Case Studies
*To ensure confidentiality and privacy, the names and/or professions of the actual people in each of the following case studies have been changed.
Bill is what you might call a “good ole’ boy” in his early-forties. He’s a big, handsome, former scholarship athlete (somewhat famous in his local area) and a skilled salesman. Bill has a lovely wife, Laura, two children, a friendly dog, a large family and boyhood friends with whom he keeps in contact. Bill is also an alcoholic who can’t stop drinking, although he has promised to do so many times. Bill is a belligerent when he drinks and often passes out on the floor in front of the family. There is also history of alcohol dependency in his family. His father was an alcoholic that left the family when Bill was 8, his mother is chain-smoking former drinker, and two of his three brothers are active drinkers. Like most alcoholics, he is self-centered and has little quality time for his wife.
Bill’s father-in-law (who lives in another state) called me late one Friday afternoon after his daughter (Laura) had shown up at his house, for the third time, to avoid her drunken husband. That night we arranged a face-to-face talk, the family was desperate and ready for a loving confrontation. To persist in accommodating Bill’s drunken behavior any longer would enable him further, and cause too much pain.
We wanted to catch him in a fresh incident, so he couldn’t deny it, so we set up an intervention immediately. “What does Bill stand to lose?” I asked. The answer was, “job, wife, children, friends, dog, and home – in that order.” Our next challenge was selecting the right friends for the intervention. We spent Saturday calling and enlisting support for our plan. Solid planning is required to accomplish a viable intervention. We made sure everyone was on the same page, saying the same things – we didn’t want to give Bill any leverage to deny his addiction – we needed to be in control, as we're dealing with a superb manipulator and an egomaniac who was about to be seperated from his first love...alcohol.
Bill’s mother seemed unhealthy and we didn’t want to include her in the intervention out of fear she would not keep it a secret, which is essential. But Laura insisted. Our solution was to tell her mohter-in-law about the intervention very late the night before so she would have little time to sabotage our efforts. The plan was to meet at 6 a.m. at Bill’s brother’s house to rehearse our message and bond before going to Bill’s house. As expected, Bill’s mom didn’t show up to rehearse; she went to Bill’s house by herself.
Once the intervention began, I locked the door to the house. But a minute later an unhealthy older brother showed up banging on the door, so we let him in. Bill seemed to be suffering from ADD (Attention Deficit Disorder), and was moving all around the house, sitting in our presence only a minute at a time.
His siblings and mother were trying to control things, shutting us out of different bedrooms, where he was moving and hiding. Eventually two friends and one recovering brother made their heart felt and firm comments. Then members of Laura’s family spoke including her step father whom Bill respected. However, Bill was not listening to Laura. Several times Laura struggled with the words, “Honey, I love you and if you don’t go to rehab right now this morning, you’re leaving our house permanently.” I told her she was dancing and needed to hold him and make a stand, which she did with courage, holding his face to hers. Bill gave a bit, but seemed more concerned about his job, the source of cash to keep his habit alive.
So we called his boss. Laura did a great job describing the situation, and I handed the cell phone to Bill in a locked bedroom where he was hiding once more. His boss convinced him to give in and accept help. After Bill had packed, he waited an hour in defiance before leaving the house for Rehab
Bill completed rehab, enduring a week of family therapy there. He is now in outpatient therapy. Bill and Laura have a very clear boundary and worked out a written contract in Rehab. They both are working on their part in the ‘family disease’; both have therapists, and go to AA and Al-Anon meetings. They sound very happy and hopeful, acknowledging the reality of the consistent work ahead.
I think this difficult intervention was successful for the following reasons:
- Laura and her family being clearly ready to act
- We acted quickly
- The friends, Laura, her family, and one of the brother’s were well rehearsed
- The interventionist’s focus on consistent, difficult truths being repeated in a loving way and physically being there and supporting the key players, to not let up on Bill.
- Thoughtful planning, including having the boss’s Telephone #.
It’s important to remember that Bill had a piece of his soul that wanted to be healed, and he had presence of mind to react positively to this intense pressure. We were able to use the available pressure to all our advantages, Bill included. The hard work and super emotional effort was well worth it.
Dmitri was a daily hard drinking, hot-tempered electrician in his late-thirties, living in a rural farming area. He has two brothers and a sister. He is currently single, having recently had his on-again, off-again alcoholic girlfriend leave him “for good!” He lives alone in a deteriorating wooden house, owned by his aunt who lives in the home next door. For over a year he has had no hot water. The kitchen has at least three feet of piled, cascading paper and a few chipped porcelain plates caked together with all manner of moldy old food. He chain-smokes and barks rather than speaks. His family and acquaintances seem to fear him and his sharp tongue most of the time. But he is valued at his job when he’s clean.
The family had tried two unsuccessful interventions in the past year using Vernon Johnson’s Intervention book. His aunt finally called me in desperation. After discussing the situation, she seemed ready to evict him from her rented house, exert her control over her well meaning, but misguided family.
In this case it was essential to talk to all the people involved over the phone. Four people were eliminated from the intervention due to their negative and weak presentations. Tragedy ran deep for most of the family with deaths, suicides, ill feelings, and job loss among them. All but one of Dmitri’s many cousins were using drugs and alcohol. This was a hard bunch and the aunt was a saint. But this saint had finally recognized her limitations.
It was Thanksgiving week and I had to figure out how to lure this mad bull into Rehab. With the family’s permission, I went to Dmitri’s job, the seemingly most vulnerable option for us. The one straight edge cousin also worked for this electrical company, and through him and the boss, I was able to work out a scenario in which Dmitri would be fired. He would be able to collect unemployment during Rehab and he could have his job back if he successfully completed the program. Although this was a very difficult scenario, it was the only viable option in this tense, potentially violent scene.
We met early in the morning for our ambush at Dmitri’s house. I went in with two large company superintendents from Dmitri’s work and a couple of his large cousins. The family tagged behind and offered a more gentle presence. Dmitri was in severe alcohol withdrawal, began screaming at me, until the superintendents explained to him about loosing his job unless he went to Rehab. Dmitri, embarrassed, rambled around his filthy, cold house. We followed respectively, offering soothing, until finally he gave in and packed a bag, nearly tearing. The entire family descended upon the Rehab, in guarded, yet positive anticipation.
For the first time the family had worked together, establishing a firm boundary with Dmitri’s drinking behavior. As usual, this intervention was successful due to proper planning. Dmitri completed Rehab, but has refused to follow the Rehab’s suggested after care plan, and regrettably he is working his recovery “his way”. The family states they are happy they “did all they could for him”, and continue to hope for the future. Dmitri and his siblings are working on completely refurbishing their aunt’s rented house. In the end, Dmitri is far better off.
Shannon is a bright, fifty something woman recovering from breast cancer. During the past 10 years she has held four different jobs as a receptionist, had two serious boyfriends, and steadily increased her alcohol/vodka intake to the point that her remaining family, her mother and brother’s family became alarmed. The family and medical professionals had tried about ‘a dozen’ interventions in the past few years. The only results were some “serious promises” of abstinence and outpatient treatment, which had, of course, fell flat.
In making calls to her family, former employers, and friends, I noticed frustration and a lot of self-centered behavior on the part of some key players. Due to past failures and the present consternation, we decided that I would do a solo intervention, with the support of her family, including two teenaged nieces, and a trusted former co-worker. It’s important to dig up as many connections as possible. Mature teenagers are especially good persuaders, with their innocent questions (why?) and ease of saying “I love you”.
One early morning Shannon’s brother called to make sure she was awake and dressed, and I approached. Shannon was protective of her booze and I was not very popular with her. But after gently discussing my knowledge of her issues and offering to call her family and employers for verification, she agreed to speak with me. We walked her dog around the block to get to know each other. After a stiff defense, I used the tender words her support group had used often before, with a different emphasis. At a prearranged time I asked her best friend, a trusted, former co-worker to stop by, and he delivered the family’s message of ‘get help’ or lose her whole support system. We had finally reached that part of her that wanted help, and a short while later, we were on the way to a level four medical rehab.
Shannon seemed passive during the 28 days of rehab. She complied with the work, but failed to show up at prearranged after care. However, she seems to have reached a solution that keeps her from drinking, while following her medication regimen, and maintaining a somewhat positive outlook.
This is an example of how a professional outsider can deliver the same message her family and employers had for many years, but now it had finally reached her. People have to be ready to live differently, and at the same time a gentle push allows them some dignity in the process. The family is resigned to this tenuous condition, and is appreciating the good days, and the ‘workable’ arrangement they have jointly developed.
Andrew is in his late-thirties, with a lovely, severely co-dependent wife, and a daughter by his first marriage, who was living with her mom. He had been to a two-week Rehab before but continued drinking, which was the probable cause of his divorce. He had worked very hard for fifteen years in a family business that was recently sold, and was living on the proceeds of the sale. Besides long-term alcohol abuse, he had recently started doing Heroin and was hooked into various forms of gambling. He had taken to befriending his drug dealer (and his two children) and neglected his own kids. Andrew was extremely arrogant and hugely self-centered, and downright mean to his family.
I was able to harness the anger and hurt from Andrew’s family and long time former friends, and turn it into a positive pitch for his health. We waited until his return from a Las Vegas gambling trip, and showed up early the next morning. We wanted to be there right after a gambling loss. His mother led off with a strong, loving, rendition of the current facts. We asked the ‘hated’ dad to be at the outer ring, but not talk. Andrew’s daughter tearfully stated, “You have never seen my softball games, but you go to (drug dealer’s son’s) games”.
Andrew was skilled at defense, and used every angle he possessed. At one point, toward the end of a very moving, tough loving conversation, Andrew stood up and began to walk away. We were ready. We also all stood up and converged on him. “Andrew, please listen while we all say ‘good-bye’”. It worked and Andrew agreed to go to 30 days of Rehab. Like the defensive soul that he was, he refused to take the already packed bag. He stalled; all the while the entire family followed him around like little Pac-men, refusing to give-in.
Andrew, no longer a beginner, was placed in an Intermediate unit at Rehab. After three weeks, the Rehab judged Andrew was just not “getting it” and with the same family “get help or else” edict, was sent to another, tougher Rehab to break down his considerable arrogance, which happened in a few more weeks. Miraculously, Andrew began to turn. He came home, did 90 NA meetings in 90 days and continues nearly daily meetings. He is working on the steps with his sponsor, and his girlfriend reports her Nar-Anon is working and their relationship is beginning to blossom. It’s reported that Andrew continues to harbor some resentments, which has killer relapse potential. But Andrew’s continued recovery mode will certainly address forgiveness and how to deal with anger. What a turnaround! We turned a truly painful family situation into a chance for true freedom.
