Hi Dr. T.,

I’m writing to you because my husband is an alcoholic and his drinking has been out of control for years now.  Recently though he got his 3rd DUI and he’s getting even worse.  His drinking is ruining his life & he’s taking me down with him too.  It’s affecting pretty much every area of our lives at this point. 

He’s been able to stay sober in the past for as long as 9 months.  I keep getting the advice from other people that John is not going to stop drinking until he wants to stop, not because I or anyone else wants him to stop.  This makes sense, but I just don’t know what to do with that – am I just supposed to accept that our lives are at the mercy of his addiction? 

One of the most frustrating parts of this is that his addiction has turned me into a nagger.  He constantly is telling me to ‘get off his back’  and to ‘quit nagging him’ – and the truth is he’s right – most of my interaction with John these last few months has been about me trying to get him to see the cost of what his drinking is having on us and to try to get him to stop.  Unfortunately the one way I know how to do this comes across as either nagging or threatening him. 

 ~Janet

 

Dear Janet,

It sounds like you are feeling frustrated and stuck, and for good reason! With all the feedback you’ve received from friends, family, and John it is very easy to feel confused and angry in this situation. I also hear that the way you’re interacting with John doesn’t quite fit with how you would like to interact with John. I haven’t met too many people who say that they want to nag and threaten their loved ones. I imagine that it feels uncomfortable and irritating to have nagging as your main communication strategy with John. It sounds like you’re looking for a different way to be with John that will make you both happier, and perhaps, will still let John know that you think he needs to stop drinking and get treatment.

First, I want you to know that nagging and threatening are very natural ways to act when we have addicted loved ones. The pain and frustration of seeing a loved one continue to use or drink, despite all the negative effects (such as John’s 3 DUIs) can stop us from acting and communicating in more positive ways. In upcoming months we’ll talk a lot about tips and tricks for how to improve communication, but for now I’d like to focus on using some tools from behavioral science that will help you improve your relationship with John and support his sobriety.

In order for the tools to work, we need to set aside the idea that an addicted loved one has to want to stop drinking before they can actually stop. If this was true, then many of the people I’ve treated would have never improved in therapy. People decide to quit drugs or alcohol for a variety of reasons, and we know that even people who are required by the court to go to treatment can be successful and become sober.

The thing is, people with addictions often see their use in different ways at different points in time. For example, they may be more or less motivated to stop using on any given day. Janet, think about any habits you’ve tried to change — whether it’s smoking, diet, or getting better sleep. You’ve probably experienced a desire to change along with a desire to not change or that change just isn’t possible. The sense of “I want to/need to change” and “I don’t want to/need to change” is what we call ambivalence. It’s like a tug-of-war — sometimes the “change” side pulls harder, other times the “don’t change” side pulls harder, and sometimes both sides pull equally hard. What this means is that at any point, John may be feeling more motivated to stop drinking, less motivated to stop drinking, or neutral about changing his drinking. Since motivation is a moving target, it means that that there are many opportunities to intervene! We also know that we can do things to help promote change and to make continuing to drink a little less easy.

Luckily, we don’t need to go into the details of behavioral science in order to use the tools to change motivation and actions! There are two tools from behavioral science that I think can be helpful to you Janet, as well as others in similar situations.

Tool 1:  Rewards

This may sound kind of strange, but rewards can work in situations like the one you’re in Janet. Lots of research has shown that rewarding positive behaviors, or behaviors we want to see more of, results in more positive behaviors. Additionally, it’s typically more fun to reward positive behaviors than to nag and threaten (bonus)! I’m guessing the behavior you want to see from John is sobriety. If that is the behavior you want, start rewarding it. Whenever John is sober you can reward him for his sobriety. There are lots of rewards that you can use. The trick to finding the more powerful (i.e., more likely to encourage sobriety) rewards are to think about what is rewarding to John. A reward is only as powerful as the amount John wants or values the reward. Another point about rewards is that they can be free or simple, as long as John values the rewards. Here are some ways to start identifying possible rewards for John’s sobriety:

  • What sober activities does John like to do?
  • What sober hobbies/interests does John like?
  • Before John drank as much, what did he like to do? What did he talk about doing?
  • When the two of you first started dating, what sober activities did you do?
  • What are the rewards for John’s drinking (e.g., drinking makes him more relaxed)? What are ways to achieve those same rewards without drinking (e.g., getting a massage to relax)?
  • Lastly, don’t underestimate the power of your love and caring. Genuine praise, words of support, touch, and attention can be very powerful rewards and you can use them to support his sobriety.

Janet, if you like this idea and want to learn more about using rewards instead of nagging and threatening, I’ve written more about it in this post[JBL1] .

Tool 2:  Stepping Away

Despite our best intentions, we may unintentionally reward drinking. Even when we’re yelling or nagging someone when they are drinking, we’re giving them attention, which can be a powerful reward. If the communication and connection in the marriage is bad, even negative attention can be rewarding, because at least you’re talking to and engaging with the person. It may be easier to think of the idea of unintentional reward when we view it through the lens of parenting. All of us have probably been in a store when a child begins to whine for a toy or some candy. The child’s whining grows and grows and grows until finally the parent finally gives in and says, “Fine! You can have your toy!!” Unfortunately, the harried parent has accidently rewarded the child’s whining and the child is probably more likely to whine again next time he wants something.  Similarly when we have addicted loved ones, we can accidentally reward using by giving our attention to them when they are using (even if that attention consists of yelling, fighting, or complaining).

So, if attention (even negative) can actually reward drinking, then what is the alternative? Stepping away. Stepping away means removing your attention, your talk, and even your presence when your loved one is drinking. John doesn’t like it when you nag, you don’t like it when you nag John, and nagging John can accidently reward his drinking. So what do you do instead?  Step away. Here’s an example of how to do it:

  1. When John is drinking, you may say something like, “I’m sorry you’re choosing to drink right now. I don’t like being around you when you’re drinking and I’m going to go for a walk [or some other activity that takes you away from John].” As best you can, stay calm and matter of fact when you let John know that you won’t be around him when he’s drinking (tough I know!).
  2. Physically walk away. Remove yourself from John’s drinking. How long you stay away is up to you. I encourage you to experiment with the length of time. Whatever you do, don’t go back into a situation where you feel unsafe. Also, don’t go back into the situation if you’re going back into it to tell him off, threaten him, or give him any attention. Remember, your attention is a powerful reward!
  3. Remember that you’re doing something good for you and your marriage by stepping away. You may even feel proud of yourself for acting differently in this situation. It can sometimes be hard to step away when what you really want to do is fight and nag, so give yourself some credit for doing a hard thing.
  4. Use this time as an opportunity to reward yourself. Something that I recommend to family members when they are stepping away is to do something enjoyable, take a break, get out of the house, or call up a good friend. Stepping away will be more effective and enjoyable for you if you do something that is rewarding to you whenever you step away.

Janet, I hope the information and tools that I’ve talked about in this letter are helpful to you. I want you to know that you are not alone and that regardless if John stops drinking or not, you have reached out for help and that in and of itself is something to be proud of.

Warmest regards,

-Dr. T.

 

For more information on this topic, we’ve written more about it in the series of three posts below.

 

If you connected with Janet’s situation and the advice I suggested above, the two books below are great resources for learning more about how to approach your loved one effectively. We highly recommend them.


Get your loved one sober:  Alternatives to nagging, pleading, and threatening is a fantastic book for family members who have a loved with a drug or alcohol problem and where the person isn’t willing to seek treatment. We use this with almost all the family members we work with at Sober Families.

 

Beyond Addiction: How Science and Kindness can Help People Change, is a newer book that comes from the same perspective as Sober Families. It offers a warm, optimistic, and encouraging approach to helping family members change. This is a great book for families who are looking to help their loved one and want concrete things that they can do that will help.

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