People regularly jump out of high windows to escape fire. Under crisis conditions, we are able to make rapid calculations as to the most likely path for survival. My work with adults who were subjected to extreme abuse as children has indicated that this capacity for prioritizing between terrible choices is available at an early age. Employee assistance programs and professional assistance programs employ a strategy that frames a crisis such that the alcoholic must choose between loss of job and recovery. The defensive bulwark that their self-preservative systems erect against all influences for change is sufficient under most conditions to maintain the addiction, but it can be breached.
Alcoholics sometimes experience a sudden spontaneous awakening.
For instance, one patient found himself in a gutter outside a bar and was struck by the gap between his self-concept and the reality of his behavior. A mother hit rock bottom one day when she realized that she would be too drunk to get help for her child if her daughter became ill in the night. The technique of planned intervention makes use of both force of numbers and surprise to maximize the chances of breaching defenses. The number of concerned people confronting the alcoholic seems to increase its effectiveness. Instead, those assembled express their personal experiences with, and feelings and concerns for, the alcoholic.