Back in the early 2000s, I (and one of my colleagues, Dr. Michael Larkin) carried out some research at the Promis addiction clinic down in Kent. We were researching people’s phenomenological experiences of addiction, and our interviews with the addicts receiving treatment were really helpful in the writing of what I personally thought were some really interesting papers (see ‘Further reading’ below). However, what interested me even more were the conversations I had with the clinic’s Director, Dr, Robert Lefever who told me of his interest and research into ‘compulsive helping’. Dr. Lefever has written a number of articles online about compulsive helping. In one of them he began by stating:
“Of all the addictive behaviours those surrounding relationships like sex and love addiction, relationship addiction or compulsive helping can be the most difficult to understand. This is further hindered by the confusing terminology used to describe it. Just as addiction means as many different things to as many people so do terms like co-dependency. We have tried to help clarify the situation by using different terms for different behaviours. Where people are addicted to someone they have a relationship with we call it relationship addiction, where people are addicted to helping others with their problems we call it compulsive helping”.
Dr. Lefever says that by giving these behaviours descriptive titles (like ‘compulsive helping’ and ‘relationship addiction’) help the affected person to identify the specific behaviour that they are actually addicted to. He also argues that such labels help the affected person relaise that the person responsible for the addictive behaviour is the individual and not someone or something else. However, Dr. Lefever is the first to admit that “the concept of compulsive helping can be particularly difficult to get one’s head around”.
Obviously not all helping is harmful but Lefever distinguishes between ‘caring’ (which he views as healthy) and caretaking (which he views as unhealthy). Compulsive helping occurs when the ‘caretaker’ (rather than a carer) continually takes on the responsibilities of someone else (very often a person who they love), and in essence runs that person’s life for them. Compulsive helpers often help other people that have an addiction (such as an alcoholic or a gambling addict) but Lefever claims that compulsive helpers can also end up compulsively helping people that doesn’t have problems themselves. (However, those without a problem are far more likely to notice compulsive helping behaviour in other people if they feel it is significantly and continually interfering in their day-to-day life and business). More specifically:
“Caring is lovely and healthy. I would never wish to change that characteristic in anyone. Caretaking however, is over-caring for someone, taking on the other person’s responsibilities for themselves and not allowing the other person to have the consequences of his or her behaviour…Helping is loving. Compulsive helping is destructive of both self and the other person. It is destructive of my own life and destructive of the person whom I am trying to compulsively help. That is not what I would call a loving action”.
Another short article on ‘compulsive helping’ by Rochelle Craig on her Piece By Piece Recovery website has a slightly different take and notes that:
“Compulsive Helping is when the individual finds it impossible to say no each and every time they are asked. A compulsive helper will always help regardless of what the situation is whether it is convenient for them or not. This can result in the compulsive helper building up resentment against the other person or persons and feeling like a doormat. When this happens the compulsive helper begins to resent being asked”
Like Dr. Lefever, Rochelle Craig believes that compulsive helpers take on too much responsibility, and therefore take away responsibility away from other people. Craig is adamant that people should examine their motivation for their helping behaviour to assess the extent to which it is helpful. If the act of helping others is a continual source of gaining self-worth, it may be indicative of compulsive helping. Other signs of compulsive helping is carrying on helping even if it is putting one’s own health, job, and/or other relationships at risk, Craig asserts that:
“It is important to remember that we are talking about addictive behaviour, we are talking about extremes, and we are talking about situations where the compulsive helper is so absorbed with helping others that they lose their own identity. Recovery is about self-discovery, self-improvement and building on self-esteem without relying on constantly helping others. It is about self-care first and everyone else second! Recovery is about recognising the difference between compulsive helping and genuine acts of kindness and most importantly it is learning to say no!”
In another (different) article on compulsive helping, Dr. Lefever refers to ‘compulsive helping’ as ‘co-dependency’ and claims that compulsive helping “is the most perverse, widespread and destructive of all addictive or compulsive behaviours” and the ‘need to be needed’. In fact Dr. Lefever claims that:
“Behind any addict of any kind will be a compulsive helper, or a bunch of them, taking responsibility for them. The compulsive helpers try to solve problems and ferret out information on causes and treatments. They give incessant advice and generally get in the way of addicts having any chance of learning or doing things for themselves – which, ultimately, are the only things that are going to help. Those of us who are afflicted by it go out of our way to give uninvited help. We want to feel useful and constructively helpful. These are admirable characteristics. But they can be very destructive when they are applied without thought to the consequences…When people have too much done for them, they fail to develop their own skills. They become part of the dependency culture”.
Dr. Lefever and psychologists at the University of Kent have published a number of empirical studies on addiction including compulsive helping. In a study led by Professor Geoffrey Stephenson and published in a 1995 issue of the journal Addiction Research, the researchers evaluated addiction in 16 behavioural areas on 471 patients (using 191 male addicts and 281 female admitted to Lefever’s Promis Recovery Centre). The addicted patients’ questionnaires were subjected to a factor analysis and results showed there to be two fundamentally different types of addiction labeled as ‘nurturance’ and ‘hedonism’. ‘Nurturance’ included caffeine, work, exploitative relationships (submissive), shopping, exercise, food bingeing, food starving and compulsive helping. ‘Hedonism’ included alcohol, nicotine, recreational drugs, gambling, exploitative relationships (dominant), sex, and prescription drugs.
A follow-up study published in 2004 by Stephenson and Lefever in the journal Addictive Behaviors, confirmed these earlier results but also suggested that ‘hedonism’ could further be divided into a ‘drug use’ factor and an ‘interpersonal dominance’ factor. The nurturance addictions comprised of both ‘self-regarding’ and ‘other-regarding’ factors. A more recent study in a 2010 issue of Addictive Behaviors by Dr. Vance MacLaren and Dr. Lisa Best confirmed the results among a student population (n=938). Despite this empirical research, it should be remembered that all of the data on compulsive helping has been done using the instrument that Lefever and his colleagues developed. There’s certainly a need for research to be carried out with instruments that weren’t developed and/or carried out by the people who have a vested interest in the ‘compulsive helping’ construct.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Craig, R. (2012). Compulsive helping. Located at: http://www.piecebypiecerecovery.co.uk/index.php?pageid=8
Griffiths, M.D. & Larkin, M. (2004). Conceptualizing addiction: The case for a ‘complex systems’ account. Addiction Research and Theory, 12, 99-102.
Haylett, S., Stephenson, G.M. & Haylett, S. (2004). Covariation in addictive behaviours: A study of addictive orientations using the Shorter PROMIS Questionnaire. Addictive Behaviors, 29, 61-71.
Larkin, M. & Griffiths, M.D. (2002). Experiences of addiction and recovery: The case for subjective accounts. Addiction Research and Theory, 10, 281-311.
Larkin, M. & Griffiths, M.D. (2004). Dangerous sports and recreational drug-use: Rationalising and contextualising risk. Journal of Community and Applied Social Psychology, 14, 215-232.
Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.
Lefever, R. (2012). Compulsive helping. Located at: http://promis.co.uk/addiction-info/addiction/compulsive-behaviours/
Lefever, R. (2012). Compulsive helping. Located at: http://www.doctor-robert.com/compulsive-helping/
Maclaren, V.V. & Best, L.A. (2010). Multiple addictive behaviors in young adults: Student norms for the Shorter PROMIS Questionnaire. Addictive Behaviors, 35, 252-255.
Stephenson, G.M., Maggi, P., Lefever, R.M.H. & Morojele, N.K. (1995). Excessive Behaviours: An Archival Study of Behavioural Tendencies reported by 471 patients admitted to an addiction treatment centre. Addiction Research, 3, 245-265.