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Healing the Intervention
By Ken Lucas, LISAC, CADAC
VALLEY HOPE ASSOCIATION
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The
closure process is familiar to those involved in primary therapy,
aftercare and other program components associated with today’s addiction
treatment centers. Closure offers a chance to reflect on the past few
weeks; it provides for a frank exchange of feeling; it allows everyone
to say goodbye; and especially, it charts a course toward recovery. If
any program component could benefit from closure, it is the formal
intervention. But closure for the “intervened upon” is never done. Why?
Because interventions are designed to move subjects quickly away from
their using environments and into recovery centers where, it is wrongly
assumed, all feelings will be dealt with and processed. Some programs do
provide closure for families following intervention; some programs bring
back original members to gauge progress during primary therapy or to
bring consequences into play. Yet, to my knowledge, there is no program
that acknowledges that intervention subjects need closure.
To rectify this, I propose the following:
1. While formal interventions have been invaluable to the recovery
process for more than 30 years, it is time to acknowledge that
interventions create their own issues.
2. Due to their possible severity, these issues should be considered as
possible relapse dynamics and could explain why many patients leave
treatment ACA.
3. “Intervention closure” should be established as policy for every
formal intervention team, and such closures should be used to deal
effectively with issues that stem directly from intervention.
Personal experience
The formal intervention that resulted in my successful recovery from
alcoholism took place on June 8, 1982. Present were my wife and an
interventionist from St. Luke’s Behavioral Health Center in Phoenix,
Ariz. While I was a most willing subject, the power of the process was
so great that I carried a significant amount of unattended feelings
(mostly lack of trust issues) into detoxification, primary therapy and
aftercare. I was unaware of these feelings and in the dark about their
legitimacy as a topic for discussion. Today, I remember that my sudden
entrance into a hospital-based detox unit was far easier to cope with
than the issues stemming from formal intervention were. Sadly, the first
person to ask about them was a psychiatrist whom my wife and I were
seeing to improve our communication skills almost two years after the
intervention. Up to that time, everyone I met gave me strokes regarding
my successful entry into recovery, but no one suspected or dealt with
the intervention-based issues I was still carrying around. After my
intervention, I was fearful of walking into a room where others were
gathered lest I get trapped again. And I often dreamed about the
experience. In fact, when I began my association with a 12-Step program,
I began to be ashamed of the way I felt about the intervention. After
all, how could I be a grateful recovering person, taking advantage of
all the program officers, when I was resentful of the humiliation
suffered prior to my entry into detox? I remember listing my humiliation
as a “character defect” involving what I mistakenly believed to be
excess pride. When it became clear in 1984 that my wife and I
weren’t communicating as well as we could, my wife sought counseling.
After a few weeks she asked if I would like to attend. While I knew
counseling would improve our marriage, I feared I was walking blindly
into yet another “trap.” I finally did go, but I remember being ever
watchful to the point of making sure I had a path to the doorway.
Ironically, it was not a trap, but the beginning of a warm, therapeutic
relationship wherein I not only got help for my marriage, but I began to
process my intervention. Because of what the DSM-IV refers to as
“recurring, painful, intrusive recollections,” I almost missed the
healing these sessions provided. I am not suggesting that
interventions create trauma for all subjects. But I am suggesting that
interventions create trauma for some. For those unlucky few,
interventions saddle them with issues (fear, anger, mistrust) that go
unattended throughout the recovery process.
Methodology
I believe that the best time for intervention closure is just prior to
patients entering aftercare. I do not believe it would be of any value
to ask subjects, while in primary treatment, “Would you like to have
closure on your intervention?” Thirty days of sobriety is not enough
time for most people to give that question the close attention it
deserves. At the very least, recovering subjects and their original
interventionists should participate in closure. It might help if primary
enablers attended as well. Location of a closure might be the site of
the original intervention, or any neutral site. Each intervention
closure could begin with the interventionist remarking on the idea that
residual feelings from intervention are legitimate topics that need to
be resolved prior to moving on to aftercare. In a reversal of the formal
intervention, the intervention closure would begin with the subject
speaking first and enablers speaking last. Here are a number of
thoughts:
• Intervention closure, like formal intervention, would not be just for
subjects. Acknowledging that all principal parties have a legitimate
right to process the dynamics of an intervention would be therapeutic.
• Just as subjects might discuss their intervention’s impact on their
issues, prime enablers might want to process their own issues (anger or
retaliation from subjects, for example).
• Intervention closure might provide significant feedback to therapists
regarding intervention methodology and other issues.
• Understanding formal intervention as less a marketing tool than a
catalyst for recovery might assist people in embracing closure as a
legitimate process. No longer would the bottom line of the intervention
be simply, “Did he get into our hospital?”, but “Do we need to close the
process that began this person on his journey to recovery?”
• Both primary therapists and aftercare facilitators could be made aware
of issues surrounding interventions, although they might not need to
play any real role in intervention closure. Nor do I see any need for
them to devote therapy or aftercare time to intervention issues.
However, neither therapists nor facilitators should mislead themselves
into thinking that dealing with such issues as shame, guilt, trust, or
abandonment in group therapy will take care of issues stemming from
interventions. Interventions, as I have pointed out, create their own
issues, and the proper way to deal with them is a “re-creation” of the
original meeting.
• Therapists who lead intervention closures must understand that
re-creation of original interventions must indeed provide closure and
not keep issues open longer. Therapists also must not allow
subjects to shame their families into believing that they did the wrong
thing.
• Intake forms, used by all addiction treatment facilities, often list
under the heading “Source of Referral” all types of possible referrals
(self-referral, family or relative, friend, employer, EAP, etc.), but I
would venture that no intake form currently in use has a heading called
“formal intervention.” If this were added as a choice, it would be
possible to alert primary therapists that clients have been through
intervention, that intervention has possibly created its own issues,
that these issues could be considered relapse dynamics, and that a
closure session could begin the healing that needs to be done.
• And far from being a time of conflict, an intervention closure could
be a time of bonding and expression of gratitude between subject and
intervention team. Although it may be uncomfortable for some to
admit that interventions create issues in certain individuals, it
does not mean that formal interventions are neither needed nor
effective. After three decades of use, it is obvious that interventions
are an important tool in saving countless lives that would otherwise be
lost to alcohol and other drugs. What it does mean is that we should
stop denying that intervention creates its own issues. Then and only
then can we take the necessary steps to heal them.
Ken Lucas is an addiction counselor, speaker and author
based in Phoenix, Ariz. He is a community relations director
for the Valley Hope Association addiction treatment organization.
He can be reached at (602) 263-5053 or via the
Internet at www.kenlucasbooks.com.
VALLEY HOPE ASSOCIATION
Reprinted
by permission of
Addiction Professional Magazine from Manisses Communications Group.
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