Do Interventions Ever Work?

By Bill Manville 07/14/16

How I botched the first intervention I ever tried, and learned from there.

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Do Interventions Ever Work?
Will they listen?

“Bill, my father is drinking himself to death. Have you ever done an intervention? Do they work?”

In answer to the question above, emailed to me by a Fix reader, let me quote an old song lyric: “It ain’t what you do but the way that you do it.”

I botched the first intervention I ever tried.

It began with a tearful call from Sally, wife of an old friend.

"Bill, Marty’s been drinking again, this time four days. He’s locked himself in the guest bedroom. I’m afraid he's never going to stop before he dies."

"I'll be right over."

Sally was weeping. Charlie, the son, would not meet my eye. To him, I was just another of Dad's drunk friends. Nor did I talk to them long—my first mistake. I was long time sober by then, and was doing volunteer facilitating at the big time Scripps McDonald rehab. Two years of that, and I knew it all.

(The second.)

Reeking of sweat, booze and vomit, Marty opened the door.

“Bill," he said, bottle in hand. "Have one with me. I can't stop."

I did not, but going in there alone was the third thing I did wrong.

Drunks can be charming and persuasive, and old habits sometimes can be reawakened. AA tells you: if you're going to make a 12th Step call, take a sober pal with you.

In my own mind, I thought I’d come prepared. I’d phoned Admissions. I knew they had a bed. At the end of his rope, Marty let me persuade him.

“God damn it, OK, I’ll go!”

But as the old saying goes, anyone persuaded against his will is not persuaded at all. Marty left after only three days, off on another drunk.

* * *

One of the therapists at Scripps who gave me my own facilitator training is someone who asked me to call him Fred.

“The emotional symptoms for someone like Marty,” he said when I called for advice on how I might have handled things better, “are anger, self-pity, self-disgust and depression. The only remedy he knew was alcohol. Since he didn't want to be in the rehab to begin with, he didn't give it time to work. He wanted relief, and wanted it fast. He went out and got drunk."

Fred went on: "At the end of my own addiction, I was doing a daily ton of crystal. I'm six foot five, two hundred and sixty pounds, but I was walking around high on meth, a quart of tequila in hand, plus a machete and a loaded gun—and you know what, Bill? Scared to death. Did I want to stop? Hell, no. The only reason I let my family persuade me to go into rehab was I thought they would teach me how to slow down and drink with control."

“Specifically, where did I go wrong with Marty?”

"First of all, you walked right past your two strongest allies, Marty’s wife and son. He listened to you because you’d been there yourself. Fine…but not motivation emotional enough, deep enough for him to change in his own heart and soul. So after a few days, he left and found a bar.”

“What should I have done?"

"In a good intervention, family and friends gather in a rehearsed, highly-structured manner to face the addict with what he is using booze to deny: that he is killing himself.

“In some dim, unacknowledged sense, people like Marty often see their drinking as punishment for being so awful. Which they feel they deserve! So they will not stop for themselves."

Fred’s words reawakened memories of my own drinking career, adolescent fantasies that nobody but me could understand the high romance of playing with death. Others might stop. I never would. To write inane stuff like that now is embarrassing. In the befuddled airless silence of my own drunken mind back then, they were glamorous and enticing.

"So the intervention interrupts the drinker’s destructive conversation with himself?” I said to Fred.

"We have a saying at Scripps. We will love you until you can love yourself. If you'd brought Marty’s wife and son in with you and coached them first so they were able to put their own understandable anger aside and talk to Marty out of the depths of their heart—"

"He would have had stronger motivation to get sober?"

“A good rehab cares about newcomers exactly at the time when they are filled with the most self-loathing and disgust,” said Fred. “Right from Day One, the patient is exposed to a new ethos and attitude. The other patients are all hardcore drunks and dopers too, but again and again they hear people saying, 'Stick with the winners,' and the winners are those perceived by the patients' own cool and knowing eye as most intent on getting clean and sober. What intervention does is break the rhythm, interrupt the pattern.”

“How does that work?”

"Group morale. Almost unconsciously, the newcomer begins to introject the group ethic of sobriety. They feel better, physically and mentally. Phoning home, they hear the joy that being clean and sober brings the people they love. Proud of the effort they are making, hope and self-esteem are reborn; they can beat addiction.”

I told Fred I felt that when market research told advertisers Americans basically feel they've lost control of their lives, an ugly new word entered the vocabulary.

"Nine times out of ten, anyone who speaks about empowering yourself is trying to sell you something. You don't raise your self-respect by washing your hair with L’Oreal; you don't take control of your life by leasing a new Mercedes. Those pleasures are short-lived, false and fleeting and behind the expensive façade, you know you're a fraud."

Fred was nice enough to allow me my jeremiad.

"Self-esteem grows out doing something you yourself think is admirable. Kicking addiction is exactly that. You can see the revelation in the faces of people in rehab: I don’t have to lose my family, I don't have to be ashamed of myself, I don't have to die."

Here's Fred’s step-by-step rulebook for doing an intervention.

One. Get the right mix of people.

Wives, husbands, relatives, friends—they have to be coached to understand this is not the place for anger and old recriminations. Whoever they are, the message they carry is, "We love you."

Two. No spur-of-the moment stuff.

Each participant writes a script in advance, exactly what they want to say. No generalities like, "You were always worthless, never any good."

Instead, cite specific examples of addicted behavior: "You drove the car with the children in it, dead drunk." "You threw up all over my boss's wife."

Etc.

"Very important," says Fred, "do not ask questions. That just gives the addict a chance to argue back, feel sorry for himself, rationalize and deny. All of which throws the intervention off the track."

Three. Consequences: hard-nose therapy.

Each interventionist has to carefully think out in advance a heart-felt consequence: "If you don't go into a rehab, I will divorce you."

Not let you see your grandchildren, fire you, etc.

“And you have to mean it. No empty bluffs. Addicts will ferret out any ambiguity in what you feel or say.“

Four. Do the research in advance.

Get the facts on rehab insurance, length of average stay, visiting days, etc. all in advance. Even have a bag packed, ready to go.

“The addiction itself does not care that its life may mean the death of the host,” said Fred. “Guilefully it puts up all sorts of rationalizations, barriers to the threat intervention represents to its continued existence. Team members should help each other think up possible objections, excuses and questions. Who will walk my dog? I can't afford the time. How do I explain this to my boss? And come prepared with answers.”

Five. Surprise.

Don't ask the addict to "meet us at this time and that place." He's liable to get in his car and disappear for one last binge. The best idea is surprise, and very important, says Fred, "Someplace other than the addict's house, workplace or office."

Six. Rehearse.

Don't come at this cold. Says Fred, "I like to have the interventionists go over their speeches with each other aloud, making suggestions to strengthen each other. Rehearsal is very important. That way, it comes out right when the chips are down."

Adds Fred: "Once the script is written, it is very important for every interventionist to understand that's it. On the day, no impromptu variations, additions or subtractions. Stick to the script."

Seven. Batting order.

“All in all,” says Fred, “interventions work best when the children speak last. Their love and fear are so transparent and guileless, that the patient can't resist. "OK, I'll do it." The words just jump out of their hearts and lips.

“I’ve found," said Fred in closing, "that almost nine out of ten people intervened upon in this way agreed to enter treatment."

Final note: My advice is don't try it alone. Many rehabs have trained professional interventionists on staff, ready to guide you, perhaps even be present at the intervention itself. Call them first. Talking to them, knowing they are behind you, will strengthen your resolve.

Good luck.

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