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The word "intervene" means "to come between." The use of the word intervention in relationship to substance abuse is to come between the substance abuser and the drug.
When the spouse, family, friend or employer sees that the substance abuser is out of control or the signs are too evident to ignore, that is the time to intervene.
Intervention is conducted by a counselor and is a carefully prepared process. It is the only way to break through the denial and delusion in which the substance abuser has wrapped himself. It's a time when all concerned members unite toward a common goal. That goal is treatment for the substance abuser.
Concerned individuals need to know the risk that is being taken and must accept the outcome of the intervention. Whether a success or not, the intervention is the first step in letting the substance abuser know how they are affected by his behavior.
Nearly 30 years ago in Minneapolis, Vern Johnson, counselor, became discouraged about his effectiveness in helping alcoholics. One day, a man whose wife was in the psychiatric ward complained to Vern. "I know her problem isn't a mental disorder, she's an alcoholic." He said he was so mad at his wife that he was going to bring the children in to confront her and tell her what she was doing to them. That's exactly what the man and children did and it worked. The woman began to recover. Vern was so encouraged at this success that he began to train others, and that is how the intervention process began.
The answer to this is, anyone concerned about the welfare of another individual. It is a process done in love and with love. Some think it is not a right, it is an obligation. Families will come up with all kinds of excuses. "I don't think things are that bad." "He'll be terribly mad at us." Or the timing isn't right. "Let's not mess up my wedding." "I graduate next month, let's wait until that's over." "Will he lose his job?" Anyone who has a vested interest in the substance abuser will make up a million excuses.
Family or friends, anyone close to the substance abuser, will also have to take a good look at their behavior. Have they been an enabler? They may not want to stigmatize the person with the label of a substance abuser. Most people won't confront the substance abuser. They will talk behind his back, but it takes courage to be up front. It also takes a loving concern.
The intervention process isn't entered into lightly. It should never be done when the person is under the influence of the drug. It is usually the family who intervenes. In the workplace it is co-workers who become members of the intervention team.
The leader is an intervention counselor, someone who has been trained and has experience in the process. The members can be neighbors, friends, co-workers—anyone who is not judgmental. They should be people the substance abuser admires and respects, people who are concerned about his welfare. The group's main task is to convince the person that what he does affects others and how inappropriate his behavior has become.
Each person must prepare an instance about how the substance abuser's behavior has affected them. "You drove us kids home and you were drunk." "I was so embarrassed when you staggered up the hall to my classroom." The incidents need to be specific, no generalizations. There must be no accusations or attacks, "How could you? You promised me." There should be nothing said that will put the substance abuser on the defensive.
The intervention goes much more smoothly if the group has a meeting before the actual intervention. Another important factor in intervention is that it is unannounced. The surprise element is very effective. The substance abuser will be brought into the room under some ruse. This may take place in the home or somewhere else that is comfortable. The counselor will start the intervention with reassurance to the substance abuser that they all love him and are concerned about him. Then, one by one, the others tell their story. A solution or treatment plan will have been arranged beforehand— this is vital to the success of the plan.
The most famous intervention ever written about was in Betty Ford's The Times of My Life. After she retired to Palm Springs, she said, "The family noticed I was in trouble."
One day, her daughter, her housekeeper and her secretary "marched into my sitting room and started talking about my giving up all medications and liquor." She was enraged at them, completely turned off. It was an attempted intervention that was not well planned at all. And it didn't work. It just made her feel violated and angry.
About a month later, Betty Ford's husband, her children, the navy doctor who was the head of the Alcohol and Drug Rehabilitation Service in Long Beach, and a navy nurse all confronted her again. Her first reaction to this second intervention was denial. She couldn't remember their exact words, but they had come prepared this time. Betty Ford rationalized that they hurt her as much as she hurt them. She denied that alcohol was a problem. She was in shock.
Bitter and angry at all the physicians who had prescribed pain medications for her throughout the years, Betty Ford bargained for a few days, saying she could stop the liquor, but she needed the pills for pain. The family insisted she couldn't do it alone.
Depressed, she cried for two days and then agreed to sign herself into Long Beach Rehabilitation Center. When she found out that she would share a room with three other women, she balked. When told the other women would have to move out, she said "No, don't do that" and she accepted the program.
Betty Ford said an interesting thing. She said the program was started in 1965 in a condemned Quonset hut. It was an undercover operation because the armed forces claimed they had no alcoholism problem. In 1974 the navy finally faced the problem, and the program was moved to the fourth floor of the Long Beach Naval Hospital.
As a recovered addict, Betty Ford has become very visible. She has lent her name to a beautiful facility in Palm Springs. The stages she went through to acceptance are the same stages of bereavement. These stages are: denial, anger, bargaining, depression and finally acceptance.
The first three-to-five minutes of the intervention period are crucial. Most people know when they are in trouble. The counselor lends authority to the proceedings. He is the uninvolved person in the group. Some members may feel they are being disloyal. A trained counselor will help them to see why it has to be done. It is all right for the participants to cry and express their pain.
It is very difficult for parents to intervene into their adult child's life. But it is equally hard, for them to see him wasting his life.
Andy was the oldest child of three. His parents -were a military family, and moving was apart of that life. The father was an alcoholic, but it didn't seem to interfere with his career. It interfered -with family life, though.
The father was emotionally unavailable. His moods were unpredictable, and the best way to deal with him was to stay out of his way. When Andy was in high school, he experimented with marijuana. After graduation, Andy got a job in a computer store. He was well acquainted with the computers and had the ability to extend his knowledge to customers. He was well-liked. His marijuana habit now progressed to cocaine. But he was still able to function at work, for a while. His mother knew he was taking drugs, but he never wanted to discuss it with her. He was free-basing cocaine. His ability to concentrate was deteriorating. Some days he was unable to get to work. His mother talked to a trained intervention counselor, and it was decided they had to get Andy into a treatment program. They told Andy they were having an intervention for his father. His brother, sister, employer, cousin and grandmother were included in the intervention group. Andy was shocked when the true reason for the gathering was focused on him. He looked at everyone, one by one, and listened to each confrontation. He knew everyone in that room loved him. It had been arranged for him to be admitted to a detoxification center that evening. He was escorted to the hospital by his entire family. After a week at the hospital, he transferred to a treatment center out of town. He stayed there for 90 days. That was 15 years ago, and he hasn't used a drug since. His life was saved.
One would wonder why Andy went so docilely with the family to the hospital. It is probably because, on one level, he realized he needed help. "The thing I hated and resented was I had no control over the treatment," Andy says. "Once I surrendered control to the family, I put my all into getting rid of that habit." Would Andy ever have sought help on his own? We'll never know, but it hardly seems likely. When a person is in the throes of a drug habit, he can't think clearly or get his act together.
Every time his mother visited him during the 90 days, Andy threatened to leave. "I'm not staying." His mother negotiated with him. "Just one more week, and then we'll talk about it" She was gaining time and knew that with each week he was learning a new lifestyle. The fact that Andy stayed and has never taken a drug since is proof that this intervention worked.
What's to be done if the addict won't accept treatment? If the family has intervened and extended support and treatment to the addict and he refuses, that is all the family can do except to set severe limits. He must understand the consequences for his behavior:
Enforcing the limits will take energy and consistency. Limits are worth the time and effort in the long run. The addict must know the consequences of his behavior. He alone is responsible. After the intervention he is aware of how everyone feels. If he doesn't want to follow their help and solution, they will wash their hands of him. This is a tough decision, but the addict has made the choice. The family should harbor no guilt; they have walked as far as they could.
The five stages of bereavement were discussed earlier, but I would like to go into a little more detail. Elizabeth Kubler-Ross was the first to call these five stages the grief process, and they are applicable when any kind of loss occurs. Moving from one house to another is a kind of a loss. The loss of a coat or a lifestyle, the process is the same.
Denial: This is the first stage and the feeling is disbelief or shock. This is a very anxious stage. "No, it can't be true." Denial is a numbing state that gives the person time to absorb the situation. It is a defense mechanism that protects the person until he can gather his resources and assess the facts.
Anger: After denial, a person moves into the anger stage. His anger may be reasonable or unreasonable. Depending on what was lost, he can be slightly peeved or furious. This is not the time to make decisions. This is also a wise rime to be quiet; destructive statements can erupt at this time.
Bargaining: After the anger has subsided, there may an attempt to negotiate a deal. "I'll only drink on weekends." Most of the time the bargaining is absurd—grasping at straws. But sometimes the bargaining is productive. "I'll go into treatment, if you'll go to a counselor."
Depression: After the bargaining is over, and the anger is spent, a person enters into the depression stage. This is the suffering stage of grief. This is the time for tears and low energy. This stage can last a long time—as long as it takes to work through the process.
Acceptance: Finally comes acceptance. It is the end of the struggle. To accept is a willingness to say yes, "to take." This is not a happy state; there are no feelings. It is a neutral state, to be at peace. The person has arrived at a station. The journey can continue from there.
Everyone goes through these five stages at his own pace. An individual can go back and forth between the stages until he comes to the resting place, acceptance.
The last thing the substance abuser loses is his job. He will cling to his work because he realizes it is his livelihood. Relationships can always be replaced. But a good job is hard to come by.
Jim was a trial lawyer in an ever-expanding law firm. His work was demanding, and the hours were long. Jim was a social drinker in college, but now he relied on the tranquilizing effects of alcohol more and more. Dorothy, his secretary, was his enabler for years. She handled his correspondence and did a lot of research for him. Many times he was not able to keep an appointment or forgot it, and she made excuses for him. It finally got to be too much for her, and she went to the senior partners and enlisted their aid. She was surprised to hear that they were worried about Jim also. She thought she had covered up well for him, but someone's substance abuse is hard to keep a secret. The intervention for Jim took place in his office. Jim agreed to go for treatment. He said he "thought no one knew or cared." His first reaction was relief.
Jim went into treatment and his recovery was successful. He needed the support of his co-workers to accomplish this. "I didn't realize I was as bad as I was," Jim said. "I needed that shove."
All those close to the substance abuser should examine their emotional reactions to his behavior. Dorothy felt responsible for Jim. She needs to confront her co-dependency actions.
Most workplaces have an employee assistance program. Some of the features of this program are:
This program saves employers money because it helps to retain their experienced employees. It is a place to go when there is a problem affecting the employee's work performance. Employees and supervisors can find help there for alcoholism and drug dependencies. This program is in the human resources department.
An employer is required by the Drug-Free Workplace Act to report to the government any drug-related actions that occur in die workplace.
Counselor: Andy, you know everyone in this room loves you and wants only the best for you. We have gathered here to let you know how much we want to support you. Your mother will tell you her feelings.
Mother: I'm very worried about you, Andy. The credit union called and said you were three months behind in your car payments. I have been calling you for two weeks and haven't been able to get you on the phone. I'm very upset and concerned about you.
Brother: You and I were going to go bowling. I waited over an hour for you. The bov'Hng team was short one player. It made me angry.
Sister: You told me you 'd be aver on Sunday and take Jamie to the movies. He was so disappointed when you didn'tcome. I wish you had called.
Grandmother: Andy, you have always been real special to me. I was startled by your behavior when you came over to the house. I know you were taking drugs. I want you to know you are not alone. I miss you.
Counselor: Andy, we have an appointment at 3:00 to admit you to the detox center. You will stay there a week and then spend 90 days at a treatment center in the country. We will all accompany you to the center.
Some families and some people will endure a lot of suffering before any action is taken. Getting help when it is needed reduces the amount of chaos and disruption in a household and in a person's life. Ignoring the problem does a great deal of harm. Some will say that intervention is drastic. It takes drastic measures to cure this disease. The good news is that it is successful 80 percent of the time.
What makes a person want to change? He seeks a change when he hurts enormously, when the emotional pain is unbearable. He seeks a change when he craves a new beginning. And lastly, he seeks a change when he has a sudden awareness that it is possible for him to change.
That is why intervention works. The individual knows he has to change, but he doesn't know how to "carry it off." When he is faced with a group of people who he knows loves him, and he hears how his behavior affects them, then he receives a motivational "nudge." The surprise element works. He can't evade a group of people insisting he act now. In fact, having all the arrangements made at the treatment center cinches the deal. The intervention counselor is in charge of the intervention. He should be skilled in persuasion methods. It is important that the substance abuser be treated with dignity.
The members of the group state specific acts of the substance abuser who sits in stunned silence, looking from one person to another. Betty Ford said she can still remember who sat in every chair. The room should be set up so that there is only one empty chair which is placed at the far end of the room, making it harder for the substance abuser to leave. What happens if the substance abuser bolts and won't come back? Nothing more can be done. The person is left to his own destruction. Don't make any threats you are not prepared to carry out.
If you are not prepared to leave the substance abuser, and he is not physically abusive, you will have to detach yourself from his behavior. Detachment does not mean a person stops caring. It means he lets go of the caretaker role. He has given up the idea that he can fix everything. Letting go is a loving attitude that gives the addict space and the freedom to make his own mistakes. Stay out of the substance abuser's behavior. This is not always easy. It is to break the habit of many years. New habits have to take the place of old ones.
Physical detachment may mean leaving the room or even moving out of the house. It doesn't condone or condemn the behavior of the person from whom we are separating. It is simply a means for the person to separate himself from the adverse effects of the substance abuser's behavior. Detachment may be the beginning of a new lifestyle. It is a healthy lifestyle.
The goal of intervention is treatment for the substance abuser.
Any concerned parent, spouse, friend, co-worker has the right to intervene. It is a process done in love.
Factors for a successful intervention
The five stages of bereavement are:
How to know when to seek professional help