Learn / How to Talk to a Loved One About Going to Rehab: A Conversation Guide
It can be hard to talk about substance use disorders. And that’s especially true if your loved one is in crisis, or in denial about their condition. But these conversations are crucial, and they can have a hugely positive impact. If you’re concerned about a friend or family member’s substance misuse, these strategies may help you show them that rehab can help.
Remember that everyone’s journey is different. The following tips are only suggestions, and they may not resonate with everyone. As you prepare to talk to your loved one, consider their needs, goals, and values. By taking their unique situation into account, you can make them feel even more supported.
These conversations should not happen at random. It may not be appropriate to tell your loved one what you’d like to talk about in advance, because a person in denial may avoid the subject at all costs. However, you should show up for this conversation intentionally, instead of bringing it up in the middle of another activity. Even if you see a good segue, don’t take it. Remember the moment for a future date, and reference it when you start your well-planned conversation.
Choose a private, comfortable environment where your loved one is likely to feel safe. Decide who’s going to be there. Depending on the situation, it might be best to approach them one-on-one, or with a group of trusted family and friends, or even with a trained interventionist.
In a group, you’ll have support from more people, which makes it harder for your loved one to evade accountability. On the other hand, this dynamic might make them feel ganged up on or threatened. You know your loved one best; try to choose the format that you think will have the greatest impact on the specific person you’re talking to.
On the day of your meeting, make sure to care for yourself as well. Your emotional state will set the tone of the conversation. If you can approach them from a calm, centered place, you’ll be able to communicate much more effectively.
These conversations aren’t effective if anyone in the room is using substances of any kind. That includes you, and it includes substances that your loved one isn’t misusing. For example, if they struggle with the overuse of cannabis, it may seem safe to talk to them over a beer. It’s not. This can impair your judgment, erode their trust in you, and invite them to disregard your opinion.
It’s important to set an example for your loved one, through both your words and your behavior. Spending sober time together can show them that there are ways to connect with people without engaging in substance use. This is an extremely important part of healing, and may give them hope that change is possible.
This conversation is going to be hard, and likely painful for both of you. There’s no way around that. Your loved one may lash out at you, argue, or simply ignore what you’re saying. It’s natural to feel anger and sadness in response.
However, it’s absolutely vital that you remain level-headed. Don’t express your frustration to them. By engaging in a fight, you send the message that this subject is negotiable, and that you might be in the wrong. Instead, state your case as simply and kindly as you can, and listen to their response as a way of collecting more information. Plan a time to process your own feelings with someone else after the conversation ends.
It’s important to understand that having a substance use disorder is not a choice. Your loved one’s impulses may be outside their control, and caused by a combination of brain chemistry and adverse life experiences. This is because substance misuse activates the brain’s reward system1 “by directly raising the levels of dopamine. Although each addictive drug also has its own unique effects, which is why alcohol feels different from cocaine or heroin, stimulation of the dopamine component of the reward system seems to be a common denominator.”
Even if a person does not enjoy the feeling of being high, they may be driven to use substances in order to increase their dopamine levels. It can be difficult to see a way out of this cycle. And no matter how hard it is for you to be around their unhealthy behavior, it’s likely harder for them to experience it.
Despite this, people who misuse substances are still responsible for their behavior. It’s possible to hold them accountable for their actions, without attacking them or thinking of them as “bad people.” The best way to encourage change is to approach them with kindness, understanding, and respect.
You can be kind without minimizing the impact of their behavior. Be compassionate, but firm. This is your opportunity to share your experience of their addiction, with as much detail as you can. Talk about how their behavior has affected you, and how you’ve seen it affect them.
However, “brutal” honesty can easily turn into an attack. Instead, make simple, objective statements that brook no argument. For example, saying “you ruined my birthday” is an accusation. On the other hand, saying “you showed up 3 hours late on my birthday, and we missed our dinner reservation,” conveys the same idea through purely factual information.
It’s likely that your loved one has a different narrative than yours. They certainly have more information about their own behavior than you do, but they may also have excuses that you find questionable. These different narratives can make it hard to agree on the facts of the issue.
Denial is the tendency of people with substance use disorders2 to ignore their symptoms “in spite of evidence to the contrary.” This is a very common symptom of substance use disorders. If your loved one is in denial, they may try to argue with your version of events. You may be tempted to give in to their arguments, out of compassion or just exhaustion.
However, it’s important that you not give in. Doing so can validate their denial, and enable their substance misuse. Instead, accept that this conversation will be stressful for you both. That’s ok. While it may be painful in the short term, this particular type of discomfort may help them grow and heal over time.
Before you start the conversation, it’s best to do some research into your loved one’s options. Starting rehab can be very daunting, and people with severe substance use disorders might not be able to handle the logistics without help.
You may need their help with certain specifics, but you can certainly get started on your own. As you prepare to talk to them, try to answer as many of these questions as you can in advance.
In order to get this information, it may be helpful to talk to the admissions team at a rehab center. These experts have a great deal of experience helping people begin treatment, and they may have valuable advice.
Arrive at the initial conversation with specific resources in hand. Remember, though, that this is your loved one’s process, and not yours. Unless you’re their parent or guardian, all you can do is make suggestions. It’s up to them to decide how to proceed.
At the end of the conversation, it’s time to make a plan. If your loved one is receptive to your ideas, you can help them decide which steps to take next. This may mean any number of things, from attending a local support group to connecting with an inpatient rehab program.
In some cases, however, they won’t be willing to accept your help. If that’s the case, be prepared to set boundaries and care for your own mental health. Only you can decide what boundaries are appropriate here. However, if there are no consequences to their refusal, you’ll send the message that your opinion is unimportant.
If you’re struggling to set boundaries with someone who has a substance use disorder, you may benefit from learning more about codependency.3 This pattern of behavior often develops in response to dysfunctional relationship dynamics, and it may impact other areas of your life. After the crisis passes—either because the person gets help, or because you decide to step back—you may need to make time for your own healing process.
After you talk to a loved one about their substance misuse, it’s important to follow through on your commitments. If they accept your help, that may mean helping them get into a rehab program, advocating on their behalf, or just spending time with them. Alternatively, it may mean setting strong boundaries with them, or even severing the relationship.
People in the throes of substance misuse often lack structure. If you really want to help, it’s absolutely vital that you do exactly what you say you’re going to do. Don’t agree to help with anything specific unless you have the capacity to carry it out to completion. And in the same vein, don’t articulate boundaries unless you’re prepared to uphold them. Doing otherwise might just serve to destabilize the person you’re trying to help, and may even lead to further self-destructive behavior.
And remember that while this conversation is extremely important, it’s just one step. No matter how well or poorly it goes, life will go on, and both you and your loved one will move forward. You can’t predict or control the future. But you can set the intention to heal, and encourage the people around you to do the same.
If you’re looking for a rehab program for a loved one, you can browse our directory of rehabs, which lists key information like pricing, location, insurance accepted, and more.
Reviewed by Rajnandini Rathod
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