I was born on a fault line of trauma and emotional wreckage. Sudden deaths, substance abuse and mental health problems were part of my life from a young age.
I can remember the night my father died. I was seven years old and the house smelled like alcohol. Nobody told me the truth about what had happened. I lived with a lot of family secrets.
It wasn’t until some snotty little girl on the playground came skipping over to me and told me exactly how my father died, that I realized he had taken his own life.
While mine was a harsh life, it was a resilient one. And I had many screens of opportunity. As luck would have it, in the midst of all that confusion, chaos, sadness and trauma, I was sent away to a camp, Camp Wood Echo, which was run by a social worker.
My experiences there were key to my later becoming a social worker and a university professor. I was able to run and play, shoot bows and arrows and just found a safe haven in which to be a kid again.
The camp owner, Mr. Rubenstein, also ran a local community center—where the true impact of community mental health activities was imprinted on my brain.
I stumbled through high school like most teenagers do; making out in the backseats of cars and not really caring about my studies. My mother, who looked and dressed like Cher long before the height of her fame, subsequently married a gentleman who also had a substance use problem.
Luckily, by hook or by crook, I got accepted into the University of Pittsburgh, where I did a bachelor’s degree in English Literature and sociology, later receiving my master’s degree in social work from San Diego State University and my doctorate in education from the University of San Diego.
While at San Diego State, I was given the opportunity to create one of the first graduate school courses in substance abuse or alcohol—open to social workers, counseling, self-development, public health or psychology students.
Because guest lecturers would often pass San Diego on their way to the newly founded Betty Ford Center, they often stopped to give speeches in my classroom.
One day, Dr. Frank Picard, head of an independent treatment center called Springbrook walked into my classroom. He was tall, stately, soft-spoken, and mesmerizing.
When he spoke my heart stopped, because he was describing my family. He was describing how one does an intervention and how one can help and identify a loved one’s treatment. I was immediately smitten. I knew I was really great at dealing with crises.
I had worked as an ER social worker—give me a crisis, I just am just magnificent. Give me sudden death, I am phenomenal. So I said: “I can learn how to do this.” Under his tutelage and on the side, I began doing interventions and continue to do so to this day.
Since that time, I have published three books and had the opportunity to speak all over the world, but it really comes from my family of origin.
Today, I feel honored to work in many different venues. I consult with behavioral healthcare centers, helping their clients and working collaboratively with some of the top behavioral health care centers in the world. I also work with a young group out of New York called Youth Prevention Mentors, which really combines my basic love of peer mentoring and parent-based intervention.
I work with families who have young adults, from 13 through to 27. In that arena there is always an identified loved one—usually, it’s the young person—who has been acting out.
That could involve anxiety, depression, executive functioning problems, difficulty with school or substance abuse.
I also help adults in crisis. I am currently working with three women who were widowed, a woman who has intergenerational trauma and processes her disorder by shopping and gambling and have previously worked with CEOs and COOs and their families.
While working with the family unit, we often try to help that young person by putting a wellness mentor with them, and I work with the family to effectuate change without sending a young person away somewhere else.
For example, last year we worked with a gender-fluid 17-year-old who was self-harming. They were abusing alcohol and not doing their work. Their parents were definitely very high-achieving, very talented, and wanted to send them away to an institution.
But I said no, we don’t need to do that. We can work together by helping them with a wellness coach, who could help explore further their identity, and a psychiatrist who was able to prescribe the right medication.
The outcome of that story was really good. They recently celebrated over a year of recovery in Twelve Step and is currently a freshman at a prestigious college in Boston.
In my eyes, the most important thing to know about families is that when they come together and ask for help, they have been functioning in a way that has a status quo for a long time.
What we’re asking is not just for the identified loved one, who comes with the problem, to change. We need to invite everybody to change. And change takes place very slowly.
I’m working with a very interesting family right now who has a 24-year-old female who really hasn’t learned how to live life yet, and is in a relationship with a 52-year-old male.
Her mom is very successful, but going through her own existential crisis about who she is. What I am trying to do is help her live her own life and be able to detach. A lot of the work has to do with learning how to talk; what do we say and how do we say it? Learning to talk in “I” and feeling terms.
The other big thing is self-care; giving people opportunities to grieve their losses, unpack what has happened in their lives, and give them permission to begin taking care of themselves physically and emotionally, consistent with their values or spiritually.
When I work with people I always give them assignments, but they’re always invitations to change. For example, could you do nine things this week to take care of yourself physically and emotionally?
That could be walking, or skipping, or playing pickleball. What do you do? Do you do a gratitude list? Do you like being creative? I think the most important thing is joining up where that person is, and being present with those individuals.
The toughest problem I encounter is resistance and denial. People are stuck in their ways, and it takes 90 days to change a behavior even if you want to.
Wonderful research from Prochaska and DiClemente suggests there are various stages of change. First, it’s not even in your head. Then, you’re a little bit pre-contemplative. You’re thinking about it, and then suddenly you take action, but you go backward and need to get back to that action phase.
I believe the biggest thing is having patience. As someone who does interventions, you’re fast—like an ER doctor who has to make a quick decision. But you have to have patience, a lot of empathy and to understand the stages of change.
Think about how difficult it is to give up chocolate or cigarettes. That is difficult enough for one person, with a family you are inviting an entire system to change, not just one person.
I’m famous for helping people develop change agreements. Often in families that have problems, one doesn’t know where one starts and the other one stops. My mantra is: “I love you and I care about you and I’m only going to support you in health and wellness.”
But that means that you are actually only able to support them in health and wellness. That does not mean you pay for their phone which is a direct link to their drug dealer. And I have found this often the hardest thing in the world for parents to give up.
In the event of a family member not following through with rules that have been set, they experience the consequences of their behavior.
Mental health and substance abuse are brain diseases, and you’re trying to take a look for a strength-based positive solution to that disease. But sometimes people don’t want to follow directions and they have to experience the consequences of their actions.
What you can do is encourage help, set limits and be their accountability coach. Even for something as simple as a gratitude list. I can’t even begin to tell you how many people send me their gratitude lists every day, and I write them back. I want them to be able to follow through and have some structure.
I tell all families I work with: “You did the best you could do with the resources you have. And now maybe we can learn to do something a little different.”
If I could share one piece of advice to be a better family member, it would be to seek help. To question behavior and look outside. Understand that there’s always, in my mind, hope and a strategic solution.
I still pick up my own phone and talk to everybody who calls. I give them 15 minutes of my time. I don’t want people to be afraid of asking for help, and I want them to know they’re not alone.
So many families worldwide experience mental health issues, substance abuse, or some other type of problem. COVID-19 has caused more anxiety and depression than we’ve ever seen before.
We’re living in an anxiety-fueled world that, for young people, is uncertain. We’ve had riots and natural disasters; we have social media.
But in my eyes, there is always a solution. Wherever you are in the world, I believe there is a resolution for you and your family.
Dr. Louise Stanger is an award-winning interventionist, author, social worker who specializes in substance abuse disorders, process addictions, mental health disorders, sudden death, trauma, grief and loss.
All views expressed in this article are the author’s own.
As told to Newsweek’s My Turn associate editor, Monica Greep.
Do you have a unique experience or personal story to share? Email the My Turn team at firstname.lastname@example.org.