Susan Sarandon’s character on the hit Showtime series Ray Donovan is one of the most powerful Machiavellian if not the most powerful studio head in the movie industry. Samantha Winslow, the character’s name, yields tremendous power as a media mogul and has final say about life or death at any means. Sam is ruthless in her demeanor, full of rage and self loathing, and is an untreated alcoholic (though who is not in that show). She wields Hollywood like it’s a mighty sword. As such, ethics are out the window.

I can, as a social worker and family expert, only wonder what her family was like. But the story goes deeper for Samantha. Never having forgiven herself for the tragic death of her young daughter – killed while she was driving under the influence – she runs an empire which behind closed doors is full of lies, deceptions, backstabbing, wiretapping, eavesdropping and even murder. In short Samantha stops at nothing to get her way. And while the world knows differently, her whole team around her turns the other cheek less her wrath turns toward them.

While Sam is allegedly a fictionalized character, one wonders if she was inspired by a real-life person who wears the Emperor’s New Clothes with such pride? Perhaps a conglomeration of powerful women and men who have endless resources (money, prestige, power, influence) and use it through confidentiality agreements and Non Disclosures, etc. to control and dominate their world. It’s as if they are determined to make their version of reality the only one available to the public. “The truth is it is not reality but a fragile reality that they have created and need to keep real at all costs, otherwise their glass castle could crumble,” writes Dawn Hedgepeth LCSW CDWF , a colleague of mine who works in behavioral health. These type of folks run ripshod in their addiction and ruthlessness while all the while the folks on the payroll are too afraid to speak up and say what they really saw. These types of people who fabricate reality can be celebrities, politicians, executives and sports stars.

As I have written earlier, with high wealth, power and prestige comes a host of other problems. Addiction runs rampant when there is no one on the payroll, in the family or on the team to speak up. And there are many people with voices. These are the people around the Samantha’s of the world – the housekeepers, maids, hairdressers, personal assistants, stylists, medical teams, trainers , coaches, security. And then there are the wealth managers, estate attorneys, political aids, executive assistants, public relations team, and the cleanup crews.

So it is not unusual, for example, for security to block a surveillance camera so their client is not caught in a compromising position or for the hairdresser to look the other way when their client is drunk or loaded, or the lawyers to pull a bullet-proof defense from their back pocket or the money manager cover the player’s gambling debts. But the tales spread like wildfire. The stories woven about high profile individuals – whether in Hollywood, on the playing field, in the boardroom, in our legislature or in our schools and universities – remain locked in the eye witness accounts until someone comes forward. These are the enablers.

What is an enabler? Simply put, it’s the best friend who tells his buddy struggling with alcohol addiction that one more won’t harm him. It’s the mother who secretly deposits cash into the daughter’s account who just finished her sixth visit to a rehab center. And it’s the executive assistant who overheard on a phone call a lewd comment her boss made to a client. It’s the single voice, the individual, group, organization or community that does not speak out against the actions of a person like Susan Sarandon’s character

Of course, there’s a more nuanced relationship here than simply calling out inappropriate, offensive, destructive or immoral behavior. In most cases, the axiom of abusers and their enablers is power. Look no further than the implosion of Harvey Weinstein’s movie empire to see how power protected his citadel of abuse operating out of the glitz and glamour of Hollywood. The parallels between Sarandon’s character and Weinstein are uncanny.

And what about the enablers who aren’t harmed or abused by the corrupt wielding of power from a man like Weinstein? Money is at the heart of the issue, explains Kim Masters, editor at large for The Hollywood Reporter, for a piece in The New York Times. “The unfortunate reality of Hollywood is that if someone has money, then they can generally find some kind of audience of people who are interested in working with them.”

Money played a pivotal role in the case of Dr. Carmen Puliafito, a renowned Dean in USC’s Keck School of Medicine. This past summer, the Los Angeles Times reported Puliafito embroiled in a scandal that involved drug-fueled parties, overdoses and young men and women. In pictures and video footage the LA Times reported on, Puliafito could be seen “inhaling and then unleashing a thick plume of white smoke. Seated next to him on a sofa, a young woman smokes heroin from a piece of heated foil.”

How did the Harvard graduate turn into what appears to be a partier? According to the report, Puliafito “was a key fundraiser for USC, bringing in more than $1 billion in donations, by his estimation.” So we can see how nobody wanted to step forward and blow the lid on Puliafito’s addiction to drugs and other process disorders. And as a Dean, his circle of influence reached far and wide. “Puliafito oversaw hundreds of medical students, thousands of professors and clinicians, and research grants totaling more than $200 million.” He had enablers positioned at every corner.

Unfortunately, abusers and their enablers are not sequestered only to media. As an interventionist and clinician who works with clients and their families experiencing substance abuse and mental health disorders, abusers and their enablers can be found in many communities across a multitude of industries. And it’s not just about power. For many of my clients, the ones in the position of being an enabler are driven by fear. They fear the relationship will be lost, rejection will take hold, they’ll be branded a failed father or grandparent, sister or cousin. Kim Masters calls fear the “ultimate silencer’. And in the shadows of that fear lurk cases like Tiger Woods, Lindsey Lohan and many other executives, influencers, sports stars and politicians.

But there is hope in breaking the silence. Someone tipped the scales in the Puliafito and Weinstein cases – a faint whisper in a crowded room that miraculously rose above the noise and spoke truth to power. How is it done? Courage. The courage to speak out comes from wanting change.

I believe change can happen when voices rise up and no longer play the enabler role. There have been many trailblazers in the media’s eye on this subject. As for families and their loved ones, I’ve seen cases of a sister or a daughter, aunt or uncle, friend or colleague finally saying enough is enough. Because the truth is the person walking in the Emperor’s Clothes needs help. And with courage and conviction, we can work together to bring these issues out into the light.

This article was originally published on Huffington Post.