As of the writing of this book (summer 2003), hundreds of parents, children, husbands, wives, lovers, and friends of substance abusers have enjoyed improvements in their lives by using the CRAFT program. We have seen some incredible changes for the good happen to many wonderful people. For example, worried parents recently came to my office, concerned about their thirty-four-year-old daughter who was addicted to heroin. After listening to their description of the many things she was and was not doing that frightened them, I asked them the simple question, “Do you ever say anything nice to you daughter?” At first they were somewhat taken aback, perhaps a little offended, but after some thought they realized that so much of their energy focused on the problems with their daughter that they had lost sight of her positive qualities. Their answer to my question was, “No.” After a few sessions of discussing when and how to use positive communications (see chapter 9), they were able to begin a constructive dialogue with her. She was very difficult but eventually agreed to come to ONE treatment session to see what all the fuss was about. We had prearranged to have an appointment occur quickly when she indicated she was ready to come in, and the meeting was very successful. Taking it slow and meeting her where she was (curious but not committed), we talked about the impact of heroin on her life, her relationship with her parents, and her dreams and goals. By the end of the session, she agreed to come back and explore whether treatment was a good idea for her. Her parents wept with joy.
When a middle-aged mother came in for help to get her eighteen-year-old son into treatment for marijuana abuse, she sobbed as she described him. He was a typical rebellious teenager—stubborn, disobedient, and irreverent. His mother had pleaded with him for years to go to therapy but he repeatedly refused. As far as he was concerned, he did not have a problem; the only problem he saw was his mother's nagging. After the mother learned how to map out her behavior and its impact on him (see chapter 2), things started to change. She stopped nagging, pleading, and threatening and changed the way she responded to him to minimize the friction between them. She also learned how to “reward” him for desirable behaviors (like not being high) in a nonconfrontational manner so that their life underwent a metamorphosis from arguments and hurt feelings to relative calm and the reemergence of mutual respect. Mom found that her personal stress levels decreased dramatically—she was able to sleep again, stopped relying on antacids to keep her stomach calm, and returned to the enjoyable activities she had dropped when her son's behavior grabbed all her energy. Most exciting for Mom, however, was when the young man showed up at our clinic for help. When we asked him why he chose to come to treatment at this time, he said, “I guess I just felt like I owed it to my mom. She has been treating me so nice I decided to give it a try.” Needless to say, his mother was even more thrilled than were we.
CRAFT has proven itself with the CSOs of individuals who abuse alcohol, marijuana, heroin, amphetamines, and a host of other substances. Thus, although we have written this book to primarily focus on people whose lives are affected by alcohol, you can apply the same methods with loved ones who abuse other drugs. However, if illicit drugs are the problem in your loved one's life, I would encourage you to seek the advice and support of either a therapist or physician. These drugs raise not only legal issues that alcohol (for those over the legal drinking age) does not, but can also negatively affect one's life much more quickly than alcohol on its own. If your loved one is addicted to illicit drugs, you must be especially vigilant about safety issues. Not only do some of these substances trigger violent outbursts that put you directly in harm's way, but they are associated with a drug culture that operates outside the law and often uses physical violence as a means of keeping its members in line. Thus, if your loved one is involved in this lifestyle, you and your dependents may be at serious risk for violence. The risks, moreover, do not stop there. Drug paraphernalia left in the home or anywhere that children may find it spells potential disaster for the children's well-being, and illicit drug use sets your loved one up for being a transmitter of serious diseases such as hepatitis and HIV, among others. Therefore, your loved one's drug abuse potentially targets you for disease. So, as you work through this book and apply the skills you learn to your relationship with your drug-abusing loved one, remember that safety is more difficult to ensure than if your loved one used only alcohol. Apply the same principles but be extra vigilant for danger and be ready to walk away if need be, or to seek outside help.
This book represents the accumulation of all that I have learned over the past three decades and the best of what science has told us is most useful to people whose lives are afflicted by loved ones who abuse alcohol and other drugs. Use it in whatever way will be most helpful to you. You can read it and work through the material on your own or go through it with a friend. A clergyperson, counselor, or psychologist can also help you as you develop new and more satisfying ways of living with your loved one who abuses drugs or alcohol. You are the best judge of what method feels most comfortable to you. Regardless of how you use this book, however, be calm, be patient, and above all be safe.
I wish you good living.
—Bob Meyers
* * *
* Al-Anon and Nar-Anon are self-help support groups for the friends and family members of substance abusers. The groups are based on the same Twelve Step model on which Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are based.
chapter 1
The Program
The subtitle for this book, Alternatives to Nagging, Pleading, and Threatening, was chosen deliberately to emphasize that our program offers a positive alternative to the usual tactics people use to try to get their loved ones sober. If your loved one is still abusing alcohol or other drugs, in spite of your repeated efforts to get her to quit, then it is time to try something different. It is time to try the Alternatives.
Learning the alternatives to nagging, pleading, and threatening is fairly straightforward. It will not take years of study for you to master these tools. You simply need to work your way through this program and give some serious thought to what you want and to the choices you make. Whether you do that quickly and decisively or slowly and deliberately is entirely up to you. Although the concepts are not complex, your life is, and change will happen at variable speeds despite your consistent efforts. Just keep in mind that if you do not try at all, it is likely nothing will change (at least not for the better). On the other hand, if you use the Alternatives, there is the very strong likelihood that your life will improve. Hence, dig in!
The alternative to nagging, pleading, and threatening can be found in a simple system of behavior that has two goals and one central procedure. The goals are (1) to improve the quality of your life and (2) to make sobriety more attractive to your loved one than drinking. The central procedure is something we call “behavioral mapping.” It is a way of figuring out how you and your drinker affect each other and how that pattern may be modified to achieve different results. For example, Ruth found it very upsetting that Paul would open a beer as soon as he came home from work every day. In fact, she found it so upsetting that each day she would bitterly complain about it, and they would fight. After mapping out their typical after-work scenario, Ruth realized that her complaints actually made it more likely that Paul would drink. He used the arguments as an excuse to justify his “needing” a relaxing drink. Her nagging also gave him a reason to “punish” her by drinking. Using the same Alternatives you will learn, Ruth was able to change her reaction to Paul's after-work beer. Further, by doing so, she eventually made it more enjoyable for him to skip the beer than to drink it. End of beer. End of complaints. End of arguments and punishment. Beginning of a better quality of life for Ruth and a shift toward sobriety for Paul.
Sounds simple, doesn't it? Well it is both simple and difficult. The techniques are not difficult to learn. What can be difficult, however, is applying them in your current life. The way you and your loved one interact is a well-rehearsed routine born
of your natural style, his natural style, the impact of alcohol on your loved one's brain and behavior, and the interaction of all of the above. If you think of the changes you want to achieve as a journey, you can draw a parallel between the simple lines on a road map and the techniques you will learn, and then draw a parallel between the actual roads you travel and the life context in which you implement them. Real roads, unlike their clean counterparts on a map, have potholes, detours, and traffic jams. Your life has hard-to-break habits, unforeseen crises, and just plain discouragement that you will need to overcome. However, just as you wouldn't give up a desirable journey simply because some of the roads are bumpy, you won't give up on changing life with your drinker just because it is not always easy. Change is almost never easy; but change for the better is always worth the effort. After months and years of nagging, pleading, and threatening your loved one, you are ready for a change.
A Look Ahead
As we have already said, there are two simple objectives to this program. One is to improve the quality of your life. That means not only getting your loved one to stop abusing alcohol, but more importantly, putting the sanity back into your own life regardless of whether she ever gives up drinking. That's right. It is time for your quality of life to become less dependent on whether your loved one is drunk or sober, in a good mood or bad, home or out. To this end, we will help you create a safety plan to ensure that regardless of your drinker's mood, you and those dependent on you do not become victims of violence. (We cover this in chapter 3.) On a happier note, chapter 4 offers you a glimpse of the future you will create. In other words, as you work your way through that chapter, you will figure out what you want your life to look like and begin to translate those dreams into attainable goals. Chapter 5 addresses the guilt that gets in the way of moving forward and helps you feel good about finally being in the driver's seat. Part of moving forward, of course, means rebuilding your emotional and social life. Chapter 6 shows you how.
The objective of moving your loved one toward sobriety, believe it or not, is also helped by improving the quality of your life independent of his behavior. As your stress level decreases, you will be able to deal with your drinker in a calmer, less reactive manner, and your relationship will improve. This in turn will help you motivate your drinker toward sobriety. Unfortunately, your improved attitude, while necessary, is not sufficient to accomplish this second goal. Thus, we also give you a tool kit of techniques that are effective alternatives to nagging, pleading, and threatening. To begin with, the behavioral map we mentioned earlier forms the foundation of almost every strategy. Thus, an entire chapter is devoted to teaching you how to use this important technique. Chapter 2 will explain the behavioral map, provide lots of examples, show you how to use it in your own situations, and help you practice until you can map your interactions and be confident that you really are getting at what triggers your difficulties. Combining this awareness with the other techniques you learn will empower you in a way that nagging, pleading, and threatening never could. Moving on to these other techniques, you will find chapters devoted to disabling your enabling behaviors (chapter 7) as well as useful problem-solving and communication techniques (chapters 8 and 9). “Behavior Basics” (chapter 10) will equip you with the core tools of behavior change so that you can more easily modify your behavior and that of your drinker. (Lest you shudder at the thought of “modifying” anyone, stay calm. The section on page 7 called “A New Angle on Control” will explain what this really means. We are not pushing anything so devilish as mind control!)
Chapter 11 is devoted exclusively to helping you select and support the best treatment approach for your loved one. Chances are you have been down the treatment road before—telling your drinker that treatment will help, begging her to consider it, even getting an agreement to try it, only to have your drinker not keep the appointment or drop out after only one or two visits. In fact, the unhappy reality is that the majority of drinkers who enter treatment seldom remain for more than one or two sessions. However, individuals whose partners, parents, children, and lovers have learned the Alternatives stay in treatment six or seven times as long as other drinkers do (Ellis et al. 1992). We attribute this to the fact that our clients learn how to suggest and how to support treatment. There is more to successfully engaging someone in treatment than guilting or goading this person into it (as you well know). We will teach you how. You will also learn what to do to make staying in treatment as attractive for your loved one as possible.
Finally, chapter 12 addresses the important issues of relapse prevention and what happens after you have done everything you can. As you move through this journey of change, you will experience successes and face obstacles, some minor, others not. However, one of the key advantages of the Alternatives approach is that it prepares you to deal with obstacles, potholes, detours—whatever falls in your path. Thus, difficulties become opportunities for you to gain control over your life. Ultimately, whether or not your drinker achieves lasting sobriety, your journey with us will give you the skills and tools to enhance your own quality of life. Hence, in a best-case scenario, the two of you will achieve peace together and worst-case scenario is that you will have done everything possible and be able to move on and take care of your own life. In either case, your future looks brighter.
About Change
As you read this book, keep in mind one important truth. Change is not an event. It is a process—a slow process. No matter what behavior you want to change—a nail-biting habit, overeating, or how you relate to someone—it does not happen in one big jump. Making change is no different than taking a long car trip. You may decide on Monday morning to drive from New York to Los Angeles, but it will take longer than the moment of decision to get you there. You need to pack your bags, figure out what roads to follow, and so on. What's more, once you start driving, you will find that some of the roads you had planned to travel are closed or in poor repair. You will need to find detours, tolerate potholes, and otherwise adjust your plans as you go. You will also find that if you drive for shorter rather than longer periods each day, the trip will be more enjoyable, and you will feel more rested and in control. The same goes for your change journey.
The improvements you are after will take time and are best achieved in small steps with careful planning. Given how long you have already lived with your drinker under the present circumstances, you can tolerate it a little longer as you make small, controllable changes. Rather than whipping through this book and making a mile-long list of things to “fix,” work through the Alternatives with the plan of making one small change at a time. As these changes begin to feel natural, go back and add more. What you learn here is yours forever, so you need not hurry up and get through them quickly! Take your time, go slow, and enjoy the knowledge that you are on a life-enhancing journey.
Keep the journey in mind as you move forward. When things don't go smoothly, remind yourself that every road trip has its snags. A highway detour between Albuquerque and Phoenix would not send you scurrying back to New York, so don't give up on your hopes for your drinker just because one or two or more attempts at change hit a wall. Each time you try a new technique and it does not work, sit down and think through what happened. Review your original plan, review what you did, get a clear picture of how your drinker responded, and think about how you might improve your approach. Use the same motivated problem-solving skills you would use if your highway of choice had a detour and you needed an alternate road to Los Angeles. These detours might be a nuisance, but they are a natural part of the journey. Expect them and you will master them.
A New Angle on Control
Only you really know how much blood, sweat, and tears you have invested in this relationship. However, we feel safe betting that you have tried repeatedly to get your loved one to change. Experience shows that when people love someone, they give him the benefit of the doubt, again and again. They keep trying in hopes the individual will finally “see the light” and
change. This would be a great strategy except for one problem. Most people try the same tactics over and over. The sad thing is they do this not because what they are doing works but because it is the only way they know how. If you think about it, you can see it makes no sense. In fact, it has the same effect as parking yourself in front of that detour on the Albuquerque/Phoenix highway and revving your engine in front of the road-closed sign hoping the noise will force the sign to let you pass. How much more productive it would be if you could pull out a road map and find an alternate route to your destination.
Open yourself up to new ways of interacting with your loved one and have the courage to take control of your situation. Rather than continually knocking your head against the same old walls, come along with us and learn how to control your reactions to your loved one and, through your reactions, shape a change in her behavior.
Get Your Loved One Sober Page 2