There are many common misconceptions about an intervention and its goals. A common misconception is that an intervention is solely getting them to go to treatment or rehab. Even though one of the goals is to get the loved one into treatment, it is not the only goal. Getting someone to go to treatment is not necessarily a difficult thing to do. Getting your loved one to stay in treatment, increasing their willingness to apply the fundamentals of recovery, having them complete treatment, and applying the principles of recovery after treatment are the true goals and are more important than just getting them there.
If we want to achieve a long-term solution, we must achieve several goals in addition to getting them to go to treatment. Outlined below is a summary of these goals:
THE 7 GOALS OF A SUCCESSFUL INTERVENTION
ALCOHOL, DRUGS, THE A.M.A. AND THE “DISEASE CONCEPT”
The American Medical Association (AMA) endorsed the concept of alcoholism as a disease in 1957. In addition, other organizations across the country (the American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians) have also classified alcoholism as a disease at various times. The findings of investigators in the late 1970’s led to explicit criteria for an “alcohol dependence syndrome” which are now listed in the DSM-IV and the ICD manual. In 1992, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published a definition for alcoholism that defined alcoholism as, “a primary chronic disease with various factors influencing its development.”
Although there is some controversy surrounding the idea that addiction is a disease. Some feel that addicts are victims of a disease while some feel that they are not. However, there are some points of which it is important to be in complete agreement:
It has been theorized that almost every major form of treatment and recovery (whether 12-step, cognitive, faith-based, or psychotherapeutic) can be successful if the client is willing. Although there are no studies to prove this, observation does suggest a correlation between willingness and recovery.
It is because of this connection that increasing the willingness of the client is a major focus of the intervention process.
It is also suggested by some that there are 3 basic types of addicts. Granted, there are certainly all kinds of gray areas in between, but most addicts can be categorized into one of the following three groups that we have listed below:
A SOCIAL OR MODERATE USER
A social user seems to only use socially, occasionally having a glass or two of wine, or even the occasional hit off a joint. There have even been known to be social users of hard drugs who never seem to develop a problem with it (i.e. the person who does a line or two of cocaine once every few years). Understand, however, that even the social user can become addicted to drugs or alcohol with enough use.
A HARD USER
A hard user appears, at first, to be an addict if you look at a particular time frame in their life. However, when a negative consequence occurs because of their substance abuse, they often quit without the aid of treatment. For example, someone who drank heavily in college but was taken advantage of while under the influence and has never picked up a drink since. Another example is someone who gets married and stops smoking marijuana because their significant other tells them to. If the person does not seem to quit no matter how often or how many negative consequences pile up, then there is a good chance that they are.
A REAL DRUG ADDICT
A real addict has periods of abstinence with heavy binges or is a continuous user and does not seem to summon up enough willpower to quit no matter what the negative consequences are. The real addict drinks for an underlying reason, as opposed to just enhancing their life. No matter what negative consequences happen, they usually cannot quit permanently without the help of some form of treatment and recovery. Left to their own devices, the addiction will progressively get worse while destroying the hopes and dreams of their loved ones and eventually killing them.
THE BASIC NATURE OF ADDICTION AND THE REASONS FOR MANIPULATION
To understand and predict the actions and reactions of your loved one during the intervention process, it is first important to understand the nature of addiction itself. In almost every case of addiction, it is not the substance that is the primary problem, although its use is causing problems. But rather, the alcohol or drug use is but one of many symptoms of an underlying problem.
An effective treatment program focuses on the underlying causes and helps heal them. What is an underlying problem? Quite simply, most addicts are usually only about one thing – and that thing is usually about avoiding discomfort at some level and to some degree. Whether it is emotional or mental discomfort, physical discomfort, or external stress, it is a diminished ability to confront these things that dictates almost every move an addict makes.
We cannot emphasize enough that the operating basis of an addict, sober or not, is about avoiding discomfort.
Imagine that you are going to sit down with your loved one and have a discussion. You are going to talk to them about their drinking or drug use; how it is affecting you, how it has affected them, their life, and their future. Also imagine that you are going to discuss an adequate treatment solution (usually in the form of a comprehensive inpatient program) to solve the problem. Now, no matter how loving and caring you may be during this conversation, they will most likely find this topic very uncomfortable, sober or not. For them, it may feel confrontational rather than a simple discussion, and for them it will be a rather unpleasant situation to be in.
In addition to this, going to a treatment facility is an uncomfortable option. As we described before, the operating basis of an addict or alcoholic is about avoiding discomfort. We are going to describe all the various methods of manipulation that they may use to make this uncomfortable situation(treatment facility or conversation) simply “go away.”
Note: There are several reactions an addict may use during an intervention and on the following pages we have listed them to help you to gain a better understanding as to exactly why they behave the way they do, whether they are sober or not.
THE REACTIONS OR MANIPULATIONS OF AN ALCOHOLIC OR ADDICT DURING AN INTERVENTION
As the interventionist covers the various behaviors below, check off any that you feel your loved one would exhibit to deal with an uncomfortable intervention.
“I don’t use drugs. I did before, but not now. A doctor prescribes my medication. I’m not that bad. I don’t need rehab. I’m not a junkie. I don’t drink every day. I can quit anytime I want to, I just don’t want to right now. It wasn’t my drugs; I was holding it for a friend. I am fine. Everything is ok. There is no problem.”
If you believe or accept their adamant denial, then this uncomfortable conversation/confrontation is over, right? Of course, the uncomfortable treatment facility has magically gone away as well, for it is no longer needed. Your loved one has successfully found a way back into their comfort zone.
“Yes, I screwed up, but I will never use drugs again. I promise. I can beat this on my own. I don’t need rehab. I’ll go to an outpatient clinic or see a counselor or maybe one of those meetings next week. I’ll see a psychiatrist once a week. You can drug test me every day. I just need to get a job, and you can even hold on to my paycheck. Just give me another chance. I’ll stay at your house. I can quit. I just need your support. I swear to you it won’t happen again.”
Remember that every criminal standing before the judge awaiting sentencing is usually quite sincere when they say, “Your Honor, I’ll never do that again. I’ll be good. I promise.” However, that sincerity will fade as soon as the consequences are no longer present. In most cases, the offering of hope is not an offering of recovery or treatment, but rather just a temporary band-aid – an extremely minimal and non-intensive solution with no long- term gain.
If you accept the offering of hope, then the uncomfortable conversation/confrontation is over. That is until next month when you are in the same situation as you are in now. Never accept a minimal solution in the hopes that “something is better than nothing,” for the minimal solution has only one motive – to make the intensive treatment facility “go away.”
In recovery, minimal solutions often have minimal results even if your loved one is sincere. Be very wary of the offering of hope, it is usually nothing more than a very convincing manipulation. Many parents have walked in on their loved one dying of an overdose because weak promises were enough for them instead of them going to treatment.
This is their way of minimizing the uncomfortable options by cutting them in half and then offering you the hope that they will stay longer. Many families make the mistake of thinking that if the addict goes into treatment and begins to feel better, they will stay longer and finish the program. This is a fallacy. An addict who goes into treatment with the intention of only doing 30 days and thinking about it will only do 30 days, especially once they begin to feel better.
In addition to using fear against you, it is not uncommon for an addict to alternate between using fear and offering you hope in the form of minimal to no treatment. If they achieve this, you will recoil from the fear and grab onto the minimal hope as a last-ditch effort. Many times, families fail in the intervention process because they are stuck in the middle of fear and hope. Fear that if they continue standing their ground their loved one may be gone forever; and the hope that tomorrow things might change. This is one of the associative factors as to why most people do not find sobriety; their loved ones are unwilling to make a move. If you do not make the necessary changes and instead wait for them to change, you will lose them to their addiction.
Although there are many different types of manipulations that an addict may use during an intervention, most of these reactions can be found in the previous list. Hopefully this demonstrates to you that an addict behaves much like any other addict. They are not as unique as you or they might think. Their behavior is quite predictable and with the information in this section, you should be better prepared for any major reactions during the intervention itself.
SUMMARY OF REACTIONS AND MANIPULATIONS
We have covered several of the most common reactions or methods of manipulation that an addict will use to avoid facing an uncomfortable life situation, using an actual intervention as an example. It is interesting to note that the problem is not so much a drug or alcohol problem as it is one of how they handle uncomfortable feelings or situations. Every method that we have described really has one thing in common: What can I say or do to make an uncomfortable situation go away?
An addict can be quite skilled at telling you exactly what you want to hear just to avoid the situation. Understand that in addiction and recovery, words and promises without actions mean nothing. These are his survival mechanisms that have worked in the past. For them, these are the same methods that they will also use to make the intervention and its goals disappear.
To make a comparison, if a family member was stricken with cancer and collectively as a family you sat down with them to talk about the problem and an effective solution, then odds are that they would be receptive considering their condition. Would they use any of the previous methods we have described? Even though it would obviously be a very uncomfortable topic? The answer is no. In addition, they would probably be willing to participate in a comprehensive solution. The more intensive the treatment, the more encouraged they would be about it. It is the cancer that is the problem and there is a solution.
In comparison with a drug or alcohol addiction, it is not necessarily the substance itself that is the problem. It is how they deal – or more importantly – do not deal with an uncomfortable life situation that is causing the substance abuse. Even if your loved one is completely sober at the time and you do decide to confront them, you may witness many of the manipulation methods or symptoms that we have outlined. To effectively get your loved one into treatment, you must determine an adequate treatment solution and never compromise that solution.
Do not allow yourself to be manipulated out of a successful solution. An intervention should not be a negotiation. Watch carefully for the reactions described and understand that each manipulation has only one result for the addict – to continue their lifestyle of substance abuse. An emotionally sick addict has very little healthy emotional coping mechanisms to determine the best form of treatment. Some argue that they are the least qualified to make such a decision. Although some of their ideas may have temporary abstinence potential, none have a degree of merit in terms of long-term recovery and are manipulations created by the addict.
THE PROGRESSION RATE OF ADDICTION
We have outlined the idea that the problem is not a drug or alcohol problem as it is one of impaired coping mechanisms. The drug or alcohol use is just one of many symptoms of this failure to deal with uncomfortable feelings and life situations in a healthy manner. As an addict uses substances to cope with the uncomfortable, they slowly become unable to deal with these situations sober. Over time, this failure to deal with life manifests itself in the form of many classic symptoms that can change over time.
The best visual representation of how substance abuse damages the body is best seen on the “Jellinek Curve” or Progression Curve of Addiction (which is demonstrated on the previous page). Understand however, that progression rates vary due to: substances used, the frequency, the amount, and other factors. For your information, we have supplied a breakdown of the average progression rates for the most commonly abused substances in the list below:
|Barbiturates (Phenobarbital, Seconal, Nembutal, etc)||2-7 years|
|Benzodiazepines (Xanax, Valium, Klonipin, etc)||5-10 years|
|Opiates (Heroin,Oxycontin,Vicodin,etc)||2-7 years|
|Club Drugs (Ecstasy,LSD,GHB,Ketamine,etc)||Unknown|
A common misconception is that if an addict switches from one substance to another, they start at the top of the progression curve again. In actuality, if someone changes substances, the downward progression continues where the other drug left off.
For example: someone spends 10 years drinking and is somewhere in the middle of the alcohol progression curve. Then they decide to quit drinking but switch over to a much more rapid progression substance such as cocaine – they would progress more rapidly but would continue at the middle of the progression curve even though they had never touched the new substance before.
Oftentimes we will see an addict who has been drinking alcohol or smoking marijuana for years at a slow steady decline and then he switches to opiates or crack cocaine and then the progression speeds up. The family then mistakenly feels that their loved one “has a crack or heroin problem” because the decline is so sudden, but the problem has existed for years at a much slower rate with a different substance or activity.
SPECIAL NOTE: Most interventionists consider methamphetamine the most dangerous of all interventions due to their explosive, random, sometimes violent nature. These interventions are more difficult because by the time a methamphetamine user reaches the bottom of the progression curve he is oftentimes delusional, psychotic, or even insane.
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