If my beloved wife of twelve years received a cancer diagnosis and we had two kids under the age of seven, would anyone label or judge me for doing everything possible—even to the point of giving up important parts of my life—to keep my family stable and relatively happy? If I took on two jobs, quit my exercise program, resigned from the company softball team, and stopped seeing friends to address this unexpected family crisis, would anyone in my life call me out as enmeshed or enabling? And if I went to a therapist for support, would my therapist ask me to explore the ways in which my dysfunctional childhood might be pushing me into an ‘unhealthy obsession’ with my wife’s cancer diagnosis?

Of course not.

In this situation, friends and family would show up on my doorstep with flowers, homecooked meals, and sincere offers to help with childcare, shopping, yard work, and housecleaning. Meanwhile, my therapist, clergy, and employer would understand and accept that my family is in crisis, that I love them, and that I must give of myself in an extraordinary way, even if that looks a little obsessed or makes me seem a bit nutty at times. And if any of these supportive individuals felt that I was overdoing my attempts at caregiving, possibly to my own or my family’s detriment, they would not chastise me. Instead, they would nudge me toward caring for myself as well as my family while offering gentle advice about how I might care for my loved ones more effectively. They wouldn’t stand back and judge me; they would lean in to help.

Unfortunately, things are different when it comes to addiction.

Let’s say my spouse of twelve years became addicted to alcohol and prescription painkillers. Let’s say she lost her job because she was drunk and high at work. Let’s say that because of her addiction I can no longer trust her to adequately care for our kids. What happens now when I take that second job, stop going to the gym, stop hanging out with friends, eliminate my recreational activities, and start to obsess about her drinking and using? Will my friends and family, my employer, my clergy, and my therapist support this degree of caregiving and caretaking while empathizing with my frustration and exhaustion?

Most likely they will not.

In the addiction world, support and therapy for a loving spouse (or parent, sibling, best friend, etc.) typically involves judgmental head-shaking, tut-tuts, and expressions of concern about the caretaker’s problem, with that problem being identified as dysfunctional attempts to love, save, rescue, and heal the addict.

Move over empathy; make way for judgment.

Addiction is a universe where caregiving is often viewed as enmeshed, enabling, and controlling, and choosing to stick with an addicted loved one is seen more as a reflection of the caregiver’s troubled past—meaning unresolved early-life trauma and abandonment issues—than an indication of love and healthy bonding.

This does not make sense to me, and it troubles me deeply. If I love someone with a physical illness or a disability by helping that person and the rest of my family, even to my detriment, I’m a saint. But if I love and care for an addict in the same way, I am called out as enmeshed, enabling, controlling, and codependent, and I’m likely to be told that my efforts to love and care for the addict and others in my family are keeping us stuck in the problem. I may also be told that I need to ‘get out of my disease’ and ‘pull back from all my unhealthy rescuing.’

When those who love an addict eventually make their way to therapy, either on their own or in conjunction with the addict’s treatment, do we honor and celebrate their devoted efforts at caregiving to the best of their ability and then offer them support and guidance? Hardly. Instead, we almost instantly assume they are enmeshed, enabling, controlling, and thus contributing to the problem. Then we give them a label—codependent—that sounds a lot like a diagnosis. Once labeled, these wounded, scared people are asked (at the height of a profound interpersonal crisis) to look at themselves and ‘their part’ in the problem. They are told that they are ill, just like the addict, and they need to work on themselves so they can fix whatever it is they’ve been doing wrong.

How is this helpful? Why do we pin the stigma of addiction on the addict’s family as well as the addict? Why do we negatively label hard-working, deeply loving, intensely loyal, profoundly afraid, nearly exhausted loved ones of addicts as codependent or worse? Is this the kindest and most effective way to invite them into the healing process? Does this represent the empathetic, non-judgmental embrace that such people clearly need and deserve?

I find it hard to understand why we choose to initiate therapeutic relationships with painfully overwhelmed and under-supported loved ones of addicts by thrusting a negative, pathological view of caregiving on them. Then we expect them to not only embrace this concept but to start working on it immediately. And when they act out against this model, we call them difficult, which reinforces our mistaken belief that they are as innately troubled as the addicts they love.

What about their grief for how their lives have turned out? What about their years of feeling confused, anxious, overwhelmed, and fearful about the future of their addicted loved one, themselves, and other members of their family? What about the fact that they have been victimized in their own homes, sometimes for years on end, by an addict who is more willing to lie, manipulate, and keep secrets than to face the truth?

Even when caregiving loved ones have been ‘doing it all wrong,’ experience has taught me that it’s not a good idea to tell them that, or to blame them in any way for facilitating and perpetuating someone else’s dysfunction. And why would we expect otherwise? If you were exhausting yourself working part-time in three different places while taking care of multiple people including an active addict, would you feel engaged by a message that asks you to start looking at your problem? Most likely you would not. Instead, this message would feel both hurtful and counterintuitive.

If our approach to loved ones of addicts alienates them before they can take advantage of the care and insight we can offer, then maybe we need to change our methodology. Maybe it’s time to find a better, more empathetic and compassionate way to approach caregiving loved ones of addicts. Instead of blaming caregivers for resisting a path that feels innately wrong to them, maybe we should find a less intrusive, less shaming way of supporting them.