For two years, I worked with a police department in Massachusetts, meeting people at the ER right after they’d experienced a non-fatal overdose. This was one of the most pivotal points in my understanding of what’s missing from the current system.

Once a patient was medically cleared, a nurse or navigator would ask them one question, “do you want help today.” That question was how I got permission to walk in and talk with them.

Nine out of ten times, the answer was no.

That shocked me. I knew it wasn’t true. I had already heard thousands of people in recovery share their stories by that point in my own journey, and not one of them liked the life they were living.

I would stand in the hallway with tears in my eyes, so frustrated, following the nurse down the hall after being told I couldn’t see the patient because of their “no.” I’d say, “but they do want help, they don’t mean it when they say no.” At first, the staff looked at me like I was a little strange. They were super busy in the ER. Who was this lady?

But I kept saying it. And one day it hit me. I went to the chief of doctors. “We’re asking the wrong question. Ask them if they’ll speak to an addict.”

Every single one said yes.

Same person. Same overdose. Same day. Same bed. Completely different answer.

What changed wasn’t their readiness. It was the question.

That one shift let connection begin. 

So often, the questions we ask and the statements we make are aimed at some imagined finish line, as if someone is just going to say, “oh, you’re right, what am I thinking, of course I want help.” Asking someone “do you want help” in that state, means we don’t understand that state.

It’s like asking someone standing in a burning house to think about redecorating. Their whole brain is occupied with where’s the exit, is anyone behind me, is that beam going to fall? You could offer them the most beautiful blueprint for a renovated life and it wouldn’t register. Not because they don’t want a better house. Because you can’t plan a renovation while you’re calculating whether you’ll make it out the door.

The thought of “my life is falling apart” gets replaced almost instantly by whether they’re about to get sick from withdrawal. Where their stuff is. Whether their truck got towed. Who might have seen them. What they’re going to tell their boss, or their kids, or whoever they’ve been quietly trying to hold it together for. Their mind is full. Just not with the thing we think it should be full of.

Yet.

We do not understand. Therefore we are not reaching them.

“Will you talk to an addict” is the right question. That doesn’t mean they’re fully engaged, or ready for help, or solved in that moment. It means connection can begin.

We need a strategy that gets us one step closer to them. Just a step closer.

In that job years ago, it became clear I’m an expert at engaging people. In fact, my boss checked off “expert” on my evaluation in this one area (though that’s an interesting story that deserves a whole email of its own).

This is exactly why waiting for your loved one to “want it” keeps so many people stuck. You’re waiting for a yes to a question that was never designed to get one. There are other doors, ones that meet them where they actually are, not where you wish they were.

This is one of the first things we teach you inside Foundations, how to understand what’s really happening in your loved one’s mind in these moments, so we can find the door that will actually open.

Speak soon,
Kate

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