The Key to Getting an Alcoholic Into Treatment
Getting an alcoholic to go into treatment is not an easy thing to do. Many people who have tried will argue that it is downright impossible. They will say that you can never really get someone to do something against their will. While this may be true for the most part, that doesn’t mean that you are completely helpless to do anything. There may still be some things that you can do (or behaviors that you can change) in order to move someone closer to treatment.
Ask yourself: “Is this person truly ready to change?”
Before you go wasting a lot of time and energy into trying to convince someone to go to rehab, ask yourself if you think that they are really ready to change yet or not. Of course there is no way to know for sure in most cases, but it is usually pretty easy to tell when someone is definitely nowhere near the point of change.
It all has to do with surrender. Ask yourself how close this person is to being in a state of total surrender. And what exactly does “total surrender” look like?
I would describe a state of total surrender as being:
* No longer manipulating other people to get what they want.
* Giving up on life.
* No longer caring about what happens to them.
* Becoming open to suggestions about what they should do to get help.
* Realizing that their drug of choice is making them miserable.
And it may also be easier to describe the opposite of surrender as well. For example, if someone has not yet surrendered, then they may be:
* Looking forward to more self medicating.
* Manipulating other people in order to get more drugs, alcohol, or money.
* Not being very open to suggestions about what they should do.
* Fighting hard to stay in control of their life.
* Believing that they only way they can have fun is by using their drug of choice.
So really consider the alcoholic and where they may be at on this scale of surrender readiness.
If someone is still having lots of fun with their drug of choice then you can be pretty sure that they are nowhere near the point of surrender. People don’t change easily. In fact some people will not change at all, even when there is overwhelming evidence that they should do so. Such is denial.
Look at their consequences. How have they suffered at the hands of their addiction? How has alcohol ruined their life? If the answer is “not much” or “very little” then it is probably too early for them to commit to making a change. On the other hand we do not necessarily know what another person’s bottom will be. So it doesn’t usually hurt to try to nudge someone towards treatment at any given time. But at the same time you need to be realistic about it, which is why you are evaluating their desire to change in the first place. If they don’t have any consequences in their life from addiction and they are not completely miserable then the motivation to change is going to be lacking.
You see, getting help for alcoholism is a huge change. It is a really big deal for an alcoholic to do this. Trust me when I say that it does not come easily. Every alcoholic is going to resist such a change a great deal. It is only in a situation of extreme desperation that they will consider getting help for this condition. There is far too much pride wrapped up in the decision for an alcoholic to just casually decide to get help.
Of course you can always offer the idea to an alcoholic, that they should seek professional help. But if they are not struggling or miserable or desperate for change then they will likely not respond well to your plea.
Therein lies at least one clue about your approach: timing matters.
Therefore if you bide your time and wait for the alcoholic to be at a point of misery in their life, you may be able to convince them to get professional help provided your timing is good. Don’t bother approaching them when things are normal or when they are happy. This will not generally work. Instead, wait for a time when they are experiencing some sort of negative consequences from their addiction. Maybe they are in the hospital or in jail due to their drinking. It becomes a bit more difficult to maintain denial when you are sitting in a jail cell for drunk driving. Don’t get me wrong, the alcoholic may still be in denial at that point! But at least you have increased your odds of communicating with them so that they will hear you.
Piercing through denial
The alcoholic lives in denial.
There are at least two levels of denial. The first level is the obvious one, where the alcoholic covers up their ears and says “la la la I am not an alcoholic, no way, no how!”
This is not usually the problem. Most alcoholics quickly reach a point in their disease where they no longer argue this fact. They know that they have a serious problem. They love to drink and they no longer deny it.
So the second level of denial is a bit trickier. This level is where the alcoholic is saying “I am a unique alcoholic and I have to drink to be happy and those recovery programs don’t work for me.”
So this is much trickier to deal with. The alcoholic admits to their problem but they refuse to accept a solution. Perhaps they have been to rehab before (maybe several times even) but they are convinced that they cannot be helped. They have resigned themselves to being a drunk for life.
It is very difficult to get past this level of denial. The only way to do it is for the alcoholic to arrive at a certain conclusion on their own. They must reason it out for themselves. And in many cases it will be like a bolt of lightning has hit them and they finally realize the truth.
That they are miserable in their drinking habit, and they always will be if they continue.
This is what the alcoholic refuses to acknowledge. Or they may believe that they are mostly miserable with their drinking, but they cling to the idea that they will be even more unhappy if they are stone cold sober.
So what can be done?
Let me tell you how it doesn’t work.
It doesn’t work by dangling happiness in front of the alcoholic. That doesn’t work.
You would think that it would work, though. That if you could convince the alcoholic that life would be happy and joyous in recovery that this would convince them to get help. But it doesn’t work this way.
You see, the alcoholic is so miserable and they are so convinced that they are completely unique that they don’t believe that your little fantasy even applies to them. They don’t really believe that they can have all of that happiness and joy that you are describing in recovery.
So that approach doesn’t work. You cannot entice the alcoholic to change by offering something positive.
Instead, the alcoholic gets through their denial by being overwhelmed with misery. It is a negative thing. They get sick and tired of being sick and tired all the time. They become exhausted with misery. They get burned out by the chaos.
This is what denial is centered around. The alcoholic is in denial of their misery. They cling to the idea that they can become happy at any time simply by taking a drink.
The alcoholic breaks through their denial when they fully admit and accept that their alcoholism is making them miserable. But they have to reach this conclusion on their own and figure it out for themselves. It is only then that they will agree to get the help that they need.
How to affect the alcoholic indirectly
Hopefully by now you realize that you cannot directly control other people.
So simply imploring the struggling alcoholic to get help does not generally work.
However, this does not mean that you cannot take steps to affect the person indirectly.
Remember, the key is that the alcoholic must break through their denial on their own. They must figure out how miserable they are in addiction for their own self.
In order to help accelerate this process, you should do the following things:
* Stop enabling the alcoholic. These are behaviors that you do in order to “help” the alcoholic but in the long run they only serve to keep him drinking. For example, if the alcoholic is so hung over from the night before (or still drunk) and you call in sick to work for him so that he does not lose his job. In the short run you are “helping” him by keeping him in good with his job. But in the long run you are only enabling the alcoholic so that they can continue to drink. Remember they will not change if there are no consequences to their drinking.
* Refuse to give in to manipulation. If the alcoholic says “I need 20 bucks for groceries” and you know that they are going to get some food but also alcohol, then don’t give in to that manipulation.
* Let them know where you stand. Offer to help them get professional help, and make sure they know that this is the only thing you will ever help them with. Anything else that they might need, just forget it. You will only help them arrange professional help at a rehab center. That’s it.
* Go to an Al-Anon meeting and share your story with the people there. Get help and support for yourself. Reinforce that you are doing the right things and that you are behaving the right way. Check yourself and be held accountable so that you do not fall back into enabling behaviors.
* Take care of your own self first and foremost and set an example of sobriety and good health.
Those are the key things that you should be doing in order to help the struggling alcoholic in your life. Notice that none of them are very direct, but all of them added together will help to make a difference.
In addition to this, if the alcoholic has other enablers in his life, you may try to get those people to come to an Al-anon meeting with you, or simply send them this article so that they can learn what they should be doing. If an alcoholic runs out of enablers then something is likely to change much more quickly. If he has a permanent enabler then he may be stuck in denial for a very long time.
What is the groundwork that you can do in order to be prepared?
At some point the struggling alcoholic will realize that they have had enough, and that they are sick and tired of being sick and tired.
When they reach that point of surrender, you want to be ready to help them.
Up until that point, you should not be willing to help them at all, unless they agree to go to rehab and get professional help.
Once they have surrendered your job is fairly simple: get them into residential treatment.
Now there are other options for people who want to get help for their alcoholism. For example, you could go to AA meetings, or you could go to counseling, or you could go to outpatient therapy.
My suggestion is that you ignore all of that stuff in the beginning and urge the alcoholic to get into residential treatment.
Because residential treatment is generally the best solution, and it also includes most other forms of treatment. In other words, if they go to rehab then they will also be exposed to AA meetings. And they will probably be assigned a therapist or counselor. And the rehab will give them an aftercare plan that will probably involve outpatient groups or ongoing therapy. And they will be told to go to AA meetings once they get out of treatment. And so on.
So going to inpatient rehab really covers all of the bases. It is a total solution because it includes so many of the various forms of treatment. In fact it really includes them all. So you could do worse than going to inpatient rehab, but you could not do much better. Therefore your goal is clear: get the alcoholic to go to inpatient treatment.
So how do you do that?
Get on the phone. Call up treatment centers. Ask questions.
You are not responsible for saving the world here. In fact, you could easily just shove the phone at the alcoholic and dial a number for a local rehab and tell them: “Ask for help. Tell them that you need help.” And then let things go from there. If that is all you do then you have done your job. There is only so much you can do anyway. We just want to point the struggling alcoholic in the right direction.
The limitations of a tough love approach
Some people believe that taking a hard line “tough love” approach is the best way to deal with the alcoholic.
There are some good and bad points about this approach. If you do it right then essentially the tough love approach is what I have outlined in this article. Your stance should be one where you are willing to help them get professional help, but you are NOT willing to help them with anything else. The person may try to manipulate you into giving them money. For example, they have a baby and they need money to support their baby and they trying to get you to give them money. This is manipulation in the worst way. They are counting on your good will and your concern for the baby in order to extract money from you. Realize that on some level, even if you buy baby food directly and give it to them that you are still enabling. They are still wasting money on booze and drugs and then counting on you to bail them out. So at some point you have to use the tough love approach and put your foot down. It is never an easy thing to do.
And there are limitations to the approach, because some people are just bent on self destruction. They are going to self destruct no matter what you do. In that case you may feel guilty if you put your foot down, stop enabling them, and then they suffer massive consequences. You cannot beat yourself up in such cases. What you need to do is to get to an Al-anon meeting and get support for yourself. Know that you are doing the right thing by not enabling someone.
Sometimes all you can do is offer a solution and be ready to help
Sometimes none of this stuff will work.
Sometimes you do everything that you can and the alcoholic continues to slowly self destruct.
In that case you basically have two choices.
One, you can try to help them directly by organizing some sort of formal intervention.
Two, you can simply make your position clear to the person and then be ready to help them when they finally surrender (as outlined in this article).
My personal opinion is that a formal intervention is generally not a good idea. This doesn’t mean that you should never do it, or that it could never work. But I believe that it is mostly an issue of timing anyway. So in cases when a formal intervention worked out, it was mostly because the person was at or near a point of surrender anyway. The intervention was not necessary.
Now that is just my personal opinion and you may want to explore the option anyway. I believe that if you follow the indirect approach outlined here that you will be doing as good as you can to help nudge the person closer to surrender. Stop enabling. Refuse to be manipulated. Get support for yourself at Al-anon. These are the basics that help the alcoholic realize just how miserable they really are.
If you try to push a person directly into treatment then it will not work. The reason it doesn’t work is because it does not address the most important element of surrender, which is the timing. Has the alcoholic reached a point of total surrender yet or not? This is all that ultimately matters. You can organize the biggest and best intervention that the world has ever seen, but if the alcoholic is nowhere near the point of surrender then they are not about to change their life.
Conversely, if the alcoholic has finally reached a point of complete and total misery, and they break through their denial and they realize that they will never be happy in addiction, then your job is now a thousand times easier. Now you can simply offer to call up a rehab and the person will be willing to go. They will be open to getting the help that they need. You will not need to arrange a big parade just to convince them to take action (which doesn’t really work anyway).
All that matters is the willingness of the alcoholic. Are they willing to get professional help?
Their willingness is based entirely on surrender. Have the surrendered to their disease?
Their surrender is an issue of timing. They either have surrendered, or they have not done so yet.
If they haven’t surrendered yet, then there is not much you can do, other than the indirect ideas outlined above.
If they have surrendered, then all you need to do is call up a rehab center and set things in motion.