and looking after yourself at the same time
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If you have a friend,
spouse, or loved one that is an out-of-control user, what can you say to them?
Here are some of our
typical pleas:
“You have to stop
using.”
“You’re going to kill
yourself if you keep using.”
“Your using is killing
me.”
“Your using is tearing
apart the family.“….and so on.
First of all, none of the
above is actionable for the user. They are trapped in a cycle and probably can’t
even bring themselves to care about many of the consequences you are
threatening.
Denial is an
essential component of becoming addicted to alcohol or drugs – after all none
of us really like to admit we have a problem with anything, and in the addictive
process this tendency becomes all the more pronounced.
Denial is a
major barrier in the way of overcoming alcoholism or drug addiction– an
absolutely essential first step is for the person to actually accept that at
least they might have a problem. If the person you are concerned about does not
admit that they might have a problem you are facing an, almost, impossible task
(In professional terms this is called Pre-Contemplation). If they are able to
reach this conclusion, then they may become amenable to speaking to a
professional in confidence. If they remain convinced that there is no problem,
then it is highly unlikely that they will wish to speak to anyone – after all –
what would be the point?
The truth of the matter
is, you have very little verbal control over a user. Things that you say
will have very little control over them, even if they are sober when you say
them.
As such, it
may well be the case that the behaviour of this individual triggers unpleasant
feelings in you such as anger, exasperation, irritation, depression. It would
not be unusual if they have become violent or aggressive towards you on
occasions. If you are to motivate this person to seek help you must do your best
to stand back from these feelings. I recognize that this is very easy for me to
say, whilst being very hard for you to do. However, you must do your best if you
wish to maximize your chances of success in convincing the person to seek help.
The bottom line here is that People Nearly Always Need to Make Decisions for Themselves.
This is not just related to alcoholism or drug use, but is generally true in
life. Someone is much more likely to want to do something if they feel that this
has been their own decision, rather than an ‘order’ from someone-else, or that
they have to do it just to keep someone else happy.
So what can you do?
The healthiest decision you can make is for yourself. That decision is for you to be
healthier in terms of your relationship to the user.
There is nothing you can
say that will make someone magically stop using.
However, there are
several things you can do. Some of what you can do involves verbalising your
intentions to a user. Your intentions. Not verbalising demands
for them to change their behavior. Merely what you intend to do, given their
behavior and/or their using.
At the same time you can help the user to help themselves.
Helping motivate someone you care about to seek help for their addiction
People Nearly Always Need to Make Decisions For Themselves. This is not just related to alcoholism or drug use, but is
generally true in life. Someone is much more likely to want to do something if
they feel that this has been their own decision, rather than an ‘order’ from
someone-else, or that they have to do it just to keep someone else happy.
1. NEVER
directly disagree with them – rather walk away if you are about to.
2. DO NOT
PRETEND that you do agree with them either.
3. In
general, avoid making statements of fact.
4. DO
ask open-ended questions (questions which deliver a response other than a simple
yes or no) if you can. Closed questions (requiring a yes or no answer) are still
much better than making statements.
5. Keep in
mind the idea that you are going to let the resistance wash over you. You are
not going to become resistant or defensive yourself in response to the person’s
statements, but you are not going to give in to them either – you are going to
go along with them.
Here’s an
example of a bad response:
User: ‘I’ve
got a stinking headache this morning.
Helper:
‘Well you shouldn’t drink so much then’.
User: ‘What
do you mean?
Helper: ‘I
mean that you need to stop using.’
The ‘helper’
has made statements, which although may be justified are only likely to force
the ‘user’ further into denial. In this case the user is likely to leave the
conversation thinking ‘What rubbish; it’s nothing to do with using’. (Remind
yourself: Your job is not to justify yourself; it is to move the person towards
accepting that they might have a problem with alcohol.)
Here’s an
example of a good response:
User: ‘I’ve
got a stinking headache this morning.’
Helper: ‘Is
it a bad one?’
User: ‘I
think I’d better take the day off work.’
Helper:
‘Will they mind?’
User: ‘They
said it could be a disciplinary next time, didn’t they.’
Helper:
‘Why’s that?’
User: ‘Too
many days sick.’
Helper: ‘Do
you think you’ve taken too many days sick?’
This kind of
response has completely avoided talking about alcohol, and has generally avoided
saying anything that could be construed by the user as a criticism. If the
conversation ends here, then the user is more likely than not to leave the
conversation thinking: ‘Have I taken too many days sick?’ This would be a first
step in the right direction towards contemplation of the possibility that too
many days sick might be related to using too much. This has been achieved
through an empathic response, and the use of questions rather than statements.
Note also
that although the helper demonstrated concern, they did not say anything to the
effect that it didn’t matter about taking time off work. This is an important
balance to achieve – demonstrating empathy whilst not ‘letting the person off
the hook’ either.
Responsibility
If someone is going to make changes to their using behaviour they must first accept that it
is their responsibility to make these changes and no-one else’s if this is to
occur. Others may support and advise, but it is the person with the problem that
has to take the ultimate responsibility for actually making those changes. This
applies to most situations in life.
If the using
is causing problems, then these problems are ALWAYS the responsibility of the
person that lifts the bottle towards their mouth. In fact, if that person is to
make real progress in sorting out their life, then they should really start to
take responsibility for ALL the problems in their life, whether or not these are
directly related to using.
So your
behaviour may need to be modified to encourage the user to take responsibility.
Don’t help; Don’t hinder. This means you don’t reward or excuse behaviour caused
by drinking or drug taking. Don’t clean up after the user if they are
incontinent or vomit. Don’t phone in sick for them, but, don’t stop them phoning
in sick. Don’t go out and buy alcohol for a drinker and don’t give money to an
addict.
It is vital
that you avoid giving any advice until the person indicates that they are ready
to be receptive to this. In other words, your user will have already indicated
that they accept that they at least might have a problem, by the time you use
these tactics.
If you
deliver advice before the person has indicated a willingness to listen, then
your advice will do worse than fall on deaf ears. It is only likely to push the
user further into denial – to listen to your advice before they have reached
their own conclusion that they might have a problem, would be to accept that
they do have a problem before they have done so!
Remember the
theme that people have to come to their own conclusions; they have to believe
that they have reached these conclusions by themselves. You must not force this,
and you must not rush it
Assessing your relationship with the user
You may have been in this
situation for a long time and seen no change. At some point you may have to
examine your relationship. Ask yourself this gut-wrenching question: “Is my
intention to continue in this relationship with them regardless of whether or
not they continue to drink or use drugs?”
If you don’t intend to
continue associating with this person, then set a limit. This limit is for
your sanity, not theirs. For example, “if you don’t get help by the end of
this month, I’m walking away from the relationship.” This is a firm limit with
actionable consequences. Don’t make this type of threat unless you fully intend
to follow through with it though.
Remember that there are
essentially only 3 possible outcomes between you and the user:
1)
They get help and stop using.
2)
You leave.
3)
The relationship continues with the alcohol/drugs and the chaos.
So you might stop and do
some thinking. Long term thinking. Do you really want to be in this same
situation, say, 10 years from now? Given the possible outcomes, there are
essentially only 3 things you can say to a user:
1)
“Keep using.”
2)
“I’m leaving.”
3)
“Get help by next Tuesday or I’m leaving.”
Let’s take a closer look
at the third option, which is setting limits and boundaries. Unfortunately, many
people are not in a position to be making ultimatums. There might be things that
are holding them back from doing so. Financial concerns, breaking the family
apart, having no place to go–these are all things that might keep someone
trapped in an unhealthy relationship. There are 2 steps to overcoming these
types of fears that hold you back:
1) Build self-esteem
2) Find support (outside
of the dysfunctional relationship)
If and when you decide to
make the healthy decision to stop the madness, you will then have to determine
exactly what is acceptable to you and what isn’t:
Decide on your boundaries and set limits
Decide what your limits
are, then discuss them with the user. Your limit might not be “I’m leaving,” but
rather “I’m not bailing you out of jail any more” or “I’m not going to be around
you when you’re drunk/high” or something similar. Your limit is not a punitive
consequence–instead, it is a limit you are imposing to save your
own sanity. Don’t make it about them. It’s about you staying healthy. The
limit you set should directly reduce the amount of chaos you have to experience
due to their using.
Make your intentions
clear, and be prepared to follow through with them. Don’t make threats that you
don’t have full intention of carrying out if necessary.
Isn’t there some other
way to change someone’s behavior?
No, there isn’t. Consider
the following thought experiment: Say you enjoy taking walks in the park every
day. The weather is nice, it’s good exercise, and you have plenty of extra time
for these walks. But then someone in your life demands that you stop taking
these daily walks. You resist. Conflict ensues. You think to yourself “I should
be able to keep taking my walk every day if I want to!”
That is the exact same
reaction that the user has when you tell them to stop using. “But,” you say,
“Using is so bad for them, and it’s destroying their life! My walks are healthy
for me!” That doesn’t matter. Just because you think you know what is best for
someone doesn’t make a bit a difference. It all has to do with a little
something called free will. You wouldn’t let someone else control you….so
what makes you think you can control someone else?
Alcoholism and Drug
addiction is not logical. Therefore the user will not listen to reason. They
will not hear your well planned arguments about why they should seek help and
live a better life. You can promise them the world and it won’t matter. They are
trapped. They are stuck. They cannot hear your arguments until they are ready,
which maybe too late for your relationship. However there is always hope and
using the right approach can help you move the user towards accepting
responsibility quicker.
Finally
Try to
remember the following essential principles in your interactions with your loved
one:
1. People
need to make their own decisions – support but do not order, bully or beg.
2. Never
directly disagree with the person, but do not pretend that you agree with them
either (if you don’t).
3. Ask
questions, avoid statements!
4. Try to
highlight inconsistencies in the statements made in a way that does not engender
a feeling of resistance in the person you are trying to help.
5. Roll with
Resistance.
6.
Demonstrate empathy and concern – try to avoid outright sympathy or criticism.
7. Don’t
rush it – bide your time and wait for a spontaneous response. But remember that
you need to feel safe and sometimes you have to make hard decisions (such as
leaving) to protect your sanity.
8. Accept
that the user’s using is driven by subconscious influences.
9. Allow the
natural consequences of the using behaviour to occur – neither help nor hinder.
10. Try to
avoid taking on the role of the professional helper. Phone us for advice or for
a professional intervention.
I would like to acknowledge many sources that helped to make this article what
it is, especially Dr Bruce Trathen of Dryoutnow.com.
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