Do You Have to Want to Get Well for Treatment to Work?

Do you need to WANT to get well for treatment to work?

We have all heard the line… “You can’t force someone into treatment, they have to want to get well for it to work”. I must say, I wholeheartedly disagree and I believe this fallacy has lead to devastating consequences for people who really needed help.
Some people do choose to ignore a potentially deadly outcome for their loved ones who are unable to dislodge themselves from their toxic addiction and self destructive behaviors on their own. As the person continues to fall deeper and deeper into their addiction, eating disorder, anxiety or self harm, the close network of family and friends often begin to scatter in fear of being trapped in the cross fire of the anger and depression that shape the fall out: the lost job; a marriage falling apart; losing one’s kids; losing one’s property or worse--one’s life.
Family and friends give up and quietly wait for their loved one to “hit bottom,” praying there will be no disasters, but unwilling to take the steps necessary to get the person into a treatment program. There can be many underlying reasons for this kind of passivity, most certainly, co-dependence and denial play a role as does ignoring the responsibility of the unhealthy family system that created it. As the individual’s denial (as well as that of those around them) gets played out, all those who passively comply with it, are accomplices in what unfolds. Beneath the surface, there is an unhealthy web of agreements that is camouflaged by the behaviors of identified patient. Alcoholism, drug addiction and mental illness affect and may be inadvertently encouraged by the entire family. This is a hard pill for many to swallow, but until the family and friends (and even in some instances the therapist) begin to make different choices themselves, the chances of the client seeking help on their own are very low.
An intervention; either formal, informal or even legal, can create the false bottom needed to propel the client toward treatment. Often times, the individual is desperate for help and is just waiting for someone to notice. While they may not be 100% committed to treatment at the time, they are aware that something is terribly wrong and they don’t want to continue to live the way they have been living. What matters is not how they got into the treatment program, but that they got there at all.
We, at Treatment Consultants, have worked with countless clients who have come into treatment programs kicking and screaming, under coercion from their parents, under threat of losing their spouse and children or under court order and yet, they got well anyway. With encouragement, a focus on instilling hope and purpose and some specific therapeutic interventions, we have seen remarkable progress in bringing someone from intense resistance to a passion for their own recovery.
Once the person gets into the therapeutic setting, the program structure is the vehicle to getting healthy. Momentum can be created by virtue of the fact that the client becomes accountable through attending the program and participating in the therapeutic process. A residential setting that specializes in the treatment of chemical dependency, process addictions, and co-occurring disorders allows the client to actively deepen their insight, bringing themselves into the present, and re-connecting to parts of themselves they had lost.
Recently, some effective therapeutic modalities have been woven into treatment programs. One of them is Motivational Interviewing. These interviewing techniques use the energy of resistance, flipping it into motivation for change. The idea is to embrace the ambivalence and use this dichotomy as a tool for exploration and resolution. Instead of directly confronting the addict and thus activating the resistance, the therapist leads the exploration and allows the client to identify what they want from their lives, change the behaviors that are not working for them, and develop alternative, healthy coping strategies.
As a complimentary therapeutic modality, Dialectical Behavioral Therapy (DBT) dovetails with motivational therapy in many ways. It encourages the client not to polarize, but to use mindfulness to build emotional tolerance and cognitive regulation. These skills then allow the client to cut through the escalation of triggering emotions. Additionally, learning to practice interpersonal assertiveness skills builds the self confidence of the client by providing techniques for healthy relationships with others.
With a great assessment and a team approach which includes psychodynamic therapy and psychiatry in conjunction with education, cognitive behavioral skills, experiential techniques, body centered therapies and a 12-step component, you have a winning combination for change.
Back to the question, “Do you need to want to get well for treatment to work?” Certainly, it will go more smoothly and quickly if there is an initial readiness for change, but even “readiness” does not guarantee a healthy recovery. The willingness to get well can emerge out of the treatment itself and of course a solid continuing care plan is critical.