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Don't get the cart before the horse

by Ned Wicker

Drug and alcohol treatment can come in a variety of forms and some of the traditional ways of handling the difficult task of getting a person into treatment may not always be fruitful. Sometimes we try to put the cart before the horse, getting side tracked on issues that aren’t germane to the problem.

Interventions can get an addict into treatment

Emily Grace Whitacre has been involved with interventions for over 20 years and has learned that the motivation for treatment may not be the person’s health, but may come from a completely different direction. She is an assessment and referral specialist, but her passion is in doing intervention work and helping addicts and families throughout the process. How that process begins is not always what is expected.

“One of the first cases I handled was for a man who came in for a court-ordered assessment,” said Whitacre. “But when I asked him why he was here, he said ‘I don’t want to lose my car.’ It’s the sweetest car you’d ever want to see, but I might be drinking too much, and I might be spending too much at the bar, and it might get repossessed.’ He clearly had some health issues, but they were not his concern. He did not want his car repossessed.”

The car may have been his concern, but his health was the issue. He didn’t necessarily want treatment for his drinking, but if that’s what it took to make sure they didn’t take away his car, then he was willing to cooperate. Often there is no willingness at all and people on the outside looking in do not recognize an opportunity to help.

“I think that’s one of the biggest barriers,” said Whitacre. “When we see someone who is resistant, or gruff, or we like to throw out the word ‘denial,’ but what we’re actually working with is someone who does not have hope. It’s (their addiction) what they know."

"I often use an example of being in a deep, dark pit. You can look around and see how ugly it is. You see there is no ladder and the reality is I have no way of getting out, or you can say ‘Pit? What pit? It’s really quite nice down here. I chose to be down here.’ Psychologically, which one would you rather do?"

"If we as friends, and family and treatment professionals can throw the ladder down and make sure (they know) it’s there and how to use it, then they have the option not to use all that resistance.”

"The traditional philosophy has been that a person has to want help before they can receive it. People will say “you can’t help an alcoholic that doesn’t want help.”

“I think there’s a lot about that statement that’s a myth and it’s a myth that has killed a lot of people,” said Whitacre. “There are a number of reasons for that. One, it’s not the reality of people we see in treatment. An old colleague of mine said that most people come into treatment at the end of someone else’s foot. I think that’s true. People are coming in to save a relationship, or to protect their bank account, their job or to deal with their legal status."

“The other reason I think it’s a myth is that it’s backwards. To expect someone with addiction to get motivated or to have insight is purely backwards. It’s like calling your doctor and saying you think you have bronchitis. The doctor says ‘OK, when you’re feeling better, when you fever is gone, and you’re sleeping through the night, and you’re not coughing and your appetite is back, schedule an office visit because then I’d like to prescribe you an antibiotic.’ That’s nuts, but it’s just as nuts for us to say about an addict that when they are motivated and they believe they have a problem, that’s when we’ll help them. It’s after they get into treatment, whether it’s in-patient, or going to meetings. That’s when it happens, not before.”

People have to be off drugs before they will see clearly

People aren’t going to see clearly until after they get the alcohol or the drug out of their system, so they are not mood altered. The motivation may come through education, or their idea of what addiction is can come though having peers, people who can hold up a mirror and show the addict his or her self. Those things can help people get the insight and motivation to pursue a different path.

“We want to sometimes put the cart before the horse and we expect them to have the motivation, then we’ll come in with some kind of treatment,” said Whitacre. “Intervention starts when a family member, or an employer or a friend says ‘This is enough, I need help.’ That’s where hope is born a lot of times.”

Addiction is a family disease. There is hope for the family and in that hope lies hope for the addict. Families do not have to be powerless.

“Families have been told that they have to detach, they don’t know about the option of intervention,” said Whitacre. “They think the addict has to reach out. They don’t have to sit back and wait. They can call a local treatment center. People may call and say there is nothing they can do for their loved one, but they want to know what they can do for themselves.”

Emily Grace Whitacre knows that process of getting a person into treatment, and into recovery, can take a lot of different forms. She has learned to deal with the horse first.

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