Care and Compassion Over Tough Love

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What does "tough love" mean? It depends on who you ask.

To some, tough love is simply the opposite of coddling—it refers to letting a loved one face the consequences of their actions as part of a learning experience. In theory, this definition sounds reasonable. But in practice, tough love often goes much farther than that, and the concept can be used to excuse or encourage caregiver behavior that’s harsh, counterproductive, and even abusive.

If you love someone who’s struggled with addiction, you’ve likely received advice from someone at some point recommending tough love. Proponents of this approach believe that cutting off resources, support, or contact will prompt your loved one to change their behavior. But this is rarely the case, especially when it comes to a medical illness like addiction, which alters a person’s body and mind and makes abrupt behavior change very difficult.

Where does the term "tough love" come from?

The phrase seems to have first emerged in 1968 when Bill Milliken authored a book by the same name. Milliken was involved in street outreach intended to prevent at-risk kids from dropping o­ut of school. He advocated for a no-nonsense, firm approach, while still communicating that the outreach came from a place of concern and love.

From there, the term was applied to elder care, self-help, and other contexts. Its association with parenting, especially related to caring for children who struggle with substance use or other problematic behavior, is the one that’s most well-known today.

What’s wrong with tough love? Aren’t boundaries a good thing?

Yes, establishing boundaries is critical in every relationship: in families, at work, between romantic partners, and more. But tough love often goes beyond that in ways that are not productive. It can damage relationships and create long-lasting wounds, all while failing to change the behavior it intends to.

It creates an atmosphere of distrust and disrespect.

Whether or not something is done for someone’s "own good," it can still hurt just the same. When it feels like love is conditional, limited, and hinging upon certain behavior standards that are hard to meet, it’s difficult to feel safe or to genuinely connect. This can lead to an adversarial relationship dynamic in which the people involved don’t trust or respect each other.

It can get abusive.

The tough love model is often used to enable physical violence, emotional abuse, humiliation, and other harms. Not only do these approaches not work to correct behavior, but they’re also proven to put people, especially children, at even greater risk of health problems later in life, including substance use disorder.

In her book Help at Any Cost, journalist Maia Szalavitz investigates teen boot camps and "scared straight"-type treatment environments. She uncovers horrible abuses, including deaths, and very little regulatory oversight. Caregivers should beware of any treatment programs that espouse a tough love approach.

Tough love sometimes achieves short-term results, but they’re unlikely to hold up over time.

For example, a parent threatening to kick a child out of the house unless he goes to rehab could indeed lead to the child agreeing to go to rehab. However, evidence shows that forced or coerced addiction treatment rarely improves the patient’s outcomes long-term—in fact, it can even be harmful. Instead, lasting recovery is more often the result of an individual choosing to seek help and being an active, consenting participant in their own care.

It can backfire altogether.

Not only is tough love rarely effective, but it can actually fuel the flames of troubles. According to the National Institutes of Health, "'get tough' treatments do not work and there is some evidence that they may make the problem worse."

This is especially true when it comes to addiction. Substance use disorders are heavily stigmatized, and as a result, people coping with them often feel unworthy and unlovable. Receiving a tough love approach from parents, friends, or others is only going to make the person who’s struggling feel worse. People who feel badly about themselves and their relationships are less equipped to make positive changes in their lives, like reducing substance use or seeking addiction treatment.

Experiencing consequences is a natural part of life and can help us all learn and adapt. But tough love is not necessary to make this happen.

There's nothing wrong with declining to intervene and solve all your loved one’s problems for them. What’s more, creating sensible rules and expectations for children is an important part of parenting, and doing so helps kids feel grounded and safe in their environment.

It’s when we attach our love and support to harsh, unreasonable, or unpredictable conditions that "tough love" comes into play. And there are better ways to manage relationships than that.

What to do instead? Be compassionate. Be respectful. Be consistent. 

Establish boundaries, and then clearly and consistently communicate those boundaries. Let your loved one know what they can and cannot expect from you and stick to what you say. This will look different for every person and every situation.

“Figure out what works and then be consistent with that approach,” Dr. Michele Borba tells When it comes to parenting specifically, boundaries and expectations are ideally set early on in a child’s life so that they know what to expect. But it’s never too late to begin an honest, respectful dialogue around behavior and values.

If you have a loved one dealing with a substance use disorder, be compassionate and encouraging. Let your loved one know you won’t judge them or harm them. Offer a supportive listening ear. There are also effective programs that can help families encourage their loved ones to seek treatment, like Community Reinforcement and Family Training (CRAFT). According to Very Well Mind, CRAFT “utilizes behavioral principles to reduce substance use, encourage treatment, and reduce the stress felt by the individual's loved ones.”

If your situation is urgent and you need more detailed guidance and support, reach out to a qualified health professional, like a family care doctor or a licensed family therapist.

Remember that you don’t have to navigate this difficult work alone. And you don’t need to use a tough love approach to help your loved one with addiction or any other issue.

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