- Mental Health
Because We Cannot See: When Addicts Need an Intervention
I am not a doctor. This is a description of my successful intervention experience twenty-six years ago and some basic guidelines for an intervention.
You should always find trained individuals to counsel you if you think an intervention might help a loved one see that they have a substance abuse problem.
It is imperative that you have professionals involved if any of the following are present in those wanting to participate in the intervention or are applicable for the addict.
- Has a history of serious mental illness
- Has a history of violence
- Has shown suicidal behavior or recently talked about suicide
- May be taking several mood-altering substances
Sometimes, We Have to See from Another's View
Seeing Life Through Another’s Eye
When people have clarity, there is no question that using drugs and alcohol are self-defeating. However, when we are in the grips of our addiction, we do not see reality, nor can we appreciate the rational caring viewpoints of others.
Many of us require an intervention by others to understand just how much harm we have inflicted, the damage to our relationships, and to know that there are still people willing to help.
Twenty-six years ago, I worked at a small southern college in Gainesville, GA. My dual roles, House Director and student helped me justify my tranquilizer and alcohol use. I'd make self-serving comments to anyone who would listen that if they had to put up with over one hundred college students and be a student, they would need something for their nerves as well.
"Nerves" is not a medical term or condition. Although my doctors understood my reference to the anxiety and stress. Yes, I wrote doctors. It is not uncommon for us to doctor shop; where we seek out complicit physicians who willingly dispense prescriptions as long as we meet the co-pay.
Or, if we use controlled substances, we might go to more than one doctor, get a 30-day supply, and go to another for the same symptoms and get an additional 30-day supply.
Then we have to make sure that we don't take Dr. X's prescription to the same pharmacy where we've taken Dr. Y's. It's no wonder that I had nerves, all those surreptitious activities - sneaky, underhanded and probably today, illegal. In 1988, there were still locally owned pharmacies where they knew you by name, not an electronic alert that I had scripts in all the other Mom 'n Pop drug stores.
Limited Vision Prevents Us from Seeing Clearly
Part of my limited vision and diversionary tactics were to deflect criticism from co-workers and family by pointing out my grades. I was a Dean's List student.
A 4.0 in my major and an overall GPA of 3.89, while carrying 15 hours a semester.
If you think about it, how would an academic institution judge someone; by their grades. Whether it was a student or an employee, erecting the GPA shield bought me time and kept people from addressing my issues.
It focused their attention on the one valuable asset I had at the time, and my hope was that they would not look at other behaviors so closely.
I also used the answer a question with a question approach. When someone asked me about my use, I just reframed the question into my own with, "Do you think someone with a substance abuse issues would be a Dean's List student with a 3.89 GPA?"
That invariably focused the conversation on my better qualities and took the direct attention off any suspected substance abuse issues. However, that all changed when the college hired a new dean. I worked in the Office of Student Development, and this was to be one of her departments. She believed in meeting with each staff member individually; getting their feedback on strengths and weaknesses.
Several of my co-workers determined that my erratic behaviors and suspected substance use were a weakness. After discussing their concerns, she calmly told them that no one on campus was qualified to make an assessment, but that she was in a position to require me to have one.
I met with her for what I assumed would be my luncheon get together and instead, she informed me that there was concern about my pill use and drinking. Since she was new and had not observed any of these behaviors, she wondered if I would have an evaluation to determine if I had a substance abuse problem. I immediately agreed, thinking I could justify my use to any counselor.
Even When We Avoid Seeing, Our Addiction Shows
Have you been questioned about your alcohol or drug use?
We Cannot Hide What is Apparent to Others
My assessment was rather low-key. I had expected a form with yes/no responses and was prepared to lie.
Instead, the counselor asked standardized questions that I found challenging. It was apparent that I would not be able to rationalize my use to this woman. I knew that she saw me for what I was, addicted, troubled and desperately in need of help.
However, I did not cooperate when I got uncomfortable with her probing questions about the way I appeared that day.
Rather than give her more ammunition, I informed her that I didn't want to continue the assessment. Then I asked if she had to report her evaluation to the school.
I hoped that legally she could not report this evaluation without my consent. When she verified this, I told her we were finished and that she did not have my permission to report her findings or evaluation.
In my delusional state, I thought I'd found a way out. Feeling smug and self-assured, I grabbed my purse and left. Clearly, this was not a case of no news is good news, and when the college did not hear from her, they collectively made other plans.
On September 30, 1988, I was called to the president's office. Not unusual, I had been there before for meetings and tea. the office reeks of education and English library influences in the décor. However, the moment that I went it, I realized there would be no offer of tea.
Five deans and the president all stood up, formed a single line and produced 4 X 6 cards. Some shuffled their cards as if they were out of order, others smiled weakly at me, and some looked to one another for guidance.
As a psychology major, I knew what they were preparing to do - have an intervention, and I would be the subject.
While we have TV show of the same name today, where people typically deny a problem, throw fits and make wild accusations, I did not. Nor, would I put these people nor myself through the ordeal of recounting all of their collected examples of my out of control behaviors.
Instead, I just asked them what they expected. They expected me to get help and be at the treatment facility of their choice by 8 PM. Although this group of individuals had no counseling to help them facilitate the intervention, the outcome pleased everyone; I agreed to treatment and entered detox that night.
In my case, that intervention began my healing; it's been twenty-six years and I am still in recovery. However, interventions have improved since then. We are more knowledgeable about addiction, attitudes and ability to stage one that is more likely to produce the desired result - getting the addict some help.
Do you hear the love and concern when others comment on your drinking or behaviors?
When Others Still See Us Through Loving Eyes
For many of us in the addicted population, any one individual confronting us about our use is ineffective.
We can argue with the best of them, deflect one person's point, and use the time-worn, "Well, that's just his or her opinion." We discount the individual, as if any one person's opinion doesn't count.
Combining forces for an effective intervention is a better approach. Also, having a licensed interventionist to weed through the examples and determine who, if anyone, is a weak link is paramount.
Think about this logically, if five people are giving the same example, it may be five people talking about it, but it is still just one example. We'll talk our way out of that example by presenting it as some isolated instance. So we fell into the Christmas tree in front of all of them, it still was just too much holiday wine on one day.
But if these same five people give distinct examples, even for the same type of behaviors, it is more powerful and compelling evidence of our problem.
Looking for the weak link references the individual, who, for their reasons may not be solidly in favor of requiring treatment for the person. It might be a family member who feels guilt, also. A sibling who has said cruel things out of frustration, or a parent who carries remorse for perceived bad parenting.
And we can spot a weak link, or enabler the minute we walk into a room. The one who will cave if we cry or may think they are somehow responsible for our choices, and we can use that information to distract from the intended purpose of the intervention.
I knew that none of those people at my intervention would cave. Yes, they were uncomfortable but none of them would back down on their guidelines for my continued employment - get help or you are fired.
After I had been in treatment about four weeks, my father told me that the college had asked him and my mother to participate. Much to his credit, my father told them he couldn't; that he knew if I started crying, he would take me out of the intervention and probably not have the same resolve nor make equivalent demands as the college had. He knew that this was the best thing for me, so he removed himself.
As we talked about it, I knew that had he been present, I would have cried and manipulated him and not gotten treatment.
Dr. George Northrup On Pre-Intervention Steps and an Intervention
Have you ever participated in an Intervention?
Interventions Help Remove the Masks and Facades
If an Intervention is Needed: How To Effectively Conduct One
A trained interventionist lets the family and friends vent about their sense of betrayal, anger, fear and sometimes guilt.
It isn't that there is anything wrong with having these emotions, or that they can't be discussed in an intervention. But focusing only on those emotions creates a defensive posture in most people and they can distract from the main goal - getting the addict some help.
Having a written statement, often revised and reworked several times is the norm. These letters convey the love, concern and how the relationship used to be before drugs and alcohol took over. How do these letters accomplish this?
By reinforcing the following:
1. That the person still loves the addict; not the action, the use or the other self-defeating behaviors. It's okay to be angry about the actions, just distinguish between the user and the acts.
2. The concerns for the welfare of the addict, whether it physical, emotional, financial, or mental.
3. That the family and friends miss communicating and visiting with the person. Whether it is a family function or a work golf tournament doesn't matter; examples of how it used to be are helpful in conveying this message.
4. How good the relationship used to be, or remind them of accomplishments when they were not using.
5. That today, there is a choice - treatment, with a plan in place, or....
With any ultimatum, the group must be in agreement about the consequences of choosing not to enter treatment.
For some families, it may be that they will no longer give money to the addict. They may still buy food, pay tuition, or pay rent, but not give the addict cash. Be prepared to state that you will withhold money unless they get help for their addiction. However, you can reinforce that withheld support will continue if they choose treatment if that is feasible.
6. Give concrete alternatives when possible.
- Go to detox if it is medically indicated.
- Come home and enter outpatient treatment for 12 weeks
- Restart recovery support meetings for 90 days
- Enter a long-term facility for three months
Options and the semblance of choice can sometimes defuse an emotional and irrational response from the addict.
7. Once the team, interventionist, and resources are outlined, have a mock or rehearsed intervention. The interventionist has an opportunity to watch the interaction among the participants:
- Who strays from the stated agenda
- Who has their own issues
- Who is ambivalent about the goal
- Who is too emotional to participate and
- Who cannot stay on track when the addict's anticipated responses and reactions are role played
These are all critical pre-intervention criteria that will help ensure the best intervention possible.
Treatment: The Ultimate Objective
Unfortunately, family members, friends and employers all think because they have valuable information, they should be included. While their information is valuable, how they present the facts can make the intervention too contentious to achieve the desired results.
Getting the addict help is the fundamental objective; not condemning, shaming, or belittling the person. Whether we act like it or not, most of us feel guilt and remorse for our behaviors; our addiction is just stronger and overrides those feelings.
Also, in our use, we are not doing something to others; we are doing something for ourselves. Selfish and self-centered, yes.
But we rarely factor, "If I loved them, I wouldn't do this". We do love our families. We still do drugs. This is not a comparative for most of us addicts.
What If the Intervention Doesn’t Work?
It is difficult when all just want the addict to get help, and they walk away from the intervention, angry and refusing to get help. Everyone, but the addict realizes they are trapped in the prison of addiction.
Families and friends, who have done all they can, enlisted the help of a trained interventionist, and had their mock, staged or rehearsed intervention need to know:
"All you can do, is all you can do."
Without being cliché, this is probably the most difficult thing for families to accept.
For some other participants, they may have to distance themselves and not communicate with the addict for a set time; followed by stating that the family member or friend will connect in a few days, to see if the addict had a change of heart. Often, when an addict reflects on the care, concerns, and examples, they will change their minds and want help.
Make sure they have a number to call - a family member, friend, or in some cases, the interventionist. Giving the addict a safe number to call if they change their minds is another life-line that some addicts choose.
When We See What You See
Sometimes Interventions Work - After the Fact
If the addict asks for help after the intervention, mission accomplished.
Unfortunately, some family members will spend time on the "Why didn't you take the help yesterday?" Or worse yet, "I told you that you needed help."
Forgo those words and be grateful that your loved one is getting treatment and they can finally see their lives as you see it.