Denial – the Biggest Block to Diagnosing and Treating Addiction?

You may have seen firsthand how an alcoholic or addict refuses to acknowledge their problem. Even when their addiction is clearly evident to you and everyone else.

Isn’t that strange? And frustrating?

In a society where alcoholism and drug addiction are associated with “abuse” and addicts are depicted as morally depraved with a lack of willpower, physically unfit, mentally unsound social outcasts, it is not difficult to figure out why they deny they have a problem. They don’t fit the stereotype.

And besides, everyone else around them is practicing denial, too. When you look back and hear the stories of all the missed opportunities to diagnose addiction in the early stages, it breaks your heart to consider all the misery that a therapist could have prevented.

Professional Denial

Ramesh, an inpatient client at Hope Trust, was twenty years old when he was drinking an average of five or six beers or three or pegs of hard liquor every day. Despite continued drinking, occasional use of marijuana and amphetamines, and persistent, unrelieved depression, Ramesh’s therapist did not believe that he was an alcoholic. The psychoanalyst thought that his client’s underlying problems were depression and unresolved psychological conflicts. Ramesh “progressed very well” in therapy, he insisted, even though he continued to drink and use drugs.

“Professional denial” is rampant in our society. Thousands of recovering alcoholics and addicts can tell you stories about how their doctors mentioned their swollen, enlarged livers but only suggested that they might perhaps want to cut down on their drinking. As usually happens, the alcoholic responds by temporarily cutting back from a daily average of six mixed drinks to four or five!

Like Ramesh, countless alcoholics consult psychiatrists and psychotherapists who are ignorant of the neuro chemistry of alcoholism. They view heavy drinking as a symptom of deeper emotional problems. Months or years pass, and patients spend time and money searching for the “real” cause, thought to be buried somewhere in the multilayered psyche.

Family Denial

Family denial is as common as professional denial. When Krishna, another client, was twenty-six years old and a student at the university, his brother began to worry about his drinking. One Sunday, when there was no liquor in the house, all the bars were closed. He watched in amazement as his brother systematically searched the kitchen cabinets, took out all the cooking ingredients containing alcohol, and drank them one right after the other. Still, he rationalized away his fears: Krishna was young, in college, and most of his friends were also drinking too much. “We used to think that alcoholism was something that happened to someone’s dad or uncle or grandfather. Students might drink too much – but alcoholism, no way!” recalled his brother.

That’s classic denial. Think about it: Why would a young man guzzle bottles of almond, orange extract, vinegar and other stuff if he didn’t have a drinking problem?

After all, the thinking goes, addiction is a shameful weakness, something that happens to emotionally unstable people from dysfunctional families or people who have been severely traumatized by life experiences – how could it happen to someone like Ramesh? For heaven’s sake, he had previously worked for a reputed company and is the son of a successful professional!

The Addict’s Denial

Alcoholics and addicts practice the same sort of denial in rationalizing that they can’t possibly be alcoholics. No self-respecting human being want to be considered “one of them.” Denial helps the alcoholic assert with confidence: “I’m not weak or screwed up or self-destructive, so I can’t be one of them.” In alcoholics, however, denial goes deeper than fundamental ignorance or wishful thinking – it is a symptom of their addicted brain.

Addicted brains do not think rationally or react logically.

• An alcoholic sits in his living room, getting good and tight on beer after beer, but comforts himself with the thought that he’s not like his household maid’s husband, who keeps coming home drunk. “Sure,” he thinks, “sometimes I drink too much, but I’m nowhere near that “
• An alcoholic who works in a corporate believes that alcoholism is not something to worry about because he’s the CEO of a major corporation and earns a big, fat monthly pay package.
• A thirty-five-year-old thinks he’s not an alcoholic because he drinks only beer, and everyone knows that most alcoholics get drunk on hard liquor such as vodka or whiskey.
• “I never drink before noon! I can quit whenever I want! My family loves me! I’m a good husband! I can’t be an alcoholic.”
• “I can stop for days. I’ve done that. I choose when to drink. I’m in control,” says the binge drinker.

In the alcoholic, denial is a symptom of a brain muddled by addiction. In the early stages of the disease, alcohol or drugs is a source of intense physical pleasure, and the addict has good reason to practice denial. Sure, they may be drinking a lot, but alcohol and drugs make them feel good, and it isn’t doing them any apparent harm. Why stop?

As the disease progresses and the brain cells continue to adapt their functioning to the presence of alcohol, the addicted brain begins to mastermind the addict’s denial. When the neurons get agitated and start crying out for the substance, the brain will notbury their need by conveying the message to cut down or stop. When you’re hungry, your brain says, “Eat!” When you’re addicted to alcohol, your brain says, “Drink!”

Alcoholics and addicts in denial have been called stupid, stubborn, selfish, immature (to list only a few of the pejorative terms used), but in reality, they are simply following the dictates of their addicted brains. That’s why they cannot accurately judge what is happening to them, why they stubbornly refuse to look at reality, and why they cannot “just say no.” Their brains are urging them on, using all sorts of physical and emotional prods; “Go ahead and take a drink, it won’t hurt you!” the brain cajoles. “And, by the way, don’t listen to those fools telling you to cut down. They don’t know what they’re talking about.”

Willpower vs. Addictive Brain

The surprising fact is the alcoholics can and do talk back to their brains, calling on reserves of inner strength and willpower that few nonalcoholics ever have reason to summon. These brief battles inevitably end in defeat, however, for the sword of willpower is soon rendered defenceless against the mighty cannons of the addictive brain.

As strong as the denial system must be to protect the needs of the addicted brain, it cannot defend the addict against their self-hatred. As the addiction strengthens its hold and makes a mockery of the individual’s willpower and strength of character, depression, anxiety, and fear deepen.

As the alcoholic reaches for the bottle, knowing the devastation it will cause, and it is that seemingly willing alliance with the devil that creates the fierce, eternal tortures of shame, guilt, and self-loathing.

Of all the unrelenting horrors that occur as the addiction progresses, the most unbearable of all is the belief that if death or insanity dies come, it is not undeserved.

 If you or a loved one is struggling with addiction, call +91 90008 50001 or 98490 69609.

Intervention services are also available to help the person get the treatment they need.