Dr. Jean Hager
When a family contacts me to help a loved one who is suffering from active addiction, and is interested in an intervention, I am confident they are in a desperate situation. They see me, the interventionist, as the last hope for recovery for a family member or friend in physical, emotional, and mental crisis.
What they most likely don’t see the first time we meet as a group to prepare for the intervention – a caring, empathic, non-judgmental, supportive confrontation to interrupt the progression of the terminal and fatal disease of addiction – is that the intervention’s success has little to do with my role as the therapist or “healer”, which Cheryl Mattingly (2000) refers to in her essay, Broken Narratives. It has more to do with their emergent roles as narrators, and their powerful position of having personal experience with the addict’s destructive behavior and telling the story of the negative impact these interaction(s) have had on them. This unique kinship between addict and loved one is why an intervention has any effect on the fragile, but well-defended, chronically ill person. Mattingly (2000) writes: “The art of the good story depends upon its capacity to dramatically transform lived experience.” (p. 183)
The only tool that family members and friends can use to possibly break or put a crack in the addict’s wall of denial (self deception), and other defense mechanisms – such as rationalization and projection, and a delusional system that causes euphoric recall of events they have blacked out – is sharing explicit concrete data outlining specific destructive or abusing behavior, a true timeline of the drinking or drug usage’s progression, and, most importantly, that the family member personally observed the negative behavior. This collection of incriminating data is then written in letterform, and the family member reads it to the addict at the intervention. The confrontation letter is thoughtfully written and rehearsed prior to the intervention. The reason to read the letter, and not just direct a stream of verbal assaults at the addict, is because the phenomenological process that occurs for most – if not all – intervention members is powerful. Without the letter, the fear is that the focus would shift or skew, and potentially sabotage the intervention’s success.
In an intervention, the story emphatically begins with the ending. The family and friends who make up the intervention team write and tell their stories having firsthand knowledge, or very close to it, of how the addiction started, how it progressed, and what they will do or not do if the addict does not accept treatment. In other words, they give an ultimatum regarding the future of the relationship. The loved ones are overwhelmed by a dichotomy of feelings – fear, anger, resentment, compassion, love, and hate – all directed at the addict. But as powerless as they feel, and as helpless as they initially presented in the first session, they emerge as the narrators, the storytellers, and the major keys to the intervention’s success. Their goal is to write a narrative in a way that the addict will receive, as well as accept the reality of the crisis. This means the addict’s defenses are down long enough to see the need for treatment. As Mattingly (2000) identifies this process, “The story’s structure exists because the narrator knows where to start, knows what to include and exclude, knows how to weight and evaluate and connect the events he recounts, all because he knows where he will stop.” (p. 185)
My role in the intervention is to choreograph or guide the members of the intervention team, and direct them as if they were actors in a play: where they will sit, who will speak first, and who will follow. I educate them on the disease concept of addiction, and the benefit of an intervention. I tell them about the downside, too, and I provide support, encouragement, reassurance, and validation. How I interact with the family members, and how confident they feel in my ability, is crucial because they need to accept and follow my coaching exactly as I outline it to give the intervention a greater chance for success. Mattingly (2000) references the importance of the relationship between healer and patient, and in this particular therapeutic setting, I strongly agree: “The capacity of a healer and audience to create a dramatic moment, a ‘time out of time’, is often culturally linked to the healer’s perceived efficacy.” (p. 206)
After the intervention, the family and other members of the intervention team feel a tremendous sense of relief if the addict immediately enters a treatment program. But the intervention’s covert success, resulting from their sharing of stories, is that they, as a group, will interact differently from that moment on.
I conclude with one more quote from Mattingly (2000) that helps solidify this point: “A narrative form is sketched in action, one with beginning, middle, and end. This is a drama, characterized by suspense, excitement, heightened desire, even a kind of foreshadowing, an elusive gaze into possible futures that live far from this small clinical encounter.” (p. 206)
References
Johnson, V. (1986) Intervention. Minneapolis: Johnson Institute Books.
Mattingly, C. (2000) Emergent Narratives. In Garro, L., & Mattingly, C. (Eds.), Narrative and the cultural construction of illness and healing (181-211). Berkeley and Los Angeles: University of California Press.