Using Compassion & Empathy to Engage With Loved Ones With Substance Illness

 

Written by and for people with Lived Experience

Today’s Learning Moment – 09 21 20 Issue:

Using Compassion & Empathy to Engage With Loved Ones With Substance Illness

Loving someone who is struggling with mental health disorders such as substance dependence illness is one of the hardest things anyone can experience. Listening to your loved one and helping them recognize that you hear how they are feeling and what they are saying is the simplest and most effective way to create a partnership with your loved one. Remember that always. 

They are most likely struggling with more than one mental health disorder which can complicate things as they struggle through the seemingly poor decisions and the consequences of their decisions. The person you love who is struggling with addiction is struggling with the daily gruesome internal fight not to use. Most often it seems the need to self-medicate, numb the pain of the failures and the horrors of trauma, wins out. Your loved one sincerely promises….again and again… to remain abstinent, and doesn’t.  All of this seems to stand in the way of loving them the way you would like to.

Quite simply numbing feelings and medicating is why people, suffering in addiction, use drugs/alcohol. It is not meant to hurt you even though it does, endlessly. For them, It’s always about easing their emotional suffering and pain, - at any cost. And you are grievously hurt because of it.  So it seems almost impossible to speak with and listen to your loved one when you feel so helpless.  But there are ways that you can create a safe and open relationship with your loved one. There are ways to work through your pain and their humiliation of substance illness.

How we interact with them can cause alienation, especially if we confront, cajole, belittle or threaten. Any communication strategy we use must start with staying connected. The goal is always to strive for partnership status in their illness. Let’s look at some real tools and tactics you can use.

As we said above, listening is likely the most important thing in your relationship with them.  When you listen you let your loved one know you have heard their story.  You don’t have to agree or even like their story but just acknowledging their story helps validate their experience and build trust with you.

One great listening strategy is reflective listening.  Simply put, you are a mirror for your loved one.  There are various ways to reflect back what you’ve heard.  You might repeat back exactly what was said, you might paraphrase, you might add an assumption or observation to what was said.  You might reframe their statements into something more positive.  There are many ways to use reflection and many resources to explain the various types of reflection.  In the end, reflection is even more powerful than questions as it lets the person know you’ve heard what they said and truly engages or motivates them more in the conversation.

Using open-ended questions are very effective.  It’s not about “leading” your loved one to say what you want to hear. It’s about discovering their journey, what they’ve experienced and how they feel about it... “What happened then?”, “How did that feel?”.  Open-ended questions allow your loved one to explore the issue more generally and can help both of you zoom in on realizations.

Discussing times when your loved one did things well can be helpful.  Building self-awareness of successes is an important way to help boost strength, possibility and hope:  “A person won’t change unless there is enough to lose if they don’t change and enough to gain if they do”.  Building possibility and hope is far more effective than imposing guilt, shame and punishment.  Your loved one needs something to look forward to.

A really good tool to help build hope and look at the consequences all at the same time is something called the decisional balance grid.  Basically, it poses two questions that look at pros and cons.  The first question is. …“If you were to continue using your substance just as you are now, what would be good about that?  What would be bad about that? … Then:

“If you were to change your substance use somehow what would be good about that?  What would be bad about that”?

The goal is to come up with a list in each column under each question.  Several things come out by doing this.  Barriers to change are identified through bad things about changing and good things about not changing.  Also, you are both looking for the list of bad things about not changing being much longer than the list of good, and the list of good things about changing is a much longer list than the bad.  This is your loved one telling you what they need to do and what their preferences are, not you telling them.

We all know how hard it is just to start looking at any of the bad or horrible things that have happened in our lives. It's like standing on the highest diving board, or cliff and making that decision and actually jumping off into the water below.  These strategies can be an enormous help in helping your loved one get “ready” to change.

So yes, loving someone who is suffering from the horrendous symptoms of addiction is complex and one of the hardest things you will do in trying to support your loved one. Using these ideas about listening and validating and collaborating will show that you have compassion and will help you feel calm and focused on dealing with your loved one. Compassion opens the door to empathy. Empathy will help you understand the issues and create a safe space for your loved one to let you know what they need, what works, what doesn’t work. And most of all, they will feel okay to let you know that they really do love you too because they trust you to listen.

Lastly, all of this almost always happens in tiny baby steps. You may have this conversation many times before they are ready to choose to move away from substance use. Remember, they have self-election. Resist pushing their choice. They must choose the road to healing for themselves

Authors: Ben Goerner & Ron Merk 2020

The principals described here are taken from a technique called Motivational Interviewing used by medical professionals helping substance illness patients to move forward in making healthier choices around their substance illness. This article provides basic MI communication principals that can be used by families supporting their loved ones with substance illness.

References

https://www.mcgill.ca/familymed/files/familymed/motivational_counseling.pdf
https://www.ncbi.nlm.nih.gov/books/NBK64964/
https://www.psychologytoday.com/ca/therapy-types/motivational-interviewing

Families Helping Families is an initiative of the Port Alberni Community Action Team. We send out “Learning Moment” articles regularly to help folks understand substance illness. Knowledge is vital in understanding the illness of our family members. You may copy, distribute or share our articles as long as you retain the attribution. You can be added to our distribution list by dropping us a note to: albernihelp@gmail.com