November 21, 2018

What to Do When an Addict Refuses Help

How do we help a loved one who is engaging in destructive behavior and refusing assistance?

The painful truth is that we cannot always help another person. If we expect to be able to change someone else in order for us to feel better, we may be setting ourselves up for double failure.

We can help ourselves by understanding our own feelings of powerlessness and getting the support we need to manage our emotional response.

When we become less dependent upon another person’s behavior to feel that everything is OK, we will be calmer and better able to empathize with that person, who may feel powerless to change.

A person’s refusal to accept help does not mean that he is refusing to get better.

If a person refuses help, how can you say that he wants to get better?

Other factors may be at work. Imagine a young child who has just fallen. Terrified to look at his injury, he shouts that he does not need the doctor. Imagine a man addicted to drugs who rejects medicine, therapy and a rehab program because none of them helped in the past.

Many of us, when presented with risks in life, prefer the pain we know to the unknown suffering we imagine.

There are real fears behind refusals of help. The child may fear that the doctor will inflict more pain than he’s already enduring. The elderly woman may fear what is most unbearable for her — the loss of lifelong independence.

Many of us, when presented with risks in life, prefer the pain we know to the unknown suffering we imagine. Our Jewish tradition is rife with such stories. Consider the Israelites’ initial response to God’s having redeemed them from slavery in Egypt: They wanted to go back to Egypt, where at least they’d had food they enjoyed and knew what each day would bring, rather than have to depend upon God to provide manna while leading them toward an unknown land.

Current scientific research has shown that addictions produce biochemical pathways, making changing self-destructive habits extremely difficult physiologically as well as psychologically.

Our tradition teaches that change is possible. On the High Holy Days, we’re reminded how the Gates of Forgiveness remain forever open to those who truly wish to repent. Until the last moment, God is eager to welcome us no matter how many times we’ve failed.

We are told the world hangs in the balance.

Good and evil are represented as two sides of a balanced scale. As little as a feather’s worth of goodness can tip it toward redemption. This feather may not be the full achievement of change. Rather, a small effort toward goodness may sustain the world.

We shouldn’t expect success in changing the problematic behavior?

We may need to redefine what constitutes success. Rather than solving the problem, success may mean moving a person from utter despair to a semblance of hope.

Altering the outcome behavior — the problem — is often doomed unless a new way is found to alleviate the underlying pain.

Self-destructive behaviors serve as means of managing deeply troubling emotions.

Suppose a family member chances upon a young person who is cutting herself superficially with a razor in order to manage her pain. It’s a terribly distressing sight, and the entire family wants this behavior to stop immediately. “Don’t do that!” the family demands.

A better approach would be to encourage the suffering young person to understand her feelings and find other ways of managing them. The family might say to her, softly, “What are you feeling or thinking that is causing you to cut yourself? We don’t want you to suffer.”

In my experience, the majority of troubled people really do wish to feel better.

Most can be helped in finding less harmful ways of coping with emotional pain.


Rabbi Edythe Mencher is the Union for Reform Judaism’s caring community faculty member and a licensed clinical social worker.