There is no negotiating
Intervention: How to get a loved-one to treatment
It’s all about enablement and leverage. Period.
People stop using substances for various reasons. If it is the threat of incarceration, well, that’s easy — go to rehab or go to the slammer. Sending the individual to rehab immediately — if possible, before charges are filed — doesn’t guarantee non-incarceration; however, sending an offender to rehab as part of a one-year treatment plan right after the arrest goes a long way in postponing the arraignment and softening the eventual outcome for the defendant. From DUIs to nonviolent felonies, I’ve played a role in that process several times.
Other motivations to stop using include loss or impending loss of a job; a spouse and/or family’s threat to leave; loss of home, friends, or money; and even, sadly, death — whatever it takes for someone to “hit bottom.” I have had clients go to treatment years ago and remain sober to this day for those reasons and, unfortunately, a few who didn’t.
Yes. No. Nah, never mind.
How many times have you experienced one who’s abusing substances express a desire to change but has no definite plans to do so?
There’s a scene in Chinatown (1974) when Jack Nicholson’s character, a frustrated “J. J. Gittes,” is trying to get Faye Dunaway’s “Evelyn Mulwray” to reveal a dark family secret. With each of Gittes’s slaps across Mulwray’s face (a felony in today’s world and never advised no matter how frustrating the situation), she blurts out, “She’s, my daughter.” Slap! “She’s, my sister.” Slap! “She’s, my daughter.” Slap! “She’s, my sister.” Slap! Now you know what it’s like dealing with someone addicted who repeatedly says he wants to go to treatment but then says, “Nah, I can do this on my own” (minus the slapping, of course).
While most of us would call it “fucking crazy,” two esteemed psychologists, Dr. James O. Prochaska and Dr. Carlo DiClemente, call that the contemplation stage when two desires exist side by side — the desire to change and the desire to continue the current behavior. One way to get off that merry-go-round is intervention and it is normally the last thing the individual is expecting, and he or she is usually not too accommodating.
CRAFT
There are two dominant forms of intervention. One is the highly regarded CRAFT (Community Reinforcement Approach to Family Training) system. Chiefly developed by Robert Meyers, PhD, at the University of New Mexico, CRAFT teaches family members how to — in a non confrontational way — “break your unintentional participation in patterns related to their loved-one’s use. For example, a mother who often calls her son’s employer to say that he is too sick to come into work, when he is really too hungover to come into work, will stop making those calls. Instead, she will calmly express that she is no longer willing to call in sick for her son.”¹
The positive factor of CRAFT is that the family’s progressive, consistent, non-enabling but supportive behavior frequently produces the “Hey, I gotta stop this shit or I’m gonna die” moment when the individual finally surrenders and goes to treatment because he chooses to go. On the negative side, it often takes time for CRAFT to be effective, and frequently the family’s patience breaks down before success can be achieved. The unspoken fear, of course, is that the addiction will lead to a criminal justice nightmare or, even worse, with fentanyl so prevalent in today’s substances, kill the individual before that goal can be achieved. Is the family willing to take that chance?
Pack Your Shit and Go Therapy
A second form of intervention is using the strongest points of leverage that can be utilized to get the individual to treatment and a total cutting-off of enablement. Probably the easiest example is intervening between an adult child living at home and the family members enabling the adult child to continue the substance abuse. The parents hold onto a hopeless fantasy that one day he will just wake up, decide to stop using, and get his life together. Fat chance. As long as the enablement continues, nothing is going to change.
So far, I have described what millions of families are experiencing throughout our nation, but there is a light at the end of this endless tunnel.
It begins with the family accepting that their enablement is feeding the disease that’s killing their child or loved one. Frequently, the hardest part of the intervention is getting the family members to follow through on their commitment to cut their loved one off and not enable further in a moment of weakness or because of guilt feelings. What they must do is counterintuitive to most parents’ instincts, but the plan will only work if they are 100 percent committed to it.
That’s the hard part, offering the victim a choice, but sticking with the commitment to go through with either choice — “Accept our gift of treatment or pack your shit and go!” There is no negotiating. It has to be this plan and all enablement stops now. Only when the individual is convinced that you mean what you say will it have the desired effect. “We’ve had enough of watching you kill yourself and our role in helping you do it. If you accept our offer of treatment and recovery, we pledge to do everything in our power to help and support you, but we cannot support any other choice.”
Time is the Enemy
If the intervention is successful and the individual agrees to rehab, time is now the enemy because the treatment plan must go into effect that nanosecond. You want to get the individual out the door and into rehab as soon as possible, not later when he has time to change his mind or wants to see the other choices or, worse, research more options. That’s why arrangements with the rehab have to occur prior to the intervention — the less the victim has to say about where he is going, the better. Don’t invite his opinion, just get him there.
If the intervention is happening out of the family home, a family member should have surreptitiously packed a bag with rehab-approved clothes and items that are all ready to go. Just pack enough for the first couple of days. Yes, there will be items the individual will still want and need, but they can be shipped later, or he can purchase them on location. He can also phone in his goodbyes to friends while on the road or once he’s there, depending on the facility’s phone policy.
If travel by plane is necessary and the next day is the soonest flights are available, keep the victim at home but have someone with the individual at all times. Do not let him out of the house alone nor out of your sight.
If the victim is in the early stages of withdrawal or will be by travel time, if necessary, take him to a nearby detox facility for medical detoxification, which could last up to ten days. It’s not a great choice since it is preferable for a long-term rehab to treat the patient from the beginning. Most importantly, you want to avoid the “miracle cure.” That’s when only after a few days the victim declares he is “clean” on the other side of withdrawal. He suddenly believes that he is “cured” and no longer needs to go to treatment. Along with the predictable return to his previous ways, there is the increased danger of death by overdose due to the victim’s reduced tolerance to what he was previously ingesting.
If a medical caregiver is already involved with the patient, avoid a detox facility altogether by having medications ready for easing the symptoms just long enough for the journey per the particular substance of choice.
The point is to get the individual out the door as soon as possible, and if that means a multi-hour drive, preparations have to already been made.
Rehab? I don’t Need No Stinking Rehab
Unfortunately, during an intervention, the victim’s surrender and departure for treatment doesn’t always occur. Addiction does everything it can to defend itself and if it means walking all over the ones who love him, so be it. The addiction doesn’t care. Your loved-one’s addiction couldn’t give a shit about your feelings, so you have to be prepared for the worst:
- The patient denies there’s a problem: “I don’t need rehab! I can stop anytime I want.”
- The individual leaves the room in a fit of rage: “Fuck you! I can’t believe you tricked me like this!”
- The individual offers cop-out excuses, proving that he has no intention of actually getting sober. He instead tries to placate her enablers: “Okay, but I’m not going to that rehab. I’ll go to outpatient treatment and AA meetings every night, I promise . . . it’ll save you money, too.”
The addiction is defending itself, and you are being played. This is where it’s imperative that the family stick to their original offer and hold their ground. No negotiating. It’s your way or the highway. No other avenues will be considered. It has to be “go to treatment” or it’s “pack your shit and go!”
If the victim is living at home, he has to leave the house immediately — not tomorrow, not next week. Now. If he lives outside the family home and you, the parents, are paying his rent and utilities or supplementing his income in other ways, that ends right now. He can sleep on friends’ couches until they tire of his mooching. You must take away the car, but if it is in his name, you must stop the car payments and stop paying for insurance, gas, and maintenance. Same goes with the cell phone. He’ll have to figure out a way to pay for it. In other words, he’s really on his own — unless he accepts your gift and goes to rehab.
Here’s where parents usually ask themselves, “What kind of parents are we? Who could do this to their own flesh and blood?” A parent who wants to save their child, that’s who. That applies to other family members as well. All it takes is one relative or friend to feel sorry for the victim, and the enablement continues. Otherwise, that is the only way this works.
No telling how long it takes
Depending on the leverage, surrender could take minutes, hours, days, weeks, or months. I’ve experienced them all. Since a bed is not always available when the client is, it is also essential that, prior to the intervention, one or more alternate facilities have been chosen and are ready for the individual’s arrival as well.
Joseph and Betty of Minneapolis are the parents of a son, Barry, whose failure to launch had rendered him an unemployed thirty-something man hopelessly and chronically addicted to meth. The only leverage they had was evicting him from one of their rental properties where he had been living rent free. I warned them that getting Barry to treatment could take six minutes, six hours, six days, six weeks, or six months — or it may not happen at all. Despite the hard-core stance they had to maintain, Joe and Betty were in, committed. They knew nothing else was going to work.
It took six weeks of no utilities and finally a sheriff’s order to evict Barry. Then homeless, he eventually saw the wisdom of surrendering and accepted his parents’ gift of treatment. Upon Barry’s admission to the right rehab for his diagnosis and resources, Joe and Betty saw the detritus of their son’s addiction when they inspected the rental house. Every appliance, copper pipe, and wire had been ripped out and sold to support his destructive habit.
During this six-week odyssey from hell, Barry hated me. Understandably so since I was his addiction’s enemy, and it did everything to fight me. On day 45 of his ninety days of formal treatment, I got a call. “Walter, this is Barry. I want you to know that I love you . . . you saved my life.”
Did I save Barry’s life? Of course not. I simply opened the door to the professionals who could teach Barry the tools of recovery.
After the Bay of Pigs fiasco in 1961, President John F. Kennedy said, “Victory has a thousand fathers and defeat is an orphan.” Ultimately, I’ve learned from those in recovery that notwithstanding all the support and treatment, sobriety is solely up to the individual. The individual is the hero.
Next: What is Treatment?
Walter Wolf is the pen name of a 30-year veteran of the movie and television industry who produced studio and independent films and television throughout the United States, Australia, and South Africa. That all changed in 2010 with one 3 A.M. call that a family member was in crisis due to addiction. Today, he is an interventionist who matches adults and adolescents with the optimum treatment program and facility for their particular diagnosis, demographics, financial and personal needs. In order to demystify and explain in layman terms what treatment is and how to get it, Wolf wrote The Right Rehab which became the only step-by-step guide for vulnerable families navigating the confusing world of addiction and mental disorder treatment, health insurance and recovery.
To know more about interventions and finding the right treatment for you or a loved one, read The Right Rehab or go to www.therightrehab.com or call Walter Wolf at 1–310–210–4334.
Footnotes
[1] “What Is CRAFT?” Sober Families, 2019, https://www.soberfamilies.com/about-craft.
