How do we begin to help a loved one who is an addict or otherwise engaging in destructive behavior?
As both a rabbi and a psychologist, I begin by checking my own [Tzelem←→N'shamah] relationship.
What is that?
The Book of Genesis and modern psychology both affirm that in each human being there is a relationship between two aspects of the Self. The first is the bodily, breathing part called the N'shamah, which is always present at the core and essence of each person ("God molded the human of dust from the soil, He blew into his nostrils the breath of life; and the human became a living being"). The second is our cognitive or mindful self, Tzelem ("God said: 'Let us model humankind after us, according to our likeness'"), whose task it is to witness, name, and bless whatever comes through the bodily self. When these two are in balance and in an I-You reciprocal relationship, life works, because relationship, first with our inner selves and then with others, is the basic religious and psychological unit. Each of us is not a Self. Each person is a relationship between "selves." That is why I use brackets around [Tzelem←→N'shamah]-to indicate the interrelated unity of Tzelem and N'shamah-and a double arrow to signify their reciprocal relationship.
How do these "selves" relate?
Some of our "selves" are kind, loving, generous, and responsible. Other "selves" have been profoundly wounded by a variety of life circumstances. It's when these wounds have turned into "negative selves" that our "neglected selves," will show up-despite our best efforts to silence and control them-and prompt us to do "stupid" or sometimes "bad" things.
What do you mean by "neglected self"?
To paraphrase a teacher of mine, the neglected self refers to the wounds we carry that have not yet been integrated or "humanized." We are all deeply wounded, but some of our wounds have been touched with love and blessing, thus becoming integrated into the overall fabric of human goodness. Other wounds have been denied, untended, unhealed, and unblessed, thus becoming the "neglected self" that assumes a semi-autonomous expression of negativity and springs into action when touched. A healthy state of being is achieved when all of a person's inner selves are "balanced" and attended to caringly.
How does all of this help us in our interactions with an addicted person?
For us to help an addicted person find his or her "way out," we first need to make sure that our own [Tzelem←→N'shamah] relationship is in reasonably good shape. In other words, we need to watch that our own "neglected selves" don't derail our interactions. We do this best by accepting and respecting all of our inner selves, and letting them know that, although we won't give them control, there is room for them in our "world." The "negative" selves thus feel heard and respected and don't have the need to take over in order to be noticed. And, invariably, they have done something useful and good for us. In short, the idea is to value and bless all the rejected selves, and bring them into loving relationship within our larger self, our [Tzelem←→N'shamah].
Sounds like an idyllic way of being.
Yes. And it's a very tall order, even for non-addicts. Failure is the norm.
Can therapy help?
The most important thing I've learned as a rabbi/therapist is that one person alone or a psychotherapy in itself does not change anyone-change comes out of relationship, and relationship is a sometimes thing. People drag into my office their addiction, depression, anxiety, expecting and hoping I have the silver bullet to cure them. I tell them: "I have retired from the 'hit-man' business. If you expect that psychotherapy means one person fixing another, give it up! It just doesn't work. If, instead, you are willing to explore ways to foster a realistic, caring, appreciative relationship with the 'selves' in you that are anxious/depressed/addicted, we can talk about that. It will not be easy. And if change results, it will happen first in your relationship with those 'selves' in you; then in our relationship here, in which I will participate as fully as I know how; and then in your relationship with those you care about, and who care about you." When the relationship has gone well and change happens, clients will often say as they leave, "Thanks for all you've done for me. I'm a different person. My addiction no longer rules me, and I'm doing better with my life." My response is: "I couldn't have done it without you!"
What can bring an addict "back"?
An addict's first step back is awareness that there is a "self" within that he or she cannot control. Alcoholics Anonymous (AA) describes this as "hitting bottom." In AA the first step out is entering a relationship with a sponsor, someone who has achieved a level of sobriety.
What determines whether or not someone hits bottom?
The curse of addiction is that hitting bottom does not come easily, and no one can predict how and when it will happen. Sometimes it's only after years of denial and multiple attempts to "go straight" that an addict "gets it"-realizes that he/she has no control, cannot get sober on his/her own, and needs help.
One of my clients, a forty-something political figure who had been imbibing large amounts of booze since his teen years, asked me at the end of our first session, "Doc, do you think I'm an alcoholic?" I responded, "If you have to ask me that question, you are!" That week he "blacked out" on his way home from a Yankees game and awoke not knowing where he was. He finally acknowledged to himself that he had a "big-time problem" and checked himself into a detox and rehabilitation center.
In another instance, a father of three refused to acknowledge his alcohol abuse and repeatedly smooth-talked his wife out of action with partial truths and lies. She was beyond wits' end. One winter day, totally exasperated, she had all the locks changed and the windows bolted shut (once before he'd climbed through a window), and that evening she refused to let him in despite his repeated importuning and promises. He slept fitfully in his very cold car-and the next day went into treatment.
Another client regularly declared his love for his pleasant and somewhat meek wife, but once at home, he'd go into the bathroom, smoke crack, and come out a screaming, raging, tyrannical, abusive tiger. His drugging led to bankruptcy. This didn't get his attention. Even his wife's mustering the nerve to serve him with divorce papers didn't seem like a big deal. But when a restraining order followed which prevented him from seeing her and the three children he loved, he was jolted into attention. He joined AA and became completely absorbed in-one might say even addicted to-treatment. He showed up at two meetings a day, went to daily Mass, saw me twice a week, and started repairing his relationship with his in-laws, who were wise in the ways of AA. Sober and clean, he started to get his financial house in order, and after years of being employed far below his skill level, gradually moved up the corporate ladder. Eventually he decided he didn't really love his wife, but would stay in the marriage because he did love his kids.
In short, the same way we never know when someone will hit bottom, we cannot predict the outcome of getting sober and clean. This married man realized he didn't love his wife, realized what he was doing to his kids, realized he could do better in the corporate world and proceeded to prove himself right. A different "self" showed up.
What do you say to a family member who desperately wants to change the self-destructive patterns of a loved one?
I gently explain that pleading and cajoling are close to useless. So are well-meaning but nonetheless enabling "solutions" whereby loved ones assume they can act as the addict's conscience. Hiding the bottle or other manipulations of the environment are also futile. Sometimes a draconian measure may be the only answer.
A dear friend of mine decided to shock his beloved sister, a long-time alcoholic. He arranged for a friends-and-family gathering with an ultimatum. Leaving anger at the door, every person explained to his sister how her alcoholism was affecting him/her and said : If you don't commit to getting sober, I will no longer have anything to do with you. Participation in this intervention required the difficult prior commitment of each individual to walk away and sever all ties if this woman refused to become sober. In this case it worked. Now sober for fourteen years, she is tremendously grateful to her loved ones for having invoked the ultimate aloneness of her continued abuse.
What does Judaism have to say about the ethics of such interventions?
A competent and respectful intervention is fully consonant with Jewish tradition. Judaism affirms that we are not full owners but rather stewards of our lives, which are at best sacred loans to us. We have an obligation to maintain God's property in A-1 condition. Addicts in particular may waste their lives, abuse themselves and others, and even "kill" themselves slowly or quickly. Thus, intervening is Jewishly appropriate. As a sometimes-wise woman I knew used to say, "What works, works!"
Consider, too, the interesting juxtaposition of Lev. 17, 18, and 19. Lev. 17 says, "You are not to hate your brother in your heart; rebuke, yes, rebuke your fellow," and then Lev. 18 and 19 affirm: "Be loving to your neighbor (as one like yourself)." As I see it, it is consistent with these teachings to engage in interventions that rebuke another human being respectfully, while not holding enmity.
You've talked about seeing our relationship with an addict through the [Tzelem←→N'shamah] framework. What about our relationship with God?
Being created in the "likeness of God" does not mean we look like God or are created in the image of God, as is commonly assumed, for God, in Judaism, is incorporeal. What we can say is that since, in essence, we are in a relationship between our various "selves," God, our model of Divinity, must be as well. God, like us, also struggles to do good. God, like us, lives and changes in relationship. And like God, it is through relational change that we become full partners in creation.
Rabbi Jack H Bloom is a licensed psychologist in private practice in Connecticut; director of Professional Career Review for the Central Conference of American Rabbis; and editor of Jewish Relational Care A-Z: We Are Our Other's Keeper (The Haworth Press). He was interviewed by Reform Judaism editor Aron Hirt-Manheimer and managing editor Joy Weinberg.