has informed the interventions of the mental health community in all manner of problems—not just addiction.
Now, let us consider for a moment the relationships between the rescuer and the other two points. It seems that if a rescuer wishes to help a victim this can be done in two predominant ways. First, a rescuer may nurture the victim. In the case of addiction the rescuer may provide shelter, food, and other necessities. Or, conversely, a rescuer may attack the persecutor. A would-be rescuer in the case of addiction may try to protect the victim from legal, medical and other consequences of addiction.
Freedom from this unhealthy drama comes when addicts and codependents are taught about the Drama Triangle and are instructed in the primary ways a rescuer tries to rescue (namely by nurture of the victim and attack of the persecutor). Acceptance of that dynamic, along with an understanding that addicts are their own persecutors, crystalizes the problem. Victim and persecutor merge into a single self-abusive person. Now, how can the hapless rescuer help? If rescuers attempt to nurture the self-abusing addicts they will inevitably also nurture and, therefore, make stronger the persecutors. Similarly, when rescuers attack the persecutor they necessarily end up attacking both persecutor and victim inflicting additional misery on the victim. I can see no way to make that dysfunctional relationship workable. The more rescuers nurture the more they enable. The more rescuers attack the more they enfeeble. Such drama is damaging to all involved to stay clean we must be free of it.
This is why my friend was discharged from treatment. When he began to harm himself by drinking, it was no longer possible to help him.
Avoiding the self-torture of active substance abuse gives our loved ones can love us without fear of hurting us.