Reader Mailbag: Can I Force a Family Member who is Out of...

Reader Mailbag: Can I Force a Family Member who is Out of Control with their Drinking to Attend Rehab?

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Can you force someone into addiction treatment? What if that person is a family member? What if they are completely out of control and a complete danger to themselves?

It is only natural to want to help someone and keep them from self destructing. Because this is such a tricky area, the laws differ by state (and by country of course). Therefore you are going to have to look into your options at a local level before you can decide what the best course of action is.

Local laws regarding the commitment process may differ

Forcing someone into treatment requires a legal process that you have to go through. In some places you can only commit people to treatment for certain reasons, such as the threat that they are going to harm themselves. In other places this legal process can extend to reasons of substance abuse. But it depends on the state so you will want to look into that as well.

The easiest way to do this is to get on the phone, call up treatment centers in your area, and ask questions. If anyone will know the laws regarding this process, they will. As such they can advise you as to what your options really are.

Obviously we want to help the alcoholic in question, not just lock them up and throw away the key. So talking to a treatment center makes sense anyway. It is usually the best first step that you can take.

Your next question: Even if you can, should you force someone into treatment at all?

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If you are trying to help an alcoholic to get better then you have to ask yourself another important question:

Is it right to try to force them into treatment against their will?

Obviously if they want to go to rehab then there is no problem. But this is often times not the case and the alcoholic will not be willing to attend treatment.

So even if you can force them to attend, should you?

You might consider these counter arguments:

1) Willingness. If the person is not willing to attend treatment then how effective can it possibly be? You cannot force someone to want sobriety. That is not how treatment works. It is not brainwashing. They have to want to change.

2) Resentment. If you force someone into rehab then you also have to deal with any resentment that comes out of that decision. If you force someone into rehab then you should not be upset with the consequences of that action (i.e., they resent you for it later).

3) Boundaries and enabling. Normally we don’t need to push the alcoholic to do anything, we just need to get out of their way so they can suffer the natural consequences of their own actions. This is the only way that they are going to learn and change and grow–by experiencing consequences. If you force them into rehab “before their time” then you are cheating this natural flow of things and they will likely not do well.

4) Wasted resources. If they are not ready to change they are not ready. Forcing them into treatment is a waste of everyone’s time and money.

You can force a person into treatment (sometimes) but this does not insure that they will stop drinking. That choice is up to them and no one can make it for them.

The idea of doing an intervention without forcing someone into rehab

There is another idea that appeals to many friends and family members who have to deal with an out of control alcoholic: An intervention.

Why not throw a party and corner the alcoholic and try to talk them into treatment? This is essentially what an intervention is, I am sure many of you have watched the television show as well.

There are pros and cons to doing an intervention, and my opinion is that they are usually a mistake. Of course some interventions are successful but I chalk most of that up to lucky timing.

I am not trying to be negative here, this is really how I see the situation. Interventions are bound to create some amount of tension, stress, and even resentment.

My basic argument against an intervention is that it does not really work. The reason that I say this is because:

1) A person’s success in treatment is based entirely on their level of surrender and their willingness. Are they still in denial? If so, treatment will fail. Have the surrendered completely to their disease? If so, then treatment will likely succeed.

2) If a person is NOT in a state of total surrender, nothing will cause them to get there except for more pain and misery. You cannot talk someone into surrender. You cannot talk yourself into surrender. It doesn’t work that way. You have to earn your desperation through misery and suffering.

3) If a person is in a state of surrender then you are wasting your time with a big organized intervention. Just put them in the car and drive them to rehab.

So this is what recovery really boils down to: It is all about willingness. It is all about surrender.

And you cannot talk a person into a state of surrender. It is like trying to convince someone to change their opinion on something when they have their heels firmly dug into the ground: It just ain’t gonna happen. Talking rationally about the reasons they should go to treatment is not going to help. If they aren’t ready then they aren’t ready. Bring in their friends and relatives and communicating with love is not going to change this. Nor is an intimidation display going to help that is designed to scare them. None of that stuff really works, and if it does work, then it was just lucky timing, and the alcoholic was on the cusp of change anyway.

Again, this is just my opinion, but it is backed up with 12+ years of sobriety and over 5 years of working full time in a treatment center. I made a lot of observations and so everything that I have learned is what I am putting forth to you here. If I thought that interventions could be even the slightest bit effective I would be pushing for us to use them more. Instead, I advocate heavily for other solutions, such as:

1) Inpatient treatment.
2) Setting healthy limits and boundaries around the addict or alcoholic in your life.
3) Offering to help someone get to rehab, but making it clear that you will not help them in any other way.
4) Going to Al-anon to get support for yourself, and so that you can learn how to set healthy limits and boundaries.

All of those things are more effective (in my opinion) than the idea of organizing and intervention and trying to talk someone into quitting drinking (or just going to treatment, either way).

What is your role if the person refuses treatment?

If the person refuses to go to treatment then you have a few basic options:

1) See if it is legal in your state or country to force them into rehab. Consider if this is wise or not. Make a decision.
2) Organize a formal intervention to try to convince the person to get help. Consider if this is wise or not. Make a decision.
3) Go to Al-anon for support, set healthy limits and boundaries, and do informal interventions (not organized) to try to talk the person into getting help.

In my opinion the best option for most people is option number 3. You may decide that it is more effective to organize a more formal intervention, but I would still urge you to consider the ideas in point number 3 above. This will also play an important role if (and when) the person finally decides to get help. If you have support through Al-anon and you are also practicing with setting healthy boundaries then this will only help to increase the odds that the person remains sober in the long run. Going to rehab is not a cure, after all. It is just a starting point really.

If a person refuses to get help at this time then you have to play the waiting game a bit. I know this can be very difficult at times when someone is self destructing before your eyes. It is difficult to stand by and watch. This is why they talk about detachment so much at Al-anon. It hurts to be around an addiction, to watch the effects of it.

Keep in mind that the typical alcoholic or drug addict is motivated by pain and misery. Or rather, they are busy chasing happiness in their drug that they will never really find, and meanwhile they are creating all sorts of pain and consequences for themselves.

At the same time the alcoholic is afraid of sobriety. They fear the unknown. They fear getting sober.

So they have pain and misery from their drinking, and on the sobriety side they have this intense fear. Normally they will not admit to being afraid, so don’t bother discussing it with them. They will cover it up with anger and get defensive, usually.

So what happens is that eventually the alcoholic will experience so much pain and so much misery from their addiction that the misery will become greater than their fear. When this happens they will get clean and sober.

Their fear is static. It doesn’t change. They fear sobriety.

Their pain and misery is cumulative. It is growing over time as they continue to experience more and more chaos in addiction.

Once they reach a certain threshold of misery, it will outweigh the fear, and they will give sobriety a chance.

This cannot happen if there are people in their life who are trying to “help” them by alleviating their pain.

They have a label for this in Al-anon. They call it “enabling.”

If you are taking action in order to reduce the pain and misery of the alcoholic in your life, then you are enabling that person. What you need to do is to back off and let them fall down and skin their knee. If you keep “putting pillows under them” as they fall then they will never find the motivation to get sober.

So let’s be clear on this.

You do not have to make the alcoholic miserable.

They will do that all on their own. Their disease will cause them to become more and more miserable over time, without any help from you.

Your only job is to get out of the way. They are on a crash course with misery. Let the person run this course. Let them experience the consequences of their addiction. This is what will eventually cause them to surrender fully. Only after the surrender will they be willing to change their life.

I know that this can be especially difficult to do because sometimes backing off and letting them experience consequences can be very damaging, or even risky. Alcoholics have died because someone stopped enabling them. Does that mean the enabler is guilty? Absolutely not. They did the right thing and then fate took the life of an alcoholic who was clearly out of control. You should not allow the guilt of this to cause you to make poor decisions. Keep in mind that people who enable alcoholics kill them even more often, because it allows them to continue drinking and using drugs. It is better to withdrawal your “help” than it is to be a part of someone’s drinking pattern.

Can you ever really force someone to get help against their will?

Is it ever really possible to control another person?

Not really. In the end all we can do is to lead by example. Some people will follow our example but this is somewhat rare. That is why you must keep doing it consistently until the person can wake up and realize that you are getting better results than they are in life.

I don’t believe that you can force someone to change against their will. It is important to set clear boundaries and to stop enabling the alcoholic in your life so that you are not part of the problem. This is an indirect approach to getting them to sober up. It obviously does not force them to change. It only removes you from being part of what is keeping them drinking.

The best course of action for any serious alcoholic is to get to inpatient treatment. Sure there are other solutions but none of them are as safe or (generally) as effective. Inpatient treatment is the best choice for a struggling alcoholic.

If someone agrees to go to treatment then my suggestion to you is not to waste any time. You have a window of opportunity so seize it. Get on the phone and start calling up treatment centers, find out what it would take for this person to check in. This is the single most important step that they can take in rebuilding a new life for themselves.

One of the most complicated things about alcoholism and addiction are the relationships that are involved. It is always complicated when a loved one is addicted and you don’t know how to convince them to get help.

Communication is key, but often times when you try to argue with an alcoholic or a drug addict you just end up screaming at each other. Neither person is really hearing the other and nothing gets accomplished. Eventually it devolves into ultimatums and the whole argument is extremely counter-productive.

There are a few ways to try to avoid this. One way is to only talk about it when you are both clean and sober. Another way is to go get support from an Al-anon meeting so that you know how to set healthy limits and boundaries. These limits and boundaries should not be delivered as threats or as ultimatums. They are simply what actions you are going to take if certain behaviors don’t change.

What you need to be sure of though is that you never make a hollow threat that you don’t intend to follow through on. This is poison to the relationship and it almost certainly WILL get tested. Do not make a threat or a promise that you do not fully intend to keep. As a side rule to this, you probably should not make threats or promises while you are angry and in the heat of an argument. Only set a limit or boundary for yourself after you have had time to cool down from an argument, and perhaps even after you have discussed the issue with supportive peers at Al-anon groups.

You are not setting a boundary so that the alcoholic changes. That is not how you want to think about this. You need to set a boundary so that you maintain your sanity, regardless of what the alcoholic chooses to do. You have to realize (and plan for the contingency) that the alcoholic or addict in your life may continue to self medicate until the day that they die. And that this may continue for several more decades. The goal of Al-anon is so that you get yourself into a position where you can deal with these sort of consequences. Or so that you can set a limit for yourself so that you know when to say “enough is enough, I am leaving now.”

You cannot force another person to change, but you can make the decision that you are only going to deal with a certain amount of chaos and misery in your life. As they say in the program (I am paraphrasing this a bit): “Chaos is inevitable, but misery is optional.” You can choose to avoid the misery if and when it becomes too much for you. But if you never make a conscious decision about that (how much is too much?) then you will forever be trapped. The goal of Al-anon is so that you don’t have to be forever trapped and miserable any more. You have choices today.

Do you have a question for Spiritual River? Contact us and let us know your question and we will try to answer it in a future post.

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