Addiction is usually viewed as a victimless crime in which the only person affected is the one abusing substances. Any family on the receiving end of an addiction can tell you this could not be further from the truth. The devastation addiction causes stretches far and wide. It not only affects the family but also society. A significant impact that addiction can have is the negative, long-term effects on children. When someone is tearing a family apart, the family only has a couple of choices. They can do little to nothing and hope that one day their loved one will hit bottom and want help, or they can work together as a family and consult a professional to determine what can be done differently.
Family Intervention is about addressing all the moving parts, not just focusing on how to stop the substance user and make him or her go to treatment. A family guided by a professional is much stronger and has far more ability to engage in effective strategies than the sole substance user running the show with fear-based illusions of control. A substance user’s primary goal is to seek comfort. Seeking comfort can range from stopping at nothing to achieve the effects of the substance of choice or arranging shortcuts and manipulations on others to minimize consequences. A family system that is counterproductively at odds with one another while utilizing ineffective strategies to fix the problem can often make matters worse. A Family Intervention seeks to bring all affected family members together to discuss and strategize the necessary steps to help the substance user see the need for change. A Family Intervention is not about proactively hurting loved ones but rather learning how to step out of the way so they can be held accountable. If substance users want to stay in their addiction, they have that right. Family members have the right to change what they have or have not been doing and enter into their own recovery. In doing so, the family increases the likelihood of the substance user seeing the need to accept help.
Long-Term Treatment for Substance Abuse
Family intervention services help to prepare families with education, self-awareness, and effective strategies that become part of their new way of living. It is important to recognize that the process of recovery from addiction is a long-term one; in fact, many consider recovery a life-long process.
Family Interventions focus on several moving parts that make up the overall process. Of these parts, there are 4 where families appear to need the most help. The first is understanding addiction and what the substance user is going through as well as what is needed to improve the situation. The second struggle deals with enabling. It isn’t about understanding what enabling is doing for the substance user but rather understanding what enabling is doing for the enabler. The third is codependency and having the family’s emotions be in harmony with the substance user. Lastly, and arguably the most difficult to overcome, is reaction to the substance user. From intervention to treatment and long thereafter, recovery coaching, therapy, support groups, and counseling seek to focus on addressing these concerns by instilling self-awareness. Below, we will discuss each of these parts of the process. We will look at how improving in these areas of struggle can help increase the opportunities for sustained long-term recovery for both the family and their loved one.
Substance users not only have a problem with substances, they also have a problem with perception. If an addict’s only issue was the physical or mental dependency, then the available solutions would be far less complex. How can someone with a severe illness take opioids for pain relief for extended periods of time and then stop taking them when the condition improves? Reflect on a substance such as caffeine or nicotine; some say nicotine is more addictive than heroin. Although physically and mentally challenging, how is it that a cigarette smoker can just quit? Why do individuals who use nicotine or caffeine in excessive amounts not lose their jobs, their spouses, their children, or go into debt or jail? Why can’t other addictions, such as heroin, alcohol, benzodiazepines, huffing, cocaine, crack and methamphetamines, just be stopped by willpower alone as happens with nicotine and caffeine? A big difference exists between a physical addiction and the need to self-medicate underlying behavioral and mental concerns. Some just quit the drugs specified above, but those people are few and far between.
The need to feel better and to medicate internal problems for substance users is so powerful that they are willing to go to great extremes to do it. They are also willing to take anyone willing to go along for the ride. Most families are under the illusion that substance users can overcome their problems with willpower, gym memberships, jobs, significant others, or other external factors that would make them feel better. In our experience, substance users have to change their behaviors. This could include seriously addressing: their trauma; their ego; the belief they are the smartest person they know; instinctively blaming everyone and everything else for their problems; their fears of simultaneous success and failure; and their feelings of inadequacy and low self-esteem. Until the behaviors, feelings, thoughts, traumas, and concerns are processed and addressed, substance users will seek comfort through external means. Addiction recovery is an inside job and is a problem of behaviors and perception. Substance abuse is their solution to problems which has led to both physical and mental dependency.
Helping is doing something for someone who is unable or unsure how to do it alone. Enabling is doing something for someone who could do it alone but doesn’t because it’s being done for that person. When we enable, we disable growth and change. Wanting help and having to seek help are two entirely different things. Furthermore, the obvious outcomes of enabling are not nearly as much of a concern as why the enabler does it in the first place. The person enabling a substance user receives as much, if not more, benefit than the substance user from the enabling. Examples include: feeling needed in the relationship, having a purpose, avoiding confrontation, and feeling validated. In situations of divorce, it is not uncommon for one parent to enable an addiction out of spite. There is always a reason for enablers’ actions. At their core, they know what they are doing is not helping the substance user. This question comes to mind: What do enablers receive in return, and what is so needed that they allow their loved ones to stay sick in order to get it?
The likelihood substance users will see the need for change and move out of the contemplation stage is significantly reduced when they are comforted by an enabler. The less substance users feel the consequences and the less they are held accountable, the greater the chance they take advantage of the comfort and continue their addiction. This causes many underlying resentments with other family members, especially the substance users’ siblings and the enablers’ spouses. When a parent is giving full attention and enabling the substance user, other family members fall into maladaptive roles that unbalance the family system. They then direct their anger at the substance user, but their misplaced emotions and anger should more properly be directed at the primary enabler.
Codependency describes a relationship that ties one person’s emotional needs to another’s. In situations of substance abuse, the codependent enabler often engages in behavior that provides comfort to the loved one because their emotions are intertwined. So rather than worry about their own needs, enablers do things for someone else in order to feel better, bringing comfort to themselves. Sound familiar? Substance users do it every single day. We believe that codependency could be considered a substance use disorder and classified as severe. The substance of choice wouldn’t be drugs or alcohol; it would be the person you’re using in order to feel better about yourself. If the substance user feels bad, the codependent feels bad and when the substance user feels good, the codependent does likewise. Much energy goes into comforting the loved one to help the enabler feel better. It has been said that codependency is similar to lighting yourself on fire to keep the other person warm.
We tend to behave in certain ways towards those around us for our own emotional reasons, even though this might be hard to admit. We all exhibit codependent behaviors from time to time, and that is normal. However, letting codependent behaviors get in the way of the recovery of a loved one is not a productive behavior that will bring relief from the addiction anytime soon. As with enabling behaviors, what does the codependent receive in exchange for enabling the substance user? A major problem of the codependent relationship with a substance user is that it is one-sided. The substance user does not have much to do other than reap the benefits of the enabling all the while avoiding discomfort and gaining an overwhelming sense of entitlement. When the codependent starts putting his or her own needs first and stops worrying about whether or not the substance user will be upset is when things start to shift. It is this fear of change that keeps most people from doing something different. A concern of a codependent is this: Will the loved one seek comfort elsewhere if the previously provided enabling and codependent behaviors change? Rather than seeing change as productive and leading to a possible solution, the codependent will view this as having failed, of not being worthy, and that he or she is no longer wanted, loved, or needed.
An intervention has two possible outcomes for the substance user; either help is accepted or it isn’t. What we are about to share is not an opinion. It is an overwhelmingly common occurrence we have observed and is based on experience and facts. As we always say, if you want to know why a family does not do an intervention, just look at how they react after the intervention when their loved one accepts help. Families often ask: “What if they say no?” Their real concern is: ”What if they say yes?” Here is why.
When the substance user does not accept help, families appear not to be nearly as upset nor do they complain as much as those families whose loved ones do accept help. The family’s demeanor after an intervention where the substance user declines help can best be described as exhausted acceptance. However, things drastically change and escalate when the loved one accepts help. Initially, the family appears overjoyed and relieved. What follows is basically a textbook look into the functioning of a dysfunctional family that was aiming misdirected emotional darts at the substance user for causing the turmoil. When the substance user says “yes,” everything for the family changes. The blamed family member (the substance user), now in treatment, is no longer responsible for ongoing problems. Families’ displaced emotions of fear manifest themselves as anger at the intervention team as well as other family members and the treatment program. Just five days earlier, the family told us the substance user was incapable of being honest. As a result, the family calls us, screaming that their loved one just told them about conditions at the treatment facility. Families report a laundry list of issues, and when we ask who told them these things, their reply is “the substance user.” Families cannot help but react to the substance user, dragging the chaos and drama of the past into the present, for that is all they know. This is their way of still feeling needed, and it gives them an illusion of control. Now that the substance user is no longer present, the family seeks to divert attention from themselves and the real family problems. The hero tries to pull rank, terrified of being overtaken should the substance user get better. The chief enabler and martyr, more worried about what will happen to them than concerned with the substance user getting better, go into a tailspin.
We cannot stress enough that an intervention is not about someone coming in, giving a speech, and talking a loved one into treatment. That is NOT an intervention. That is a 12-step call, and you should not be paying for that. If your intervention team is not equipped or qualified to handle the intervention process and sees this as an event, you may find yourself worse off than before with no idea as to why. The family’s recovery is just as important if not more important than the substance user’s. If the family doesn’t enter recovery, the substance user most likely won’t either. And even if the loved one does but the family acts out, and the professional fails to help them understand why, then the substance user has little chance of sustaining sobriety. The loved one will get pulled right back into the dysfunctional family system where this all started.
There are more issues that will and should be discussed in family recovery coaching, including counseling, therapy, and addiction treatment programs. The four we have discussed, addiction, enabling, codependency, and reactivity, are just several of many pivotal points that should be part of an overall treatment plan that involves the family.
People defer to professionals of all trades on a daily basis without thinking twice about it. Everything from plumbing and electrical to dental and medical, we go to experts to ask for help. Why is that not the case with a substance use disorder and associated codependency? In all the examples above, there is a real benefit to seeking professional help. An electrician gets the lights back on, a plumber restores the hot water, a dentist fixes a broken tooth, and a medical doctor heals your ailments. Sounds great! So why with addiction do substance users and families run from professional interventionists and other addiction professionals? A substance use disorder appears to be the only potentially fatal illness where the patient and the patient’s family fight to stay sick. Unlike the examples above, the data and science tell us why this is so. The family already has what they need, and their maladaptive needs are being fulfilled in a maladaptive way that works for them. But unlike the other examples, the family doesn’t see it that way. A professional interventionist goes beyond focusing solely on the substance user. The professional interventionist and the support staff help to become a bridge and create self-awareness by helping families understand the why behind the behaviors causing the problems.
Another way to answer the questions above is to put things into perspective. You call the electrician because you do not like living in the dark, you’re uncomfortable. What if living in the dark gave you purpose, brought you attention as a victim? What if someone told you to wait until the power came back on, that there wasn’t much else you could do. As time passed, you learned how to live in the dark, and someone convinced you that calling an electrician would be a bad idea, that it wouldn’t fix the problem. Gradually, you came to believe there was no other way to live. Given all that, would you still call the electrician? If you were more comfortable living with the problem, and the problem fulfilled something you needed, would you do something about it? This may seem far-fetched and, for some, downright ridiculous. If so, then why are families and substance users continuing to fight to stay sick? To say they are not getting something in return by maintaining the status quo would not make any sense. For if they weren’t, then why would they continue to live this way or allow their loved one to do the same? Families do not have to fight so hard to avoid changing the situation and allowing a professional interventionist to help. The fear of change has to become less than the fear of staying the same. We can help with that.
The Intervention Process
Interventions are a process, not an isolated event. The part of the intervention that involves the substance user is but one piece of the process and is rarely the most challenging. Families allowing us to guide their participation is by far the most difficult part of the process followed by talking the family off the ledge and reducing their reactivity after their loved one accepts help. The intervention process requires a family to understand fully what the expectations are. It doesn’t necessarily mean they have to all be on board with what to do in the beginning. If family members were already all on board and on the same page, they would not be calling for professional intervention services. What is required is the family must concede that what they have been doing isn’t working, that a professional could provide better guidance and suggestions, and they must be willing to listen to the data and science.
Below are some matters a family should consider to increase the chances of a successful intervention. Although a desired outcome for us, please keep in mind that success does not mean the substance user accepts help. Success means you did everything you could to stop the destruction, to understand why things are the way they are, why you did things the way you did, and why the family started its own recovery. In order to be an appropriate candidate for professional intervention services, a family may want to consider doing the following:
- Surrender and concede that what you have been doing isn’t effective. It is suggested that what you expect your loved one to do in treatment, you should be doing as a family. Trying to fix, manage, and control the addiction did not work for the substance user nor has it worked for the family.
- Be open to addressing your reactivity and learning how to say no to the substance user. Consider the value of fact-checking your loved one’s accusations with the interventionist, with other family members, and with the treatment team. Just because the loved one says something during a phone call does not mean it is true.
- Respect your other family members. They have all developed ineffective and maladaptive coping skills and roles. Nobody is right or wrong, and this isn’t about winning. These are called family interventions and not solo interventions for a reason. Concede that no one is in charge of making a solo decision because any decision affects not only the substance user but also other family members.
- Allow the professional intervention team to do its job. Do not hire the intervention team if you’re going to continue to call the shots by determining the treatment plan and who will be at the intervention. Your intentions may be great, but your judgment is severely compromised. Most families who tell us how to do our job are not working on solutions for the substance user; they are looking for solutions for themselves.
- An intervention is a process, not a singular event. The ultimate goal is to change behavior for both the person who is addicted as well as the family.
- Family Recovery and Family Aftercare are as important as anything else you will do. If you’re doing the intervention to learn how to control things differently or simply to get a loved one to rehab, then perhaps you’re not ready for a professional intervention and the healthy change that comes with it.
With the help of professional intervention services, the families of substance users can learn and understand effective solutions to help their loved ones see the need for treatment. The intervention is not about cutting them off and kicking them out of the house while being stern and forceful. We’re not here to make things difficult for them. The goal is to establish boundaries while holding them accountable and accepting their decisions. If that means continuing to use drugs or alcohol, they have that right. Families have the same right not to provide them further comfort.
Many families define achieving success as the substance user entering treatment. The same families tell us their loved ones have gone to treatment several times, and the treatment center failed. Rarely if ever do we have a family concede that perhaps the substance user or family members were partially to blame for failed attempts. Successfully getting the loved one to treatment and then allowing him or her to leave early is not a failure of the center or the treatment team, including the interventionist. We cannot control the substance user directly, but the family can control allowing their loved one to make bad decisions with impunity.
Successful interventions and treatment outcomes should not be defined by a particular viewpoint. Many parts of the intervention process combine to contribute to the overall outcome. The more a family accepts and follows suggested solutions, the greater the likelihood of a positive outcome. Success can best be defined as a family realizing they did everything possible to help their loved one and stopped doing things that allowed the situation to get worse. Acceptance, self-awareness, family recovery, healing family wounds, and closure are all good gauges when considering what constitutes success.