It is often the case that a friend or relative of someone who is drinking heavily
recognises that this has become a problem before the person themselves. Denial is an
essential component of becoming addicted to alcohol – after all none of us really like
to admit we have a problem with anything, and in the addictive process this tendency
becomes all the more pronounced. Denial is a major barrier in the way of overcoming
alcoholism – an absolutely essential first step is for the person to actually accept that
at least they might have a problem. If they are able to reach this conclusion, then they
will become amenable to speaking to an independent professional in confidence. If
they remain convinced that there is no problem, then it is highly unlikely that they
will wish to speak to anyone – after all – what would be the point? (they say to
In the paragraphs below, I summarise the techniques that can be used to convince
someone to overcome that first hurdle – acceptance of the fact that ‘they might have a
problem’. These techniques are based on an intervention used by professionals in the
field known as ‘Motivational Interviewing’. To use these techniques yourself will
probably be more difficult for you than for a professional – for the simple reason that
at some level you are emotionally involved with the individual you are trying to help.
As such, it may well be the case that the behaviour of this individual triggers
unpleasant feelings in you such as anger, exasperation, irritation, depression. It would
not be unusual if they have become violent towards you on occasions. If you are to
motivate this person to seek help you must do your best to stand back from these
feelings. I recognise that this is very easy for me to say, whilst being very hard for
you to do. However, you must do your best if you wish to maximise your chances of
success in convincing the person to seek help.
The bottom line here is that People Nearly Always Need to Make Decisions For
Themselves. This is not just related to alcoholism, but is generally true in life.
Someone is much more likely to want to do something if they feel that this has been
their own decision, rather than an ‘order’ from someone-else, or that they have to do it
just to keep someone else happy.
The essential ‘trick’ is to get the person to believe that they have made their own
decision to seek help. In fact this is not a ‘trick’ at all. Hopefully, the person really
will make their own decision to seek help. Your role will be to help them to reach a
stage in their thinking process whereby they are ready to make that decision. You will
not achieve this by lecturing or demanding or bullying or begging. You will achieve
this by developing a certain ‘attitude’ in your interactions with the person. You will
learn this attitude over time by implementing the techniques below. It won’t come
easy at first, but keep on trying and eventually it will become second nature to you.
There is an acronym for the techniques you must implement – FRAMES. Try to
remember this as a first step in modifying YOUR behaviour in order to get the best
out of the person you are trying to help.
Really, these are in the wrong order. It should read: FRESAM. Stage one of learning
these techniques is about Feedback and Responsibility. Stage two is about Empathy
and Self-efficacy. Finally, as the person starts to accept that they might have a
problem with drinking, Advice and Menu of options comes into play.
Next page .. Stage One: Feedback
The above information is copyright of Dr Bruce Trathen MBBS MRCPsych (2006). ISBN 0-9545164-0-0. The author grants permission for these guidelines to be downloaded, copied and distributed freely, but does not grant permission for their sale.