There’s No Such Thing As Resistance

When an addict comes to treatment, he is often classified as “resistant.”  And yet JL Moreno, the creator of psychodrama, believed there is no such thing as resistance; there’s only inadequate warm up.  This may seem like semantics, but it isn’t.

Every addict is “mandated” to treatment in some way:  by the courts, a job or by his family. No matter how you slice it, when addicts go to treatment, they’re usually not warmed up to the idea; they’re usually doing it because they “have” to.  They’ve run out of options.

If the addict got to treatment as a result of an intervention, then the model that’s used can make all the difference in whether the addict enters willingly, or he’s fighting it every step of the way.

In the Johnson Model of Intervention, or what I like to call the “surprise party,” the family gathers in secret before the intervention event and then, under the direction of an interventionist, confronts the addict in an effort to convince him to go to treatment.  It’s a highly stressful, one-time event where all the focus is on the addict and how he has a problem.  This model doesn’t typically address just how sick the family is, and believe me, the family is just as sick as the addict, if not sicker.  If the intervention is “successful,” the addict is shipped off to treatment and the family hopes for the best.

One of the drawbacks of this model is that because of the earlier, secret planning by the family, they have warmed up to the idea of the addict entering treatment, but he hasn’t.   Then because the pressure to go to treatment is sprung on the addict en masse at the intervention event, and some would argue in a shaming way, it’s no wonder he is “resistant” or unwilling.   Moreover, since all the focus is on what’s wrong with the addict, rather than looking at the illness in the entire system, it’s no wonder he’s pissed.  As many treatment Admissions Directors will tell you, it’s a recipe for anger and resentment, and the addict often spends the first week or two struggling with acceptance at being there and being furious at everyone.

In the Action Intervention™ Model, in contrast, everyone is invited to a 2-3 day Family Workshop and there are NO secret meetings prior to them all coming together.  Over the course of a week or two, we coach the family on how to invite the addict to the workshop, one by one, allowing him to warm up to the idea that the entire system is suffering from the disease of addiction and that together, they’re going to work to change it.  By helping the family understand that addiction is perpetuated by enabling – that is, making excuses for the addict, bailing him out, giving him money, etc – we help them see that they have been participating in the progression of the disease.  This also serves to take the “heat” off the addict, and places it where it really belongs – on the disease of addiction AND enabling and codependency, and in so doing, reinforces the need for everyone to change, not just one person.

As I often tell family members, “You’re suffering from addiction.  You may have never used drugs, but YOU are suffering from addiction.”

As the expression goes, “Addiction is a contact sport.  Eventually everybody gets to play.”  In order for the entire family system to change, not just the addict, everyone needs to be involved in his/her OWN recovery process.  And when everyone is, not only are their better outcomes for the addict staying clean and sober, but there are better outcomes for the entire family getting healthier.