Does Tough Love Work?

Mental illness is a horse of a different color to a degree. The reason I am able to sit here and discuss this topic right now is because my husband did exercise some tough love when I was in a very dark place. I was unwilling to seek help (didn't see the point). He literally brought it to me. He called 911 first, and that was not helpful, then he contacted my doctor and told him what what going on. That set some things in motion. I was so angry with him. At the time I felt that it was an invasion, that if he wasn't willing to support me mentally then he was part of the problem etc, etc, etc. The truth however was that I was in such a bad place that I wasn't making good decisions.

No, I think most evidence Ive heard of points to it being more damaging than anything. I mean it seems to be based on the premise that the individual just isn't putting enough effort into 'recovery' and also seems to diminish peoples self worth which doesn't help mentally ill people who already a lot of times have issues with that sort of thing.

It also seems to ignore the fact the individual is suffering from symptoms they cannot fully control, even someone who is getting proper treatment is still going to experiance symptoms especially under stress...its not a matter of something they can just stop doing, like I can't choose to just stop having an exaggerated startle response due to PTSD and it seems the tough love approach expects that of them or they get no support or help...just further ostracizm and isolation which in effect probably makes matters even worse.

Thank you poster. NEWS FLASH PEOPLE, there is no
cure for mental illness. IF there was don't you
think mentally ill people would be fight to
get in line.

Exactly! Tough love doesn't cure mental illness. It can be useful for many things, but if a person isn't capable of changing certain aspects of his or her mental illness, tough love isn't going to help. I do think you have to take a stand on what you're willing to live with. Maybe a person's illness is too much and you can't be there to support him/her. It's understandable that you have to do what you need to do for your own well being. But a person with mental illness needs love, support and understanding, and that isn't easy to give when the person can't control his feelings or behavior. Tough love can help addictions, in the sense that they might finally get help, but tough love can also be cold and uncaring. I think it is to be used sparingly.

Actually I seldom go to movies.

I get my information from the school of hard knocks like most of us here. I have two sons who suffer from two different forms of what gets labelled mental illness (which covers more than bipolar btw). I actually attended a tough love meeting when my older son was a teenager - and read the materials they gave me. In the end I decided it was too harsh for me, but the parents there were well-intended. They were mostly dealing with adult children who were living at home, abusing substances, unable to hold jobs, and having constant contact with the law. I still remember one mom - this was over a decade ago - saying she never imagined that her house rules would include 'no illegal drugs allowed in my house' and 'I will not bail you out of jail after a DUI.'

Yes, believe it or not, there are people who suffer from forms of mental illness who refuse to get any kind of help but who inflict their behaviors on the people around them - including family members who love them. When those family members continue to shield them from the consequences of their behavior, they allow them to avoid dealing with their issues.

My understanding of tough love is that it entails drawing firm boundaries and insisting the person deal with the fallout from their own behavior. That may include getting mental or substance abuse treatment if necessary. So the tough love doesn't cure, but it might move someone toward getting treatment.

Here's the wikipedia article: Tough love - Wikipedia, the free encyclopedia

I don't like tough love practiced on me, I think it's a waste of time when a person needs to be loved and they're being yelled at instead or paddled or whatever else tough love brings, instead someone should be passionately talking to a person in need. Tough love creates anger in the person it's used on and that person may respond to tough love in a negative way. I do believe in exceptions in rare cases where it should be used as a last resort.

I agree that yelling and hitting are counterproductive, but my recollection from the meeting I attended many years ago is that tough love doesn't include that.

Now your adding in others reasons for tough love. Everyone here hasn't learned just from the school of hard knocks. Some of us live with bp dx, have received training on bp dx and attend support groups. Rather than a tough love class. What really pissed me off was your comment:

["So if I'm bipolar, and I've done things while in a manic state - destroyed relationship, run up huge bills, etc. - that make me suffer once the mania is past, I might eventually be motivated to try and avoid being manic again."]

So if I have asthma I should be able to make myself stop having asthma attacks?

I also covered receiving mental health treatment. Maybe you skipped that sentence. Again I receive treatment and I still had a manic episode. The little pamphlet you read left out the fact that episodes can happen at ANY time, WITH TREATMENT or without. There's no cure or stopping it.

I know there are mentally ill people who do not believe in treatment and their families have to make tough decisions, set boundaries.

When you stated "I have two sons who suffer from two different forms of what gets labelled mental illness (which covers more than bipolar btw)."

Your comment sounds like you do not believe their condition is a mental illness.

"Which covers more than BP dx" is not the same as one of them having it.

I think tough love works in some families and not in others. In some families it's just like routine to get that kind of treatment and have family members (depending on how sensitive they are) respond to it without adverse repercussions.

I know in my family it doesn't work because some family members are very sensitive (due to their mental illnesses) and it can damage relationships to the point where nobody (which includes healthy family members) knows what to do and/or how to fix things.

I had somewhat of a similar situation with a psychiatrist although I don't believe toughness was behind his intentions. I hit a certain dose of lamictal and noticed a dramatic relief from all of my symptoms and I felt very happy. The next week I told my psychiatrist and he was happy and then he nonchalantly said, "Now you're going to have to desensitize yourself". That's a lot easier said than done since that is a major symptom of manic-depression for me. I've never been able to overcome that. The remark seemed kind of impersonal, rough and glib.

How is it supposed to make someone desire treatment? I don't get that...don't think i would want to bother with treatment or the person trying to get me to go if they informed me their continued support was only on the condition I do this or that.

Works much better if people close to me recommend something in a supportive manner with the knowledge they aren't necessarily an expert and so they can give advice not demand I start doing things or else I get 'tough' treatment for others.......I mean another issue with something like tough love is there is a fine line between that and mental abuse or so it certainly appears.

So if someone was to harm them self out of depression because cutting is how they currently deal with the pain and they go too deep for instance.

Would it be best to let them deal with the 'fallout' of their own actions or help them keep from bleeding to death? Also since the tough love approach essentially increases stress on an individual and stress is proven to make psychological disorder symptoms worse....how does this move them towards getting treatment rather than just burning them out? The thing with mental illness is people typically need help dealing with the 'fallouts' caused by their symptoms.

As for wikipedia, well...its a good starter source not exactly a reliable source of information about what treatments work best for the mentally ill.

I don't agree with the tough love approach at all for mental illness. No way!

Depressed people typically hate themselves enough, they don't need tough love crap.
Even on medications... it take time to work.

If I am in an ugly Manic episode I already hate my self and feel a burden to everyone anyway.. Tough love is only going to make it worse.

I pretty much agree will the last paragraph Costello but it sounds more like common sense than what we've come to know as tough love. I guess that's the thing. The phrase is overused and means different things to different people. From that wiki page:
I think most of us can tell the difference between authoritativeness and authoritarianism. There was also a link there to the "business" of Tough Love which kind of falls under self-help, motivational guidance, and professional guidance and like most self-help and expert guidance... is nonsense and its prime motive is to make money.

edit: Coco, I don't think I said what I think you think I said

George H. we're cool. The above comment was to
first thank you and next to inform those
that have been fed misinformation (I was venting )
I should also add I'm a mental health
social worker. I've worked in the field
for seven years, before my onset of BP.
I've attended more professional trainings
than one little tough love class and a pamphlet.
It really burned me up for someone not
knowledgeable to mislead people.
Mania is serious (and dangerous) and if people w/ bp dx
could stop it the vast majority would.

I am not sure what exactly it is, but it looks like a behaviorist approach, and therefore, would have very limited applicability to "managing" mental illness, alongside with other behaviorist approaches. It certainly cannot "cure" mental illness. If it could cure mental illness, it would have long cured it, since it is fairly easy to implement and was implemented a lot. So the fact that mental illness exists, even though in the past and to some extent now people with depression got/get told to get their act together and all of that, seems to prove that "tough love" cannot cure mental illness beyond reasonable doubt.