As a family member becomes increasingly alcohol dependent, most families find themselves wishing they knew what to do. Initially we all tend to look the other way and hope that we're wrong, but eventually most of us will start getting angry as the side effects begin to spill over into our lives. Then we're also, probably, going to feel guilty about being angry. It is, after all, a disease, isn't it? How can we be mad at someone who is ill?



Lewis Thomas, M. D., essayist and late Director of Memorial Sloan Kettering Cancer Center, once wrote that in medicine the most difficult part is knowing that "frequently the best we can do is to stand back and quietly wring our hands." For many of us, that is how we respond as the problem grows. And sometimes it is the best that can be done.

Eventually, however, patience wears thin, circumstances become intolerable, and our own lives begin to be affected in ways we can't ignore. Bank accounts are overdrawn, court dates appear, bail is requested, and emergency room visits arise. Quietly wringing our hands ceases to be an option, and as chaos and anger grow, so does the need for action, productive or not.

There are scant few possibilities. Traditionally the professionals have urged and orchestrated "interventions," forceful confrontations between the drinker and those affected by his or her problem. The chastened drunk, suddenly made aware of the error of their ways, is whisked off to a prearranged residential placement and started down the path of life long recovery. Everyone lives happily ever after.

Except that it hardly ever happens that way. Confronted drunks become resentful drunks. Treatment fails within days or weeks or months. Everyone's situation is worse than it was before and everyone is considerably poorer. There still isn't any resolution in sight.

Now what?

Backing up just a bit, when the urge to do something becomes a demand, it is good to remember that we can't force anyone else to change, at least not for very long. All we can really do is change ourselves. Change how we behave and those around us will also change in response, though it isn't very predictable exactly how. That's the hard part. Preparing for the uncertain and unexpected.

At some point most of us decide it's probably better than living with the current miseries and messes and wondering what disaster is around the next bend.

The options are still few. "Soft" interventions without confrontation and prearranged treatment work better than their hard counterparts. This involves a clear statement of what needs to change, and how the family members are going to change. How the drunk is going to change is left up to them. Maintaining this resolution is the tough part, as we all know.

Good follow through generally takes the form of disengagement. The drunk is relatively free to meander along on their inebriated way but without company, rescue, or support. Others simply divert their attentions into developing their own lives, interests, and activities as well as their own exits, if it comes to that. Frequently the family members are the ones who can benefit most from a supportive counselor familiar with all of the complicated issues and dynamics. It isn't easy saying goodbye, even if the drunk disappeared into a bottle some time ago.

In the end, intervention means changing the rules, usually unilaterally. Remember that the drunk did this when she or he chose that route. You are only responding in kind when no other reasonable or productive choices exist. You are allowed to save yourself.