At a training not long ago on CRAFT, the presenter, Dr. Robert Meyers, told a story that I want to pass on to you.
But first, if you have never heard of CRAFT, it stands for Community Reinforcement and Family Training which is an evidence-based approach that family members (or friends) can use to facilitate getting an unmotivated loved one struggling with addiction into treatment.
How CRAFT works?
I am most fond of this approach because, unlike traditional interventions that rely upon coercing a person into treatment through harsh group feedback, CRAFT relies upon using basic behavioral strategies to rearrange the world of the addict so he or she internally reaches the decision that treatment is necessary.
We have known for a long time that external motivation gets the job done; interventions do often lead to treatment. But unfortunately, once there, the person we so badly care about does not engage in treatment, does not really want to be there, and often drops out. We are back to square one and saying that treatment does not work. It is a vicious cycle.
In these situations, treatment fails because of a lack of internal motivation. Those who need to change their behavior have to want to change their behavior, which is why CRAFT is so powerful. It works to increase internal motivation for change by eliminating the positive reinforcement for acting out in an addiction, and enhancing positive reinforcement for non-acting out behaviors.
If you don’t understand basic behavioral approaches to change using reinforcement, then it is time for Dr. Meyers’ story.
A case study
A woman who had been admitted to a psychiatric ward was driving the staff crazy. From the time she woke up until the time she went to bed in the evening she would scream her head off. The staff tried everything they could think of to get her to stop screaming, but nothing worked.
She had to be placed in a room alone, away from the other residents, and restrained at times. Although medications could have been used to sedate her (and probably were at times), they were not the answer.
After many frustrating weeks of listening to her loud cries, a doctor was brought in to see if he could help. His name was Nathan Azrin. Nate walked down the hall to the woman’s room as staff likely snickered about how he possibly could make a difference given all that had been tried.
When he arrived, the woman was sitting on the edge of the bed rocking back and forth screaming like she did throughout the day. He stood at the doorway for quite some time. He may have thought about why she was screaming, but also knew that whatever the driving reason, she could not speak and exploring the why would likely be a long journey.
Instead, being a behavioral psychologist, he considered her behavior and what he wanted her to do instead of screaming. Well, this was easy, he wanted her to stop screaming. Then, he considered the times when she was doing what he wanted her to do: eating, sleeping, and breathing. During these activities she did not scream.
As he stood in the doorway, he began to focus more on the immediate moment to moment rhythm of her screaming and breathing. Then he got an idea…
Right at the moment when she stopped screaming to take a breath, he walked over to her and gently stroked her hair. After she inhaled and began screaming again, he slowly moved back to the door and waited until she had to take another breath. He then repeated the movements with every breath: move close to her, look her in the eyes, gently stroke her hair, and then move away as she screamed.
Why CRAFT works
Nate knew, that at our core, we all have one unifying need: love. And he believed that by reinforcing the moments when she was not screaming, even though they were just seconds, with loving touch, that just maybe…maybe, he could alter her behavior. While staff had isolated her, restrained her, and stayed clear of her, he moved closer to her. And his approach worked.
By that evening, he was sitting next to her on the bed, gently stroking her hair, and the screaming had stopped. He told the staff that when she woke up the next morning and started to scream, someone was to sit next to her and gently comfort her. In fact, anytime she began to scream, the antidote was the same.
My thoughts on CRAFT
I love this story because so often when we are challenged in life we tend to overlook the obvious. We seek out expensive treatments, elaborate self-help strategies, or engage in complex change regiments only to become frustrated when change eludes us.
Dr. Azrin is among the most cited psychologists of all time, and although he may go down in history for his popular read, Toilet Training in Less Than a Day, for me, he will go down as an individual who taught me about love.
Hillary King says
I really appreciated reading this post about love. I find so often in our comings and goings with others that most people are in search of truly being loved by another human being. I thought of a book I read about a year ago entitled “The Ultimate Secrets of Total Self-Confidence” by Dr Robert Anthony. I recommend this book to everyone. Towards the end of the book he talked about loving others and not only telling people we love them but showing them, he then went on to talk about if we are to smile at someone that really doesn’t mean much but if we change our perspective and begin to smile FOR someone how much deeper we care for that person (who may be a complete stranger) and how often times that true heartfelt and sincere smile can change a persons day by being able to feel loved. Love is a powerful thing in every persons life.
Thanks for the book referral and nice words. Love is a powerful thing!
Danielle Hawkins says
Love, such a small word with an incredible impact on human behavior. This blog reinforced what I know, if we invest in people with our hearts positive change will manifest. The Lord asks us to disciple to other the easiest and most effective way is through love. To love ourselves, and our neighbors. I hope to impact at risk youth with this very concept love and forgiveness. Teaching families to love to forgive and acceptance of one another. This lady needed love and responded can you image the change in youth if they feel that they are loved and have a purpose? The effects would change underage drinking, drug use, crime, divorce rate and dysfunctional family life. We do not need a degree to create a better outcome, take a look around and see who you can love.
Lisa Storelli says
Thank you Dr. Fitzgerald, we all need to take into consideration what we do for a typical intervention and see what we can do to change it. We as a society see the textbook version of many applications on how to fix or address issues when in reality we just need to use ourselves to figure out others. In this example of you demonstrating love and reward when someone has high stress and need, you have shown us how to respond in a positive way.
The typical intervention on television shows the removal of a subject from a household, bring them to treatment and in the end they leave the treatment center and go back to using drugs or alcohol. So what is missing at these distant treatment facilities? The teach the person how to cope but shouldn’t there be more of a family/loving nature for them? The whole system needs to change not just the one person. The interventionee needs to have support from all sides and everyone involved needs to change. Just like with love, you could not be the only person to share attention, rewards and hope.
Thanks for the comment. As I suggest in this blog entry, one answer to the the typical intervention is CRAFT. Unlike interventions that I believe can often do more harm than good, CRAFT is an approach that in many ways has a foundation in love, particularly since Azrin was the guy who trained the guy, who started CRAFT (that was a mouthful :))
Well put! At risk youth most definitely need love, you can make a big difference. Good luck.
Janelle Johnson says
I really enjoyed reading this article and couldn’t help but feel for both the staff and the woman who was constantly screaming. There are many times in life where our patience is tried and it is difficult to remain calm but this article reminded me that it is always worth it to take a step back, take a deep breath, and show love. As I have gotten older I finally realized that everyone wants to be seen, heard, and loved. The manner at which people go about obtaining those things can be different but the overall goal is the same.
Kodie Troglia says
I really appreciate you taking the time to blog about CRAFT. While I really enjoyed the story, I am very intrigued about learning more about CRAFT. My mother has struggled with alcoholism for a very long time. My father did too but he got help and is now a recovering alcoholic. We have tried to have interventions with my mother, but she always feels like we are attacking her which makes her drink even more. I am going to bring this up to my sister and see if we can’t try to use this approach on my mother. I will have to keep up on your blog as you have so much to share!
This was a truly touching read, CRAFT has implemented a means of allowing the addict to “internally [reach] the decision that treatment is necessary” by reaffirming the power of a comforting gesture as positive feedback. I am a firm believer that an addict will not make a change until they decide to do it for themselves. You can push a person as much as you want, threaten, fight, plead, but if a person isn’t ready to really commit to the change for themselves then the treatment will not be successful. I know that with my struggles with addiction, that I tried to stop before but I didn’t want to do it for myself; I was told to stop by my sister at which point I decided that I could do whatever I wanted and yeah I kind of felt guilty at first, but I later decided that it was my body and I could do whatever I wanted with it. No one could stop me. I now know that she planted the seed which allowed me to finally grow to the point where I cared enough about myself to make that change. I know that my family’s love and support along with my faith definitely helped me through the worst of it, and I know that it was my choice to get clean. Knowing that it was my choice has helped in times of weakness/relapsing when I decided that drinking would be a good idea so long as it was in moderation. It took a lot for me to realize that I had a problem, and I knew that in order to get better it had to be something I wanted to do. After that, the commitment just seemed like the obvious next step. Now don’t get me wrong there are still temptations out there, being a 24 year old college student existing within a very “liberal” social group, but I know who I am and the decisions that I have made are for myself and as long as I stay true to myself and my choice, I don’t have to fear going back to that sad and lonely place of addiction. Knowing that I was loved and supported was definitely enough to motivate me to conquer any challenge that may come my way along the path to sobriety.
Also get the HBO DVD series and watch the video piece on CRAFT. It is powerful stuff and very likely can help you and your sister help your mom. Good luck.
Well said! Your past can also be a tremendous source of strength and creativity as you move forward in life. Best of luck to you.
That story just brought memories of my own. Sometimes it does just take just a simple stroke of the hair or some comforting words from someone. just to know that their is someone there and that they care for you. Knowing that your not alone can help. Everything can not be solved with meds alone. i have learned from experience it sometimes take consuleing and medication to help.
Kimberly Anderson says
It’s amazing what love, and human touch especially, can do to soothe a person. Much like the staff moving away from the screaming woman, I think we have a tendancy to shy away from people and/or situations that make us uncomfortable. We think of ways to “deal” with it that keep the discomfort (whatever that may be) at arm’s length. There seems to be a protective wall that keeps us from engaging in making simple adjustments towards change right away. Dr. Azrin obviously has a solid understanding of what we all really need at the core. Thank you for sharing. I will definitely keep this story in mind (in a healthy, professional way) throughout my work with at-risk teenagers.
All I have to say is WOW. I have always heard about the power of touch. But never in a way had that made so much sense. In fact as humans we are so often busy in our own lives that we pay little attention to the needs of others. What I found to be so impressive in our story is that Dr. Azrin was not like all the others in just trying to shut that lady up by forcing her to be secluded or drugged. Instead he embraced the idea that maybe she needed positive interaction in order to change her behavior. She wanted so much to be loved and no one wanted to give her the time of day. Dr. Azrin gave her something that nobody else was willing to do and that was to give her attention, love and compassion. Thanks for the wonderful story.
Astra Cho says
What an amazing way to understand someone. Love is so powerful and I think it is the strongest way to communicate to someone you care about that their addiction is hurting you. Positive interaction is so powerful, especially to those who haven’t experienced much of it; what a genius approach to truly understanding this lady. Many times today, we try and medicate individuals rather than treating the problem and I think this is a great example of finding and understanding the underlying issue rather than just treating symptoms of the issue at hand.
Well said, thanks for the comment.
Betelehem Shenbulo says
The story of the woman is truly inspiring. Some of us who have family members or friends that are struggling with addiction at times tend to give up and distance ourselves from those people. We feel betrayed and angry when they relapse and go back to their old habits. This story really touched me and made me realize my love and support is way more important for my friend to continue to fight and overcome her addiction. Every one of us wants to be in loved and accepted at our best and especially at our worst. Love gives a person self-motivation for changing and overcoming obstacles in life.
Adam Caughell says
What a great story that can be applied to many different situations in which “all you need is love” in order to get desired results. Instead of the constant focus of administrating special treatments, medications, or just completely ignoring the issue like the staff towards the woman a different and more obvious approach is taken by using a loving touch by the psychologist. The approach of using love verbally or physically towards a person could result in them conducting a more acceptable behavior. This is a similar approach I was planning to use towards a family member who is going to be getting out of alcohol treatment soon and although interaction with this person isn’t always easy, I still feel that showing that I care and want to spend time with him, that it could prevent relapse. The story really supports the concept, and the famous words of John Lennon, that “all you need is love.”
This story is truly beautiful, and although it makes me realize and appreciate all the love that my friends and family members have shown me over the last five years, my heart hurts for the many that do not have the love and support that is so needed to overcome addiction. In sharing a bit of my story, I was one of the one’s that was “tricked” and caught off guard by a harsh and persistant intervention. They had got me at one of my low moments, weak, frustrated, and tired of feeling so empty. I agreed to go to treatment, and felt like I was finally ready to really hear what my counselors had to say. I do agree that a person is only going to change when they are ready to change, and that forcing someone into treatment who does not want to be helped is futile. What I will say is that, for me, the love and support I had from my friends (the ones that tricked me) and family was why I stayed and got sober. Now nearly 5 years later, one thing that still troubles me about the stories that I heard in treatment was that of the lack of support that many of my fellow addicts/alcoholics had on the “outside.” Most of these people had come on their own, or been forced by the court, and some if not all of their family and friends were addicts as well. I heard the same story over and over, they would come to treatment, it would go well, they would be released after a few months, and then a soon relapse. Most of them said that their friends and family would look down on them, or hassle them for being “too good” for them now and eventually they would slip. I can’t express how often I still think about how it must feel to being fighting addiction alone, and to know that when you are trying your best to survive it, you have no support from your loved ones. I feel truly blessed and honored to have the love and support in my life and attribute most of my recovery to this love.
Todd McBride says
With all the trials and tribulations all those doctors at the psychiatric ward went through to try and stop this woman from screaming, who would have thought something as simple as love which Nathan Azrin showed would have stopped the woman from screaming. I Feel CRAFT is a great approach for getting unmotivated addicts to get treatment because it makes the addict feel it is necessary. Many times you hear about drug addicts that are forced into treatment from their parents or loved ones and they never really try and set their heart into getting sober, this is where I feel the CRAFT approach is far better. There is a show on tv called intervention and most of the time you see an intervention when family and friends sit around the addict and tell them how much they are loved and how the drug is destroying their relationship with all the people who really care, I feel when the addicts hear their family and friends telling them how much they are loved and how the drug is ripping them apart I feel that this is a good way to really get the addict to want treatment. Just showing your love to the addict and showing them you really care can do magical things.
Tamera W says
This story touched me very deeply and was something I could relate to me life. I am not technically mentally ill , except maybe my depression and PTSD, but I am a recovering addict. I am in my mid forties and was addicted to drugs for over 20 years. I was abused as a child and raised in chaos and poverty. Because we moved around a lot and I was in so much psychological pain, I don’t believe I ever learned how to bond with people well and that has not changed in the six years I have been clean. The reason all this relates to the story about the women screaming is because although I do not scream out loud, I feel as if I am constantly screaming inside and I am so grateful when someone comes along that knows how to reach me and give me a little peace. I do not know how to communicate my needs to others so it feels as if it is up to them to figure it out for me just like the Dr did for this woman. Thank you so much for the work you do and thank you for learning how to understand the needs of others. We all need love even those of us that don’t know how to ask for it. As the CRAFT theory states is really is all about relationships and that is such a personal journey that no one right answer exists for everyone. Thank you for the work you do.
Hi Dr. Fitzgerald,
I am a member of Professor Kaufman’s class at PSU, and you came to talk to us a few weeks ago. After that class, I have frequently considered the importance of behavioral intervention when addressing addiction. I began to see addiction as a symptom of many underlying distresses, which are often correlated to traumatic experiences. I particularly enjoy this story because it shows a realistic way to approach behavioral intervention. Perhaps there could be parallels to clinical drug intervention, using the same method of positive reinforcement. I personally believe that reinforcement is much more effective than negative reinforcement to foster discipline, yet I do not have any clinical experience with drug interventions.
Love is a major contributor in changing people’s behaviors. I once worked for an orphans home back in Saudi Arabia. I specifically dealt with teenage orphans who hasn’t find a home yet. When i started working there, they hated me and didnt respect me nor responded to my requests in helping them in their school work. They would hold an explanation toward any good action I did to them by saying that i am only doing this because I got paid, which was pretty frustrating at times because id postpone most of my family commitments to ensure that they are ok. When the orphan home declared that they weren’t able to pay us, many of the workers quit. I on the other hand didnt because I felt sorry that these girls dont have any one that support them. That situation proved to the girls that i was looking to achieve something beyond the material value. From that moment, the girls attitudes changed to the better. They no longer fought with other girls at school. Their academic performance became higher, and most importantly, they developed a sense of appreciation to themselves, people around them, and the world. Now, most of these girls have graduated from high school and are studying in colleges. This would defiantly prove how love would make people change for the better.
Thanks for your comment and openness about your own life. My suggestion is to not wait until people figure you out, but realize the leverage point for you to move forward is to work your own developmental capacities that get constricted due to trauma and addiction. Find a good relational private practice clinician and work your emotions. Also read, “Growth of the Mind” by Stanley Greenspan.
Gloria Peak says
Love is such a simple word, yet so powerful. Love is a word that has different meanings to people but has the power to change peoples’ lives. Feeling loved, and/or giving love has a tremendous effect on people and can truly change a person’s outlook on life.
Loving someone can change negative behavior of a person.
There are countless stories where new parents first lay eyes on their newborn baby and realize that negative behaviors in their lives have to be changed and the sacrifices that need to be made. I know a friend who had a baby at a very young age. He wasn’t a typical high school kid who worried about passing his math test. He worried about how he was going get his drugs and get high. He dropped out of high school and worked at several part time jobs, but could not hold any of them for more than 3 months because of his marijuana addiction. He later found out that his girl friend was pregnant and was frustrated and annoyed of the situation, and wanted her to abort the baby, she disagreed. When he first laid eyes on his newborn son, he fell in love with his son. He went back to school and got his G.E.D. while working 2 jobs. Wanting to give his son a better life, but unknowingly saved himself from drugs and got himself a higher education. Not only being loved, but having to love someone can have a great positive impact on a person’s life.
Couldn’t agree more!
Sierra Brooks says
The minute i read the first 6 sentences i feel in love with this article. i feel like in today’s society we always forget about the little things in life. Because people always need love no matter what obstacle you through. Love is so priceless and it can help save lives no matter what issue and problem. Love is a major impact that combine the parts in life that really matter. When you lack that affection it can make you scream, shout, pain, and anger. So when reading this it made me feel so much empathy for that poor women. And the correlation between love and human life is a major thing that people often so look.
Thanks for the nice feedback!
Jerry Chalmers says
I’ve seen an abundance of tragedy and death when it comes to addiction. I have seen many people enter rehab, come out, and get right back into the partying lifestyle. I’ve comforted many friends as I dropped them off at rehab. Once I dropped my brother off at rehab and he was home before I was. I’ve also been involved in a few interventions with friends and family members. The majority of them didn’t want to hear it.
I myself got involved with drugs and alcohol at a young age. I was a compulsive partier. I didn’t do it every day, but once I started I couldn’t stop. I wanted it all. When I did It, I went all out. It took me roughly twenty years to figure out that I had a problem, and that I needed to do something about it.
One day I took a hard look at myself in the mirror. I didn’t like what I saw anymore. Life was flying by, and I had done nothing significant with my life accept become a really good partier. I decided that I needed to make a change and try and do something meaningful with the life I had left.
I went cold turkey. I quit smoking tobacco, drinking and doing drugs. It wasn’t easy, but it was necessary. I just couldn’t do it anymore. My life eventually became more manageable over time. I decided to go back to school and pursue a career geared towards helping others, which I am currently in the process of doing.
We all have different personalities. We all behave differently. We are all from various environments, and we all have varying genetic characteristics. I don’t know why addiction happens, but it does. Perhaps we start drinking with friends. Maybe its peer pressure or perhaps we do it to help forget. Eventually it starts to control your life and eventually it becomes a serious problem. There were a million times that I would come off a bender and swear to quit, but once I felt a bit better, I’d be right back in the swing of things.
Anyhow, I believe that people can be helped and I agree with this concept, but ultimately I believe that you must want to help yourself. You have to start loving yourself again at some point. I also believe that making some changes are essential. I have seen too many people come out of rehab, start hanging around with the same people and end up back in the same lifestyle. Some ended up in jail, some ended up dead and some keep on trying.
The story was quite interesting and this concept seemed to work in that particular situation. I’m all for the CRAFT concept. I believe that people need to be loved. Increasing internal motivation for change with love during non acting behavior sounds quite interesting and I’m all for it, but ultimately I believe you have to start loving yourself and helping yourself.
Thanks for the feedback! You make an excellent point that a key to successful change is self-love, which I couldn’t agree more. Unfortunately, a lot of addiction is fueled by underlying adverse childhood experiences that keep people stuck in shame and self-loathing cycles. Self-forgiveness and acceptance can reverse the process. Also, seeing life for what it is, as you did, is very self-motivating.
Karissa Newell (W12- Karissa) says
Wow! What a powerful story. The meaning of love is an emotion of strong affection and personal attachment. With such a word that means so much, everyone in the world needs love. The days I am sad and down a simple hug can change my view on things. Without love you feel lost and alone, which I think this woman felt in the psychiatric facility. It’s the simple things in life that people take for granted, like having a loving family that most people don’t realize is such a special trait. I think a lot of people turn towards drugs and addiction when they don’t feel loved. Treatment isn’t always the case and sometimes people just need a hug and someone to talk to. I really enjoyed this post and it is incredible what love can give to someone.
Nadia Mendiola says
This is such an amazing love story. It’s amazing how love can empower people. Sometimes we tend to miss the most obvious signs in front of us and try to handle difficult situations on our own hands, which brings us father away from the right solution. THis story is a great example. The woman needed the attention and love that everyone feels fond of, what we want and need to keep us alive “within”. Thank you for sharing this story.
As for the addiction and treatment presentation you shared, I never stopped to realize how important it is to build “relationships” with those in need of treatment. I use to think that people who face addiction simply go through therapy, treatment programs, or seek medical assistance, without realizing that its essential to build a “relationship” first with people to help keep them away from their addictions-drugs, alcohol, food, etc whatever it may be. I could not agree more, ADDICTION=RELATIONSHIP. Thank you so much for such an informative presentation.
I have always thought that many people in our society want a “quick fix” for everything. Whether they want to lose weight or stop a cold. I agree that most people don’t stop to look at the problem in the same way that Azrin did. Positive reinforcement has been a driving force in changing behaviors for many centries now. It is amazing to me that something as simple as a little affection can change someones behavior, but it also makes a lot of since. Love is a powerful gift that doesn’t cost anyone a thing to give.
I think that The Beattles song is very appropriate as well.
Alicia Fine says
This is a great story that will help a lot of people. Tons of people go through this kind of therapy, and no one can ever figure how to fix there problems. After reading this story it is crazy to me how easy it was, everyone was over looking the little things in life. Love is something that everyone needs. The feeling of feeling lonely or alone is the worst feeling. Some things are as simple as rubbing her on the head, that gives her comfort and love. The thing that gets to me about this story is they just put her in a different room away from everyone else. Did they really try everything they could before resulting to this? I personally dont think so. Forgetting about someone and making them feel lonely and sad will not solve any of the problems. Love is a very powerful feeling that can fix a lot. This is a great story that I will keap in my head and remember in day to day life. Because this is something that can be used in the simplest way’s, for example giving people compliments or showing someone you care about them.
Cam Chau says
In our society, we tend to look for quick and easy solutions. However, when dealing with problems involving any living species whether it is a person, a dog, or a plant, there are no quick and easy solutions. In this article, the staff may use medications to get the resolve they want but they are not really solving the problems. They are only treating the symptoms. As a mother of three teenage boys, I learned that when I used love and kindness to communicate with my children, the tasks around the house get completed quicker than when I use loud and angry demands. As a licensed massage therapist, I have clients whose main reason for receiving a massage was the loving touch they so crave for. This article demonstrated that a loving touch is the most essential components for healing. Yet, we tend to undervalue it due to our busy lives.
Pamela Dye says
I really enjoyed your article. I am am am 7 years clean off meth and what really helped to get me clean and kepp me clean was understanding the pains and hurts from my childhood that I was covering up with the use of drugs. There were so many painful feelings and a lack of love that I felt it caused me to hide those painful feelings or ignore them with the use of drugs. Once i found a Chrstian based recovery program and felt safe and loved in my group I was able to explore and actually feel those childhood hurts. I then was able to work through and process those feelings and the need for the drugs to mask those feeling went away. I replaced them with healthy relationships with people I could trust and be vulnerable to and the unconditional love of Christ. Getting clean was never so hard when I was forced into it, staying clean was. I think this is why CRAFT is so much more effective. There are inside emotions and feeling that commonly need to be addressed and dealt with before the outward actions can change. Sometimes we just need to be loved and touched and we are seeking out that love through the use of atificial feelings that we find in our addictive behaviors. For me it was the love of God that made the difference and I am very grateful. I had a lot of life to fix but I am making it happen. I am a student at PSU and look forward to your visit to our Drug Education class.
Ashley Byers says
I think that story sets an amazing example about how we should react to situations that may at first be tiring, stressful, or annoying (like her screaming may have been). The woman in the story was physically screaming and I think that is a very clear way of showing her distress. I think in many situations where we are faced with the suffering may not be as obvious, and it may not be as loud. I think that it may express itself in odd behaviors, manners of living, reckless or quick decision-making or something else. I love the approach the physiologist took and I really appreciate that he took the time to watch and think before he jumped to conclusions or made harsh criticisms about the patient. I think that too, is a way we can help those around us. We can simply take a moment to assess the situation and then proceed with gentleness and a simple plan that is not designed to make us feel better, but is designed to help the other person.
Roxanne Simas says
At certain points in life where it has gotten over whelming to the point where words no longer seem to matter or make anyone listen I get so exhausted I finally just break down and cry. In a way crying is my version of her screaming. I so frustrated and so many people have counted me out nothing seems to calm me down but after a long enough time and enough people telling me its going to be alright I begin to rebuild myself and feel ok. We as humans can’t function properly without human to human interaction and although a little quiet time never hurt anyone we can’t grow or adapt without others around us. If people gave up on me and isolated me every time i was difficult or they couldn’t understand me i would probably scream to just to hear sounds.
Arianne Hurtado says
I really liked this story because it shows us how simple things could be if we opened our eyes and looked. We as a society tend to throw away people that are not to our standards. Like the women in the story being isolated because no one wanted to deal with her. She was obviously suffering from a traumatic issue and yet no one took the time to get passed the screaming until Dr. Azrin. He took the time and reached her with tenderness, similar to what you do with a child. I know from experience and many parenting classes that nothing works better then praise and reinforcement. That is what Dr. Azrin used to reach that woman and of course it worked, we need to try that first.
Jennifer Nguyen says
This story is very touching. It reminds me that no matter who we are, what we have been through, or how we act, we are all human and that, in the end, all we want and need is love. I find that to be really comforting and it makes me feel more sympathetic towards other people when I know that love is what connects us all. I also think it is amazing that the kind act of Dr. Azrin towards the patient was just as effective (if not more effective) as medication. Love truly is a very powerful tool. However, as simple as it is to use love as a remedy, I also think it is sometimes hard to come to the realization that what is needed is love. We can get so overwhelmed with the present situation that it easy to overlook or forget about the simple things like love.
Caroline L says
Wow, what a great story. I am a firm believer in the power that love has over people. Often times, we overlook the ability that love has to change and heal people. I think that this shows a really positive way to help someone to find comfort, and then, through the new-found comfort, the ability to evoke change. As you said in your presentation to my drug education class at PSU, one of the biggest pieces of addiction treatment is focusing on the relationships in the addicts life. Having strong, loving relationships is crucial to recovery and management. I think that an addict knowing that there is a truly loving relationship in their lives when they are sober can be a very motivational force to maintaining a clean lifestyle. I feel as though the positive reinforcement that having support and love when the person is sober can really be a driving force through recovery.
Trevon Hartliep says
Forcing someone to do something they don’t want to do is the best way to ensure that they stop that action as soon as possible. Interventions to get addicts into treatment are a effective first step in getting them into centers, however it is very likely they will quit as soon as possible. This is because no matter the reason they were forced into it and that is something human beings automatically rebel against. I think that is what makes this CRAFT approach so powerful is because it is gently and patiently causing the addict to decide for themselves to get treatment, which is a huge factor in them being able to complete the program. Hopefully Dr. Azrin can spread the word about this effective tool in treating drug users so that we can start to shift our perspective towards treatment rather than containment.
Andrea Beck says
It seems so odd that those who were already in charge of the care and treatment of this woman had not considered her need for human interaction and affection. I would be interested to know what time period this took place in. I would hope that in todays’ world full of research and information that we would not be turning our backs on such basic psychological needs. Information concerning situation such as this would benefit to be used in our prison systems as well, often times those incarcerated would have benefited in the past as well as the present from some positive human contact and understanding.
This story brought tears to my eyes. I completely agree that in live in general we ignore the obvious. Love is something a lot of us overlook and I think we need to change that. In my opinion everyone deserves to be love. Love fills your body with hope. When someone shows they love you, you want to make them proud. Love can really heal most everything. I also really took into heart when you talked about how a person receiving treatments needs to want to get help. No matter how much you help that person they need to want to get better themselves. This is so heartbreaking because I have a family member who needs to get help and wont. This was a very inspiring article to read.
Candice Orozco says
It’s crazy to imagine that with all the doctors and qualified employees that worked in that institution that not a single one could figure out that maybe isolation wasn’t the best tactic for this woman. It’s also mind blowing that such a man could help the poor woman with an idea so simple as love and compassion.
Yes, often it is the simple, common sense solutions, that make a difference.
Mindy Buxton says
Candice, it is crazy to imagine that such qualified professionals can have such a mental block when it comes to the “personal” needs of people as opposed to the “medical” needs. I was recently at my neurologist’s office and when looking at the blood-work that my naturopath took, her outlook was an extreme difference. My naturopath chooses to look for what the optimum levels should be, and my neurologist thought that the levels she is looking for are a little excessive. Most medical specialists look for emergency levels. It just really goes to show that simplistic ideas of love and compassion are not emergency cases.
Mayra Fuerte says
Love really is a powerful thing and I can see how a little affection can really help someone heal. Human are not only naturally social beings, but they also naturally love. The way the staff was going about her treatment and isolating her was only doing her harm in the end. In my health psychology class how people suffering from a disease do better in group therapy where they can talk to others who are going through something similar. People just need someone to listen to their problems and what they are feeling, that’s how they feel important and that they actually matter. It helps people cope their disease and “heal” from something that is incurable.
Maikhanh Tran says
I really appreciate this story because I think that this is relatable to almost anybody. In today’s society, it is almost instinct to just avoid bad things when they happen but this is a great example of thinking “outside of the box”. Although it seems as though this should be our natural instinct to do which is get closer to comfort, but it was no in this situation with the nurses. The title of this blog already says a lot about how we should approach similar situations like this one in particular. I think that rather than just ignoring and isolating someone, displaying care and affection goes much further and would be much more affective. Sometimes just having someone there to listen is also extremely powerful.
Chris B. says
Love is an important aspect of life. We do and have seen people do crazy things for it. In this heartfelt story the women was missing a connection with someone or being a part of a community, isolation was not the best tactic in treating her so she was missing contact from the outside. It’s nice to know that there are programs for addicts who want and are willing to change and not forced into treatment. The love aspect is an interesting and fascinating phenomenon. I think that sharing a bond with someone gives someone hope and motivation to push forward. It gives them a reward to look forward too. My mom’s brother was an addict when he was younger and he went to rehab for 3 months. When he got out and told my mom that without the support of her and the family he wouldn’t have made it out alive. So having someone who cares and loves you can push someone to get help in this case. Having those support systems really helps someone especially when they have to go through it alone.
Thank you for the heartfelt story!
Kristin Henno says
I found this post very interesting. I like the way CRAFT approaches the situation by relying upon basic behavioral strategies to rearrange the world of the addict to realize that treatment is necessary. While learning about addiction, the one thing that I have noticed too, is that intervention doesn’t work. I have seen this happen first-hand. This post suggests it is about external and internal motivation and I agree after what I have learned and read. The story presented in this post was great!! Nate’s idea was brilliant. Love is such a powerful thing. I am a golfer and know how important positive reinforcements can be and how effective it is. Although this situation is different then golf, positive reinforcement can work with anything. Love and positivity can work wonders.
Nazanin Sanaee says
What a great stort to share! You have no idea how much this story touched me deeply and was something I could relate to my life too. I am not mentally or physically ill at all but I am a strong believer of love touches many thing no one can touch!!! The reason all this relates to the story about the women screaming is because even thought I never been addicted or involved with any kinds of drugs but I always feel like I have a lot on my plate to take care of. I do not scream out loud, I feel as if I am constantly screaming inside and I am so grateful when someone comes along that knows how to reach me and give me a little peace. I do know how to communicate my needs to others but still feels good when someone else is the one reaching out to me.what the Dr did for this woman was beyond and above what any one can do for her at the time. Thank you so much for the work you do and thank you for learning how to understand the needs of others. We all need love even those of us that don’t know how to ask for it are even more desperate. The CRAFT theory is so true; life really is all about relationships and conection. I strongly think that is the time you try any thing as a drug when you lose all of that conection and love. Love and touch is such a personal journey that no one right answer exists for anyone to simplify it. Thank you for the work you do and what you do is priceless.
John Fitzgerald says
Nazanin, thanks so much for the beautiful feedback! It’s true, we get so lost in our lives we often fail to take the time to slow down and feel our needs. When we do, they are actually quite simple, love being the most important.
Elizabeth Santana says
It’s comforting to know that there are still people who believe that the solution for some of life problems is some simple love and attention. We live in a world where prescriptions are given out like candy and the belief that medications will solve everything prevails. But the reality is that they will never reach the root of the problem. How could a medication replace the experience and feeling of love? Sure, a pill will probably deal with a problem much quicker but it will never heal someone completely. I truly hope the CRAFT approach can be used more often and can be implementing in todays health care systems. Thank you for sharing Dr. Fitzgerald!
April Kelso says
What an eye opening story! I feel as though I was supposed to read this tonight. My 7 year old is struggling with focus in his class room. I feel as though I have tried every form of punishment that I can think of and don’t know what else to do. Tonight, reading this story of positive reinforcement, it dawns on me, I need to work with his teachers and myself to recognize those moments when my son is doing the things that he should be. I must be consistent in this reinforcement so that he realizes the desired behavior and the reward. I also need to step back and understand what is causing these underlying issues and simply come along side him, showing just how much he is loved and supported.
John Fitzgerald says
April, parenting is not for the faint of heart! Thanks for your comment, it made my night.