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  Intervention for Alcoholism and Other Addictions  

Because individuals suffering from alcoholism and other addictions are prone to serious denial about the harmful effects of their behavior on themselves and others, efforts to reason with them and to convince them to stop causing such harm are frequently met with denial, defensiveness, justification or minimization, and even attacks upon the messenger of what to the alcoholic or addict is bad news: that his addictive behavior is irrational and harmful and therefore must be curtailed.

Talking to such alcoholics and addicts in a rational and objective fashion is therefore often useless or even counterproductive. In other cases the alcoholic-addict may agree with observation that his behavior is harmful to himself and others, may agree with the need for change, and in some cases even make an attempt to relinquish or moderate his addiction. But this is often followed by relapse and a repetition of the same cycle, sometimes up to dozens of times and extending over a period of years. Such people manifest remorse, guilt, and a passionate determination to "do better next time," or they say that "it will never, ever happen again." But the behavior recurs in spite of their apparent insight and desire to behave differently.

Those around such addicts become frustrated, angry, depressed and often hopeless. They are usually well aware that something is seriously wrong and that the alcoholic or addict desperately needs help. But they are baffled and helpless as to what to do when, as is all too often the case, the alcoholic-addict insists that he is just fine, that everything is under control, or that if in fact there is a very small problem, he himself is well aware of it and fully prepared to take care of it on his own resources. He does not, he assures anxious friends and family members, need any help. If they continue to press the point he becomes defensive and often angry and may begin to point out their own shortcomings, to drag up old conflicts, or simply walk out in a huff – usually to engage in still more addictive behavior in consequence of his resentment and self-pity for being so grossly misunderstood and badly treated as to be told that he has a serious problem for which he needs professional help!

The turmoil caused by alcoholism and other addictions can be considerable - and it tends to get worse rather than better over time. Addiction causes people who are not naturally that way to become progressively more self-centered, inconsiderate, dishonest, defensive and suspicious. They may experience unpredictable mood swings, outbursts of emotional and sometimes physical violence, and make major decisions without adequate consultation or forethought. They come more and more to act like the proverbial loose cannon and can cause a great deal of destruction not only in their own lives but in the lives of others. Such people are correctly said to be out of control -–and those who care about them often do not know what to do but stand helplessly by and watch as they create more and more problems for themselves and everyone else, praying that the outcome will not be a fatal one and that sooner or later the afflicted individual will hit bottom or otherwise come to his senses and either stop his destructive behavior on his own or seek professional assistance for doing so.

The technique of intervention gives those who care about the alcoholic-addict a tool and a forum by which they can express their concern in a structured, focused format that often leads to the first step in the direction of recovery. A well-organized and properly conducted intervention has been the gateway through which many an alcoholic-addict has passed from a deteriorating existence of addictive misery to a lifetime of healthy and rewarding sobriety.

An intervention consists of a group of friends, family, co-workers or other important people in the alcoholic-addict's life who present in a non-accusatory way their observations and concerns about the individual's behavior as a result of his alcohol or drug use. This is done in a controlled, objective, and systematic fashion in order to overcome the denial and minimization of the addict and to present a unified front of support and care as the plea and recommendation is made by all present for the addict to get some help to stop his self- and frequently other- destructive behavior with substances.

The classic book on intervention is Intervention: A Step-by-Step Guide for Families and Friends of Chemically Dependent Persons, by Vernon E. Johnson, D.D.(Hazelden, 1989). Barely 100 pages and written in clear and simple terms, this little book gives an excellent description of the disease of chemical dependency as well as a practical account of the theory and practice of intervention. Written by the leading pioneer and exponent of intervention and the founder of the Johnson Institute, this is the best introduction to the topic available.

"Intervention is a process by which the harmful, progressive, and destructive effects of chemical dependency are interrupted and the chemically dependent person is helped to stop using mood-altering chemicals and to develop new, healthier ways of coping with his or her needs and problems. It implies that the person need not be an emotional or physical wreck(or "hit bottom") before such help can be given." From Intervention, by Vernon E. Johnson.

Treatment for the alcoholic or other chemically dependent is sometimes unnecessarily and dangerously delayed because of the false belief that the addicted individual must first "hit bottom" and thus "want to get better" before he is ready for help. The purpose of the intervention method is to break through the alcoholic's powerful denial and avoidance defenses -defenses that have been patiently and carefully built up and strengthened over a number of years in most cases- and to connect him at least temporarily with the reality of his condition so that he will accept the help that everyone but himself is well aware that he needs. The collective feedback of people who know him well, who have observed and can describe the effects of alcohol or other drugs upon his personality and behavior, and the effects that these effects have had upon them, is a powerful, if usually only temporary,  antidote to the strange lack or loss of contact with reality that is called denial. 

A properly done intervention is confronting but it is also deeply caring and supportive. Each participant first affirms the worth of the alcoholic and their positive feelings for him, which in fact is the only reason they have agreed to participate in the intervention. If they didn't care about him they would just leave him alone and let him destroy himself. But because they do care they supply him with their factual observations of how he has behaved -and frequently misbehaved- due to alcohol or drugs. One by one and in non-judgmental, factual terms they describe to him actual negative  experiences that they have had with him because of his drinking or drug use. There is never any shortage of these when one is dealing with the kind of alcoholic or addict for whom intervention is appropriate. The cumulative effect of these descriptions, coming as they do from people who know and care about the alcoholic, is to hold up a mirror before him in which he is forced to see himself as he really is and has been rather than as he mistakenly believes he is. 

The aim of most interventions is to get the alcoholic or addict immediately into a treatment program of some kind. Experience shows that promises of reform, sincere and often tearful as they may be at the time, seldom hold up down the road without ongoing assistance of some kind. A well-planned intervention has arranged the specific treatment in advance, taken care of all practical objections, and even packed the alcoholic's suitcase so that he can be driven straight to the hospital or to the airport to fly to the hospital. Other arrangements besides inpatient hospitalization may be chosen in particular cases, e.g. outpatient treatment and/or AA.

Although Vernon Johnson's book Intervention is intended as a how-to-do-it-yourself guide for family and friends to conduct an intervention without professional assistance, it is almost always preferable to secure the help of a trained interventionist who is also an expert in chemical dependency in setting up and conducting an intervention. This makes matters much easier for all concerned and relieves the already stressed and anxious family of the burden of having to learn how to do something that is for them very difficult and frightening: confront the person they care about with the destructive effects of his addiction in a way that both gets his attention and convinces him to get immediate help for his problem. Interventionists who have done this procedure hundreds or even thousands of times have learned the fine points and tricks of the process and know the best and most effective way to organize, conduct and conclude the intervention.

The following books deal with chemical dependency and intervention:

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Family support

Another Empty Bottle
Intervention resources

Frequently Asked Questions

Intervention FAQ

Interview with Sharon Lowe

Original Papers

The Addict's Dilemna

Addiction, Lies and Relationships

Addiction and the Mechanisms of Defense

Alcohol Addiction

Drug Therapy of Alcohol Dependence

Excuses Alcoholics Make

The Female Partner of the Male Alcoholic

Getting Away With Addiction? 

Intervention for Alcohol and Drug Dependence

Obstacles to Recovery from Addiction

Prescription Drug Abuse

Prolegomenon to the Metaphysics of Recovery

What is Recovery?

Why is Recovery So Hard?

Worried Sick About His Drinking?

Your First AA Meeting: An Unofficial Guide for the Perplexed