Expert: Peter L. - 10/26/2011

Question
My brother has struggled with life ever since I remember. Growing up in a very unstable home with alcohol and drug abuse, from both parents, and eventually ending up in my dads suicide, is the start he's had in life. Although he drank before and made many bad choices while he drank, after our dads suicide and his wife announcing divorce he spiraled out of control. His drunken times [which were often] consisted of calling and harassing the family, saying things like we don't care about him or love him. If we try to talk to him or help him he rages and gets verbally abusive, the whole time denying he is drunk. He has even gone so far as to go to the police station to get a breathalyzer to "prove" he hasn't been drinking. After going through this for several months he finally admitted his problem and went through a 13 month program at teen challenge. He really seemed to be doing well. He graduated about a month ago and despite our support and him staying out of the area with family at a well organized ministry, with a good job, and having his daughter every weekend, he began suspicious behavior about 2 weeks ago ending in an obviously drunk man just a few days ago. It has been confusion an chaos ever since as he denies his drinking and harasses the family once again. though truly it is worse because he has become much more dishonest and manipulative. We need some thoughtful and real help soon for I fear if we don't he will end up hurting or killing himself or someone else. I feel it important to add we are a bible believing Christ professing family, having turned to God for there is no hope apart from him. Yet I find myself asking why, why did he turn out this way and not my sisters and I. So, after feeling like we have tried everything what now? Is a mental hospital the right choice, for his behavior goes well beyond anything normal, it's insanity. should we shun him, at least until he's willing to admit his problem again? We can't help him until he does anyway. I thankyou for any advice you can give. Godbless.

Answer
Hi Leah,

One resource I refer people to often is this piece called the The Addict's Dilemma:
http://www.bma-wellness.com/papers/addicts_dilemna.html.

It helps to explain the seemingly paradoxical nature of addictive disorders.

I frequently get messages from family members looking for solutions for problems similar to those you present in your message.  I first let people know there are no easy pathways to dealing with addiction.  One point I do stress, however, is that in my view there should be a limit to how much the family sacrifices in their pursuit of helping their addicted family member.  I say that because often over-involvement by the family can have a negative effect.  There is a fine line between being acting with dedicated helpfulness, and being codependent. Codependency can give the alcoholic/addict "tools" with which to sustain the addictive behavior.  

I have had clients respond only when given the "bottom line" from a spouse, relative, or someone else significant in their lives.  The ultimatum is not a guaranteed strategy, however, but it is readily apparent why people close to the addict/alcoholic use it: They are at a loss, and burned out.  Addictive behaviors are enormously destructive to all involved, and I feel there should be a limit to what family members offer.  

Many addicts and alcoholics will tell you they were driven to change only when "hitting bottom."  I have seen this phenomenon so many dozens of times that I feel it is only when the price of using a substance is too high will there be an effort to stop.  Substances provide powerful benefits to the person using them, and they sense a great loss when they contemplate terminating that use.  It is a "death" of sorts.  

At this point I would ask your brother what he wants to do at this point.  If he denies any further that he has a severe addiction, you have all the information you need, that his relationship with alcohol is more important than his relationship with all of you.  Perhaps he should be free to pursue that relationship, and relieve others of the responsibility of trying to intervene.  

If he admits he's got a serious problem and needs more help, encourage him to go back to treatment and stay in it.  He needs a combination of treatment from inpatient/rehab to outpatient relapse prevention.  That whole course of treatment might extend 1-2 years.  Anything less and he won't make it, and you all will become more frustrated, angry, and jaded.

It's his call.  You only need listen to his choice and respond favorably. If he's in treatment, reward him with positive comments and encouragement.  Tell him you're all there for him -- but he has to follow the treatment plan.  If he drops off of it, he's in a state of relapse.

I hope this is helpful.

Peter