Addiction is a disease, but the person suffering from it isn’t the only one who feels its effects, according to Robert J. Ackerman, a former Indiana University of Pennsylvania professor and a nationally recognized addiction specialist.
In fact, Ackerman said, any one person who abuses a substance jeopardizes at least four other people around them.
“This does not count extended families, friends or co-workers,” he said. “In reality the number is much higher than four people.”
Ackerman is the former director of IUP’s Mid-Atlantic Addiction Research and Training Institute. He currently teaches at the University of South Carolina Beaufort.
He also is a co-founder of the National Association for Children of Alcoholics and is the author of more than a dozen books, including “Children of Alcoholics: A Guidebook for Educators, Therapists and Parents.” It was the first to examine the effects of the disease on children whose parents suffer from it.
And he knows of what he speaks — his father was an alcoholic who entered sobriety in his late 1950s.
“It was good to be around him when he was sober,” he said. “It was hell to be around him when he was drinking.”
Ackerman said addiction has ripple effects — marriages fall apart, children grow up in violent households and negative emotions come to dominate. Therefore, it is important for the family of an addict to seek support for themselves, regardless of whether the addict is in treatment, he said.
In his work, he routinely hears family members rattle off a litany of sins the addict has committed.
“And my response is, ‘What are you doing? What about you?’” he said. “Each member in the family has the right to recovery. We don’t have to wait for our addicted family member to go into treatment.”
He said family members have to take care of themselves, not only for the sake of their own well-being but, really, for the sake of their addict. Otherwise, he said, it’s impossible to work on a healthy recovery plan, one in which all are on same page.
A part of those plans will invariably include an effort to steer an addict into recovery. One way to go about it is by of what’s known as Johnson Institute intervention, a type of climatic intervention in which family and friends sit down with an addict and encourage him or her to enter treatment, oftentimes by applying some leverage.
Ackerman said that if a family chooses to organize one, they should consider asking a professional interventionist for help. A professional can offer guidance on what to say and what not to say and what to do in the event that the addict grows angry and storms off.
There are, however, other ways to intervene and encourage an addict to enter treatment, said Laurie Roehrich, an IUP professor and clinical psychologist who specializes in addictive behavior.
“The reality is that interventions can occur at many levels,” she said. “You don’t want to get trapped in the myth that it must be confrontational and dramatic.”
She said substance abuse and dependence are variable and play out differently for each person. So some creativity certainly doesn’t hurt in thinking of ways to intervene, and neither does referring to the science on what may and may not work.
And the science, according to psychologist and author Robert J. Meyers, says that an alternative method he has developed works.
He calls that method Community Reinforcement Approach Family Therapy, or CRAFT, which he describes in his book, “Get Your Loved One Sober: Alternatives to Nagging, Pleading and Threatening.” The method, based on a strategy employed by professionals, does away with confrontation and the listing of sins of the addict.
“What good does that do to lay all of that stuff on (the addict) like he doesn’t know it? People already know they’re in deep trouble. All it does is make that person feel worse,” said Meyers, who is retired from the University of New Mexico and its Center on Alcoholism, Substance Abuse and Addictions.
In his method, family members are taught how to embrace the addict when he or she is sober, but distance themselves when he or she isn’t. In that way, family members reward and reinforce positive sober behavior and ignore the negative addiction behavior.
“What we’re teaching them to do is reward the good (behavior), stay away from the bad (behavior), and let them know you care about them every time you can,” he said.
CRAFT also emphasizes the importance of allowing the addict to suffer the consequences of his or her behavior and shows family members how to recognize their own enabling behaviors.
Another nonconfrontational approach is called motivational interviewing. Although not an intervention method — it’s a counseling technique for professionals who have been trained in it — there are some take-away principles that could be useful for family members.
The method’s goal is to help the addict recognize his or her own problematic behavior through nonconfrontational, empathetic questioning.
Roehrich said a conversation between an alcoholic and a clinician employing the technique might look like this:
“I know how much you seem to enjoy going out to bars or parties and having fun, and often that seems to involve a lot of alcohol. I also know how much you love your family. They seem worried about how much time you spend away from them and that you seem out of it and distant when you have been drinking. The bars and partying seem like they might not jibe very well with your values as a parent. I’m wondering what your thoughts are about that?”
“It is not pushy or confrontational,” she said. “You roll with resistance, point out discrepancies, empathize with their ambivalence and help them to explore options for treatment or other methods for dealing with the problem.”
Ann Sesti, an assistant director at IUP’s Center for Heath and Well Being, said the method is about trying to understand what motivates an addict and what would motivate them to stop using, or at the very least, to stop using so much.
“The whole process really avoids directly telling them what they need to do. That just creates resistance, which then blocks motivation to change,” she said.
All that having been said, Roehrich reiterates that there is no one right approach because addiction itself is variable.
But if there is one basic rule to keep in mind, it’s this: “The most important rule would be to intervene early and often, and with compassion. Don’t be a bystander,” she said.