An Interview with Board Certified Interventionist Roger Canevari

By Meghan Vivo

If someone doesn’t want help for their addiction, there’s nothing anyone can do. This is a myth that has been debunked by decades of successful interventions. A group of caring friends and family can “raise the bottom,” helping an addict recognize the seriousness of their drug problem and find the strength to recover – even if they don’t fully buy into the process at first.

Addiction interventions have saved millions of lives in the past 50 years, and they are becoming even more effective as our knowledge of addiction grows. Roger Canevari, a board certified interventionist with more than 25 years of experience in the field of addiction and owner of Recovery Found, notes a few key ways the modern addiction intervention differs from interventions of the past.

A Loving, Respectful Approach

Early on, interventions were viewed as opportunities to vent long-held resentments and to blame and shame an addict into getting help. In the past two decades, addiction interventions have evolved into a respectful expression of love and concern, explains Canevari. Rather than condemning the addict, family, friends and co-workers respond with compassion and an understanding of the impact addiction has had on the individual’s ability to make healthy decisions.

“Our role as professional interventionists is to guide the intervention on a loving and respectful course,” says Canevari. “We encourage the family to make decisions based on what they are emotionally and physically capable of following through on, and then express themselves in a healthy way.”

Not Just About Drugs

In the past, experts assessed the need for an intervention based on the type of drug being used and the extent of abuse. Now, it is just as important, if not more so, to evaluate how the addictive behaviors have impacted the individual’s quality of life.

“Drug use is a symptom of an underlying problem,” Canevari explains. “If we focus on the drug, the individual comes out of rehab and uses a different drug or a compulsive behavior like gambling or sex. The intervention has to delve beneath the drug use into the real issues.”

Entering drug rehab is not something that is forced upon the addict, but rather a decision they are actively involved in. If the addict is reluctant to get treatment, Canevari presents more than one drug rehab center to choose from and asks that the addict at least tour the facility to see what they’re saying no to.

One Size Doesn’t Fit All

After decades of research, we know that addiction treatment is most effective when it is tailored to the needs of each individual. The same is true for addiction interventions. While the structure of interventions has largely remained the same over the past 20 years, according to Canevari, the modern approach is flexible enough to meet clients wherever they are.

Canevari doesn’t routinely recommend a particular drug rehabilitation center for every client, but rather works with the family to understand the type of care that would be most effective for the individual. The intervention participants and the individual struggling with addiction then make the final decisions.

“Intervention should be a very individualized and creative process,” says Canevari. “We do not use generic models or a cookie cutter mold; we design a specific plan to meet each patient and family’s needs.”

A Long-Term Process

Despite becoming more widely available, most people’s knowledge of addiction interventions is limited to television portrayals on shows like A&E’s Intervention.

“Television shows highlight one moment in time, but an intervention is so much more than that,” explains Canevari.

The intervention is only the first step. Addiction recovery is a lifelong process, which is why interventionists like Canevari are focused on the long-term success of their clients.

In addition to guiding the intervention, Canevari educates his patients about relapse prevention and remains involved throughout the treatment process. He serves as a liaison between the drug rehab center and the family to help facilitate a smooth transition from treatment to daily life back at home.

The Critical Role of Family

Traditionally, interventions have been designed with one purpose in mind: getting the addict into treatment. For Canevari, the primary goal is making changes within the family system, which typically has the effect of convincing the addict to enter drug rehab.

“What we’re really doing is teaching the family how to do an intervention,” Canevari explains. “It is critical that the message comes not just from a professional but also from the people the addict cares about most.”

Canevari recommends that the family stay involved throughout the process, from beginning to end. When the intervention ends, the family doesn’t put their loved one on a plane and go back to life as usual. Instead, Canevari recommends that they accompany the interventionist and the addict during the admissions process, spend the first few nights in a hotel near the drug rehab, and actively participate in the center’s family program. Not only does family involvement increase the likelihood that the addict will complete treatment, but it also helps the entire family begin to heal.

“It is very helpful for the family to physically see the facility and make a connection with the staff for a smooth admission and treatment stay,” says Canevari, who was rescued from addiction by a life-saving family intervention in 1983. “In the most successful addiction interventions, the addict doesn’t feel like they’re being tossed away. The family’s message is, ‘It’s not just about you, it’s about all of us.’”

A Growing Field

When Canevari first started conducting addiction interventions nearly 20 years ago, he was part of small group of specialists doing this work. Since then, thousands of interventionists have joined the ranks.

When choosing a professional interventionist, Canevari advises families to find someone who is board certified and highly experienced, and to interview more than one to determine if their philosophy is a match. A professional intervention is one of the most effective ways for addicts and their loved ones to begin the healing process, but it requires experience and know-how to ensure that it is done right.

Since 1995, Canevari has conducted interventions throughout the U.S. and South America with a 97% success rate of getting addicts into treatment. He has more than 25 years of experience as a nationally certified alcohol and drug counselor and board certified family interventionist. Although he is not affiliated with any particular drug treatment center, Canevari works closely with some of the best drug rehab centers in the world, including Promises in Malibu, California.

“I consider it a privilege to guide others into recovery just as I was guided over 25 years ago,” says Canevari. “For me, an addiction intervention is not a confrontation but a celebration of life in recovery. By taking away some of the shame, fear and denial surrounding addiction, we can create a window of opportunity where one may never have existed.”

Most people at some point in their lives discover someone they love or work with has a problem with alcohol or drugs. Public health experts estimate 1 in 10 people has a substance abuse problem, so it is unlikely you will never meet someone who needs addiction treatment. And chances are some of those people need an intervention. How do you know if an addiction intervention is the right next step for your family?

The biggest obstacle to addiction treatment is denial. Any attempt to address substance abuse behavior is often met with outright hostility – how dare you suggest such a thing. This attitude is encouraged by a number of factors: as a society we still incorrectly look at addiction as a moral failing and the addict who is confronted about their problem feels threatened. What would they do if they didn’t have their drink or drug of choice? How could they handle life? You are, in effect, threatening their very ability to survive in their eyes.

The point is you can rarely just ask someone if they have a problem with alcohol or drugs and get a straight answer. Most likely, you will have to do a little detective work and figure out on your own if that person needs an addiction intervention.

Here are 10 tell-tale signs that someone you know needs an alcohol intervention or a drug intervention.

1. Tolerance

They need a lot more alcohol or prescription pain medication, whatever their substance of choice, to get the effect they are seeking. You might notice they are filling a prescription more often, or buying an extra case of beer more often. This is because as an addiction escalates, tolerance develops, and the body requires more of the drug just to feel “normal.” If you see tolerance increasing to risky levels, an intervention is a good idea.

2. Deceptive Behavior

The addict will try to disguise their behavior. They might do this by hiding bottles of alcohol, showing up at events already intoxicated so they don’t appear to drink too much in public, or hiding opiate prescription medications in unmarked bottles so you can’t identify them as addictive substances.  In an intervention you can address the deception and move the addict toward treatment.

3. From Clean and Sharp to Just-Rolled-Out-of-Bed

The addict’s appearance deteriorates. An addict has one goal each day: get the alcohol or drug they need. As this need becomes more pressing, other needs get left by the wayside. Their clothes may appear disheveled or they may shave less often; they might appear tired and haggard much of the time. Women will often try to disguise this with more makeup. Remember, however, an alcoholic or addict will put enormous effort into hiding their problem, so a decline in appearance may not occur until the later stages of addiction.  By pointing this aspect out in an intervention, you begin to break through the addict’s denial.

4. Forgetting What They Did or Said

It is common for heavy substance abusers to experience black outs or brown outs. These are periods of time that the alcoholic or addict cannot recall. They might have hazy recall or no recall at all of events that occurred when they were intoxicated. You might remark on something they said or did at a party, and they look utterly baffled. This is a sign of serious substance abuse, especially if it occurs more than once or twice.  Reminding the person about each of these episodes can be a very powerful part of the intervention.

5. Financial Woes

They are having money problems that can’t be explained. Addicts can be pretty adept at manipulating others to feed their addiction, but eventually the cost of substance abuse catches up to them and they can no longer hide dire financial straits. If someone is wealthy, this sign can take a lot time to show up, which may mean their addiction can progress to a much more serious stage before they feel financial pressure to find a solution.  If you have been enabling the addict with money, the intervention is a good time to let them know that money will only be put toward treatment from here forward.

6. Risky Behavior or Just Clumsy

They experience an unusual number of accidents and injuries. Or they may miss the accident, but end up with a DUI. If your friend gets one DUI, that’s a problem; two DUIs indicates a much bigger problem. Generally, normal drinkers get the message with one mistake. Those who get repeated DUIs get them because they cannot stop themselves from drinking; once they have that first drink, they lose the ability to control their intake. For prescription drug addicts, they may have real injuries, or they may begin to “manufacture” pain to get more medication. As addiction progresses, the addict has less regard for their physical health. They may become more accident prone and show signs such as bruises or unexplained injuries.

7. Moody and Unpredictable

They exhibit irrational behavior and mood swings. Being around an addict can be like riding a roller coaster. They will often overreact, particularly to even the slightest mention of their drinking or drug use. You never know if they will be angry, depressed, happy, elated, miserable, hostile…the list goes on. Often their mood is determined by when they last used, how much they used, if they are in withdrawal, or if they are nursing a hangover. Once the addiction has a total grip on a person, their mood is determined by the availability of their drug of choice, sufficient opportunities to use it, and how adeptly they maintain sufficient intoxication to avoid withdrawal symptoms – it becomes a tougher game to play as time goes on.

8. From Responsible to Just Getting By

Previously responsible people are now late to work, sleeping too much, or grades are slipping. Usually if you have known a person for a while, you will recognize certain baseline behaviors. This person is very responsible, rarely calls in sick to work, or always does pretty well in school. If you do know this baseline, changes in behavior can be pretty striking. Someone who prides himself on never calling in sick to work, starts calling in on a regular basis, or worse, goes to work anyway and gets sent home. The young adult who was always a straight-A student has now dropped one class and barely passed two others. Your spouse falls asleep at 9 pm and it would take an atom bomb to wake him – he never used to sleep so heavily.

9. Isolating Themselves

They start to isolate, preferring to be alone at home. Does your friend or loved one avoid doing things they used to love, particularly things that involve other people? Isolating is a common behavior as addiction progresses. They may only want to be around others who drink the way they do, so they narrow their social circle to other substance abusers, or they may have found it’s just easier to get the level of intoxication they want by staying home and taking care of business. Other people just get in the way.  The intervention may be the first time the addict has been in the same room with all their loved ones at the same time. Breaking through that isolation is a powerful part of the intervention process.

10. Worsening Mental Health Problems

Mental health issues that were once mild are getting much worse. Maybe they always got a little down, or had some mild anxiety, but as the addiction progresses, mental health issues often get magnified. Depression may deepen dramatically, or the anxious person might start having panic attacks or develop phobias or paranoid behavior. Alcohol and drugs are often ways of self-medicating for real emotional or psychological issues, but they are a poor solution and usually serve only to exacerbate underlying mental health issues.

We suggest you first read “How to Recognize a High-Functioning Alcoholic” to help you eliminate any denial or soft-pedaling by family members. The high-functioning alcoholic can be one of the most difficult to do an intervention on because denial is so strong.

Families often proceed with an alcohol intervention when the alcoholic has really done significant damage, such as been arrest for DUIs, ended up in the hospital, been in a car wreck, or has completely ruined their financial, professional, and family lives.

It’s different with the high-functioning alcoholic.

This person is often at the top of their profession, making good money, and managing to keep all those balls in the air despite their heavy drinking. They can be some of the toughest interventions because they will challenge you thus: If I’m such an alcoholic, why am I so successful at work?

A professional alcohol intervention is absolutely critical in getting any high-functioning alcoholic to see that he or she needs help. The professional interventionist will be very experienced in getting past this powerful denial. They will know exactly how to best get across the point that just because you’ve been getting away with it, doesn’t mean it’s not a problem.

An alcohol intervention is essential if the high-functioning alcohol you love is in a profession where impaired judgment can truly harm others – such as a doctor who could harm a patient, an attorney who could seriously undermine a legal case for a client, or a high-level executive who could make decisions that threaten jobs and livelihoods.

The high-functioning alcoholic is not as invulnerable to criticism as you might think at first glance. The professional interventionist will do a thorough pre-intervention and will likely come up with many ways to overcome denial. Certainly if you see a problem that is big enough to warrant looking into an intervention, it has more than likely been a problem for a while. Consequences might not be devastating yet, because the HFA often has the money and the power to hide behavior or make the consequences “go away.” But consequences do eventually pile up for everyone.

Typically the cracks in the armor begin appearing when the alcoholic begins to harm family members. Maybe he gets arrested for drunk driver or embarrasses himself at a work event; maybe she makes poor choices while intoxicated, such as an affair; maybe he develops some health problems such as stomach or liver problems. While the HFA can hide the problem at work, the spouse usually gets the brunt of the bad behavior, and divorce is often one of the signs that the behavior is out of control.

The best way to do an alcohol intervention on a high-functioning alcoholic is to hire a very successful interventionist who has a long history of doing difficult or high-end (such as celebrity) interventions. They will understand the denial, the ego, and the obstacles that can undermine an intervention.

In addition, alcohol dependence can take a toll on everyday activities that people without alcohol dependence can easily complete. For example, cognitive processes may be impaired because of changes in the brain related to a history of binge drinking.

On a more broad scale alcohol dependence presents a significant cost to public health. In addition to needing medical and mental care, those with alcohol addiction may also need financial assistance to complete the treatment needed.

For all of these reasons, it is imperative that an increased risk for alcohol dependence in an individual be detected early. Intervention and treatment can lessen the impact of alcohol dependence from all aspects, from the challenges to daily tasks to the broad impact of alcohol dependence on public health costs.

Recently, Lin Xiao and colleagues in the Department of Psychology at the University of Southern California in Los Angeles studied the brains of 14 teenagers with a history of binge drinking to determine how executive functioning is affected.

The researchers used magnetic resonance imaging to look at the neural scans of the participants. These results were compared with those from 14 additional teens who had never tried alcohol. The study focused on evaluating executive functioning because it is involved in several critical aspects of life, including addictive tendencies, reward urgency, decision making and academic ability.

The comparison showed a distinct difference between teens who had binge drinking in their history and those who had never tried alcohol. The binge-drinking teens showed increased neural activity in areas of the brain dedicated to perceiving the emotional state of others around them.

When there is increased activity in this area of the brain, individuals are more likely to misunderstand a social environment. This can lead to poor choices.

In addition teens that had a history of binge drinking experienced a stronger, more urgent reward response reaction when compared to those who do not drink.

The findings of the study lend support to the growing evidence that shows that even a short history of binge drinking may present social problems. In addition, there may be an increase of problems such as anger, substance dependency, and compulsion.

The findings present information that may be helpful in the future for identifying those at risk for developing alcohol dependence.

The study’s findings appear in a recent issue of the journal Psychology of Addictive Behaviors.

A new study suggests that there may someday be a way for youth to be screened for a higher risk of drug use, by examining the networks in the brain. Researchers at the University of Vermont have discovered that the way that the brain is structured in an individual may affect how impulsive they are, and therefore, impact how likely they are to try illegal drugs.

The study is the largest ever to use imaging of the brain to examine the specific neural networks that affect drug use. The study included approximately 1,900 14 year olds.

Led by Dr. Robert Whelan and Dr. Hugh Garavan, the study’s findings provide support for the belief that some teens are at a higher risk for experimenting with drugs and alcohol. Their findings are printed in a recent issue of the journal Nature Neuroscience.

The findings are important because scientists have long questioned whether drug use is impacted by certain composure of neurons in the brain or if the use of drugs impacts the brain’s patterns. Dr. Garavan explains that the wiring seems to precede the introduction of drug use to the brain. Dr. Garavan was principal investigator for a previous study called IMAGEN, from which the data was drawn for the current study.

The researchers found that when imaging reveals decreased activity in a neuron network in the orbitofrontal cortex in the brain, the individual’s risk is increased for experimentation with tobacco, alcohol and illegal drugs in early teen years.

When the networks in this region of the brain are not as productive, it results in a child who is more impulsive. When faced with an opportunity to try drinking or drugs, instead of refusing the opportunity, teens with decreased activity in the orbitofrontal cortex are instead jumping on the chance to try a dangerous substance.

In addition, the researchers showed a connection between other discovered neuron networks that are involved with the development of attention-deficit hyperactivity disorder (ADHD), which are areas of the brain that are different from those affecting drug and alcohol experimentation.

This information is useful in understanding previous research that suggested that there may be a connection between functions in the brain that affect drug use and those that affect ADHD. The findings in the current study show that the two are affected by separate areas of the brain. This suggests that ADHD is not a predictor for drug use, as previous studies have found.

The findings of the study provide important information for the understanding of both drug experimentation and ADHD. The ability to examine very specific areas of the brain for the risk of both issues may someday lead to effective screening tools.

Addiction has more to do with how a person thinks than anything else, and the "it must be perfect or it’s a total failure" mindset can actually lead a person to seek solace in substance abuse. The all-or-nothing, black-or-white thought pattern can easily lead a person into depression or anxiety when they keep bumping against the less than perfect realities of life.

The person who sets unrealistically lofty goals for themselves can easily feel like a complete failure when they fail to wonderfully over-achieve. This person may assume that others view them as worthless because when they are less than perfect, that is how they see themselves. Drugs or alcohol can seem like a way to escape from overwhelming self-imposed feelings of inadequacy. On the other hand, even when it seems they are meeting every person’s goal, the perfectionist usually manages to see some fault or shortcoming somewhere. The paradox of perfectionism is the thing sought after but forever eludes the seeker.

This actually fuels addiction since the person who realizes they will not be able to perfectly adhere to any recovery program decides not to even try. Or, their exceptional self-expectations may lead them to demand that they overcome their problem on their own with no outside help. Either way, the perfectionistic attitude is what keeps the person trapped in their addiction.

The perfectionistic person rarely only sets high standards for him/herself. This person frequently has high expectations for others around them as well. Of course, this leads to confrontations and not surprisingly, people around the perfectionist quickly scatter in order to avoid constant criticism. Unfortunately, this leaves the perfectionist isolated and without anyone to challenge their unrealistic and unhealthy way of thinking.

The perfectionist often is able to achieve certain levels of success, but their successes feel hollow even to them. The all-or-nothing personality needs help learning to appreciate minute accomplishments, because life is more about day by day, step by step moments on a journey than anything else. The perfectionist misses these small achievements because they are overlooked in favor of a big picture. But, if the person can learn how to take note of the small victories, they will actually begin to develop a healthier self-esteem. After all, people have value apart from what they accomplish.

Celebrating things like courage and persistence can completely re-vamp the way the perfectionist is used to thinking. In the same way, when they realize that mistakes and failures can be opportunities for learning and growth, radical changes in thinking take place. Life is full of imperfections – accepting them and using them for good is much more realistic and is the only way to escape the negative thinking of perfectionism.

A recent article details a report released by the state’s Department of Health that shows more than a 300 percent increase in the number of drug thefts from hospitals and healthcare facilities in four years.

The thefts in Minnesota were attributed to employees stealing drugs from their patients, primarily pain killers. Drug diversion resulted in their patients doing without the much needed pain relievers.

While pain pill thefts are on the rise, so is the number of prescriptions that have been written as well, including those for pain and stimulants. Medical facilities have been forced to crackdown on these types of crimes in hospitals as well as improve their oversight practices to prevent them from happening in the first place.

With the availability to these types of drugs, both to those who need them and those who abuse them, it is concerning that there appears to be no end in sight to abuse of prescription pain pills.

So what happens to a medical professional who is stealing drugs from his or her patients’ to feed their own addiction? Are they fired on the spot or offered treatment? Should they ever be allowed to return to a job where they have access to medications of this sort?

All these questions are relevant in this time of an increasing problem with prescriptions.

One thought is that if the employee completes the proper treatment and have proven that they no longer have a problem, then they should be allowed to return to a job in any healthcare facility.

But are you only setting them up for the possibility of failure again? Would you allow a person who has been a heroin addict return to the same circle of friends who helped them get hooked on the drug in the first place?

It would seem that to answer these concerns, it would have to depend on the person or an entirely new system of protection in place to allow them to return to the medical world, but not have access to a potential problem.

Some researchers believe the personality and drug of choice combination is too simplistic. They believe that it has more to do with heredity and lifestyle patterns over several years. If you have a parent who is a drug addict then your chances of being one too are heightened.

This could also be explained by the environmental factor. Those who are around you and what is available could be part of the bigger picture when it comes to if you choose to abuse drugs and what drug that may be.

It seems common sense to think that if a child grows up in a home that is filled with drugs, then it would be easy for them to obtain that substance when they reach the adolescence and young adult age. If it was not in their environment, then it would not be as easy to obtain.

When researchers try to make the tie between personality types and the drugs they choose, it seems they may be leaving a few things out of the equation.

Famous musicians may choose heroin or cocaine because it is what is around them and they are more expensive drugs. Your average person who does meth may do so because that is what is in their environment and is somewhat affordable.

There are so many pieces to consider when predicting if someone will use drugs or not. Consider the home life, the environment around them and then determine the likelihood from that.

Many might argue that environment, not heredity plays a stronger role in determining whether someone who grew up with an addict is likely to become one. The idea being that by simply living with a person who is abusing drugs, and who is involved in the chaotic lifestyle that often accompanies drug usage, that it will influence the easily impressionable child into using drugs in the future.

Either of these could be plausible explanations if you have wondered why, for example, your mother or father drank or used drugs. They may also easily explain why your siblings may, too, have followed in their footsteps. What might be baffling is why you didn’t get the gene, or despite the same exposure as your siblings, why you didn’t start using or drinking.

Interventions Don’t Just Apply to Helping Loved Ones into Recovery

Growing up with a mom or dad who drank or used drugs (or both) can be isolating, dangerous, chaotic, and fraught with uncertainty, fear, confusion and anger. Maybe you were abused or were neglected. Perhaps you had to frequently take care of yourself when they were high. You may never have felt settled and comfortable at home or had to care for them because they couldn’t care for themselves.

Reactions to the dysfunction growing up around drugs and/or alcohol can vary from sibling to sibling. It is not uncommon for one or more to start using at an early age while another may become hyper responsible, excelling in school, even graduating from high school a year or two early – if for no other reason than to put distance between home life and self.

In your solitude, did you often wonder why? Why me? Why my parents? Why didn’t someone help me? Why couldn’t they stop? And if one or more of your siblings turned to drugs, did you wonder why him/them and not you? Why were you spared?

The answer to the question ‘why not you’ can be as convoluted as why your parents used drugs and maybe your mom’s sister abstained from drinking her entire life. And sometimes in seeing the dysfunction present in a home with addiction, older relatives can intervene in ways that you may not have seen growing up but that you maybe can appreciate now. Why those interventions helped you and not your siblings can certainly be the cause of incredible guilt.

The Best Way to Help

Seeing patterns repeating themselves in your siblings can be terribly disheartening. While you couldn’t have helped your parents when you were a child, your sense of powerlessness and guilt now that you are all adults can be overwhelming. If you have extended your hand numerous times and it has been refused, there are several things you can do.

Keep the door open. Although you may have to keep distance from your siblings if their use is destructive to both themselves and you, always keep the door open. Setting boundaries is healthy; closing the door forever isn’t.

Be a good example. While you don’t have to push in their faces the successes you have achieved, you can show them what it is like to live without drugs or alcohol controlling your life.

Don’t own the guilt or shame. Recognizing that addiction is complex, and can at times be random, don’t allow anyone to lay blame on you for not making the same choices they did. It is common for addicts to project and deflect. Don’t own it.

Continue to wish them well. If you pray, pray for them. Think good thoughts for them and hope their bottom will come sooner rather than later. And be willing to be there when it happens. Until that day, always have a kind word even in the face of hostility. Part of not owning the guilt means also not reacting to the cruel words said under the influence.

Get therapy, talk to someone or join Alanon. Addiction is a family disease and whether you took or take drugs, you were/are affected by the dysfunction. Keeping yourself sane can take various roads. Don’t be afraid to choose one or several.

When family members and friends of drug addicts and alcoholics first reach out to their loved ones in order to get them to admit there is a problem, most understand that they are likely to meet a certain amount of resistance. When you have a lifetime loving connection with someone, however, the expectation is that after awhile you will be able to break through the walls of comprehension and that he or she will start listening and paying attention to what you have to say. But unfortunately, substance addiction is one of the most insidious opponents that any person will ever encounter, as it possesses the mind, body, and soul so thoroughly that it becomes extremely difficult to escape from its corrupting influence. Those in the grip of addiction become resistant to reason and logic, which can make them completely immune to the entreaties of those they love, even when their lives are collapsing all around them.

For family members and friends, being continually rebuffed by addicts in denial can be baffling and frustrating. When it is so clear to everyone else that there is a problem, why are addicts unable to see the incredible damage they are doing to themselves and to those they supposedly love? If you find yourself in this position, what you should know is that your loved one’s refusal to admit he or she needs help is based on two powerful factors – the defensiveness of an ego that feels itself under attack, and the strength of the physical addiction itself.

Paddling the Boat of Addiction Upstream on the River of Denial

People forced to face up to their substance abuse problems will frequently fall into a defensive posture because from their perspective it feels as if their self-image and sense of personal strength and dignity are under attack. Admitting weakness and the inability to control behavior is hard for anyone, and those in the throes of addiction can feel especially vulnerable and threatened when confronted with the truth. But even beyond this basic psychological reality, the physical addiction caused by drugs and alcohol interferes even more with the ability of substance abusers to separate truth from illusion. Addiction and denial have a dialectical, mutually reinforcing relationship, as the former makes the latter more formidable while the latter helps the former maintain its iron grip on its victim. Addiction and denial, together, represent a true axis of evil, and they are powerful obstacles for anyone to overcome.

If at First You Don’t Succeed…

Breaking through the walls that addicts set up may seem impossible, but in reality it is not impossible but merely difficult, and it is important that you recognize this crucial difference. Ultimately, it is up to the addict to get past the denial, and to overcome the powerful compulsion of the addiction, and all that anyone else can ever hope to do is to offer a little bit of guidance and moral support as their loved one attempts to find the way back to sobriety.

Patience, calm determination, good humor, and a consistently loving attitude are much more likely to have a positive influence in the long run than anger or frustration. And the best way to learn to make the shift in the way you have been reacting to the addict or alcoholic in your family is to stop taking what the addict says or does personally. When interacting with a substance abuser, you must remember that it is not the person you love who is talking, but their addiction, and you have to see through this screen to the fragile, scared human being that still lies beneath.

Essentially, you have to reinvent your relationship with your loved one based on the new reality, and to recreate this relationship in a successful way you must be prepared to be in it for the long haul. You must know going in that the time and effort you invest in trying to help your friend or family member recover from substance abuse may not reap benefits immediately; in fact, they may not even reap benefits any time soon. But when those walls of denial and addiction finally do come tumbling down, the benefits that come then will be substantial, and well worth the wait.