Tuesday, December 27, 2011

How to help an alcoholic (Wish Id have read this before....)

Since you’re here, you probably have a friend or loved one who is an alcoholic. And you probably want to know: how do you help an alcoholic in the real world? What can you do that will make a difference? Let’s find out:

First things first: work on changing your behavior, not the alcoholic

It is a hard fact to swallow at first, but the truth of the matter is that you are probably not going to be able to directly change an alcoholic’s behavior. Manipulating or threatening the alcoholic will only drive them deeper into isolation and heavy drinking.
If you try to control another person’s drinking, you are going to experience a loss of control and real powerlessness. Instead, if you focus on changing your own behavior, you will experience full control and an empowering mindset. This is how you go about helping an alcoholic: by focusing on your own behavior and how you choose to interact with the alcoholic….not by focusing on how you can manipulate or change the other person.
Keep reading. I will explain more below about how changing your behavior can help the alcoholic.

How can I convince an alcoholic to quit drinking?

This is a very difficult thing to do, most would say it is downright impossible. But that doesn’t mean that you can’t make a difference in the potential sobriety of a person. Show your support as best you can and let them know that you will support them in any way that you can if they choose to stop drinking.
There are no secret tricks or manipulations when it comes to this stuff. Some people imagine that there might be a way to threaten or coerce an alcoholic into quitting drinking. There definitely is not. If you threaten them, they will simply withdrawal further away from you.
Most, if not all alcoholics, are slowly self destructing, and they know it. Threats mean nothing to someone who is self destructing. You can’t intimidate someone who has nothing to lose. It is simply more fuel for the alcoholic fire.
Trying to shame an alcoholic into sobriety doesn’t work either. If you succeed in shaming them, this will only make them want to drink more because they will truly feel shamed. The alcoholic really is a sick person. Would you shame a disabled person? Of course not.
So basically, there is no way to directly convince an alcoholic to quit drinking.
All efforts to influence an alcoholics behavior are going to be mostly indirect, but this does not make them unimportant. You can influence their behavior and decisions, just not in a very fast or direct manner. More on this below.

How can I help an alcoholic make the decision to go to treatment?

Much like trying to convince someone to quit drinking, this can be a difficult task. But getting someone to agree to treatment is much easier, but at the same time, it is probably not very useful. Here’s why:
Recovering alcoholics who are sober now will talk about a point of surrender that they reached in their drinking. Virtually every one of them that you talk to can pinpoint that moment of surrender, when they finally threw in the towel and stopped fighting against their disease. This is the moment of surrender. This is where recovery starts.
No one knows how to induce this moment. If we did then we would have solved the problem of addiction and recovery. The best we can do is to encourage people towards this moment.
Once someone has reached the point of surrender, anything you do to help them will basically work. Any treatment center you send them to will produce good results. If they have not yet reached the point of surrender, then nothing you do will matter. At all. Nothing you do can overcome a lack of surrender. The alcoholic is still fighting and struggling and trying to control things and it’s just not going to work.
So how can you convince them to go to treatment? Simply offer to take them to treatment. If they’re not interested, then it makes no sense to press them further, because they are not ready. Even if you can somehow manipulate them into it, you are wasting your time. Not ready means not ready. And this has never been more true than when it comes to quitting drinking.
The best we can do is to be prepared to get them into treatment when the moment is right. Have a plan, make some calls, see what is available for alcoholic help. Then when the person has finally surrendered, you will have some options as to where you can take them.
How do you know when they’ve surrendered? When they ask for help. When they are ready to change on your terms, not on their terms. When they throw up their arms and say “I’ll do whatever you tell me to do. Show me how to live,” that is surrender. That is the start of recovery. Anything else on their part is more manipulation (such as “give me money,” or “I promise to go to treatment next week.”).

How can I organize an effective intervention for an alcoholic?

I have already written extensively about interventions, and I have a small bit of experience with them. I still think it is a possible option in some situations, but for the most part I am starting to see more and more evidence that formal interventions are almost never helpful. There is a sliver of hope here, though, because they occasionally do work in guiding an alcoholic towards recovery. But more and more I am seeing that they are never the magic bullet we think they might be; they cannot possibly be an instrument of real change. An intervention can not be the switch that goes off in the alcoholic’s mind that creates real surrender. That switch must be flipped in some other way, unfortunately, and there is seemingly no rhyme or reason to it.
But an intervention still might have benefits, even if it can not force recovery to happen instantly. For one thing, a formal intervention can:
1) Let the alcoholic know that people do care.
2) Show them that help is available (in the form of treatment).
3) Be a step towards their eventual surrender, even if it doesn’t get them clean and sober right now.
So if you are considering an intervention, understand that while the goal of the intervention is probably for the alcoholic to attend a treatment center and never drink again, this is probably an unrealistic expectation and you shouldn’t get your hopes up that high. More likely it is a step on their path to eventual sobriety. It might plant a seed for their awakening later on. Keep this in mind if things don’t go perfectly as planned. How do you help an alcoholic? Not by whacking them with a two by four, unfortunately. It takes gentle nudging in the right direction, and this idea of “planting a seed” is just that type of nudging.

How can I stop enabling an alcoholic?

This is really the core strategy that you need to focus on in your dealings with another alcoholic or addict: do not enable them.
What is enabling?
It’s just what it sounds like. If you enable an alcoholic, you allow them to continue drinking when they otherwise might have had to stop for some reason. But this gets tricky, because sometimes when we try to help an alcoholic, we are actually enabling them. Other times when we think we are “hurting” an alcoholic, we are actually helping them by observing healthy boundaries. Figuring out the difference here is critical.
If you can stop enabling the alcoholic, then this will get them closer and closer to facing reality and making an eventual decision to stop drinking on their own. This is the goal of helping the alcoholic–to force them to examine their own reality and hopefully make a change. Trying to convince them verbally is pointless. Threatening them is pointless. The key is to not enable them. Here’s how to go about doing that:
1) Don’t deny them consequences of their drinking
If the alcoholic in your life gets pulled over for drunk driving and lands in jail, leave them there. Do not bail them out. Sitting in jail is a natural consequence of their behavior, and they need to experience that consequence. It is part of the learning process. If you deny them that consequence, then they cannot learn.
Obviously, it might take several consequences before the alcoholic “wakes up” and decides to try something different (like recovery). But if there are never any consequences, why would the alcoholic ever decide to change? They wouldn’t. So do not deny them the natural consequences that occur due to their drinking.
This doesn’t mean you have to go out of your way to punish them or get them into trouble. Just let them fall on their face. If you keep “putting pillows under them” when they fall, then they will never be motivated to change.
2) Understand when you are helping versus enabling
Genuinely helping an alcoholic would involve things such as directing them to a treatment center, encouraging them to get help, or possibly taking them to an AA meeting. Examples of enabling behavior would be like if the alcoholic needs to borrow 50 dollars to keep their electricity turned on.
Just because the alcoholic needs money for something other than drinking does not mean you should give it to them. In fact, you should never loan or give money to someone who is still drinking, regardless of what they need it for. Doing so is enabling because they will continue to spend their other funds on drugs and alcohol.
Your approach to “helping” them needs to become very “hands-off.” The only way to really help them is when it is directly linked to a recovery effort (such as going to meetings or rehab). Everything else you might do for them is just manipulation and control on their part. Help for alcoholics does not come in the form of money or favors. Knowledge and encouragement is what they really need.
Beware of bargaining as well. “Loan me 50 bucks today and I promise I will go to rehab on Monday” does not cut it. Never bargain with them like this. It’s just more manipulation. If they want to bargain, you set the terms, not them. For example: “I will drive you to rehab on Monday if you are still willing to go.”
3) Understand and practice detachment
Detachment is the idea that the disease of alcoholism is separate from the alcoholic themselves. It’s the idea that we can love a person but hate their disease. When we practice detachment, we can view an alcoholic’s outrageous behavior as being part of their disease without taking it so personally. We can still love them even though they are sick and their behavior is unacceptable at times.
If you really want to help an alcoholic then you must start practicing detachment. Doing so will save your sanity as well as to start pushing the alcoholic closer to facing their own reality. That’s because your detachment will force them to examine their own actions instead of your reactions. When you stop reacting to the alcoholic’s outrageous behavior, it takes away an “out” that the alcoholic can use to shift the focus.
Detachment is not easy, and you might not do it perfectly at all times. But it’s important to understand the concept and to practice it as best you can. Even if it seems like you are distancing yourself from the alcoholic, it is still the healthiest behavior you can choose. You are choosing to distance yourself from their disease and the emotional turmoil that it creates.
4) Set healthy limits and boundaries
How can we know what healthy boundaries are? By separating the disease from the alcoholic.
In other words, if the person were not drinking, would they still need you to bail them out of jail or call in sick to work for them? Of course not. So don’t do those things for them, ever.
Always ask yourself before attempting to “help” the alcoholic: “Could they do this for themselves if they weren’t drinking?” If the answer is yes, then you should not “help” them with it.
Likewise, if the alcoholic is drunk and is engaging in unacceptable behavior (such as being verbally abusive for example), would that behavior be acceptable to you if they were sober? If the answer is no, then you should not tolerate that behavior….ever.
If their behavior is unacceptable when they are drunk then it is unacceptable, period. You should not tolerate it if you would not expect it from them if they were sober.
This is the process of setting healthy limits and boundaries. You have to decide what is acceptable behavior on their part, regardless of whether or not they have been drinking. In other words, the drinking can no longer be an excuse for their behavior. Separate the disease from the person and act accordingly.
Sometime, when the alcoholic is sober, you will want to communicate your limits and boundaries with them. This doesn’t have to be an angry argument. Simply tell them in advance how you will behave under certain conditions. For example: “I will not loan you money in the future, regardless of what you need it for. I will not bail you out of jail. I will not call in sick to work for you if you are hung over.” And so on.
Always, always, always follow through on your promises. Never make idle threats. Say what you mean and follow through with it. This is the only way to affect lasting change in the relationship.
You might be tempted to make a threat that you do not intend to follow through with. Don’t do it. Only set limits that you fully intend to enforce.
5) Don’t react to their drinking episodes.
Most of the big arguments happen when an alcoholic gets out of control and either gets into trouble or makes a fool of themselves. We have a tendency to react to these situations, and it is natural for us to believe that the greater our reaction is, the more likely it is to change their behavior (or at least get through to them so that they hear us). This is the wrong strategy.
When you react to their drinking episode, they can shift to focusing on to your reaction instead of on their behavior. Carry on as normal and they are forced to examine their part in things. Stop giving them fuel for their fire by reacting and blowing up at them. This just creates arguments and possibly drives them into isolation and more drinking.
This idea of non-reaction does not mean that you forget about your limits and boundaries. By all means, stick to your guns with them. That is extremely important.
Enforce limits and boundaries with decisive action–action that you had previously decided on in a rational moment of clarity and probably also communicated to the alcoholic. In the heat of the moment, do not react. Do not pour fuel on the fire. Simply follow through with the actions that you decided on (such as, “if you come home drunk again, I’m going to go stay over at a friend’s house for the night,” or whatever the case may be).
This is how to enforce limits and boundaries…with action instead of arguing. With detachment instead of emotional turmoil.

Action items – What you can do:

1) Detach. Separate the person from the disease and act accordingly.
2) Don’t enable. Never do for the alcoholic what they could do for themselves if they were sober.
3) Don’t react. Stop blowing up at the alcoholic and thinking that this will change things. Ignore their episodes and they will be forced to look at themselves for once.Pin It

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