Seeing ‘Can’t Yet’ instead of ‘Won’t’
Last year I trained as a CRAFT facilitator (Community Reinforcement and Family Training) and began supporting family groups for parents, partners and loved ones of people struggling with addiction.
As I put my training into practice in the groups I was co-facilitating, I started noticing a pattern that no-one else seemed to be seeing. Often without realising it, so many of these families were dealing with a loved one who wasn’t only dealing with addiction but also had ADHD.
Often the person struggling didn’t know about their ADHD either, or else it was something so old and forgotten from childhood that they didn’t think was relevant to their current situation.
As we coached loved ones to set boundaries, make requests or communicate a need, they sometimes became angry and frustrated and lost hope, as everything their loved one agreed to was forgotten or dropped by dinner time: the plans, the promises, the lack of follow-through.
They saw stubbornness, bloody-mindedness, selfishness, or that their loved one simply didn’t care, adding even more resentment to an already tense situation.
But what I saw and heard was ADHD that wasn’t being managed. When I explored this possibility with the families and described how it shows up and how it affects their loved one, the light bulbs went off. Understanding this helped them become more empathetic and so able to stay calm and supportive again, and when I shared some ways they could change their approach (ways that would set the ADHD mind up to succeed and increase follow-through) they got different results.
What most families do
Since becoming an addiction recovery coach, I’ve seen how vital family or loved ones are to encouraging those they care for on the path to recovery. I also know how challenging it is to help in a way that’s truly effective and loving at the same time, not just through my role as a coach but as a loved one who’s been there myself.
Most loved ones aren’t using any particular strategy. They’re simply reacting day to day: begging and pleading, getting angry and threatening, cajoling, guilting, withdrawing… Anything to stop their loved one from hurting themselves!
Given the situation they’re in and the level of anxiety and worry they’re feeling, this is completely understandable, though sadly it rarely works, and can actually make things worse, and leaves them exhausted and worn out.
For a long time there were only two options for dealing with this situation. You could stage an intervention, which helps some families, though it isn’t always successful and can sometimes backfire, leading to mistrust and resentment and distance.
Or you could go to Al-Anon, where the focus is more on letting go and letting your loved one reach rock bottom so you can stay sane and not get dragged down with them. That’s partly effective, but it leaves your loved one in the battle of their lives without help.
Luckily there’s a third option: a strategic, research-backed middle way called CRAFT.
CRAFT: The smarter third option
CRAFT (Community Reinforcement and Family Training) was developed by Dr. Robert Meyers and colleagues at the University of New Mexico. It teaches families and loved ones practical skills to understand what makes things better and what makes things worse, and it’s backed by decades of research.
- CRAFT has three goals:
- Improve your own wellbeing and quality of life
- Reduce your loved one’s substance use
- Help your loved one engage in treatment and support
In one study, about two-thirds of families using CRAFT (64%) helped their loved one into treatment, compared with 23% using an intervention and 13% using Al-Anon.
When I first learned CRAFT, I realised I’d been using some of these skills instinctively with my own family, though I also saw that other things I was doing were potentially causing harm, to them and to my own peace of mind. I’d never heard of CRAFT, so I didn’t know there was a way to do this strategically instead of blindly.
Supporting families with CRAFT over the past 18 months I’ve watched people begin this work feeling isolated, exhausted and alone with something they can’t always talk about anywhere else, and then watched their confidence grow as they change their approach. Their own wellbeing improves, and many see their loved one begin to make better choices, including choosing recovery.
The ADHD factor
There’s a saying in the CRAFT community: All behaviour makes sense…
I love this saying! It aligns with my own coaching approach that underneath the sometimes self-destructive and puzzling behaviours we see in the ADHD world, from procrastination to addiction, is a set of unmet needs that are trying valiantly to be met in the only way they know how!
When you know this, you know that uncovering the needs beneath the behaviours is the work we need to do to make real change possible and sustainable.
ADHD is highly heritable, and ADHD and addiction often show up together, so it’s no surprise they so often show up in the same family.
Studies suggest roughly 11% to 35% of adults with a substance use disorder also have ADHD. When the two occur together, addiction tends to start earlier, be more severe, last longer and respond less well to treatment, which is all the more reason ADHD management needs to be involved. Whether that’s medication, coaching, lifestyle changes or all of these, managing it can help lower the risks of relapse and support a lasting recovery.
That’s why, for many people, addiction recovery needs to include an ADHD assessment and support to manage it.
It’s also why families using CRAFT need to adapt their approach to fit the person they are trying to reach. That way all their hard work lands in a way their loved one can hear and use!
CRAFT relies on clear communication, well-timed rewards and catching the right moment to influence change, and ADHD affects all three.
In practice, that means when you try some of the CRAFT skills and they don’t always land, what you’re seeing may not be that your loved one ‘won’t’ but more that they ‘can’t yet.’
Some examples of how to adapt CRAFT for the ADHD mind…
Don’t take every dropped promise personally. Forgetting and avoiding can come from ADHD overwhelm, time blindness, trouble getting started or poor working memory, not from selfishness or not caring.
Keep it short and clear. One request at a time, in a calm moment, then follow up in writing with a text or a note so it doesn’t rely on an already over-taxed memory.
Reward right away. The ADHD brain responds to “now” much more than “later,” so notice and appreciate the good moments as they happen.
Keep consequences close. If a natural consequence comes much later, your loved one may not connect it to their behaviour.
Be ready for the yes. Motivation can come and go super quickly, so have the phone numbers or appointment(s) ready for any recovery steps you’ve planned with your coach. That way a ‘maybe’ can become action the same day.
Get curious about what using is doing for them. If all behaviour makes sense, it might be helping them focus, calm down or sleep. That doesn’t make it okay, but it helps you understand that there’s a real need driving this! (Read more about this here: Are you self-medicating your ADHD?)
You don’t have to do this alone
If you recognise your situation here, firstly know that you’re not alone. Because ADHD and addiction run in families, some of this might sound familiar about you too, and that’s okay 🙂 It just means CRAFT needs to work for your brain as well!
If you want to learn more about CRAFT for your situation, these two books are a great place to start:
–Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert Meyers and Brenda Wolfe
–Beyond Addiction: How Science and Kindness Help People Change by Jeffrey Foote, Carrie Wilkens and Nicole Kosanke
If you’d like to talk this through with someone who ‘gets it’, as someone with ADHD in long-term recovery and a family member who’s been there too, click below to book a free discovery call with me.
