| Helping Another Recognize the Need for Help |
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Chapter 15: Helping Another Recognize the Need for Help
Tools for Relationships
By: James J. Messina, Ph.D.
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I. When do you know when another person needs help?
Another person in your life needs help when:
· You are no longer willing to accept the negative consequences of their troubled behavior.
· You are no longer willing to rescue them from the negative consequences of their behavior.
· You are no longer willing to enable their troubled behavior.
· You are no longer willing to placate or please them in order to keep them happy, content, and out of trouble.
· You are exhausted, exasperated, disgusted, disappointed, disturbed, and chronically unaccepting of the troubled behavior of the other person.
· That person is no longer able to hide the troubled behavior at home, work, school, or in the community.
· That person is chronically unhappy, hostile, angry, defensive, depressed, denying or rejecting when the troubled behaviors are pointed out as needing to be changed.
· That person chronically blames you and others for the troubled behavior and it has become unreasonable to accept that rationale.
· That person gets in trouble at home, at work, or in the community because of problem behavior.
· That person is unable to control the problem behavior.
· No promises or attempts at reformation are followed through.
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II. When do you know extreme actions are required to get another person help?
There is a need for dramatic or extreme action to get someone help when that person:
· Gets into legal trouble because of the problem behavior.
· Is in danger of losing a job or failing school.
· Is someone you are no longer willing to live with.
· Is functioning in such an unhealthy way that others in the environment are suffering unhealthy emotional stress.
· Is unable to follow through on promises to cease the “addictive” behavior.
· Seems to be controlled by the behavior and “lives” or thrives on the problem behavior.
· Is so caught up in denial and delusion about the problems that attempts to get help have been ignored.
· Turns the situation around and blames you for causing the problems.
· Goes on a paranoid attack, accusing you and others of being in a ruinous conspiracy.
· Becomes so grandiose that the world is seen as being “sick” and the troubled person as the only healthy one.
· Becomes so physically and emotionally abusive that you can no longer defend yourself enough to retain your physical and/or emotional health.
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. What drastic ultimatums will convince another person to get help?
The following are ultimatums to use if the person is:
· Your son or daughter, 18 years or older, living with you: you may need to lovingly request she/he leave home and not return until she/he has received help and is healthier.
· Your son or daughter, 17 years or younger: you may need to lovingly request that until she/he receives help and changes the problem behavior, she/he give up certain privileges and benefits gained by living in the home.
· Your spouse: you may need to lovingly inform your partner that you and she/he will need to separate or eventually divorce if she/he does not get help and change the unhealthy behavior.
· Your employee: you may need to lovingly inform the employee that she/he will be terminated from employment unless she/he gets help to change the unhealthy behavior.
· Your student: you may need to lovingly inform the student that she/he will probably fail the class, be reported to the administration, and to her/his parents for disciplinary action if she/he does not get help and change the unhealthy behavior.
· Your friend: you may need to lovingly inform your friend that you will have to cease involving yourself with her/him unless she/he gets help and changes the unhealthy behavior.
· Your parent: you may need to lovingly inform your parent that you will no longer be able to live under the same roof with her/him and/or no longer have any further contact or involvement with her/him unless she/he gets help and changes the unhealthy behavior.
· A relative (son or daughter, cousin, aunt or uncle, grandparent) who does not live in the same house as you: you may need to lovingly inform them that you will no longer sustain any contact or involvement or give them financial or visible support unless they get help and change their unhealthy behavior.
· Someone who has authority over you (your boss, supervisor, teacher, doctor, counselor): you may need to lovingly inform her/him that you will have to report her/him to their respective superiors, ethics board, or peer review group if she/he does not get help and change the unhealthy behavior.
· Someone in your support group: you may need to lovingly inform her/him that you will have to ask the group to drop her/him from the roster or to publicly reprimand her/him if she/he does not get help and change the unhealthy behavior.
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IV. What troubled behavior requires drastic measures?
· Alcoholism or problem drinking
· Illegal or prescription drug use/abuse
· Depression and chronic sadness
· Withdrawn or severe pulled-in and keeping-in behavior
· Compulsive eating, bulimia, anorexia, obesity
· Gambling, compulsive and addictive betting of money or resources
· Sexual acting-out
· Chronic blaming, belittling, sarcasm, putting down of self and others
· Suicidal thinking, gestures, or attempts
· Chronic denial of problems in personal, family, work, or social life
· Compulsive behavior with severe negative consequences
· Physical abuse of others
· Verbal abuse of others
· Sexually abusive of others
· Workaholism
· Lack of communication with people at home, work, or school
· Repression of feelings and requiring others to keep feelings in as well
· Chronic hostility or ill temper
· Severe anger and violent outbursts
· Violent behavior and thoughts toward others
· Unwillingness to work in a cooperative way with in the environment
· Chronic lying, fantasizing, or fabricating the truth
· Hyperactive, out of control, or manic behavior
· Autistic behavior or catatonic behavior
· Unresolved grief response over death of loved one or over a major loss event in one's life
· Hallucinations, delusions, or other psychotic behavior
· Extremism of any type, e.g., over-exaggeration of liberalism, fundamentalism, or conservatism
· Argumentative, ready to pick a fight at any time
· Extreme passivity, allowing others total control over their life
· Oversensitivity
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V. What needs to be done for yourself before you take drastic steps to get help for another person?
Before you can help another person, you need to get help for yourself so that you:
· Are clear as to: (1) who owns the problem, (2) how real the problem is, (3) how you contribute to the problem, (4) steps you can take to help alleviate the problem (short of drastic steps).
· Feel good about yourself and are able to self-affirm in a healthy way to arm yourself against the verbal and emotional assault of the person who resists help.
· Honestly face living with the consequences of the ultimatums as listed in Section III.
· Are in order emotionally and spiritually and are prepared to “let go” of the troubled person if she/he refuses to get help.
· Are willing to let go and let God take over from here.
· Can identify how your enabling and rescuing behavior has made it easier for the troubled person's problems to become more destructive.
· Get help to reduce your sense of over-responsibility for the troubled person.
· Can let go of any guilt you may feel about placing ultimatums on an already “sick” person in order for that person to realize the need for help.
· Can let go of the fear of taking drastic steps to get the person help; also to let go of the fear of having to follow through on your ultimatums indefinitely.
· Can live as healthy a life as possible so that the troubled person can no longer excuse her/his own behavior, claiming that “you are sick, too!”
· Can identify the existing resources in your community to which the person can turn for help. These resources include support groups like Alcoholics Anonymous, Alanon, Narcotics Anonymous, professional treatment centers, and individual, licensed mental health practitioners.
· Can use a behavioral intervention technique with your troubled person to lead that person to change the troubled behavior.
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VI. What is a behavioral intervention?
1. A behavioral intervention is a “tough love” model of presenting data, facts, and information to the troubled person in a loving and caring way. This data informs the person how the troubled behavior negatively affects others. This information is intended to motivate the person to seek help for the problem behavior. This is an effort to establish a healing environment with the troubled person.
2. The data provided in an intervention focuses on the problem behavior and how the problem behavior results in the person having trouble at home, work, school, or in the community.
3. The information about the problem behavior presented must be documented and witnessed by others. No speculation, analysis, or guessing about the problem behavior is presented in an intervention.
4. The intervention presents the problem behavior in a quantified description so the troubled person is able to get a sense of the magnitude of the problem.
5. Intervention provides credible data to the other person because all incidents of problem behavior are detailed as to date or time of the problem related events. Where, when, and with whom these events occurred is included to help the person's recall.
6. Interventions are presented with love and care. As each piece of documentation is given to the troubled person, the intervenor says: “I am here because I love you (or care about you) and I want you to get help for yourself.” The facts are presented in a supportive, honest, non-blaming and healing-oriented manner.
7. The intervenors share their feelings about the specific events listed and what negative consequences the intervenors received as a result of the troubled person's behavior. The intervenors point out that they chose their own reactions and responses (be they enabling or rescuing), and that they are no longer willing to function as enablers or rescuers for the troubled person's behavior.
8. Written scripts that include a list of data on the troubled behavior are used, and interventions are rehearsed. The intervenors have a written script need not rely on memories. Writing and rehearsing reduces the impact of nervousness that intervenors may feel.
9. A variety of people can be involved in a behavioral intervention. You can function as the sole intervenor or you and the other person's spouse, parent(s), relative(s), boss, teacher(s), friend(s), child(ren), or minister can be involved as intervenors. A professional mental health counselor could provide some stability, calmness, and mediation if necessary. The counselor may be the moderator if there are more than two intervenors with a specific person.
10. The intervention is conducted like a meeting with an agenda. Each person (intervenor) takes a turn going over the data brought to the meeting. Once all persons have presented their data, they present helping alternatives. The target person then gets to react to them. Then the intervenors present the person with their “tough love” ultimatums, pointing out resources in the community where help is available.
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VII. What is the difference between an intervention and a confrontation?
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An intervention:
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While a confrontation:
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is healing oriented
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is blaming oriented
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is supportive
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is threatening
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is solution oriented
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is a continuation of the problem
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is caring, concerned, and loving
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is vindictive, argumentative, and hostile
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is helping
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is hurting
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reduces defensiveness
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increases defensiveness
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reduces need for showing anger
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is anger inducing
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opens communication
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often ends in tears and silence
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is listening oriented
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blocks out listening
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is understanding of the nature of the problem
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is judgmental and critical of problems
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is offering assistance to the other
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is an attack on the other
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is where resources for help are pointed out
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is a form of coercion to get help
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is tough love oriented
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is enabling oriented
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is self-affirmation oriented
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is guilt-inducing oriented
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is healing environment oriented
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is self-righteous oriented
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is planned, thought out, reasonable and decisive
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is nagging, bitching, complaining, and often spontaneous
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VIII. Outline of an intervention script:
A. Reason for the meeting:
B. Intervenor (each in turn) presents documentation:
1. Date
2. What you did
3. How I felt
4. What I did for you
C. The helping alternatives for the troubled person:
1. Primary alternatives
2. Back-up alternatives
3. How a healing environment can be established together
D. The helping resources in the community available to the person:
1. Agency name
2. Telephone number
3. Contact person
E. Ultimatums to be presented if troubled person refuses to seek help for change and growth:
F. How I will cope if the troubled person refuses to get help:
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IX. Steps to take in helping another recognize the need for help:
Step 1: Identify why you believe the troubled person in your life needs help
Step 2: Identify why you need to take drastic action to get this person help.
Step 3: Identify what drastic “tough love” ultimatums you may need to use.
Step 4: Identify the problem behavior your troubled person needs help to change.
Step 5: Identify what you need help with first, before you can assist the troubled person.
Step 6: Get help for yourself to address the issues identified in Step 5.
Step 7: Prepare a behavioral intervention script and invite relevant, concerned persons to write an intervention script as well. (Use the script outline in Section VIII.)
Step 8: Meet with the intervenors to plan and rehearse the intervention script.
Step 9: Conduct the behavioral intervention with the troubled person.
Step 10: Assist the troubled person in getting the needed help. Follow through with your ultimatums if the person doesn't go for help or if the person goes for help and still doesn't change.
Step 11: If the troubled person refuses to recognize the need for help, and/or if your involvement cannot be curtailed, return to Step 1, and begin again.
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