When Someone You Love Spirals Out of Control, When Do You Stay and When Do You Go?

Photos: Getty Images) 

On Tuesday night, news broke that former NBA star Lamar Odom was found unconscious at a Nevada brothel, seemingly of a drug or alcohol overdose. Though the two are still legally married, Khloe Kardashian left the basketball star after five years together in 2013, reportedly over his struggles with substance abuse, and, primarily, his addiction to cocaine

Odom remains in critical condition, still unconscious, with Kardashian by his side after she rushing to the Las Vegas Hospital he’s being treated at upon hearing the news. 

Earlier this week, University of Southern California (USC) football coach Steve Sarkisian was fired, allegedly as a result of his own struggles with alcoholism and his violation of the school’s zero-tolerance policy regarding alcohol use. He was on his way to a treatment facility when USC’s athletic director attempted to contact him to inform him of his firing with cause.

Sarkisian, who is in the middle of a divorce, is reportedly struggling to cope with it. The 41-year-old has three children with his estranged wife. 

We can’t pretend to know the inside details of the lives of these two prominent sports stars. But their situations are one we can relate to. Many of us have someone in our lives who has gone off the deep end, due to substance abuse, mental illness, or other circumstances. 

Your relationship changes. One of you grows distant. The other does not know whether stay and attempt to protect, or leave to preserve their own sanity. If you stay, you may be miserable, but if you go, they’re on their own, and you’ll never forgive yourself if anything happens to them. 

And while we can only speculate about the current involvement of loved ones in both Odom and Sarkisian’s lives, we can use this moment to explore how friends and family can best support a loved one struggling with addiction — and when it is best for their own sanity and safety to walk away.

When it comes to identifying whether a loved one is on the brink of the kind of breakdown Odom seemed to suffer this week, “Frankly, it’s usually not that secret,” Gail Saltz, MD, a psychiatrist and psychoanalyst, tells Yahoo Health. “A one time thing is a one time thing,” Saltz explains, whereas “repeated behavior that results in harm to the person in some way and that the person is usually defensive about” is typically indicative of addiction.

Addicts, and others with self-destructive behavior, will “say their behavior is someone else’s fault, not theirs, or say they just had bad luck. They will externalize the problem and tell you that it’s coming from sources outside and not inside of them,” says Saltz, noting that addicts will also often just “straight up lie” about what happened, continually changing a story to continue to distance themselves, and any personal responsibility, from their behavior.

“The thing is to be supportive by telling that person that there is a problem. That you think that there is something going on that they need to seek help for,” says Saltz. “Support can come from offering to help find them that help, to take them to that help, to discuss with them what that help might look like.”

And yet, she explains, loved ones still must be cautious of not enabling self-destructive behavior in their attempt to provide support.

“People often feel seduced into not wanting to upset the person who doesn’t want to change, seduced into doing what that other person is telling them,” she says, noting that those with self-destructive tendencies might tell loved ones that the support being offered isn’t helpful. “They’ll often says, Pretend! Ignore! Look past! Believe the externalization I have created about the problem!”

However, she says, if the person shows an interest in making change and getting help, “you want to stay and be helpful.” It is also often worth trying to stay and help a person with whom you have shared relationships — like children — if you feel that the hurt potentially caused by them leaving might be greater than the self-destructive behavior itself.

“Sometimes someone who is repeatedly doing self-destructive behavior, especially when it comes to substance abuse, they really have to hit rock bottom before making any change, if they even are going to make a change,” Saltz adds, which is why loved ones must be especially careful that their support of a loved one in a difficult time is not, in fact, supporting the behavior that is causing the difficulty.

She recommends, for example, telling a loved one that you will fund their treatment, but won’t fund their addiction. Let them know, “I will help you help yourself, but I will not help you otherwise.”

Most important, she explains, is being clear about how much care and love you have for the person in need, while also remaining objective and not providing that love when the person struggling is not trying to make any change to themselves.

“That’s not constructive for them, or you,” she says.

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