“Why can’t my family member stop drinking or drugging?”
Is your family member ready for recovery? Being ready to make a change is key. It’s easy to see from an outside perspective how badly your loved one needs to get treatment. Hardest to take is when a loved one won’t get help or stop using even though we can see the person is in dire straits.
Family members may try reasoning, covering up, enticements, punishment, kicking them out, cutting them off and more. Often all these attempts are met with broken promises, failure and frustration. You need to know; there is no magic formula and it’s not your fault.
Recovery: The Five Stages of Change
The truth is changing our behavior is difficult. If it wasn’t, none of us would have to make resolutions to lose weight, quit smoking, spend less, save more, get organized, sleep more, floss regularly … you get the idea.
Getting someone with an addiction or substance use disorder to change is even more complicated because the disease affects the brain in such a way that it affects a person’s ability to change.
Being unable to change does not mean we don’t want to change or have a better life. It might depend on where we are in the stages of change.
In 1977, Carlo Di Clemente and James Proschaska developed the following Stages of Change model to assess a person’s readiness to enter recovery and strategies to help the person be successful. It also helps family members understand their loved one’s motivation.
Stage 1: Precontemplation – “I’m not interested in changing.”
Before you can change, you need to be aware that you need to change. Think of this as the denial or pre-awareness stage, where the person does not acknowledge a problem or is not motivated to make any changes.
What family members often hear from the individual during this stage is:
- I don’t have a problem.
- I don’t need to change.
- Everyone drinks/uses like this.
- My problems don’t have anything to do with my drinking/drugging.
- I’m just blowing off steam.
- I don’t drink/use every day.
- My arrest was just bad luck.
- You’re the one with the problem.
Although treatment might be pursued at this stage, the only motivation is to get the family, employer or legal system off his or her back. During this period, the individual still sees more benefit to continuing the behavior than repercussions.
If professional help is sought, a therapist may plant seeds about the cost/benefit to the continued addictive behavior. Family members can help reinforce the cost side of the equation by not diminishing the consequences of the behavior by covering bounced checks, calling in sick when they are hung over, bailing the loved one out of jail, etc.
If you’re in this situation, make sure to take care of yourself. Get support by seeking counseling or going to Al-Anon Family Groups. Learn about addiction and how it can affect the individual as well as the family.
Stage 2: Contemplation – “I might have a problem.”
In this stage, an individual is becoming aware that the substance use is causing some trouble and start to consider changing some day in the future. But not quite yet.
It’s helpful for family member to understand this stage is a process of questioning. The individual is struggling to understand the problem, see its causes and wonder about possible solutions. The individual may feel hesitant, stuck or anxious.
When your loved one says something like, “I’m going to drink less,” you might be ready to implement a full-blown addiction treatment solution. He or she may not be ready yet. The individual needs to come to the decision on his own, not have you make it.
For comparison, I might see that eating cake and cookies are making me gain weight and I’d like to do something about it. However, if my spouse paid for me to attend a weight-loss program before I asked for or agreed to it, I’d be pretty steamed about his pushiness and judgment rather than grateful for the help. In that light, you can see how supporting the person’s process rather than pushing a solution would be more appreciated.
Some actions you can take at this step that would be helpful include:
- Don’t drink or drug with your loved one.
- Find out where and how you can get help for the individual.
- Pass on information about addiction and encourage the person to get help.
- Praise the individual for wanting to get help.
- Keep up your own self care practices and continue to seek support for yourself.
Stage 3: Preparation – “I want to make a change.”
An individual in the preparation stage has accepted that change is necessary and is starting to gather information to determine the best course of action (checking out treatment online, reading books, attending a 12-step meeting or support group, talking to people they know who are in recovery), setting clear goals and mentally preparing to take action.
Most likely, some unsuccessful change probably has already been attempted. Members of Alcoholic Anonymous refer to these attempts as “research” to see if they can moderate use or abstain on their own.
Loved ones can assist at this stage by:
- Helping the individual to identify social support.
- Encouraging the small initial steps attempted.
- Acknowledging the person’s anxiety about changing.
- Supporting the individual to seek help from a therapist and/or treatment center.
- Suggesting participation in Alcoholics Anonymous or Narcotics Anonymous.
- Suggest other activities to replace drinking/drugging.
Stage 4: Action – “I’m taking steps to get clean and sober.”
The good news for family members…your loved one is now taking significant and practical action towards recovery, is open to receiving help and is seeking support from others.
Helpful actions you can take at this stage include:
- Support the individual’s participation in treatment, therapy and/or support groups.
- Support the individual’s new activities and relationships that replace the addictive behavior.
- If your loved one is going to AA or NA, go to Al-Anon Family Groups. Having your own program to focus on and having a common 12-step language is helpful for everyone in the family.
- Remove triggers from the home and avoid situations and places that are a trigger for your loved one.
- Consider family or relationship counseling to improve communication, trust and help with adjustments to your new family dynamics.
- Sometimes alcohol and drug use was self-medicating for past trauma, depression, anxiety or other behavioral health issue. If this was identified during treatment, support your loved one seeking treatment from a therapist specializing in treatment of co-occurring substance use and behavioral health issues.
Stage 5: Maintenance – “I’m maintaining sobriety.”
Having stayed abstinent or moved to a more controlled, less harmful way of using and still actively working on recovery for six months, the person is now in maintenance stage. Sustaining these changes can be challenging, and support from loved ones and friends can be very helpful.
Avoid taking a “now you’re cured” attitude about addiction. Like diabetes or other chronic diseases, it’s more helpful to think of addiction as a condition that must be actively managed to help prevent or reduce chance of relapse.
Continue the helpful actions from Stage 4. In addition, you can:
- Keep an open and honest dialogue about problems and feelings with your loved one.
- Support the individual having a “plan B” when attempting challenging or triggering situations and/or places. For example, drive two vehicles to a family holiday party that will be serving alcohol so that your sober loved one can leave early if the situation is too difficult…leaving the rest of the family to enjoy the celebration.
- Depending on how long the drinking/drugging has been going on, be understanding that your loved one might not know how to deal with certain situations sober.
- Be understanding that alcohol and drug use masked feelings your loved one had about previous events and may need to work through their feelings of guilt, anger, frustration, etc. about what happened. Encourage them to work through these feelings with a therapist or group.
- If you are having difficulty dealing with your feelings from the past, or if you are feeling confused and frustrated that behaviors haven’t changed even though your loved one is now sober, seek help from a therapist specializing in family issues and codependency.
By Kris Brown, staff writer. Reviewed by Mariah DeYoung, LMSW, CAADC.