As an Addiction Psychiatrist, people often ask, “How do I talk to a loved one about their alcohol or drug use?” Here are eight key tips to help these conversations go as smoothly as possible:
8. One on One or Only a Few People Works Best
Despite what is often portrayed in the media, when it comes to intervention conversations, less is better. Ideally, these discussions should take place one on one, or with as few people as possible.
While having a large group present “Dr. Phil style” can seem meaningful, it often feels overwhelming to the person who is struggling. Initial intervention conversations with more than 2-3 people often leave folks feeling more alone, more ostracized, and more distrustful of their support system.
Because of increased peer pressure from a larger presence, people struggling with alcohol or drugs will often make promises of change or commitments they have no intention of keeping simply to get out of the conversation.
It’s best to have these conversations one on one, or with only a very select, small number of people who have a trusting, positive relationship with the person in question.
7. Accept Your Own Anxiety
Intervention discussions can be challenging. Thinking and planning for them often arouses anticipatory anxiety, anger, frustration, fear, and general discomfort. This is normal.
For parents, planning to openly discuss concerns around alcohol or substances can also evoke feelings of shame, disappointment, self-blame, and guilt. All these feelings are understandable. Accept the discomfort. Give yourself grace.
When thinking or planning for these conversations, it’s ok to have a mix of uncomfortable emotions. It’s expected. No truly great accomplishment comes without some growing pains along the way.
Allow yourself to feel these feelings. They are simply a reflection of how much you care about this person. And that you are human, too.
6. Ask Permission to Have the Conversation (Skip For Teens/Children)
When you decide to begin the discussion, it is helpful to first ask your adult loved one’s permission to discuss the topic. In our efforts to help, we often skip this step. But it is a powerful and often under-rated step.
Asking permission shows respect and empathy. It demonstrates that you value the other person’s view on when and where to have the conversation. It also prepares them for the conversation so that they don’t feel blindsided or taken off guard. Something like, “John, I would like us to talk about your alcohol use. When would be a good time?” sounds much more respectful than “John, we need to talk about your alcohol use now.” The first is caring and non-judgmental. The second is demanding and can easily put someone on the defensive. Don’t torpedo your own ship before it even has a chance to sail.
Of note, while asking permission to have intervention conversations is an essential part of talking to fellow adults, it does not apply to parent-child conversations. In parent-child discussions, you are the adult. You call the shots. A conversation with a teenager engaging in risky alcohol or substance use can still be done with empathy and care. But it should not be optional.
5. Avoid Conversations Late at Night or on an Empty Stomach
This one might sound obvious. Initial intervention conversations are often lengthy and emotionally charged. Being tired or hungry can dramatically lower our natural defenses and make even the best of us snappy and quicker to anger. (Every parent who has witnessed their child tired or hungry knows this all too well.)
So, it is best to avoid starting these conversations later at night or on an empty stomach. Give yourself the best chance of success by having the conversation when both you and your loved one are well rested and well-fed.
4. Be Mindful of Your Language
Our word choices convey our attitude in subtle but powerful ways. “I would like to talk about your relationship with alcohol” is neutral and non-judgmental. “I would like to talk about your problem with alcohol” conveys a pre-ordained judgement. It automatically puts your listener on the defensive.
Use the word “relationship” to alcohol/substance of choice instead of “problem” or “habit” to convey a neutral, non-defensive tone.
Other good phrases to use include “My worry for you is…” or “My concern for you is….” Worry and concern convey love and empathy.
3. When It Comes to Outcomes, Set Realistic Expectations
We often hope that the initial conversation with our loved one will end with them agreeing on everything and enthusiastically admitting to a 30-day inpatient rehab facility.
But having very high expectations for a first-time conversation can set you up for disappointment and frustration when or if your loved one is not as ready and willing to change as you had hoped. Instead, view this as simply the first conversation of an ongoing dialogue. Having this perspective will also lower your own anxiety around the conversation.
Even if your loved one is not willing to do anything different, simply introducing your worries and concerns is a huge step in the right direction. View this as a win.
2. Ask Permission to Continue the Conversation
At the end of every intervention conversation, it’s important to ask permission to continue the conversation at a future date. This sets the expectation that your concerns are a serious issue that you want to continue to address. Like diabetes or hypertension, addiction is a chronic disease that requires ongoing, long-term treatment. Your continued conversations and involvement will show that you understand this and that you care about your loved one’s decisions both in the here and the now and in the future. Set this expectation early.
1. Don’t forget to take care of yourself
Addiction is a family disease. It affects everyone around the person who is suffering. If you have a close friend or family member suffering from addiction, it’s crucial to take care of yourself.
Talk to a supportive friend or fellow family member about how you are feeling. Journal about your feelings. Get plenty of rest. Take time out to do nice things just for you. Seek therapy. Connect with free organizations like Ala-non, which are designed exclusively to support those who are close to someone suffering from addiction. Read self-help books. One of the best self-help books I’ve read recently is Unhooked: How to Help an Addicted Love One Recover by Jason Coombs.
Do some combination of the above, and know you are not alone. Nearly half of all Americans have a close friend or family member who has been addicted to drugs or alcohol.
I am cheering for you every step of the way. I’m holding your hand. You got this.
-Lauren