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My family member is an alcoholic and refuses to get help. What should I do?

Aside from joining a support group, you may wish to take several steps to help your loved one. The real challenge will be to broach the subject of the use of alcohol or drugs in a nonthreatening and nonjudgmental way. First, you may wish to consider alternative ways of discussing the problem. Second, discuss with your family member his or her experiences with alcohol during the past, including childhood. What were his or her parents drinking habits? Describe various strategies for coping with stressful situations, both in the past and now. Talk about alcohol as a way of coping, which may have worked initially but is currently leading to unacceptable behaviors. When linking his or her alcohol use with negative coping behaviors, use open-ended questions so that you do not seem accusatory or threatening. These allow for discussion and do not end with yes or no answers. If he or she acknowledges that alcohol use may be a means of dealing with an emotional problem, such as depression, then suggest that your spouse seek counseling or the care of a psychiatrist. Third, if your spouse does not acknowledge a problem, you may leave pamphlets from various alcohol treatment organizations around the house for his or her information. Next, if he or she still refuses to get help, you may need to suggest a separation or propose some other drastic measure, which may be interpreted as coercion. It is not coercion in so far as you are giving that person a choice, albeit with specific consequences that impact on both of you.

The issue is you and your loved one's health and safety or chronic illness and potential death. Do not threaten! Be prepared to set up a set of consequences and then follow through with them. When you lay out the consequences, be sure to use "I" messages, which convey less blame. The following is an example of an "I" message: When you become verbally abusive after you have had a couple of drinks (the behavior), I feel helpless, and my feelings are hurt; then I get depressed (your feelings). If you continue to verbally abuse me and do not stop drinking or get help for yourself, then I will have to leave for the sake of my own mental health (the consequences). The formula for "I" messages:

When you _____ (describe the behavior).

Then I feel ______ (describe how you feel).

Consequences __ (describe what the consequences will be).

Many clinicians think that addiction is a family illness because it affects each and every member of a family; therefore, individual and family therapy are essential ingredients to recovery as well as attending support groups.

If repeated attempts to talk to one's family member about the problem have failed, it is then time for action. Remember that ultimately one individual has little control over the behavior of others. Someone suffering from alcoholism cannot be coerced into treatment. In that context, separation is a legitimate measure to protect yourself from the dangers of continued heavy drinking. It is critically important to stop bailing the person out from alcohol-related problems. This only strengthens the denial and perpetuates the problem, as the person never fully appreciates what dangers his or her alcohol or drug use is causing.

Many clinicians think that addiction is a family illness because it affects each and every member of a family; therefore, individual and family therapy are essential ingredients to recovery as well as attending support groups. Recovery takes a lifelong commitment on the part of the individual and the family. The prognosis is better if family members also participate in treatment. Finally, consider doing an intervention. Many of these organizations have resources that can help you conduct a group intervention. It is best to use a professional intervention specialist to guide the process and support your family in confronting the alcoholics denial. In a private meeting with family members, friends, employers, and coworkers, along with an intervention specialist, confront the abuser about the problem that drinking and/or drugging are causing him or her personally at home and at work, as well as the effects on his or her body. The facts and the objective evidence are presented in a calm nonemotional manner. During the intervention, the family and others also identify the consequences that will occur if the behavior continues and the addicted family member refuses to get help (see Question 46 for further information).

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