Many individuals engage in self-destructive behaviors. These can include addictions, gambling, eating disorders and other problems. Often, the person is not aware of how serious the situation is, since the mental health problem that they have is clouding their judgment. For example, a person with anorexia is quite literally unable to see just how thin they are – they see themselves as fat despite all evidence to the contrary. People with addictions, be it to substances or to certain behaviors, also fool themselves into thinking that they can quit at any time, that they have full control or that they are just having fun. These types of issues severely affect the person’s ability to think critically in relation to the problematic situation.
The loved ones of the person who is engaging in this behavior often feel powerless to stop them. An addiction or an eating disorder doesn’t only hurt the person who is engaging in these behaviors, but also the people around them. Sometimes, an honest face-to-face conversation can help the person realize there is a problem, but often a more serious tactic is needed. These are the cases in which an intervention can be used.
What is an intervention?
It is a planned meeting where several people who care about the individual involved in self-destructive behaviors confront him or her about it, speak up about their concerns, propose a solution and discuss alternatives. An intervention is a process that needs to be addressed carefully.
An intervention team usually involves friends and family, although it can also include a clergy member, a teacher or a colleague, depending on the situation. These are people who care about the person and who want to help, although people who are very confrontational or very angry at the person may be left out of the team for the moment. The idea is to address the person calmly and rationally, expressing one’s emotions without attacking.
It’s a good idea to work with a professional interventionist to develop the most effective intervention. They can help each person figure out what to say and propose treatment options, as well as suggest what can be done if the person rejects the intervention. If there is a risk of violence or self-harm, it’s especially important that a mental health professional is involved in the intervention process.
The first stage involved planning. The team is formed, and each person needs to decide and write down what they will say and rehearse it, consulting with each other and with the intervention professional. The intervention team will need to gather or prepare information about the person’s behaviors to have clear examples of why they are self-destructive. The planning process needs to be thorough and not done in the spur of the moment. The team needs to be well-prepared. It’s also important to keep the intervention a secret from the person it’s directed at, since they can seek ways to sabotage it or prepare to ignore it or confront it.
The actual intervention meeting needs to be prepared at a comfortable time and place. The person should be invited there without being warned beforehand.
During the intervention, it’s important that the team follows the plan they have, up to what they say and how they sit, to avoid confusion. Each person will need to express their concerns, show examples of the self-destructive or harmful behaviors, talk about their feelings in a non-aggressive manner and address the issue directly. The team should propose a treatment plan, including hospitalization in some cases, anonymous help groups or other options, depending on the situation. It’s also important that the team presents an alternative, stating clearly the consequences that will happen if the person does not accept the treatment. These consequences can be asking the person to move out or cutting financial support. It’s important to state that all the members of the team will support the person if they choose the treatment, but stay firm in relation to the consequences.
Attacks, insults and similar tactics should be avoided. The process needs to be done in a calm manner without losing track of the plan. However, honesty needs to be present – the team members need to state what they are feeling and how it is affecting them. A good idea is to use “I-statements” (“I feel that…”) and focus on the consequences of the behaviors rather than blaming the person directly. Any objections the person has should also be addressed calmly. In general, it’s a good idea to brainstorm possible objections and come up with rational and calm responses.
It’s important to ask the person to make a decision right away. They can try to stall in order to deny the situation, for example, or otherwise try to avoid making a decision.
An intervention can be helpful, but in the end the decision to acknowledge the problem and to change is up to the person. If they choose to deny the situation, react violently or refuse treatment, that is their choice.
If there is violence or danger, if the person accuses the intervention team of betrayal or reacts in a similar way, it might be necessary to leave the situation, something that is especially true for the spouse and children. If the person refuses treatment, it is important to go through with the consequences. This has the chance of being good for the person, since it can make it very hard for them to deny the situation any longer. Not going through with the consequences encourages the self-destructive behaviors, since it comes off as an empty threat and shows the person that the situation can continue on as before.
An intervention gives the individual a plan for action and shows the support of their loved ones, but in the end it is up to them whether they decide to take it or not. However, removing oneself from the situation or enforcing the consequences can help the person realize that they do have a problem.