Addiction Communication

At the heart of every relationship is communication. If the people in a relationship cannot find a way to tell each other what they need, what they want, and what they appreciate in each other, the relationship is skating on thin ice. The story of Carrie and Jason* might sound familiar to you, and is an example of how the Community Reinforcement and Family Training (CRAFT) model works for families. Carrie started CRAFT therapy by summarizing the communication she had with her husband Jason in the following way:

"Every single time we try to talk about anything more personal than the football scores, we get into a major fight. It seems as though he goes out of his way to do things that make me mad. Even when I ask him really nicely to stop something or to do something for me, he starts yelling and uses it as an excuse to get another drink. He knows how much I hate it when he drinks that much!"

Communication Styles Can Be Identified and Changed

When relationships run into hard times, whether they are related to substance use or not, there are four predictable changes in the way people communicate:

1. They stop using statements that are positive. Conversations lose their positive components and focus almost exclusively on the negative.

2. They stop using statements that begin with "I" and instead use statements that start with "you," which can easily be interpreted as an attack or coercion.

3. They stop showing understanding, and letting the other person know that they understand how the other feels.

4. They stop demonstrating a willingness to share responsibility for the situation, and focus on trying to assign blame.

In the CRAFT approach, such communication patterns are referred to as no longer being PIUS: positive, leading with "I," understanding, and sharing. A PIUS approach to communication is full of statements that have a softer feel to them. The listener doesn't feel attacked and therefore is less likely to counterattack.

It is not difficult to learn a more gentle communication style, but it does take practice. When you have been attacking each other for some time and have a history of hurt feelings, changing how you communicate is at first a little like swimming upstream; it is possible but you have to concentrate.

What you will find, though, is that if you make the effort to improve the way you communicate, your loved one struggling with substance use will find fewer excuses to respond negatively to you.

Adapting Negative Feelings to Positive Statements

Turning negative feelings and statements into positive moments of communication is a key influencing technique in CRAFT. Take the time to read the examples below and think about some of the statements you might have said to your loved one recently. Could a different approach influence your interactions, relationship, and eventually lead the person struggling with addiction to choose to be treatment receptive rather than treatment resistant?

Negative: You always screw up the evening.
Positive: I enjoy you so much when you don't drink.

Negative: You always embarrass me.
Positive: It would make me so happy if you drank soda tonight.

Negative: I'm not having sex with you when you're drunk.
Positive: I'd enjoy making love to you when you're sober.

Negative: I can't stand it when you lie to me. All you ever do is tell stories full of lies.
Positive: I want to believe you but that story seems odd.

Negative: You never listen to me when I'm talking to you.
Positive: I understand that some of our discussions are upsetting, but I'd love it if you could help me work them out.

Negative: Don't ever let me catch you yelling at the kids like that again, you bully.
Positive: I know the kids can be frustrating, but please help me set a good example by talking to them calmly.

Shifting the Pattern with "I" Statements

The quickest way to elicit a fight is to make someone feel attacked. And the easiest way to do that is by beginning your statement with the word "you."

As soon as most people hear this word, they prepare for an attack—and for good reason. Beginning a sentence with "you" flags the listener that he or she is about to be the center of attention. As a family member, loved one, or concerned significant other someone with a substance use issue, conflict might be habitual part of your relationship.

The person with addiction in your midst might naturally expect a "you" statement to signal the beginning of an attack, which puts the person into fight-or-flight mode. There's a good chance that a full-blown argument is right around the corner.

The way to break out of that mold is to talk about problems or emotional issues by making it a point to tell your loved one how you feel or what you want, rather than what the person is doing wrong. The examples below will make this clear.

Sample "You" Statements

• You're so inconsiderate for missing dinner without calling
• You're an accident waiting to happen when you drink
• You shouldn't drink tonight
• You're a slob

Sample "I" Statements

• I feel hurt when you miss dinner without calling
• I get scared when you drink so much
• I would be so happy if you did not drink this evening
• It's important to me to have a tidy home. Won't you please put your things away?

Demonstrating You Understand

By including "understanding statements" in your approach, another piece of the communication puzzle is put into the foundation of your relationship, helping the two of you get along better in spite of the problems you discuss. Such statements let your loved one know that you understand, and that you care about his or her feelings.

For instance, let's say you are trying to get the your loved one to go out and look for a job. You can use all the techniques we have already discussed and say, "Honey, I am so worried about our financial situation right now. It would really help if you sent out some job applications today."

That would be a great start. However, it would be even better if you added an understanding statement to let your loved one know you appreciate how difficult the situation is.

By saying, "Honey, I know how frustrating it is for you to job hunt in this tough market, but I'm so worried..." you are showing that you understand how the other person feels, which makes it easier for that person to hear you without feeling on the defense.

Sharing the Responsibility

If someone in your life is struggling with alcoholism or other addictions, as part of your family or as a loved one, it is crucial to understand that your behavior is intertwined with theirs. Even though you are not the cause of the problem, you are intimately involved with it and do have an effect on it.

Sharing responsibility for some of the things that go wrong in your relationship—not in all cases, but when appropriate—can make a profound difference.

When you ask your loved one to make a change, along with acknowledging how difficult it is, let them know that you see yourself as part of the picture. There is no need to take responsibility for everything that goes wrong or for the others behavior; the important action is to acknowledge that you are part of whatever situation is going on. The following statements are examples of how you might takes steps toward making your loved one feel you are sharing responsibility:

• "I understand that you get upset when the kids make so much noise. Maybe I could get them to play in their room so you can concentrate on looking for a job."
• "I know it's partly my fault that we argue so much. I'm going to try to be more understanding, and I hope you will also try to see my side of the issues."
• "I know I sometimes react strongly to your drinking even when it's uncalled for. Let's work together to solve our differences."

One of the easiest ways to show that you see yourself as part of the situation and to defuse an emotional situation is to say something along the lines of, "Can I help? You look upset."

PIUS Communication in Action

Remember Carrie and Jason? The following two activities from the CRAFT model helped Carrie use PIUS communication tools. As you review her examples, think about how you could apply the PIUS tools to your interactions.

Activity 1: Past Arguments

Think about the last three arguments you had with your loved one that began with you trying to tell or ask him/her something. Describe each one in as much detail as you can.

Argument #1
Jason and I were going to meet some friends for dinner, and on the way there I asked him, "Please don't drink tonight because you always get drunk and embarrass me." He replied that he doesn't always get drunk and if I'm so embarrassed by him, why do I even go out with him. I yelled something back…can't remember what now …and we ended up turning around to go home.

Argument #2
It was Friday night, and I was late getting home from work…meeting ran over. When I walked in around 7pm, Jason was stretched out on the sofa with a 12-pack of beer in the ice chest on the floor and five of the bottles already empty. Since I knew he had only beat me home by about an hour, I knew he had knocked back those five pretty quickly and was probably already useless in terms of helping me fix dinner and make out the shopping list for the supermarket. "You're drunk again," I said. "Screw you" was his response. We didn't talk again that night.

Argument #3
After a pretty nice evening together taking in a movie, I thought it would be a good time to reinforce Jason for sobriety. I said, "You are so much nicer when you're not drunk," thinking I was giving him a compliment. Well, he totally took it the wrong way and blew up at me, "There you go, riding me again, always complaining about drinking." I reacted and told him that if he wasn't such a drunk, I wouldn't need to complain, and from there the evening went straight down the tubes.

Activity 2: PIUS Planning

Select one argument from Activity 1 and rewrite your part so that it is positive, leads in with "I" statements, shows understanding of your loved one's struggles or point of view, and shares responsibility for your relationship and situation.

Carrie Rewrites Her Approach
Next time Jason and I have a nice evening when he doesn't drink, I am not even going to mention drinking. A more positive way to talk about the evening is to focus just on the fact that he is sober and not compare it to when he is not. Also, I think I need to let him know how happy being with him sober makes me feel and that I know it's not always easy for him. Finally, I should tell him that I do consider myself part of the situation and share the load with him. So, putting it together, I'll say something like, "Hon, thank you so much for this wonderful evening. I really love being with you like this [he knows I mean sober, don't need to say it], and I know it's not always easy for you so that makes it really special. What can I do to make things better for you?"

Learn more about the CRAFT model and techniques with the book Get Your Loved One Sober, by Robert J. Meyers, Ph.D., and Brenda L. Wolfe, Ph.D.

*All names have been changed to maintain privacy.