There is nothing you can do until they ‘hit bottom’ #MythBustingMondays

by Teresa McBean

I have few commitments; I have a host of good intentions.  One of my commitments is weekly attendance at our Family Education Program on Thursday nights. I attend unless I am out of town or sick enough to require an IV and suffer from a fearful expectation that I should be getting my affairs in order.  This is how committed I am to busting myths about Substance Use Disorder and providing hope and healing for families struggling with this dread disease.

These educational meetings support recovery by educating family members and loved ones of folks who have a Substance Use Disorder. We have a variety of speakers, all passionate about recovery.  Topics are all over the map but each one focuses on giving families SOMETHING to consider and apply in their quest for recovery.  Research.  Skill sets.  Interventions.  Contracts.  Resources.  The list is endless. 

The one common issue that participants unintentionally bring into every meeting is myths about Substance Use Disorder.  These myths are affecting their decision making paradigms and stifling hope of treatment.

The average first-time attender at FEP arrives battle scarred and weary.  Their loved one has been caught.  Maybe they OD’d or got arrested or mom found a drug stash in their sock drawer.  Chaos has erupted with crying and yelling and the promise of dire consequences that will last longer than God’s lifetime. 

It is so traumatic and scary and horrifying to find out that our loved one is using! The person comes to our group and may say, “I am just hopeful that THIS is their bottom.”  The shock has begun to diminish but there is some optimism that the person has been found out. 

Finally.  The bottom.  This is the most pernicious myth in the field of recovery. 

In meeting rooms, public defenders’ offices and hospital corridors we hear well-meaning but misinformed folks say, “I am sorry but there is nothing you can do until they “hit bottom”.  

This is an understandable confusion. Consider the baffling, cunning nature of the affliction.  Families try!  They send kids to treatment; they invest in Intensive Outpatient Programs; they go to therapists; they read books; they yell and scream and tear out their hair.  They burn through their savings and pull out their 401ks – if fortunate to have such things to draw from. All efforts may seem to result in no change. 

If I were living in this tension and someone came up to me in a meeting and said with a sad smile, “Hey, look.  This is really hard but you have to realize that until your addict hits bottom there is nothing you can do.” I have got to level with you – I would be tempted to hear that and for one tiny second (before the implications sink in) say, “Thank goodness.  I think I will go get a massage and manicure since there is nothing else I can do.”

Myths prevail because they often contain a kernel of truth.  In this regard, the vital truth is this: it is far better to have a SUD sufferer agree that treatment is necessary.  It is great if they have buy in.  It is wonderful if they agree with the treatment protocol professionals and caring loved ones advocate for them to try. And ultimately, long term recovery will require that the person acknowledges their disease and takes responsibility for managing it with a program that they find helpful. Most of the time, these attitudes develop over a long period of time and much farther down the road of recovery.

What is a bottom?  How can you measure it?  Who decides what it is? 

When we fail to slow down and think about this myth, we may soon find ourselves sitting around waiting for that mysterious bottom to bump the bum of our loved one so that they can rise from the ashes of their fall from grace and get on with life. If this is what a bottom is – sign me up.  Especially for the part that allows for me as a family member to get a teeny tiny bit of self-care.  But this is not the norm. This is akin to buying a lottery ticket and hoping that the payout covers our retirement needs.

Bottoms are often death or jail without access to treatment or psychosis or suicide.  Bottoms are heart damage, hepatitis, HIV.  Bottoms are simply the last place our loved one lands after a long, protracted fall off a treacherous cliff.

If “hitting bottom” is a myth, what is a better way to understand the intractable nature of the disease and the implications for treatment?

First up? We breathe.  We do our self-care, get our own support network, educate ourselves and find ways to rest so that we can have the energy for the long haul. We do not put our jobs at risk because we are surely going to need them.  We work hard to not blow up all our other relationships while we fixate on waiting for the bottom to miraculously appear.

We realize that although we cannot sit around and hope things turn around there are some things we are doing that are unproductive and not helpful. This is where education can help us adjust our expectations and think strategically about next right steps.

We can understand that there is no bottom and no top. What we have here is a long and winding road.  This is a chronic condition.  We will make many attempts to be helpful and it will be extremely frustrating along the way.  What works for one family may or may not work for yours.  What does not work for your family the first time you discover this problem may work 18 months down the road.

But do NOT wait for a bottom

If your first attempt to get treatment does not “take” – that is not the same thing as saying it did not work.  Every effort teaches us something. Here is what I know that I know that I know – find a way to figure out and move beyond unproductive efforts and dangerous myths. 

There are many, many small, medium and large things we can do that encourage our loved one’s willingness to seek treatment.  Although it is true that we cannot control or cure this disease with our good intentions, we have the capacity to bring more than our broken hearts and well wishes to the table.  We can learn how to advocate for recovery and create an environment that makes it more likely that our loved one will enter recovery.

One final thought. 

We do not have to wait for our loved one to get excited about recovery (the old hitting bottom and seeing the light on the same day trick).  But we can find ways to respectfully, lovingly, clearly, and directly provide a path for our loved ones to follow out of the darkness.  Have questions?  Join us at FEP – details at www.northstarcommunity.com.

Teresa McBean, Pastor
Northstar Community

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Teresa McBean

Teresa is co-pastor of Northstar Community, a church that exists to serve those struggling in various ways with issues associated with substance use disorder and its various associations - trauma, mental health issues, etc.  She also serves as Executive Director of the National Association for Christian Recovery, an organization created to support other faith communities around the country provide more effective care and support for recovery in their local community.  She has authored several books, including:  Bridges to Grace, Transformational Steps for Ordinary People and Forgiving in a World that Loves to Hate. Blog: http://www.northstarcommunity.com/devotionals/

9 thoughts on “There is nothing you can do until they ‘hit bottom’ #MythBustingMondays”

  1. This is such a touchy subject for me. I had countless people tell me you need to practice ‘tough love’ and they will hit rock bottom sooner — as if rock bottom is a cure. Being a person with addiction issues is ‘tough’ enough — it’s just about love. As we all know, we can only do what Anne said, provide an encouraging environment for their recovery, never give up hope and LOVE. Wish we could put up a sign on the busiest streets of America to bust these myths.

    1. Yes. I have a lot of empathy for all of us on this ride. I believe initially the concept of “tough love” was intended for good and not for evil, in that it was trying to address the concept of enmeshment and enabling behaviors. But as is true with many principles, it got mixed in with the anger that often manifests in “end stage codependency” which consists of withdrawal. Even that can be viewed with empathy, as it is, I think, the family member’s survival instinct kicking in. How much trauma can a mama endure without pulling back a bit? This is just a very, very challenging disease, family disease, to treat and we are all still trying to find language and articulate principles in ways that suffering families can embrace without losing the point in the application.

  2. ‪This hit home hard for me. I joined Families Anonymous in June 2014 when my 17year-old daughter ran away from home the week after graduating high school. She turned 18 that July. She suffered from SUD and depression/anxiety.
    ‪ The term hitting rock-bottom was used a lot… I never exactly knew what her rock-bottom would be. Not until now. Every time I told her “no” about sending her money, refusing to allow her to come back home while using, begging and demanding that she seek treatment…. would make her feel she hit rock bottom and would stop. ‬ I didn’t want her to hit the bottom because I was afraid of what that would be.

    ‪My daughter died of an accidental overdose less than a month ago. She insisted on fighting the battle alone.

    ‪My daughter did not want to die. My greatest, and now most horribly realized fear, has come true. ‬
    ‪I like the analogy someone else used about the rabbit hole… And the tale of Alice was one of her favorites. ‬I feel it’s much more like this.

    ‪I’m not really feeling I have much great insight to offer right now… Just wanting to express that it’s different for each of us. ‬
    The term definitely needs new understanding so that this is not the outcome when it can be prevented.

    1. I am so sorry you are in this club with me. I lost Charles to suicide while going through withdrawal. It’s a hard journey and that line of helping versus loving and letting go shifts daily. It’s a difficult, heartbreaking disease.

  3. Anne Moss, there is an article on the WTOP news website today that you should read. It may be useful to your readers here. I continue to admire you so much.

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