Don`t Confuse Intervention with Treatment

“Act as if what you do makes a difference. It does.”

William James

I am an interventionist. I help families organize strategies and tactics so that the addict or alcoholic they love willingly arrives at the treatment program they have chosen. That being said, people and circumstances often refuse to line up for this to happen in a neat and orderly way. In the first intervention I did, I found that traditional intervention models were not going to work. I had to get creative, and have had to do so many times since.

Today, after 18 years in the field and hundreds of interventions, I strongly believe that creativity and using one’s imagination is one of the most valuable tools in an interventionist’s arsenal.

The two realities in play

In any intervention there are at least two completely different realities in play. First, there is the reality of those who are not on drugs or alcohol and are, for the most part, rational. Then, there is the reality of the actively using or drinking addict. The difference is not the drug or alcohol use, but the reality of the addict—how he or she thinks about life.

Having been an addict myself, I know how an addict sees the world, and in my work this is a definite advantage.

Actively using addicts and alcoholics are not, as we often hear, “reasonable people doing unreasonable things.” The practicing addict often sounds rational, except for the fact that his logic will run in self-serving circles. This is because the addict actually sees the world differently from the person who is not pursuing a chemical embrace. Hence, you are more likely to succeed if you appeal to the reality of the addict, rather than try to drag him/her into the neighborhood of logic or reason. Often one can and should apply logic to the presentation, but at other times you have to abandon logic and instead appeal to the addict’s reality.

The disconnect from reason

One of the most easily observable hallmarks of addiction is that the addict sees himself as a victim, but not necessarily of the drugs or alcohol. The substances have become solutions. He sees himself as a victim of his circumstances and the people with whom he interacts. An addict or alcoholic will blame anything and anyone for his condition. If only he could get his car fixed, if only his boss would stop being unfair, if only family members would help him just one more time with rent or some other debt, if he could just detox, he could gain the traction he needs and life would be good again. During an intervention, you can bet the addict will see himself a victim of that as well.

Apply logic and reason, and it’s clear the addict’s condition is not the result of unfavorable circumstances, but of a gradual decline in his operating systems. Personal ethics are the first to go. Little lies grow and multiply, secrets pile up, moods swing wildly from hostility to “manic depression,” justifications replace personal responsibility, and traits such as integrity or morality are long gone.

Drugs and alcohol also affect the brain and the endocrine and nervous systems, creating inappropriate or extreme emotional responses (for example, the alcoholic who becomes hostile while intoxicated or deeply depressed when not, or the cocaine or meth addict who becomes paranoid). Further, the addict vows he can “do it on his own,” or that things aren’t as bad as his family says.

To many of you, the addict’s disconnect from reason is obvious. What is not so obvious is what to do about it, or perhaps more importantly, what not to do.

The confession

Many families believe the addict has to admit drug or alcohol abuse to them in order for treatment to work, and they’re surprised when I tell them he or she doesn’t. That notion is a myth, and is actually counterproductive to pursue.

I learned that on the first intervention I ever did, which was back in 2001 for well-to-do parents with a very off-the-rails son, “David.” My job was to get him into the program that I had attended in order to get sober.

David was on meth and was a ghost of the man he once was. His home had become his drug lair, or prison. People who had been there said he was in a drug-induced psychosis most of the time. When I arrived, the first question his mother asked me was, “How will you get David to admit he has a problem?”

It is a question I would hear many times over the years, but it’s simply not true that an addict has to admit to having a problem, to the family, before treatment will work. Moreover, pursuing such a confession will actually work against you during an intervention. It diverts attention from getting the person into treatment—which is the only real goal worth achieving. I have not seen one iota of statistical data that suggests admitting one’s problem to one's mother as the cornerstone to recovery, nor have I known anyone in recovery to attribute his success to what he admitted to his family before he went into treatment.

Nevertheless, many people, including some professionals, believe that one purpose of an intervention is to get an addict to openly admit his/her need for help. In my opinion, if it happens, great, but don’t make it your mission. The important thing is to get the addict into treatment. If the program of choice is worth its salt, the addict’s arrival is really all that matters. Addressing conditions of denial is an integral part of any good program.

The denial myth

The corollary to all of this is the belief that if a person does not admit to having a problem, he does not know he has a problem. This is simply not true.

If your loved one told you he went to the library last night when he was really out drinking, does that mean he isn’t aware he was out drinking? Of course not. He’s lying, plain and simple.

Denial is not complex psychology. People often talk about addicts as being “in” denial, as if it’s a box of neurosis or a house of mirrors out of which the addict cannot see. This is rarely the case. More often than not, addicts are acutely aware that they are in the deep end of the pool, but they lie, either because they don’t want to expose themselves or because they’re too ashamed, angry, guilt-ridden or distrustful to consider being truly honest.

“Admitting one is powerless over drugs or alcohol” is for many the first step to recovery, but nowhere have I read that admitting one’s behavior to one’s family has to be part of it. Even during treatment, when the addict is making repairs or amends for past actions, he still doesn’t need to make a full confession to another family member in order to recover successfully. In other words, simply because the addict doesn’t admit something to his family or to you as a professional does not mean he isn’t miserable and doesn’t want out. Just because he tells his mother he doesn't want help does not mean he doesn't want help. Ironically, ego is often the culprit.

Getting the addict into treatment is my only goal. If the addict is in denial, or insists he’s going to continue to smoke pot, or goes in blaming his family, cursing God or whatever, this will be wrestled with during treatment—not during the intervention!

Interventions vs. therapy

Addicts, like anyone else, hate to be made wrong. This is why, even though an intervention can have some therapeutic effects, it should never be about getting the addict to have sweeping realizations or to reconcile with the addiction. The level of dishonesty and manipulation in the mind of the active alcoholic or addict—that “other reality” I mentioned—will invariably prevent any deep or permanent gains. This is not going to change simply because you enlist a group of family members and friends to try to cajole the person into doing something he doesn’t want to do in the first place.

The first step toward recovery must include self-examination, but anyone who has worked in a program knows that this happens on a gradient that varies with the individual. Some people find their road easily, while others are obstinate and rebellious. But these challenges are exactly what residential programs are designed to meet.

It is important to see the difference between a using addict and someone who thinks logically. Confusion about this is often the reason families stumble. My advice? Make your goal a singular one: the arrival of the addict at the program with enough willingness to try. During an intervention I try to think like an addict and practically compete for the title of “best addict.” If he wins, the addiction will eventually destroy him. But if I win, he can get his life back.

Since graduating from treatment in 2001, Steve Bruno has facilitated hundreds of interventions worldwide. In 2017 he published More Than Hope, The Intervention Guidebook, which is geared toward helping families create strategies based on the viewpoint of the addict. For more information, visit his website.