Allies member Amy80 has had years of positive outcomes with CRAFT. Today, with a close friend who drinks heavily, she’s seeing progress because she’s maintained her connection with him when he is using. This may seem to contradict the CRAFT strategy to step away when a Loved One is using. But in real-life application, CRAFT is nuanced and flexible, and informed by you.
Hello Dominique. I underwent CRAFT a few years ago to help a family member, and I’ve seen how powerful it can be. But I find myself in another situation that seems “outside the box.” A good friend lives in my guest house on my property. He has been a heavy drinker for 15 years. He isolates himself when he is drinking and goes to great lengths to hide his problems from everyone in his life. He’s done a good job of keeping it a secret from everyone except me.
My friend has made some serious progress in the past year. For the first time, he’s acknowledged to me that he has a drinking problem. Also, for the first time, he’s sought help. He has started seeing a physician who specializes in alcohol treatment, and he was prescribed medication to curb his cravings a few months ago. He has periods when he takes the medication and periods when he doesn’t. Like many people with a substance use disorder, he’s attempting to moderate, and his use goes up and down. He has the occasional day when he can cut back to 5 drinks a day and other days he drinks well over 15 to 25. The first year he lived on my property, he disappeared when he was drinking heavily and went to ridiculous lengths to hide his drinking from me. He prefers to drink alone. So my approach has been to spend time with him when he’s drinking. He’s never actually “sober”—as he’s physically dependent on alcohol and would have serious withdrawals if he sobered up.
I know that goes against “traditional” CRAFT,” but showing him that I know he has a problem and I’m not running away or judging him even when he’s drinking has so far brought the problem to light and gotten him to get some help. I have felt like I need to first reward him for not isolating before I can reward him for being sober. I know connection is key to helping people get better. But I also know that right know he’d choose being alone with the alcohol over trying to sober up a little to spend time with me.
I do praise/reward him for getting out of the house on days when he is sober enough to do so. At this point, I think it’s important for him to remember that there is life outside of his dark bedroom with an alcohol bottle. I want to remind him that other people are out having fun and he’s missing out when he stays home to drink alone. I’d rather he drink and go to a BBQ or a community event than have him stay home alone and drink—for now.
My eventual goal would be to withdraw my attention more when he is drinking, but I don’t think we’re quite there yet. I do hear some wishes/dips but only when he is drinking heavily. I try to capitalize on those moments even though he is drinking. I’d love some input about whether it’s OK to reward not isolating before I reward not drinking. I feel like he’s been so lonely for so long and he’s so full of shame that he needs human connection with someone first—before he can even think about not drinking.
Thank you for writing in, AMY80; it’s a pleasure to have you with us.
“Coaxing the little animal out of the woods”
That’s how a father once described his initial goal of using CRAFT techniques to help his son engage into treatment. You’ve been through CRAFT training. There can be a lot of CRAFT crossroads in our daily lives. You’ve hit on an important question.
Today you’re asking us whether, as you coax your Loved One out of his own woods, you should first favor connection over the strategy of removing yourself when he is drinking. Your question reflects just how complicated applying CRAFT can be, and your own sophistication in trying to implement it.
First off, I’d be very interested to hear how you managed to get your friend to see a doctor and start medication for his drinking. This with a man who is seriously hiding out and drinking in secrecy.
Be sure to notice your own success
You describe still being at the stage of (literally) coaxing your Loved One out of his hiding place in your cottage, his woods. Your thoughtful consideration of the point you’re at, and your instinct to strengthen the connection between you, are really well informed.
I suspect your early success had much to do with your ability to first connect with him. You connected without judgment, with an open mind, and it really paid off. You said it:
Showing him that I know he has a problem and I’m not running away or judging him even when he’s drinking has so far brought the problem to light and gotten him to get some help.
Here’s a point of comparison: one of the strongest predictors of success in psychotherapy is when the therapist is able to build a strong alliance with their client. It is that alliance that creates the safety to open up. With CRAFT, we teach you the skills to build such an alliance with your Loved One (Module 4).
Where do we go from here?
In those early moments, it makes sense to favor creating that connection over the removal of yourself when your Loved One is drinking, as CRAFT would suggest. Despite your Loved One preferring to drink alone, your connection with him has been so positive it has already influenced him to engage with treatment.
But now you’re wondering if you should keep favoring connection or follow the key CRAFT principle of removing yourself when your friend drinks. Removing yourself discourages his use, precisely because you too are a reward. Staying around can encourage the use. It can send the message that the use is normal and okay.
The answer is partly in how you define your immediate goal. Are you interested in him being more sociable? Or in finding community activities like a BBQ that might compete with heavy drinking? Or in getting him to have more days on his alcohol medication, therefore “moderating”? Or is it about getting him to consider more addiction treatment?
Maybe none of the above. Perhaps you just want your friend to be comfortable in your presence. Able to tell you when it hurts. This is both fundamental and very difficult. And you did it. Your friend walked into treatment.
More than one way to remove yourself
When you are ready to consider removing yourself when your Loved One drinks, I wonder if it makes sense to first think of it not as physical removal but as the kind that signals you know he is drinking hard (a 25+ drink day).
Learning CRAFT is relatively straightforward; applying it in complicated and difficult situations is an art. For the moment, let’s define 5 drinks a day (therefore taking his medication) as moderating, and 25 as using. Let’s say the goal is to increase the number of days your Loved One is able to moderate.
If you are choosing to sit with him both when he is moderating and when he is drinking hard, how else, other than removing yourself, can you communicate and behave in ways that change depending on his level of use?
Can you load up the rewards on days when he drinks 5 or fewer drinks? Can you feed him barbecue, candy, sweets? Can you make your visits with him noticeably happier, longer, more attentive?
And on those 25-drink days, can you make those visits quieter, shorter, and less attentive? Can you arrive empty handed?
Don’t forget the other tools in your CRAFT toolbox
CRAFT strategies are incremental. The practice calls for little steps over sweeping ones, more subtle changes if possible—and changes that are acceptable to you. It is important that you are not put out and feel reasonably okay with the efforts you are making. Otherwise you may not be able to both sustain them and take care of yourself.
Removing yourself is one of the three principles for how to respond when you see use by your Loved One. The other two are removing rewards and allowing natural consequences (covered in Module 6). Again, how to build back that connection with your Loved One is covered in Module 4.
Still plenty of dangers ahead. And plenty of options.
We very much appreciate your question, Amy80. Thank you for caring for your good friend who has lost or never had the ability to care for himself. What you describe sounds like serious alcoholism. He will need a medical inpatient setting to detoxify (and let me remind all members here that alcohol and benzodiazepines are two drugs that can cause life-threatening seizures during withdrawal.)
One last comment: I would suggest you read up on the medication your friend is taking. In some relationships, it is possible for you to dispense the medication each day. This may be further than you are willing to go, but it is a tactic that has been studied and forms part of Couples Behavior Treatment. The studies found that sharing the responsibility for taking the medication works. It’s a ritualized daily exchange. Perhaps there’s a scripted line or two that is repeated each morning: “Thank you for being here this morning and taking this medication to help with your drinking. I hope you have a good day.”
I love your gentle way of working yourself into his life. Your small efforts have really paid off. Let us know how you and your friend are coming along. All our best wishes.