Dealing with Denial
Without a doubt, denial is the most significant roadblock to recovery. Denial is a defense mechanism, a reaction to protect oneself from the truth of addiction. Lying about one's addiction or refusing to discuss the subject may be the first indicators of denial. At this stage of denial, the addict may recognize that his substance use or behavior is a problem, but may not recognize the depth of its effects.
As time goes on and problems mount related to his addiction, denial becomes a means of psychological survival. Although denial is typically an unconscious process, it is the most common method an addict uses to manage his fears.
There are many fears that may strike deeply into the heart of an addict. He may fear others finding out about his addiction; he may fear the legal and financial consequences of his behavior catching up to him; he may fear the loss of relationships over his addiction; and most of all, he may fear withdrawal and life without the addiction.
Denial says that if the problem is not acknowledged, it doesn't exist. The painful thoughts, the emotional conflicts, and the anxiety surrounding the addiction are simply someone else's problem. If others would stop bothering the addict, everything would be fine.
Those who love and care for the addict recognize that this isn't true, but one must realize that she is highly invested in maintaining his state of denial. There is a great deal at stake in admitting the truth about addiction. Recall that addictions are commonly used to manage painful and difficult emotions and/or psychological problems.
To give up denial, an addict has to find another way to deal with his problems. Denial of addiction may also be related to denial of other mental health problems. The layers of fear and anxiety in an addict's life may go deeper than one might think.
It has been estimated that over 4.5 million Americans meet criteria for needing drug and alcohol addiction treatment, but deny they have a problem. These statistics include people aged 12 and older. It is of great concern that teenagers make up a significant portion of those individuals in denial of their need for help.
There are specific indicators that a person is in denial about his addiction. Here are some common ones:
Refusing to learn the facts about the effects of addiction
Distorting information related to his addiction such as the amount or frequency of usage
Minimizing the significance of his use of an addictive substance or compulsive behaviors
Lying to friends and family members as well as himself about the extent and details of his addiction
Selective memory related to his addiction, acknowledging only those details related to his addiction that would not raise alarm, such as going out with friends to a party and neglecting to include that alcohol and cocaine were the focus of the party
“Euphoric recall” or remembering only the good times associated with the addiction
Wishful thinking related to his addiction such as imagining he could engage in his addiction without negative consequences or that he could stop the addiction without problems any time he chooses
Avoiding conversations related to his addiction
What are defense mechanisms?
Defense mechanisms are psychological processes, often unconscious, that allow a person to protect himself from real or perceived threats or stressful situations. Sigmund Freud first described the concept of defense mechanisms in 1894. His daughter, Anna Freud, continued work in this area in the 1930s. The most commonly recognized defense mechanisms are denial, repression, regression, sublimation, rationalization, projection, reaction formation, and displacement.
How should a person's denial be confronted? Carefully. Confronting an addict's denial too harshly or abruptly may only serve to drive him away from necessary treatment. Denial is not always a bad thing. It can be positive protection for a person who has experienced trauma or emotions too painful to acknowledge all at once.
Denial is maladaptive when it persists and prevents a person from getting the help he needs. In addressing denial, one's fears need to be taken seriously and support provided. Allow the addict to freely talk about his fears in relation to his addiction.
Irrational thoughts or beliefs the addict holds need to be identified and replaced with evidence of truth. For example, many addicts believe that the addiction is too powerful and that nothing will help. This is an irrational thought that can be replaced with truthful evidence of treatment options.
A person in denial about his addiction has often isolated himself from others, cutting himself off from objective information and feedback related to his addiction. A person's imagination can easily exaggerate information when in isolation. Exaggerated and distorted information can lead to further isolation. Being a friend and gently reminding the addict of reality can help.
Denial may also be covering up shame and guilt an addict feels. Attacking a person's denial by telling him he should be ashamed of how he's affected others and damaged himself is quite harmful. Confronting denial with attacks and “beating the addict down” creates further destruction that will need to be repaired before recovery can take place.
Empathy and understanding, while at the same time telling the reality of what one sees, will reassure the addict that it is safe to face his denial. As an addict sorts through his fears and anxieties over addressing his addiction, he will need to experience acceptance and support.
The person considering the need to confront the addict may need help in dealing with her own feelings of anger and resentment before she can be effective. This is understandable. Confronting denial around addictions is difficult for everyone concerned. Patience is most definitely a desirable quality in this situation.