Motivating Someone to Seek Help
…and looking after yourself at the same time.
If you have a friend, spouse, or loved one that is an out-of-control user, what can you say to them? Here are some of our typical pleas:
You have to stop using.
You’re going to kill yourself if you keep using.
Your using is killing me.
Your using is tearing apart the family.
….and so on.
First of all, none of the above is actionable for the user. They are trapped in a cycle and probably can’t even bring themselves to care about many of the consequences you are stating.
Denial and Addiction
Denial is an essential component of becoming addicted to alcohol or drugs– after all, none of us really like to admit we have a problem with anything; and in the addictive process this tendency becomes all the more pronounced.
Denial is a major barrier in the way of overcoming alcoholism or drug addiction– an absolutely essential first step is for the person to actually accept that at least they might have a problem. If the person you are concerned about does not admit that they might have a problem (in professional terms this is called Pre-Contemplation), you are facing an, almost, impossible task . If they are able to reach this conclusion, then they may become amenable to speaking to a professional in confidence. If they remain convinced there is no problem, then it is highly unlikely that they will wish to speak to anyone– after all, what would be the point?
The truth of the matter is, you have very little verbal control over a user. Things that you say will have very little control over them, even if they are sober when you say them.
As such, it may well be the case that the behaviour of this individual triggers unpleasant feelings in you such as anger, exasperation, irritation, and depression. It would not be unusual if they have become violent or aggressive towards you on occasions. If you are to motivate this person to seek help, you must do your best to stand back from these feelings. I recognize that this is very easy for me to say, whilst being very hard for you to do. However, you must do your best if you wish to maximize your chances of success in convincing the person to seek help.
The bottom line here is that people nearly always need to make decisions for themselves. This is not just related to alcoholism or drug use, but is generally true in life. Someone is much more likely to want to do something if they feel that this has been their own decision, rather than an ‘order’ from someone-else, or that they have to do it just to keep someone else happy.
So what can you do?
The healthiest decision you can make is for yourself. That decision is, for you to be healthier in terms of your relationship to the user. There is nothing you can say that will make someone magically stop using.
However, there are several things you can do. Some of what you can do involves verbalising your intentions to a user. Your intentions, not verbalising demands for them to change their behavior. Merely what you intend to do, given their behaviour and/or their using. At the same time you can help the user to help themselves.
Helping motivate someone you care about to seek help for their addiction
People Nearly Always Need to Make Decisions For Themselves. This is not just related to alcoholism or drug use, but is generally true in life. Someone is much more likely to want to do something if they feel it has been their own decision, rather than an ‘order’ from someone-else, or that they have to do it just to keep someone else happy.
* Never directly disagree with them – rather walk away if you are about to.
* Do not pretend that you do agree with them either.
* In general, avoid making statements of fact.
* Do ask open-ended questions (questions which deliver a response other than a simple yes or no) if you can. Closed questions (requiring a yes or no answer) are still much better than making statements.
* Keep in mind the idea that you are going to let the resistance wash over you. You are not going to become resistant or defensive yourself in response to the person’s statements, but you are not going to give in to them either – you are going to go along with them.
Here’s an example of a bad response:
User: I’ve got a stinking headache this morning.
Helper: Well you shouldn’t drink so much then.
User: What do you mean?
Helper: I mean that you need to stop using.
The helper has made statements, which although may be justified, are only likely to force the user further into denial. In this case, the user is likely to leave the conversation thinking “What rubbish; it’s nothing to do with using.” (Remind yourself: Your job is not to justify yourself; it is to move the person towards accepting that they might have a problem with alcohol.)
Here’s an example of a good response:
User: I’ve got a stinking headache this morning.
Helper: Is it a bad one?
User: I think I’d better take the day off work.
Helper: Will they mind?
User: They said it could be a disciplinary next time, didn’t they?
Helper: Why’s that?
User: Too many days sick.
Helper: Do you think you’ve taken too many days sick?
This kind of response has completely avoided talking about alcohol, and has generally avoided saying anything that could be construed by the user as a criticism. If the conversation ends here, then the user is more likely than not to leave the conversation thinking: “Have I taken too many days sick?” This would be a first step in the right direction towards contemplation of the possibility that too many days sick might be related to using too much. This has been achieved through an empathic response, and the use of questions rather than statements.
Note also that although the helper demonstrated concern, they did not say anything to the effect that it didn’t matter about taking time off work. This is an important balance to achieve–demonstrating empathy whilst not letting the person off the hook either.
If someone is going to make changes to their using behaviour, they must first accept that it is their responsibility to make these changes and no-one else’s if this is to occur. Others may support and advise, but it is the person with the problem that has to take the ultimate responsibility for actually making those changes. This applies to most situations in life.
If the using is causing problems, then these problems are ALWAYS the responsibility of the person that lifts the bottle towards their mouth. In fact, if that person is to make real progress in sorting out their life, then they should really start to take responsibility for ALL the problems in their life, whether or not these are directly related to using.
So your behaviour may need to be modified to encourage the user to take responsibility. Don’t help; Don’t hinder. This means you don’t reward or excuse behaviour caused by drinking or drug taking. Don’t clean up after the user if they are incontinent or vomit. Don’t phone in sick for them, but, don’t stop them phoning in sick. Don’t go out and buy alcohol for a drinker, and don’t give money to an addict.
It is vital that you avoid giving any advice until the person indicates that they are ready to be receptive to this. In other words, your user will have already indicated that they accept that they at least might have a problem, by the time you use these tactics.
If you deliver advice before the person has indicated a willingness to listen, then your advice will do worse than fall on deaf ears. It is only likely to push the user further into denial – to listen to your advice before they have reached their own conclusion that they might have a problem, would be to accept that they do have a problem before they have done so.
Remember the theme that people have to come to their own conclusions; they have to believe that they have reached these conclusions by themselves. You must not force this, and you must not rush it
Assessing your relationship with the user
You may have been in this situation for a long time and seen no change. At some point, you may have to examine your relationship. Ask yourself this gut-wrenching question: Is my intention to continue in this relationship with them regardless of whether or not they continue to drink or use drugs?
If you don’t intend to continue associating with this person, then set a limit. This limit is for your sanity, not theirs. For example, if you don’t get help by the end of this month, I’m walking away from the relationship. This is a firm limit with actionable consequences. Don’t make this type of threat unless you fully intend to follow through with it though.
Remember that there are essentially only 3 possible outcomes between you and the user:
* They get help and stop using
* You leave
* The relationship continues with the alcohol/drugs and the chaos
So you might stop and do some thinking. Long term thinking. Do you really want to be in this same situation, say, 10 years from now? Given the possible outcomes, there are essentially only 3 things you can say to a user:
* Keep using
* I’m leaving
* Get help by next Tuesday or I’m leaving
Let’s take a closer look at the third option, which is setting limits and boundaries. Unfortunately, many people are not in a position to be making ultimatums. There might be things that are holding them back from doing so. Financial concerns, breaking the family apart, having no place to go– these are all things that might keep someone trapped in an unhealthy relationship. There are 2 steps to overcoming these types of fears that hold you back:
* Build self-esteem
* Find support (outside of the dysfunctional relationship)
If and when you decide to make the healthy decision to stop the madness, you will then have to determine exactly what is acceptable to you and what isn’t:
Decide on your boundaries and set limits
Decide what your limits are, then discuss them with the user. Your limit might not be I’m leaving, but rather, I’m not bailing you out of jail any more or I’m not going to be around you when you’re drunk/high or something similar. Your limit is not a punitive consequence–instead, it is a limit you are imposing to save your own sanity. Don’t make it about them. It’s about you staying healthy. The limit you set should directly reduce the amount of chaos you have to experience due to their using.
Make your intentions clear, and be prepared to follow through with them. Don’t make threats that you don’t have full intention of carrying out if necessary.
Isn’t there some other way to change someone’s behavior?
No, there isn’t. Consider the following thought experiment: Say you enjoy taking walks in the park every day. The weather is nice, it’s good exercise, and you have plenty of extra time for these walks. But then someone in your life demands that you stop taking these daily walks. You resist. Conflict ensues. You think to yourself, I should be able to keep taking my walk every day if I want to.
That is the exact same reaction that the user has when you tell them to stop using. But, you say, Using is so bad for them, and it’s destroying their life. My walks are healthy for me. That doesn’t matter. Just because you think you know what is best for someone doesn’t make a bit a difference. It all has to do with a little something called free will. You wouldn’t let someone else control you….so what makes you think you can control someone else?
Addiction is Not Logical
Alcoholism and Drug addiction is not logical. Therefore, the user will not listen to reason. They will not hear your well planned arguments about why they should seek help and live a better life. You can promise them the world and it won’t matter. They are trapped. They are stuck. They cannot hear your arguments until they are ready, which may be too late for your relationship. However, there is always hope; and, using the right approach can help you move the user towards accepting responsibility quicker.
Motivating to Seek Help for Addiction – Final Thoughts
Try to remember the following essential principles in your interactions with your loved one:
* People need to make their own decisions – support, but do not order, bully or beg
* Never directly disagree with the person, but do not pretend that you agree with them either (if you don’t)
* Ask questions, avoid statements
* Try to highlight inconsistencies in statements made, in a way that does not engender a feeling of resistance in the person you are trying to help
* Roll with Resistance
* Demonstrate empathy and concern – try to avoid outright sympathy or criticism
* Don’t rush it – bide your time and wait for a spontaneous response
* But, remember that you need to feel safe and sometimes you have to make hard decisions (such as leaving) to protect your sanity
* Accept that the user’s using is driven by subconscious influences
* Allow the natural consequences of the using behaviour to occur – neither help nor hinder
* Try to avoid taking on the role of the professional helper. Phone us for advice or for a professional intervention
Acknowledgements to many sources who helped shape this article, especially Dr. Bruce Trathen of dryoutnow.com.