By Jeff Jay
It’s show time. After all the planning and preparation, it’s finally time for the team to swing into action. The letters have been written and edited, the funding for treatment has been verified, and all contingencies have been covered. There are a thousand details large and small that go into planning an intervention, and when the big day comes, they all must be in order. However, one thing cannot be avoided: High Anxiety.
Jeff Jay, clinical interventionist and co-author of Love First
Everyone will be nervous. The most uncomfortable part of the whole process will be the hour just before the intervention. The intervention itself will probably go smoothly. In my experience, everything tends to fall into place after the couple of minutes. But until the show is underway, last minute jitters are the order of the day.
Most members of the intervention team will start seriously second-guessing themselves (and the process) in the hour before the intervention. “I don’t think this is going to work,” one will say. “Dad is going to get too mad.” Another will worry that the alcoholic will never forgive the intrusion. “He’s going to feel like we’re ambushing him.” Still others will start to rationalize why they shouldn’t be involved, saying, “I’ve had a few drinks with Marie over the years. Who am I to say something.” Or, “I’m just not sure this is a good idea.”
There is no getting around the stress and anxiety. It’s natural, and it’s part of the reason that intervention demands courage on the part of the team. This is not an easy thing to do, and everyone will naturally have doubts and fears. It’s true that interventions are successful 85% of the time in getting the person into treatment that day, but when that day comes, the odds might not seem quite good enough.
I like to remind families in the final hour that they are being powerful instruments of love in this process. The alcoholic is locked in denial, and without help from the intervention team, the addict will likely remain addicted until serious consequences, or death, finally intervene. It is important in the moments leading up to the intervention for each member of the team to have faith in the process and to focus on the loving action in which they are going to take as a group. “Keep praying!” I often tell them, and if there is ever a time when the maxim “pray without ceasing” makes perfect sense, this is the time.
The nuts and bolts of intervention day are straight forward. All the necessary plans will have already been made, so now is the time for follow-through. The team should meet at least 30 minutes before the intervention. Usually, the team will be able to meet at the location of the intervention, with the alcoholic coming along at the appointed time. For example, the alcoholic may believe that he is coming over to his parents’ house with his wife for brunch at 10 o’clock on Sunday morning. In that case, all the members of the team should meet at the house between 9 and 9:30. It’s a good idea to have something to eat and drink, to help deal with the anxiety. Juices are better than caffeinated beverages, but I never try to press the issue on intervention day. When the intervention is taking place, I will often ask that a glass of orange juice be placed within easy reach of the alcoholic, in case he wants a sip of something during the process.
Team members may want to review their letters once again. It sometimes happens that an event from the night before will be added to a letter if the alcoholic has been acting out. Always be careful that no anger or blame be allowed to creep into the text.
Little touches can help to put people at ease. Interventions can become tearful events, and I like to see that several boxes of Kleenex are available around the room. People should also be seated comfortably, and in a fairly intimate circle. Details like bathroom breaks should all be taken care of before the intervention. Once the process is begun, there should be no interruptions whatsoever. Phones should be silenced, pagers turned off, and everyone’s attention should be focused on the task at hand.
Seating arrangements for the intervention are described in some detail in our book, “Love First,” but in general only a couple of rules need to be followed. First, be sure that the most influential and non-threatening person is seated next to the addict. Second, if there is a person who has a particularly contentious relationship with the alcoholic (perhaps a spouse), they should be off to one side.
It is the leader’s or chairperson’s job to keep everyone on track and positive before the intervention, just as they will direct the intervention meeting itself. The chairperson does not need to be controlling in this regard, but their demeanor will set the tone for the group. A calm and purposeful air will be most helpful during the process. On the other hand, in the moments before the intervention starts, a little good hearted humor is often just what the doctor ordered.
The intervention will unfold quite naturally after the first minute. When the alcoholic first arrives at the location (the Sunday brunch, let’s say), it is immediately apparent that something different is going on. The alcoholic will see immediately that there are more people present than he expected. Indeed, he may see a sister who lives a thousand miles away, or a friend who wouldn’t be expected at a family gathering. In any case, the alcoholic will know in one split second that brunch is not on the menu, and that alcohol is the main order of business.
Initially, their defenses will go sky high. But this will only last for a few moments. In our current example of an alcoholic male, I would ideally like to see his mother greet him at the door with a big hug. She should say, “Honey, we need to talk,” and without ever letting go, walk him over to the couch and sit down right next to him. At this point, the rest of the team will take their seats.
The chairperson will make a brief opening statement, such as: “Mike, we’re all here because we love you and we’re worried about you. Everyone has written down what they want to say to you, and we just want you to listen for a few minutes.” The alcoholic will reluctantly agree, and the letters will begin.
Then the miracle. The alcoholic will have been very defensive up to this point, but then he will hear the letters. As noted in the previous article, each letter begins with a heart-felt memory, recalling when the alcoholic has been especially helpful or when they have been a source of pride. These statements are the exact opposite of what the addict is expecting to hear, and the result is wonderful. Defenses go down, tears often flow, and the door is opened to understanding.
Because the letters have all been written in a careful and loving manner, their effect is repeated again and again as the intervention proceeds. The alcoholic’s denial will weaken, and a marked change will usually be seen in his expression. Only a brief pause should separate one letter from the next. The entire process of reading the letters often takes less than fifteen minutes.
After the letters are read, the chairperson once again speaks for the group. First, the chair will ask if the addict is ready to accept help. The alcoholic will usually ask questions about the treatment, and the chair will provide details. If the alcoholic has objections to treatment, the chair and the chair alone will answer them. It is best to avoid cross-talk, and to let the chairperson handle the issues as they arise. The team should have planned in advance for every possible objection, so there are usually no surprises.
The chairperson does not need to be in a hurry to answer any of the objections. It’s often best to keep a slow and steady pace when answering, and to insert a silent pause between the alcoholic’s objection or question and the chair’s answer. This adds a note of calm to the meeting, and also keeps control with the chairperson.
If the alcoholic tries to pick a fight or escalate emotions, it is critical that no one take the bait. The addict may know intuitively that if they can start a fight, the intervention will disintegrate into squabbling. It is vital that the team stick to the plan, and that no one respond in anger at any time. The chairperson will field all questions, and keep the group on track.
In most cases, the alcoholic will agree to treatment. At the moment of agreement, everyone should immediately get to their feet and give the alcoholic a hug or a pat on the back. This action has the effect of sealing the deal, and putting the process into its next phase.
Plans should already be in place to admit the addict to a treatment center immediately. A small bag should be packed, and every necessity covered. It’s best if the entire intervention team can go to the center for admission, to make sure that the alcoholic’s commitment does not waver.
On the way to the treatment center, the alcoholic will probably not want to chat. Often the intervention team is relieved and elated, and they want to talk. However, the alcoholic’s wishes should be respected in this regard.
During the admission process, financial matters should be handled by the family, whenever possible. If there is a co-pay or deductible that must be paid, it is usually best not to ask the alcoholic for funds. However, there are times when the alcoholic must pay for their own treatment. The intervention team must develop a strategy to handle this matter gracefully. Otherwise, the intervention can be derailed at the time of admission.
At the time of admission, the alcoholic will have to sign releases, so that members of the team can participate in the family program. It is important that this detail not be overlooked, and while it is the job of the treatment professionals to accomplish this task, it doesn’t hurt for the family to make sure.
After the admission process is complete, and the intervention team is on its way home, it’s often a good idea to have a little de-briefing. Here the team can get together once again to talk over the events of the day, and to reiterate their plans for participation in Al-Anon and the family program. It’s always good to have a few words at the end, and to reaffirm everyone’s commitment to the long-term recovery process.
I always say that there is no such thing as an unsuccessful intervention, because if nothing else, the enabling system will have turned into an intervening system, and the alcoholic’s drinking will have been ruined for all times.
However, there are times when the alcoholic will refuse treatment. In these cases it is my experience that the addict will finally accept treatment within the next 90 days. This is because their life will become unmanageable without a good enabling system, and treatment will start to look better all the time.
When the alcoholic refuses to enter treatment immediately, it is even more important for the team to meet after the intervention for de-briefing. It will be important at this time to reaffirm the team’s unity of purpose, and continued focus on the issues. There should be no second-guessing, but rather a commitment to follow through on the plan. If there are bottom lines, they must be carried out. If the alcoholic has agreed to a secondary recommendation, such as outpatient treatment, this must be pursued. By dismantling the enabling system, the team will continue to make progress. In most cases though, these contingencies won’t be necessary.
If you have followed the directions laid out in “Love First” carefully, it is very likely that your loved one will accept the help that is being offered. The process doesn’t stop there, however. In the final article, we will look at other important issues, including what to do if the addict tries to abort the treatment process. I know that when I was in treatment, I was a very uncooperative patient, and I wanted to leave every day. As we close out this series, I will give you some tips on how to deal with treatment and aftercare issues.
This article copyright ©2000 by Jeff Jay. Excerpts from “Love First” copyright © 2000-2008 Jeff Jay and Debra Jay.