One of the biggest questions that families have asked me recently is: will the intervention traumatize my loved one? The first time I heard that I instantly thought: We do not want to harm your loved one, they have been hurt enough!
In truth, this is a fascinating question which demands unpacking. First, let’s look at the definition of trauma.Trauma is an “overwhelming experience that cannot be integrated and elicits animal defensive mechanisms and dysregulated arousal.” Larke Huang, Director of Health Care Equity at SAMSHA, puts it this way: “A stress that causes physical or emotional harm that you cannot remove yourself from.”
Trauma is subjective. This means the person experiencing the trauma may feel like they are not good enough, smart enough, etc. The trauma may have started with being humiliated, shamed, bullied, or embarrassed and grew from there. As such, the person may replay images and memories in their head: being told they were stupid or not good enough“if only I could of stopped my parent from killing himself” or “what could I have done better to not get fired, how could I have stopped?”
Though trauma is subjective to each individual, the trauma may have an objective dimension such as witness to a crime, a sexual assault, experiencing a national weather disaster such as fires, running while people are being shot at in the recent school and synagogue shootings in the USA, watching a fellow soldier be shot, being injured in combat, domestic violence and sexual assault, etc. Not all folks respond in the same way to either objective or subjective occurrences. It has been found that people who have been exposed to 4 or more objective or subjective events may well experience PTSD.
With this cursory knowledge of trauma, we may now investigate interventions. An intervention, in its simplest form, is a highly stylized invitation to change in which family and friends gather to invite their loved one to get the help they need. I have, as have others, written about the surprise, invitational and action processes. There has always been some degree of controversy over the surprise method of intervention being seen as a planned-out ambush that takes the dis-ease hostage while the invitational approach has been seen as more benign, softer and more respectful. The reality is both in the eyes of the beholder can be seen as an ambush, causing anger to rear its ugly head.
At best, participants bathe the identified patient in a sea of love while also sharing, in a compassionate non-judgmental way, the recent incidents that have scared and alarmed them. These alarming behaviors often includ lying, stealing, dropping out of school, driving under the influence, not taking care of their newborn, not performing at work, getting arrested, etc. Even though this is presented as compassionate and loving-care, the person at the center of the intervention may become furious that loved ones have gathered and are daring to expose their demons.
So how does trauma play a part? In doing an intervention it’s important to note that all are wounded, (Family, friends and the ILO Identified Love One) all of the participants feel to some degree inadequate, embarrassed, humiliated, bullied, shamed, etc. because they have failed in getting their loved ones attention or failed because too often they looked the other way. Or the person may even feel like the heroine in Gone With the Wind when she says, “Tomorrow is another day.”
The truth is that it is important for all participants to believe in the process and to believe change is possible. I prefer an invitational approach so that there are no surprises when organizing a meeting. I start by having my clients share that they have a problem at home that is bigger than they can solve. We then have a family meeting. In doing so, that will diminish the elements of surprise and open the door to compassion.
The interventionist must guide participants carefully as the goal is to help the person go to treatment and not tear them apart with judgment. This is not a trial and there are no judges. If there are folks in the intervention who also can be singled out for having an alcohol or other drug problem, they are encouraged to share.
“I know I too drink a lot and use mind altering drugs. However, today is about you not me. I want to make amends to you for giving you drugs and alcohol and using with you. I too am open to help. I feel frightened as once you start you can’t stop. I do not want to lose you to this disease.”
How a professional approaches their client and their family will ultimately become an imprint on their hearts and minds. Mrs. Betty Ford, a pioneer of intervention and recovery, was intervened while she was still in her robe and nightgown and was not given the dignity of being dressed. As a leader in the field she made sure all were treated with respect, no smack-downs or lock downs.
If you look at the identified loved one who is wounded, who is experiencing a substance use disorder, who may have mental health anxiety, depression, bi-polar, border line tendencies, etc. and imagine the family as having done the best they could do and are now open to changing, then as a professional you can approach the whole family.
Everyone wants to be treated with love, compassion, directness, and determination to save a life. Looked at in this perspective then, the notion of traumatizing or re-traumatizing a person because you are trying to save their life gently falls by the wayside like a leaf gently falling from a tree on an autumn day.