Can’t stop, won’t stop

Can you get a loved one to see they have a drinking problem? It’s tough, but it can be done. Susan Jackson explains…

Any recovering alcoholic will tell you that one of toughest steps towards getting help is admitting that they can’t stop drinking. However, trying to get someone else to acknowledge there is anything wrong is an entirely different mountain altogether.

It’s a dilemma many families in Britain are faced with right now especially as addicts cannot be treated against their will. Latest research suggests that alcoholism affects one in four families but these numbers are surely set to increase in the future.

Addiction to alcohol has reached astronomical heights in the UK as the headline-making statistics such as Alcohol Abuse Trebles A and E visits or One Million Children are Living with Alcoholic Parents show.

But how can those who want to help the people they care about – be it a family member or a friend –make that person see what they are doing to themselves?

According to Robin Lefever, an addiction therapist and treatment director at Promis, a company formed 25 years ago that deals with compulsive addiction from drugs to gambling to alcoholism, part of the problem is due to how addicts think about themselves.

‘It’s important to remember that alcoholism is a mental illness and an addict’s brain has a self protection mechanism that makes them believe there is nothing wrong with them. They think the problem is with everyone else,’ explains Robin.

‘They need to drink and they rationalise why they drink: a stressful job or a bad relationship, any excuse because they don’t want to stop and will do anything to continue. Often they become very manipulative; they can play family members or friends off against each other and divide them so that the pressure is taken away from them.’

When this happens those closest to the alcoholic can become emotionally ill themselves as with every promise to stay sober which can last for weeks, months or years provides the family with a high that everything will be OK, only for their hopes to come crashing down when the addicts starts drinking again.

‘It’s an emotional roller-coaster and while the alcoholic has an alcohol anaesthetic, the family does not and they become ruled by the addict and by what he or she will do next.’

Alcoholism does not go away. It gets slowly worse so that sometimes it goes unnoticed until enviably things do come to a head when a ‘rock bottom’ is reached.

‘We use the HELPS system to categorise the 5 rock bottoms that an addict may reach before they get help,’ says Robin. ‘H stands for Hospitalisation – the person may be told by a doctor that if they have another drink they will die, E is for Emotional – where they have lost everything in terms of they simply can’t feel any type of emotion any more, L is Legal – possibilities including being arrested for drunk driving, P is Physical – they may have broken bones perhaps and S is the Spiritual rock bottom – the addict acts against their true values: while once they were kind they are now mean.’

So what can anyone do? Is there any type of ‘wakeup call’ families can use? Thankfully, the answer is yes.

In the past therapists used to have to wait until the addict asked for help until in the 60’s a US Episcopal priest and recovered alcoholic Dr Vernon Johnson developed Intervention, a way to help alcoholics before they hit rock bottom.

‘Intervention first involves the family finding ‘an island’,’ explains Robin. ‘They take a step back so they can become more stable to be able to cope and understand the problem. There may have been so much blame that no one knows what to do. Intervention works with the family to unify them and focus on supporting the alcoholic.’

‘Human nature is that we are creatures of habit and change is very hard, so even when it is hard living with an alcoholic, we can’t face change so it’s easier to allow the addict to continue to drink – a situation known as enabling,’ he adds.

‘The next step in Intervention is to identify which family members would find the process of change difficult and if they are enabling the addict.  We work with them to make them see that something can be done.’

Once all the family members have the common goal the major part of Intervention starts. In the past therapists have tried many ways to get addicts to see they have a problem. They try an intellectual pathway and attempt to educate the drinker about what they are doing to themselves but studies have shown that this rarely works.

Another way is to ‘threaten’ them into recovery: the ‘I’m going to leave you ‘or ‘I’ll take away your lifestyle’ kind of thing, but again this hasn’t been shown to work in the long term.

‘Punishing people with a mental illness is not going to work,’ says Robin, ‘But what we, and other therapists have found, is that reaching them on emotional level can kick start recovery, and this is what Intervention is based on.’

‘Alcoholics usually end up feeling mad, sad and alone. They are isolated and this is where you can appeal to an addict,’ continues Robin. ‘So what we do is get their family to write an individual letter to the addict explaining how much they love them and who they really believe them to be, because this illness separates you from the person you love.’

Each letter must not just include things like, ‘I love you because you are kind and considerate’, it should give details on specific good times that the two people have shared and what great characteristics they used to have, examples like, ‘You were always there for me when I was little and needed someone to talk to’ with exact details of a particular time, like stroking your hair when you’d broken up with a boyfriend. Memories of a better time.

‘The letter should then give examples where the person has behaved badly because of their illness,’ adds Robin, ‘such as: “I made you a fantastic dinner but you were late and you were drunk and you couldn’t walk.”It’s the contrast of both times that hopefully will make the person feel the genuineness of what you are saying.’

Next comes probably the hardest part. Once all letters are written, a time and place is set up, without the addict knowing what is about to happen. The therapist is there to help, the addict is brought in and the family start to read out the letters.

‘The family are giving an invitation to seek help. If they refuse, then the family have to set out conditions for the addict: such as I’m not having you near my children if you have been drinking,’ says Robin.

‘They are saying we still love you but we will not tolerate you behaving in such a destructive way to yourself and other people. There is another model called the Arise model of Intervention where if a family doesn’t like the idea of a surprise meeting, the addict is included from the beginning. They are told that someone has contacted a therapist and would like to set up a meeting. Sometimes this is good so that the addict does not feel as if everyone has been sneaking behind their backs, and both methods are very effective.’

And what happens next? ‘Usually the addict goes to a clinic straight away and a treatment plan begins.’

If they refuse? ‘I always have what I call I fielder,’ says Robin, ‘someone who can talk the addict down if they are very angry and hopefully try to make them understand that what has happened is because of love. Intervention is not about shouting and expressing anger, it is about showing someone how much you love them and want them to get better.’

So if you are living with an alcoholic perhaps Intervention may be your last chance as in the end there are three outcomes for alcoholics: they end up in prison, in hospital or in a morgue.

If you are in need of help contact:

Promis, which has clinics across the UK can be reached on 0845 053 1785 or visit their website atwww.promis.co.uk

Intervention: How to help someone who doesn’t want help by Vernon Johnson is available at leading bookshops and at amazon.co.uk (£12.15).

Visit YouTube and search for both Promis Intervention and a US series a and e on Intervention to see examples of Intervention in action.

As well as writing about her experience at PROMIS Cathryn also spent her time creating a new body of art during this emotional and difficult time. She had a number of canvesses in her room and around our site that she was working on.

Since then the works that Cathryn created have received a good deal of public acclaim. Please take a look at them on the Saatchi Galery Website :  http://www.saatchionline.com/profiles/index/id/115385

Rediscovering one’s creativity is an important part of many people’s recovery. Often we are afraid that recovery will be a hindrance to our creativity when in fact it is the opposite. Cathryn shows us this very clearly.

Robin

HAVING people on methadone for years is a travesty. But if you get them off it you have to work out how to help them next.

It will actually cost more in the short term, but in the long term – when people go back to being productive and contributing to society – it will save money.

But half of rehab beds in the UK are empty because there isn’t enough funding.

Last year 600 people died from heroin but 300 people died from methadone.

The key point is… would anyone handing out methadone want the same for their children? The answer is “no”. What they’d want is to get them off it to live a proper life, which is what rehab does.

by Robin Lefever

Read more: http://www.thesun.co.uk/sol/homepage/news/3227492/Annual-cost-of-methadone-equal-to-pay-of-11000-nurses.html#ixzz15OCphflF

Catheryn Kemp describes her brave battle to come of pain killers in an article she has written for the Sun newspaper.

Read this fascinating account here:

http://www.thesun.co.uk/sol/homepage/woman/health/health/2953600/Rehab-diary-of-a-painkiller-addict.html

SMART Recovery was created by professor Joe Gerstein as an alternative to AA and taking it’s principles from Albert Ellis’s Rational Emotive Behaviour Therapy programme which itself was a founding cornerstone of Cognitive Behavioural Therapy, much loved by the Department of Health. The programme is thought of as an alternative to AA which considers Alcoholism, an illness, has a spiritual dimension and considers lifelong abstinance essential. SMART Recovery are clear in offering their meetings can also be used as an adjunct to 12 Step ones. In contrast to AA, SMART Recovery has no spiritual dimension, considers it possible to recovery entirely from problems with alcohol and uses only scientifically tested therapy tools which can evolve as new findings are made.

SMART Recovery has a 4 point programme:

1. Enhancing and Maintaining Motivation
2. Coping with Urges
3. Problem Solving
4. Lifestyle Balance

All very useful tools for alcoholics.

It’s fantastic that there is an alternative for those who find the religious foundations of 12 Step groups difficult and I really hope this group finds a strong hold in the UK.

In AA there is a saying that all you need to set up a new meeting is a coffee pot and a resentment against another meeting! I can see how this can also apply to entire fellowship approaches so I hope SMART evolves on it’s own merits and doesn’t get drawn into too many comparisons against AA. It should instead evolves as another much needed support tool for alcoholics.

Robin Lefever