How to REALLY help someone with alcoholism
My mom just announced she didn’t drink today. What’s the big deal?
What can you do when the ones you love are drinking too much? Check out a real-life scenario from experts at Allies in Recovery here. They help families identify and intervene into alcoholic situations. Their methods (rooted in the CRAFT intervention model) have been found to be many times more effective than a one-time, potentially aggressive HBO-style intervention.
Here, Dominique outlines some steps you can take to TRULY help someone with alcoholism. Then, we invite you to share your questions, your story, or your cry for help at the end. In fact, we try to respond to all comments personally and promptly.
First, can you relate to Kate’s story?
A young woman named Kate came to see us, deeply upset about her mother’s severe alcoholism. As her drinking got worse, her mother had quit a high-paying job as a nurse, and was now almost a complete shut-in. Kate and her brother still lived with their mother, providing food and paying the bills. Mom went out occasionally to stock up on liquor.
Kate’s brother, Dan, in his early 20’s like Kate, had also started to drink more heavily, but was less bothered by their mother’s drinking. Dan did his drinking outside the home, and only came home to sleep and to eat something before going out to work or to hang out with his friends.
Kate was in school, and, with only a part-time job, couldn’t quite support herself to move out.
She tearfully described her mother’s decline, along with her own growing involvement caretaking for her mom. Kate would put her mother to bed several times a week, and had to make sure she ate something. Her mother’s health was deteriorating.
Now and then her mom tried to stop drinking, but her blood pressure would spike and she suffered from terrible anxiety, driving her quickly back to the bottle. Moderate drinking tactics were also not an option.
Kate felt trapped under the weight of her life. She worried her mother would fall while she wasn’t home. She slept lightly in case the fall happened during the night. Her brother was of no help.
STEP 1: Look for key moments to identify WHY someone is drinking
When you’re looking to help someone who is drinking too much, start by getting interested in what motivated the drinking in the first place. Pay attention to key moments when your loved one’s motivation may be revealed. These moments surface when a loved one tries not to drink.
For example, why did Kate’s mother drink? Kate wasn’t sure. She knew her mother wasn’t happy in her life; she knew she was causing her children heartache. Her mother would talk about the pain she was inflicting and how she wanted to start out in a new life, fresh, without booze, but these words were invariably spoken while drinking.
On the rare days when her mother didn’t drink, her blood pressure would spike and the anxiety always won out. Perhaps they’d get through dinner together, but Mom always caved in and drank before the evening was over.
“She doesn’t really want to get sober,” Kate told us. “It just makes me angry. She’s not serious. It’s just talk.” Kate could barely control herself on those evenings. She knew the drinking would soon follow. She had lost all patience with her mom.
The pattern was thus clear and the time to intervene limited. It made no sense to talk to her mother when she was drinking. Even during a hangover she was almost certainly on her way to the first drink of the day.
STEP 2: Put recovery into a long-term perspective.
In other words, getting sober starts with Day One. We explained to Kate that everyone who gets sober does so by starting on one day. Day 1 may not be followed by Day 2, but it can be, and by definition it must be.
Kate was going to have to prepare for coming home and finding her mother sober. Kate had little faith in all this, having seen her mother return to drinking by the end of a sober day, time after time. We talked about these attempts by her mom as really important, albeit ineffectual, moments on the path to getting sober.
Kate was going to need a plan.
STEP 3: Work with professionals to come up with a plan.
Helping someone deal with alcoholism will require a plan that includes learning how to intervene so an alcoholic can hear your message. The main steps in planning are:
1. Figure out treatment options.
Figure it out, in detail, beforehand and write it out for your loved one.
In her mom’s case, it was critical to start with an acute detoxification unit, since the dangers of alcohol withdrawal were life-threatening. Kate would have to contact the units in her area and understand the admission process. She would need to consider the emergency room if there wasn’t a bed available on the evening in question.
2. Develop A New Understanding of Addiction Recovery.
Yes, Day 1 looks like all the other Day 1’s
Rather than hold onto anger at her mom during what appeared to be another failed day off from drinking, we helped Kate to see that this was her mother’s desire for change poking through. On some level, during these brief moments, her mother did want to stop drinking.
Kate could try stepping in during these moments, with the treatment plan and few carefully chosen words. She was also going to need:
3. Develop an Advanced Warning of Non-Use Behaviors.
Pay closer attention to signs of non-use.
Kate was going to need an hour during the day to call the treatment places to learn whether there was room that evening. To recognize the right moment to do this, Kate would need to sharpen her knowledge of any advance signs that her mother was not drinking on a given day.
Perhaps Mom talks about trying not to drink before Kate leaves for school, or Mom eats something on those mornings. Perhaps her mother sounds very different on the phone at those times. When prompted to consider what they know, family members often have a lot of information on their loved one’s behaviors both before they pick up a drink or drug and when they do not pick up that drink or drug.
4. A Few Carefully Chosen Words Go a Long Way.
What you say and how you say it matters enormously
We taught Kate a few positive communication skills and together scripted out what she would say to her mother. We suggested she buy a flower and put it in her book bag.
- Mom, I know I don’t always show it, but it makes me so happy to see you sober when I come home from school. I brought you a flower.
- (Kate looks her mother in the eyes, smiles, and puts her hand on her arm. Kate pauses, going into her room to put her things away.)
- I love you and I respect your efforts at stopping. Mom, if you’re ready to stay stopped, I’ve found a place for you to go for a few days where you can safely dry out.
- I think it’s time, Mom. Your health isn’t good and you’ll need to drink before the night is out. What do you say we do it differently this time, Mom, and we get you help to safely stop.
If Kate’s mother gets angry, or argues, or turns her down, Kate just backs off, thanking her mom for listening. There will be a next time to set up and try again.
STEP 4: Know what to do when your loved one drinks
We instructed Kate on three steps to take if her mother started drinking that night or at any other time:
- Disengage (I think I’ll go to my room and study)
- Remove rewards (not making dinner or watching TV together)
- Allow natural consequences to occur (not putting her mother to bed after she passed out).
Taken together, Kate now had a strategy to address her mother’s drinking. It wasn’t going to be easy and it wasn’t going to be fair for this young woman to manage her mother’s illness. Kate was living a nightmare that she needed help navigating. She loved her mother and told us she was willing to try the strategy. She agreed to check in with us frequently and to continue seeing her own therapist.
STEP 5: Keep it real and call 911 when required.
To this, we add one more tactic: consider emergency services as a potential ally.
If your loved one is unresponsive or her behavior is worrisome, let professionals in to assess her. You can’t be expected to know how dangerous things are. Calling 911 also signals to your mom that you are not keeping secrets. The emergency department may help convince your loved one to go into a detoxification unit.
Coping with alcoholism successfully
In following these suggestions, Kate now felt prepared and empowered. She had a plan to address her mom’s alcoholism.
You can do the same!
Please let us know how we can help you.