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STOP Saying this About Your Loved One in Addiction

While well intended, this phrase can have devastating unintended consequences.

"They have to want help"

In nearly every conversation about mental health and addiction recovery, this phrase is passed around like candy. Let me break down why I think this kind of thinking is really harmful, and how it gets in the way of both our compassion, and effective pursuit of treatment for individuals who may be struggling.

Before I get ahead of myself, let's make one thing very clear:

People who struggle with substance abuse and the mental anguish that goes along with it, do not actually enjoy their affliction.

We sometimes hear partners say “Why should I have to have all the responsibilities when he spends his whole day drinking and having fun?”

When it comes to addiction, it’s no longer about fun. Addiction takes a fun thing, and turns it into survival, self-sabotage, and a spiraling cycle of despair and depression. It’s an attempt to self-regulate, by way of external chemicals. While the moments of highs and drunkenness may look like a party, I promise you, the cycle of addiction is anything but.

If a genie showed up and said "I can snap my fingers and you will no longer struggle with mental illness, and also, nothing bad will happen. There's no catch" - no person struggling with addiction would say, "nah, no thanks, man, I enjoy having crippling episodes and dangerous relapses, while watching my money and sanity disappear faster than I can save it."

Because of this, it’s not a matter of them not wanting help. It’s a matter of presenting help in a way that is appealing, seems beneficial and does not trigger the intense feelings of shame that are so often linked with addiction.

If someone struggles with mental illness and you say "there's something wrong with you, go get help" you just put a huge barrier between them and any potential willingness they would have had, to discover different ways of being, because you made them wrong. You decided not to accept them for who they are in the first place. Why would someone want to change for that?

This idea that mentally ill people need to have sudden, miraculous moments of clarity to deserve being given compassion, support, and functional recovery options is not only ineffective, in cases of addiction and depression, it gets people killed.

Has it ever occurred to anyone that perhaps a resistance to treatment might be a symptom of many mental illnesses? So what's the solution there?

If the only answer is "they have to want it" or they don't get the help they need, that just means that millions of struggling people will never get the help they need.

Sorry, but that's just not fucking good enough for me. As a person who's struggled with life threatening mental illness, and for a long time wasn't getting help (and didn't think she needed it - for the reasons I’ve mentioned here) it took a different entry point into recovering than "admitting I had a problem". And I'm glad I got there, and didn't have people ditching me and bashing me right and left.

"Shame and blame" may occasionally result in enough pressure to get someone to accept help, but it's not a generally effective rule to pursue supporting someone with mental illness.

Maybe the problem isn't the person with the mental illness. Maybe the problem is with us, and how we are treating them.

“But Cory,” I hear you say, “You can’t force someone into treatment. Legally they have to want it, and it’s impossible to make it appealing. We’ve tried everything, we’ve even tried explaining to them that they have a disability. Nothing works. You just don’t understand how hard it is!”

I totally hear you, it can be really hard to make recovery appealing, in a society that stigmatizes mental illness, addiction, and even disability. If this is what you’re thinking at this point, I want to assure you, I’m speaking from experience. I know exactly how hard it is.

I have helped many loved ones who were resistant to treatment seek and get into treatment. I've also screwed up royally and ruined all hope for someone pursuing treatment, by the way I tried to "force them into it". It can be difficult to make treatment appealing, but as someone who has successfully done exactly that, I can tell you for certain, it’s not impossible. .

If it was impossible, no one would ever seek treatment. But many people with mental illnesses do recover, so it begs the question, why do some decide to pursue recovery and others don't?

I have every idea how hard the struggle is, because I've been on both sides of it.

Here’s a very important semantic distinction.

I didn't say "they don't have to go willingly". They do. Willingness is required. It’s very difficult to force someone into treatment, and when people are forced, it’s also less likely to stick. The goal here is willingness. But that’s not the word we use when we talk about it, is it?

“They have to want help”

The issue here is with the idea that they have to "want it". As in, they have to have a desire for treatment FIRST.

There's a huge difference between want, and willingness. We can willingly do things we may not like, or may not fully buy into, or may be skeptical about but are at least willing to try.

Instead of saying “they have to want help” it would be more accurate to say “they have to go willingly”

By law, you have to willingly receive treatment. The word "want" isn't used, legally. I’m not suggesting forcing anyone to do anything against their will. Many mental illnesses include a symptom of denial or refusal of treatment. To suggest that those people cannot develop a willingness to receive treatment is more indicative of our inability to present options in an appealing way, than it is of the “flawed” nature of their worldview (more on this in a future post). Everyone is still making choices based on what they THINK is best for them. If someone is refusing treatment, it's because they don't agree that it's best for them. To tell them they are wrong, and broken puts distance between them and help - it further solidifies that those trying to help simply do not understand. People will defend their beliefs, especially beliefs they hold about themselves.

In my experience, I've gotten a lot accomplished by respecting people's autonomy, and respecting the validity of their experiences and choices, even if I don't understand them first hand. When I tried to explain to people that they were broken and needed my help, it seems to have always gone a bit south.

Listening to them goes a long way. Did this blog post help you? If you're looking for more answers for a loved one struggling with addiction, schedule a free connection call with me.


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