12/20/2024
This Article appeared in the NY Times today.
How to talk to a loved one about their drinking
By Emily Schmall
The holidays are a time of excess. Too much food. Too much drink. And sometimes an alcohol problem can masquerade as high spirits and good cheer.
The holidays can also be a vulnerable period for people struggling with alcohol or drug use. A drinking problem can “magnify that this is not a happy time” for all, said Patricia O’Gorman, a trauma and addiction psychologist in Saranac Lake, N.Y.
So what should you do if you see family members or friends drinking too much this season? It probably isn’t the obvious time of year for an intervention. But sometimes it’s the only chance we have to see loved ones we care and worry about.
Years ago, I came home for Thanksgiving, and immediately received a request from my mom. It wasn’t to make mashed potatoes or set the table. She asked me to help my sister find a wig. The night before, on a bender, my sister had shaved her head. And that morning in the wig shop, I decided to confront her about her substance use. I knew it wasn’t the right moment, but I was desperate to inspire some self-reflection. Alcoholism runs in the family, and I was terrified.
It was a disaster. I was not prepared for her defensiveness, or to keep my emotions in check. But experts say there are ways to talk to someone about their drinking without ruining the holidays — it’s all about time, place and tone.
Set the table for success.
Approaching someone about their drinking or drug use can be helpful, experts told me, but not when the person is high or drunk. So if you’re hosting a holiday gathering that includes the problem drinker, try making it alcohol-free, suggested Dr. O’Gorman.
Experts also advise against calling out someone in the family WhatsApp group or in the middle of a holiday meal. The person may feel ganged up on, and respond by withdrawing further. It could come across as public humiliation, and shaming people for drinking can deter them from seeking help, according to the National Institute on Alcohol Abuse and Alcoholism.
“Generally, the worse someone feels about themselves, the harder it is to make change,” said Laura Kwako, a psychologist and director of N.I.A.A.A.’s treatment and recovery division. She suggested looking for a safe, private place where a person is less likely to feel stressed or cornered, and staying composed.
If you feel too wounded by the person to speak calmly, consider handing off the job to someone less upset, Dr. Kwako added. “No one’s perfect at delivering this information,” she said, “but this conversation is about getting help for someone rather than airing grievances.”
Ask what’s going on.
Kimberly Kirby, a New Jersey psychologist who has helped develop a training program for families of people with addiction issues, recommended starting the conversation by asking questions.
You could say: “I noticed you got kind of wasted last night,” she suggested. “I’m wondering what’s going on. Does this happen often? Is there something you’re dealing with?”
Really listen to what they say, Dr. Kirby said. Then when it’s your turn to talk, she recommended being brief and to the point. “Be positive,” she said. “Tell them what you want, not what you don’t want.”
Dr. Petros Levounis, a professor of psychiatry at the Rutgers Addiction Research Center, said that it was important to express empathy. “Make people understand that you’re in it with them, that you don’t support the addiction but you support them,” he said.
Be prepared to be rebuffed.
The conversation might be uncomfortable. Many problem drinkers live in denial and will respond to a confrontation with defensiveness, Dr. Levounis said. In that case, Dr. Levounis said, it could be helpful to highlight discrepancies between a person’s ambitions and the reality of how alcohol has interfered with these goals.
Don’t judge yourself if the intervention doesn’t work, experts said. Accepting this possibility is a primary tenet of Al-Anon, a 12-step program for people affected by others’ alcoholism that was started by the wife of a founder of Alcoholics Anonymous. “Nothing we say or do can cause or stop someone else’s drinking,” the Al-Anon literature says. “We are not responsible for another person’s disease or recovery from it.”
Treat yourself compassionately, too.
One recent study estimated that more than a third of Americans experience negative health effects because of someone else’s alcohol use, and one in seven because of another person’s drug use, at some point during their lives.
Talking to a loved one about their drinking may inspire them to cut back or seek help. But even if it doesn’t lead to immediate change, it can be therapeutic for you to name the problem and say how you’re affected, said Dr. O’Gorman. She confronted both a sister and brother, neither of whom remained sober.
“It’s not all or nothing,” she said. Intervening made her feel that she had done what she could to help them, she said, and alleviated some of the guilt she felt about their illness.
And interventions can be productive, even if they don’t appear to be right away. They can disrupt a problem drinker’s fantasy that they’re not hurting anyone else. In my family’s case, it took years, and several more tough holidays, before my sister found the help to face her drinking problem. She has now been sober for 15 years.
