Suggestions for Your Interactions With a Drinker:
- Be patient, change is a process
- Ask questions, and try to avoid statements
- Highlight inconsistencies in the statements made; share them as your observations, not an attack on a person
- “Roll with resistance”, expect the person will resist change and protect the ‘status quo’
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Dealing with Drinking Problem – Advice vs. Feedback
Feedback: noun – a reaction or response to a particular process or activity.
Advice: noun – an opinion or recommendation offered as a guide to action.
When you are talking with someone about their alcohol problem, try giving them feedback instead of advice. Feedback means letting the person know how their behavior is affecting you, and/or how you feel when they drink. Advice would be telling them what to do about their drinking, or recommending they make changes in their drinking patterns.
Since giving feedback may not be as simple as one would think, you may choose to consider the following:
- Provide the person with information that is descriptive and objective. When describing your thoughts stick to the facts and stay away from personal interpretation.
- Avoid using labels to describe behavior such as “irresponsible”, “unreliable”, “alcoholic”
- Try to eliminate extreme words such as “always” or “never.” These words often trigger a defensive reaction, and move the conversation away from the real issue.
- Avoid words that convey value judgments or personal attacks such as “good,” “bad,” “stupid”
- Timing is very important, so if you sense that the person is emotional, intoxicated, or angry; postpone your conversation for another time.
- Take responsibility for the feedback given by speaking for yourself instead of speaking for others.
- Make sure your emotions are in check before giving feedback. If you are feeling frustrated or angry, wait until you can be more objective.
- Direct your comments at behaviors that can be modified or changed as opposed to something that is out of the person’s control.
- Use “I statements” to describe the problem behavior
- Make sure the feedback is goal oriented, and avoid giving feedback for the sole purpose of venting your frustration or irritation.
- Take time to make sure that what you intended to say was clearly understood.
- Ask the receiver if they understood and clarify if necessary.
The goal of feedback, and/or discussions with the drinker is to HIGHLIGHT INCONSISTENCIES in the statements made by the person in a way that does NOT evoke resistance. During the conversation you may find yourself disagreeing with what the drinker is saying, but try not to directly disagree, or argue, and do not pretend to agree either. Ask more questions: “How is that? “How do you mean?” “In what way?”. Try not to become angry, defensive in response to the drinker. If they become resistant, change your approach or walk away. What you want to accomplish is to move the person towards accepting that they might have a problem with alcohol, if you argue with them, you are more likely to increase defensiveness and denial. Your goal is to move the person towards considering of the possibility that a problem exist. Asking questions rather than giving statements is one of the best ways to accomplish that.
Ownership and Responsibility for the Drinking Problem
Heavy drinkers who are experiencing problems have a tendency to blame others for the occurrence of these problems. They will do this to protect their sense of self-esteem which is already pretty low; The fact is that problem drinkers are not happy with themselves. They have tendency to project that onto other people, blaming you for mistreating them or thinking badly of them, or criticizing them. It is important to not buy into this, but place the responsibility for the unpleasant feelings with the person that is experiencing them (the drinker).
If the drinker gets to this point of acknowledging that they have unpleasant emotions about themselves, or their situation. The goal is to ask more questions to get them talking about. This is the art of HIGHLIGHTING AMBIVALENCE in the drinker’s statements and feelings. You may ask “How long have you been feeling that way?”; “What makes you feel this way?”; “Are there times you feel better?”
Work towards asking naturally-sounding questions (Why, What, Where, Who, When, How etc.) that do not lead to simple yes/no answers, but require the person to talk.
Don’t rush things; don’t expect this to work overnight, it may take weeks or months. Change is a process and it takes time. Expect to take two steps forward and one back, as the drinker’s motivation may be fluctuating depending on what’s happening in their life.
Responsibility: If someone is going to make changes in their behavior, they must first accept that it is their responsibility to make these changes. Others may help, but it is the person with the problem that has to take the ultimate responsibility for actually doing it. When alcohol abuse is present, it is easy for the family members to step in and want to give advice, try to solve the problem themselves, and attempt to fix, or cure their loved one. The drinker denies that drinking is a problem by subconscious influences beyond his or her direct control. As helpers, family members tend to judge, blame or fault the drinker. These approaches are not helping anyone. There is no need to assign blame. The act of blaming someone for a problem is really the same as saying “I can’t do anything to change that problem because it’s their fault”. This kind of thinking leads to family members feeling stuck, helpless and angry.
If you are to motivate the drinker to change, then you will have to lead them to start to take personal responsibility for their actions. You will achieve this by modifying your own behavior, taking responsibility for your own change, as well as through conversation and asking the right questions. What is the approach to take with the drinker? As much as possible, you must allow the natural consequences of the drinker’s behavior to occur, without interfering.
Consequences of Drinking Behavior
All behavior has consequences, and drinking, in the long run, tend to have largely negative consequences.
You need to stop any behavior on your part that may lead the drinker to be more likely to continue to drink. For example, you may be the kind of person that puts the drinker to bed when they arrive home. You may cover them with a blanket, or call their boss in the morning saying that he is sick and unable to work. Or, you may do the opposite and refuse to let him/her in. Both these actions are likely to contribute to the drinker continuing to drink. The only difference is that they will be drinking for different reasons. In the first scanario, you allowed them to avoid the negative consequences of drinking, making it easier for him to continue. The second scenario, the drinker ends up blaming you for the situation they themselves had created. The drinker will most likely feel a sense of injustice and anger, and continue to drink for that reason. It will only lead him/her further away from accepting that they might have a problem and they will most likely end up blaming all their problems on you.
The simple is answer is: try to do nothing. Neither help nor hinder. By doing nothing, you will maximize the chances of the drinker actively experiencing the problems consequent to their drinking, and where they have no-one left to blame for this other than themselves.
How long can you carry on like this?
If you are living with your drinker, eventually you may feel that you have no option other than to leave. Day-in, day-out for years, you will have experienced the consequences of this person’s behavior, and there is only so much anyone can take. If you do decide to leave, and despite everything you still wish to help the drinker, then you should leave making it clear that you are doing this only because you can no longer tolerate the consequences of the drinking.
Empathy is defined as ‘the power of understanding another person’s feelings’. There is a very important distinction to make between empathy and sympathy. Just because you have understood a person’s feelings, does not mean that you will demonstrate sympathy for those feelings, or feel sorry for the person. In fact, you should avoid both sympathizing and criticizing. If the drinker senses that you will not understand them as a person, their guard will remain up – and he/she will continue to be defensive and continue with their denial. You want them to drop their guard and admit that they might have a problem, and then you can demonstrate an empathic understanding of their feelings.
What may help you is to see the drinker as a person suffering from a disease, a disease of the central nervous system. There are ways in which the subconscious mind overcomes our conscious thoughts. The subconscious can be very powerful, and capable of overcoming person’s rational, conscious thoughts. It is these subconscious, primeval parts of the brain that have become all powerful in people who are addicted to alcohol. In particular there is one area of the brain that acts as a ‘reward centre’. When you are healthy, this part of the brain provides you with feelings of satisfaction and pleasure when you do things that are necessary for survival, such as eating, or having sex. In the process of addiction, the brain’s reward centre literally gets hijacked by the addictive substance. Use of alcohol (or any other addictive drug) causes the release of the same chemicals in the same part of the brain, as survival activity does (such as sex and eating). After years of heavy drinking, the reward centre no longer responds well to activities such as eating, and sex, but only to drinking alcohol. The problem experienced by an alcoholic on cessation of drinking is that the brain has by now become convinced that it needs a continued supply of alcohol in order to survive. Messages are sent to consciousness telling the person to find alcohol at all costs. The survival instinct kicks in. You can compare that to a craving that the dying person in the desert feels when thinking of water is the same sensation that is experienced by the alcoholic when craving for alcohol. Exactly the same brain mechanisms are involved in both responses. If you were that person in the desert and I placed a glass of water in front of you, could you refuse it?
At this point in time, drinking really is beyond a drinker’s control. As such, they should not be blamed for this. They need to be helped into a position where they can start to establish a degree of conscious control.
Through the processes of feedback and allowing the drinker to experience the consequences of their actions, they will hopefully slowly become ready to admit that they may have a problem. They are highly unlikely to admit this to anyone, unless they sense that person has a degree of understanding for them.
Confidence to Change
Self-efficacy refers to person’s own sense of their ability to change things for the better. This involves praising/rewarding them for positive behavior. If positive behaviors occur these should be recognized and responded to. The rule of thumb is to ignore unwanted behaviors and to reward desired behaviors. If drinkers have no belief in their ability to impact positively on their environment, then the idea of taking responsibility for their actions will appear to be an overwhelming challenge.
Advice & Menu of Options
The final stage of implementing these motivational tactics involves the giving of advice and alternatives & options to current behavior. This is the final stage, because it is vital that you avoid giving any advice until the person indicates that they are ready and receptive to change. In other words, the drinker will have already indicated that they accept that they have a problem, and may need help.
If you deliver advice before the person has indicated a willingness to listen, then your advice will accomplish nothing. If you deliver it once they admitted a problem, the next step is to offer a menu of options.
Leave informational materials for the drinker to browse, as well as other self-help materials. Don’t expect immediate results, and the person to change overnight. Be patient, this may take a while.
You may want to have this information ready:
- A referral/ appointment with an addiction specialist for an assessment
- Options for Counseling
- Information for the Mental Health Clinic in the area
- An appointment with a GP to run some tests, and get a full physical
- Telephone numbers to AA or 24-hour- helpline
- Detox services in your area
- Recovery Groups, Educational Sessions, Family Support Groups
- Rehabilitation Services
- A solid support network made of friends, family and others willing to help
- An option for healthy leisure activities
The important point here is that the drinker makes the decision about which one of these routes to follow – your role is merely to give advice as to the possible options. The drinker has by now clearly started to contemplate that there might be a problem. You have also introduced a number of means by which he/she can establish INDEPENDENTLY whether or not this is the case.
At this point – you must be careful not take on the role of the professional helper. Too much pressure and advice can push the drinker back into resistance and rebellion.