by Jeff VanVonderen
In recent years the phenomenon of intervention has caught the eye of the broadcast media. And thanks to them, what people envision when they hear the word intervention usually falls into one of four categories. The first is the “Sopranos”-style intervention, where at the end the “good fellas” beat up on their fellow fella and threaten to ice him if he doesn’t go to rehab. Second is the talk show-style intervention on a drug addict as presented recently on a TV show. Next is the “South Park”-style intervention, where after being intervened upon. the character Cartman goes to “fat camp.” While there he figures out a way to make money on the side by selling candy bars to the other clientele. And finally, there’s the more traditional view, as we hear about in television interviews with well-known people such as Betty Ford, who describe their own intervention experiences.
The concept of intervention conjures up the scene of a room, usually an office, where a group of people are sitting nervously. they are waiting in secret for the arrival of the “intervenee,” whose relationships (and perhaps whose life) are being threatened because of a condition that the person needs help with. Soon the intervene is led into the room under the illusion of being there for some other purpose. The counselor or interventionist then guides the group through confrontation after confrontation about the identified person’s unhealthy lifestyle and the harmful effects it is having on their health, their job performance, their co-workers, or the psychological and emotional well-being of family members—often multiple generations of family members. Finally, the intervene breaks down, says, “Yes, I will get help” and is then smothered with tearful, grateful hugs. Or the intervenee jumps up and storms out the door while the friends and family members sit in shock, wondering if they should have gone through with the intervention in the first place.
Interventions originally developed mainly in the field of alcoholism treatment. Alcohol is involved in a high percentage of all accidental deaths, traffic fatalities, violent crimes, domestic violence and child abuse. A high percentage of suicides involve the use of alcohol in combination with other substances, and additional deaths are related to the long-term medical complications associated with alcoholism. Unfortunately, only 15 percent of those with alcohol dependence seek treatment for this disease. So the need for interventions in this area is clear.
In addition to alcoholism and drug abuse, however, there are many other situations in which interventions are appropriate. Consider the following: a 50-year-old woman is losing her family as a result of her workaholism; a 25-year-old anorexic or bulimic can barely carry her 100-pound weight on her 5-foot-10-inch frame and is at risk of sterility or the shutdown of internal organs; a 35-year-old husband and father physically abuses his wife and children; a rigid, controlling man who no longer gets drunk and abuses his family with his fists now uses religion and words to achieve the same results; a bipolar man and his family are living on an emotionally dangerous roller coaster because he refuses to take his medications. For all these situations, and many more, it is appropriate to consider an intervention. When a person is stuck in patterns that disrupt, endanger, or demean the quality of life for themselves or others, an intervention is more than appropriate and can make an enormous difference in the present and for generations to come.
This article explores some of the mistakes that families commonly make when they experience a crisis that would make an intervention appropriate. These mistakes are wasting the crisis, playing solo, skipping rehearsal, accepting half measures and caving in afterward.
Wasting the Crisis
When a series of events culminates in a situation that is no longer under control, we call it a crisis. Until the crisis, a loved one has been walking on a stressful, dangerous, perhaps life-threatening tightrope. Friends and family often feel helpless. They are an unwilling audience for this dangerous balancing act. And that can sometimes make them feel like they’re on a tightrope as well. When the crisis occurs, it’s like the loved one has fallen off the tightrope. They have gotten fired, abused someone, gotten arrested, received a drunk driving citation, or any of a myriad of other experiences. Now they are dangling by a fingernail. It’s an emergency. Action is imperative. Time is of the essence.
Yet, all to often, family members and friends reach up and prop the loved one back up—or reach down and pull them back up—onto the tightrope to resume their dangerous act. Then they wait anxiously for the next incident and hope that it never comes, or if it does come, that it isn’t too serious. They do this because they don’t know exactly how to give help that will really be helpful. Or they do it because they have been trained through other tightrope mishaps in the past. Or they do it because they find meaning for their own lives by rescuing people who fall off tightropes. Whatever the reasons are for helping a person get back on the tightrope, the important thing to remember is this: The problem is not that the person has fallen off the tightrope. The problem is that they are living on it in the first place. So helping someone back up onto the tightrope is, as they say, merely rearranging the deck chairs on the Titanic. At best it is a Band-Aid. In essence, if in a time of crisis we help someone back onto the tightrope, we have wasted the crisis.
The goal of an interventionist is to utilize, not waste, the crisis. When it is impossible or improbable that the loved one is going to climb down off the tightrope on their own initiative, it becomes the job of the interventionist to provide a loving, supportive environment in which people who care can “push” the loved one off the rope, resist efforts to prop them back up, and provide a net of appropriate, qualified, expert help to catch them and help them resume life with their feet on the ground.
A person in need of an intervention is incapable of seeing, or is unwilling to see, the impact that his or her lifestyle is having on those around him. Those who are concerned about their loved one have found that the efforts they’ve made alone to suggest, hint, lecture, or otherwise help have failed; sometimes their efforts have even been met with hostility. So each person has tried to be helpful; each person has experienced part of the problem. And although each person sees part of the picture, the whole picture is very difficult for them to visualize. To put it another way, trying individually to help someone is like trying to play one instrument’s part of an orchestral piece. Without the other instruments, and without a conductor, the music is ineffective and the audience won’t listen. Or worse yet, the audience may try to take charge and conduct the music themselves.
The task of the interventionist is to help friends and family members play their parts together so that during the concert the loved one can hear the music, or begin to understand what their life looks like and how it affects others. An interventionist is a conductor who trains the musicians to play a piece of music clearly and crisply, music in which the audience can hear the strains of their own lives. Only when the musicians play their parts in concert with one another, under the guidance of the conductor, will the music have a chance to be heard.
The most important day of the (usually) two-day intervention process is the first day—the pre-intervention training day. Typically, this involves a lengthy and intense training session during which family members and other participants (not the prospective client) become equipped to communicate their concerns and proposed course of action to their loved one in ways that are the most helpful. During this time the interventionist gathers and organizes information about the person whose life is out of control because of their addiction or other life-interrupting behavior patterns. Every single detail is considered. Who will speak first? In what order will people speak? What will be said? Who will sit where? Will the person be brought to the intervention, or will the intervention be brought to the person? And how? What if they say no? What would likely be their main objections to accepting treatment? Every base is covered, every crack filled. The second day involves the actual intervention with the identified patient, followed by referral and escort, if necessary, to an appropriate helping agency.
And herein lis another common mistake made by family members. Time and time again, I have seen people skip that most important first day, the day of preparation. As a result, they may wind up repeating the second day, the intervention, over and over again. If they are not well prepared, the intervention usually fails. They don’t get the answer they want, the persons denies the problem and refuses to get help, and the painful wait for the next crisis begins again. In addition, they have given their loved one a greater opportunity to reinforce the defenses that have kept them in their destructive patterns up to that point. Or the family members may actually get the answer they want: “Yes, you’re right. I need help and I’ll get it.” But then nothing changes. Perhaps the “right” answer satisfies the immediate concerns of the family and they back off. Perhaps the family was not prepared with a plan of action, let alone prepared to act immediately to put their plan in place.
Accepting Half Measures
Sometimes when a person agrees to seek help, family members are so excited that they accept an inadequate solution to the problem. It’s as if they are all passengers on a stalled bus, and suddenly the most out-of-control person volunteers to drive They are so relieved to have the bus moving at all that they go for a ride to an undesirable destination. For instance, a person who is addicted and whose body is physically compromised from years of alcohol abuse needs to go to treatment. But first they need a safe, medically supervised detoxification program to avoid the dangerous and sometimes life-threatening effects of withdrawal. But they refuse to go to detox, for whatever reasons. Instead, they offer to quit on their own and promise to go to outpatient treatment and A.A. meetings. Their loved ones are so thrilled by their admission of the problem and willingness to get help that they accept the plan. While continuing to drink can kill some people, quitting (on their own) can kill them as well. Is there another life-threatening condition for which we would settle for inadequate or less than the best treatment? And yet when it comes to addiction, families do exactly that, far too often.
Again, that is why, prior to the two-day intervention event, the interventionist is busy behind the scenes planning for the effectiveness and safety of the intervention: orchestrating the time and place for a pre-intervention training session and deciding who should be present; choosing which participants will be the most effective in the intervention and weeding out those who would likely sabotage it during the event or prior to it by tipping off the loved one; prearranging admission to appropriate recovery services (doctors, lawyers, psychologists, inpatient or outpatient treatment centers, and so on) if the loved one becomes willing to accept help. Will she need detox? Does he need to be escorted? How can the time between the client’s “yes” and when they actually enter a facility be minimized and the arrangements be as seamless as possible?
I know a person who works for a crisis telephone line. When she suggests to a family that they consider using an interventionist, the most frequently asked question is, “What are the chances that it won’t work?” Her standard reply is, “The most common reason for an intervention not to work is that the family doesn’t do what the interventionist says to do.” I would have to agree. Often someone gets ahead of the plan. Someone thinks they can do it on their own because they have a “special” relationship with the client. This abandonment of the well-planned group intervention almost always leads to failure. I have even had a couple of occasions where a family member caved in and began defending the loved one in the middle of an intervention. I understand that it’s hard to stop rescuing someone when that has been your main job for years and years. But my experience is that people who choose to get help as a result of a group intervention are more likely to get more comprehensive help, are more likely to do better while they are in treatment, and are less likely to leave before an approved discharge.
There is another time when caving in undermines the whole process, and that is after the client is in treatment. Often a person in a treatment program threatens to leave or complains about their situation: they don’t like their counselor; they are “not as bad” as the other people there; the food isn’t good; another client is getting on their nerves; they don’t like their roommate; the center is not Christian or religious enough; the center is too Christian or religious. Suddenly, instead of understanding that their loved one’s new “crisis” gives them a chance to change and grow, family members give the client an “out”—a ride, money for a ticket, even a sympathetic ear—and then are sad and surprised when the client leaves AMA (against medical advice). Even with these confusing circumstances an interventionist can help people stay on the clear course that resulted in getting the person into treatment in the first place.
Conclusion: Redefining Crisis
Typically, we think of a crisis as something like a drunk driving arrest, an injury resulting from a violent outburst, the sudden revelation that previous “unexplainable” behaviors are the result of drug or alcohol use. And we would like to avoid these crises at all costs. But I want to offer a different and more helpful definition for crisis. Rather than waiting for the DUI, or the injury, or the loss of a job, there is one crisis that families can and should embrace. It comes into being when they simply say “This situation cannot and will not continue, because I can’t live like this any longer.”
An intervention that is done correctly is much more than a bunch of people getting together for a confrontation during a time of crisis. The Chinese symbol for crisis contains two characters. The first is the character for danger and the second is the character for opportunity. The danger is usually obvious to a family in crisis. Finding the opportunity in the crisis and helping the family do whatever it takes to make the opportunity a reality is the role of an intervention specialist. The negative outcome that seems so likely and so terrifying is not the only possible outcome to a crisis. Good can come from a crisis—especially if we find the courage to tell the truth.