Citations & Excerpts

"Do Drug and Alcohol Interventions Really Work?"
By Kate Jackson
January/February 2006

BRUCE COTTER
…A graduate of the Johnson Institute, interventionist Bruce Cotter has broken from tradition and developed his own model of intervention. He started out the usual way, he says, because he didn’t know any better. He did what he was taught to do, gathering groups of concerned people to confront the loved one. They wrote and read letters and stated their terms, and the impaired person most often capitulated and went off to the selected treatment.

Cotter, author of When They Won’t Quit: A call to Action for Families, Friends and Employers of Alcohol and Drug-Addicted People, a primer on interventions, became increasingly aware that although the people went to treatment, they did so only to get their friends and family off their backs, and the process made them extremely angry. This anger, he says, impeded their progress and stood in the way of their ability to process treatment. “They were furious, and many of them would just put in their time or leave in five days or a week. They felt verbally bludgeoned because it’s a humiliating and embarrassing kind of confrontation.” The whole process, he says, only exacerbated the pain of the people already in bad shape.

Circumstances forced Cotter to intervene alone with one client, and the success convinced him to change his approach to a one-on-one intervention. Now, he says, those intervened upon are far less angry, tend to stay in treatment, and do far better than those who participate in the more traditional sort of intervention. Treatment for Cotter, as for Koralek, is not negotiable.

However, Cotter says, “I firmly believe, to encourage others to wait until a person “hits rock bottom” is totally and dangerously irresponsible and will serve to keep morticians busy and cemeteries full. When people tell me want to wait until a person “hits rock bottom” before they step forward to offer help, which they do daily, I simply tell them when a person hits bottom, one of two things will happen: They will either bounce or go splat. Then I ask, “Why wait to find out which it will be?”

“There really aren’t many choices because by the time they call me in, the person is in a very late stage and usually needs inpatient treatment badly,” says Cotter. He makes them feel that the choice is theirs, however. His goal when he sits down with someone is for it to become their idea to want to do something about the problem. “No one likes being told what to do, deep down, least of all alcoholics or drug abuser. So I have to make it their idea.” His version of an intervention, he insists, is a conversation, not a confrontation, because he wants to engage them in the process. “I want them to start telling me things, and when they do, they’ll eventually come around to seeing that the prudent thing to do is to get some help and go to treatment.”

A recovering alcoholic, Cotter believes he understands the needs as well as the denial behaviors of his subjects, and by sharing his experience, he’s convinced that he can make a connection based on mutual understanding. “They’ll talk to me differently than they will to their spouse, child, boss, brother, clergyman, or physician,” he explains. “They can open up with me because ‘I’ve been there, done that’. I know what they’re feeling.” This knowing, empathetic ear, he suggests, helps him build a bridge for the client that will illustrate the damage they so vociferously deny. They’ve got their life problems on one side and their drinking on the other. Good solid treatment, he says, lets them see that connection between the two.

Interventions are essential, he insists, because the substance abusers are unable to recognize that they have a problem, despite the depth of their suffering. “Addiction is an incredible thief,” says Cotter. “It steals your money, your home, your job, your self-esteem. The addicted are people with great self-loathing and are 99% suicidal, if not be the act of actually picking up a weapon, then to the extent that they are drinking themselves to death. They’re living on the edge, and they don’t really mind a hell of a lot. That’s when I’ve got to bring them back from that brink.” He’s convinced, however, that the majority of interventions – those that are confrontational – merely degenerate into family arguments and end poorly. The impaired, he says, are already sick, and in a typical intervention, they’re verbally beaten up.

Speaking as a former substance abuser, Cotter says, “We don’t need to hear that. Our self-esteem, our pride, confidence and ego are shattered and then the people who are most important in our lives come and tell us we’re even worse than we thought we were. It’s fraught with negatives.” His method, he insists, is full of positives. “I come around and sit on the same side of the desk, so it’s the two of us addressing this problem. Now they’re not doing it alone. It’s always we: ‘We can get this thing done.’”

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