Over 6% of U.S. adults suffer from Alcohol Use Disorder.1 This is a common and serious disease in which individuals have difficulty controlling their drinking, resulting in unhealthy and dangerous drinking habits. Among this population, it is common for individuals to find difficulty in recognizing and accepting their alcoholism. This results in denial, which often serves as a defense mechanism used to avoid negative feelings associated with the disorder.
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What Is an Alcoholic in Denial?
Denial is commonly seen in those experiencing alcoholism. Although denial results in avoidance of serious issues, individuals with Alcohol Use Disorder typically do not intentionally deny their problem. Denial can be considered an unconscious process, meaning that individuals are often unaware of and unable to acknowledge their unhealthy drinking habits.
Alcoholism can cause many problems and difficulties in the lives of those experiencing it, as well as the lives of their loved ones. Denial hinders the individual’s ability to recognize these negative consequences, resulting in continued alcohol abuse. When individuals are unable
to recognize the severity of their drinking, they are also unable to make the behavior changes necessary to seek out recovery.2
Ways an alcoholic may engage in denial include:
Lying
Oftentimes, family and friends recognize the severity of their loved one’s drinking before they are able to notice it themselves. When those around them begin to confront them about their drinking habits, those with alcoholism may be led to lie to hide their drinking. This can be done to avoid confrontation with friends and family, or because they don’t want those around them to see the extent of their alcohol use. Alcoholics in denial are likely to lie to avoid admitting the severity of their alcohol consumption.
Blaming Others for Their Drinking
It is not uncommon for those with Alcohol Use Disorder to avoid taking responsibility for their drinking patterns and negative behaviors. This can be seen through individuals blaming others, environments, or stressors. An example of blaming can be saying that they didn’t
want to drink, but “had to” because everyone else was. More examples are things like blaming their drinking on their spouse because of a fight, or on their job after a stressful day.
Comparing Their Drinking to Others
Comparing is a behavior that can be used in an attempt to minimize an individual’s drinking. The person experiencing alcoholism may use someone else’s drinking habits to prove that their drinking is “not that bad.” Someone engaging in blaming may point out the negative consequences of someone else’s alcoholism to indicate that their own drinking is not causing the same damage in their life.
Rationalizing Their Drinking
Those with Alcohol Use Disorder can engage in rationalizing, or attempting to excuse their drinking behavior. This is done in an attempt to convince others, and themselves, that their drinking is healthy or “normal,” rather than problematic. Rationalization can allow alcoholic individuals to make their drinking seem reasonable, at least to themselves.
Rationalization can look like providing explanations that minimize excessive drinking; “I only had a few” or, “I only drink after 5:00 pm.” Individuals may use these reasons to indicate that their drinking habits are in line with social norms. Rationalization can also be displayed in ways like, “I am perfectly healthy, so my drinking can’t be that bad.” This can be done to show that alcohol consumption has not created health problems. Therefore, it is not unhealthy.
Dismissing Their Drinking
Those experiencing alcohol use disorder may find it easiest to avoid accepting their problematic drinking by simply dismissing the topic. The topic of their alcohol consumption is likely difficult. Therefore, they often choose to dismiss the topic. This can be especially frustrating for friends and family because it hinders their ability to provide support to the individual struggling.
An individual may dismiss conversations about their drinking by assuring others “not to worry about it,” that they are fine. They may even ask others to stop bringing up their habits and to stop “nagging them” about their drinking. Statements such as these allow the individual with alcohol use disorder to remove others’ opportunity to intervene.
Concealing Their Drinking
As others begin to recognize the signs of alcoholism in individuals, it is common for these individuals to begin concealing their drinking. This can happen when people consume alcohol, but find ways to cover it up. For instance, they may brush their teeth or change their shirt before coming home to avoid smelling like a bar. A spouse may stay up later than their partner to have time alone to drink before bed.
False Agreement
If an individual is unable to dismiss the conversation about their alcohol use, they may falsely agree with the person intervening to satisfy them. However, this conversation typically results in agreement with no action to follow. The alcoholic individual could agree that they should cut back on drinking, but their drinking patterns don’t change. After a confrontation, they may state, “That was my last drink,” with no intention of following through.
Being Overly Defensive
Defensiveness is one of the most common ways those with alcohol use disorder engage in denial. The individual may display anger or irritability when their excessive drinking is brought up. Defensiveness may look like the alcoholic individual telling others their drinking is no one else’s business, or that they are capable of making their own choices.
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Why Do People Deny Having a Drinking Problem?
There are many reasons why people deny having a drinking problem, and everyone’s experience with alcoholism is different. Many people don’t recognize addiction as something that can happen to them. People often feel that they are in control of their drinking, and lack insight into the loss of control that comes with an alcohol use disorder. Even when they begin to contemplate the possibility that their drinking is problematic, they are often fearful of confronting this possibility because of the uncertainty of what may happen if they admit their alcohol dependence.
Reasons that alcoholics might use denial include:
Shame
Shame is a strong catalyst for denial in alcoholism. It is a harmful emotion that relates to a person’s feelings toward themselves, rather than their behaviors. When people feel shame, they internalize their negative behaviors and use them to develop their feelings toward themselves. People begin to feel as if they are bad because they have done “bad” things.
When a person develops these feelings about themselves, denial allows the opportunity to avoid admitting the behaviors they are ashamed of. This contributes to alcohol use because it becomes extremely challenging for individuals to face these beliefs. Shame creates a toxic cycle, where denial is used to avoid these feelings.
Lack of Education About Alcohol Abuse
Many people have used or will use alcohol at some point in their lifetime. However, education on the difference between use and misuse is crucial to help people distinguish healthy drinking habits from substance abuse. When people are unaware of the risks and consequences that overconsumption can produce, they are less likely to maintain a healthy relationship with alcohol. Therefore, it is difficult for individuals to acknowledge their drinking as excessive without being educated on appropriate vs. inappropriate use.
Societal Views on Alcohol
Alcohol use is common and normalized in society today. This can make it easier for those with alcohol use disorder to rationalize their drinking or consider it to be “normal.” Lack of education and accurate information on the safe use of alcohol can increase the likelihood of individuals engaging in alcohol misuse. People struggling with alcohol abuse may stay in denial due to the normalcy of alcohol use in today’s society.
Neurological Deficits
Excessive drinking, especially over long periods of time, can cause neurological deficits. For example, heavy use of alcohol can result in challenges in perception. Individuals abusing alcohol may lack insight into their drinking, because the level of use has become normal. Prolonged alcohol abuse can also result in memory problems. This can cause alcoholic individuals to forget negative experiences that occurred while drinking.
Friends or Family Enabling Their Alcohol Use
The loved ones of alcoholic individuals often engage in behaviors defined as ‘enabling.’ These are behaviors that support the behaviors of the individual struggling with alcohol use. Oftentimes, it is difficult for loved ones to recognize the behaviors that enable alcohol dependence, and even harder to break free from these patterns.
Rescuing Them From Consequences
Alcohol Use Disorder results in numerous negative consequences. As people who love the alcoholic, friends and family often find it difficult to watch their loved one face these consequences. Rescuing can become a learned behavior to protect loved ones. This can be seen in many different ways, including; taking on responsibilities (childcare, bills, etc.), consistently helping them avoid legal trouble, and avoiding conflict in order to “keep the peace.”
Secondary Denial
Secondary denial can be displayed when friends and family struggle to accept that their loved one is struggling with an Alcohol Use Disorder. This can occur through minimizing, saying things such as, “They don’t drink that much, only at night.” Secondary denial can also occur when loved ones agree with the rationale behind excessive drinking—allowing the individual struggling with alcohol use to provide reasons to justify their drinking, and accepting these answers as valid reasons. When loved ones stay in denial, it allows the alcoholic individual to continue engaging in addictive behavior, because they are not provided insight into their loved ones’ perspective.
How to Help an Alcoholic in Denial
In order for someone to help an alcoholic in denial, they must first recognize and accept the person’s alcoholic behavior. Once this occurs, those willing to help can implement strategies to provide insight to the person struggling and offer support to them in a healthy way.
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Ways to help an alcoholic in denial include:
- Educate yourself: in order to help an alcoholic in denial, it is crucial first to gain an understanding of the disease of addiction. Those without experience with Alcohol Use Disorder often find it difficult to understand the cycle of addiction. When loved ones find answers to their own questions, they are able to provide more empathy and offer support without judgment.
- Avoid taking on responsibilities: it is important not to take on the responsibilities of the person with Alcohol Use Disorder. Doing things for them that they can do themselves allows them to continue their alcoholic behavior without seeing the negative effects on themselves and others.
- Practice patience: no one is able to force those with Alcohol Use Disorder to accept and address their dependence on alcohol. Communicating openly and honestly about the effects of the loved ones’ alcoholic behavior can provide space for the alcoholic individual to realize the reality of their relationship with alcohol. However, the desire to change ultimately must come from within.
- Set boundaries: while unconditional love and support can help those struggling with Alcohol Use Disorder, it is also important for loved ones to set clear and firm boundaries. Assertively communicating what they will and will not do, allows friends and family the opportunity to show that the behaviors of Alcohol Use Disorder have consequences and that their alcohol dependence will not be enabled.
- Encourage professional help: setting appropriate boundaries and communicating the negative effects of the alcoholic’s behavior can show that the efforts of family and friends are not enough to improve their experience. Additionally, allowing the alcoholic space to describe their own experience openly creates an opportunity to suggest help from a professional.
How to Talk to an Alcoholic in Denial
Direct and honest communication is extremely important when talking to an alcoholic in denial. Let them know that they have love and support while also pointing out the reasons for concern. A productive option is to avoid criticism or blame but offer resources and potential solutions.
How to Stage an Intervention
Staging an intervention can be a difficult and frightening process, but it is often necessary for someone to step in before it is too late. It is important to understand that shame and guilt, along with denial, can cause the alcoholic individual to display defensiveness or difficulty being receptive to the intervention process. A lack of openness and willingness to listen from both parties can result in a lose-lose outcome. However, proper planning can contribute to a productive experience and positive outcome.
It is, first, important to ensure a safe and comfortable environment for all parties involved. It is also crucial to utilize those closest to them who will offer genuine support and understanding, without passing judgment or placing blame. Communication must be clear and concise, without being emotionally charged. The points outlined in the intervention must be laid out in a way that will not escalate or enrage the loved one. It is also important to remember that follow-through is necessary, even if this process results in a negative outcome. Without strong boundaries and assertiveness, the intervention is unlikely to produce a positive outcome.
The Role of Intervention Specialists
An intervention specialist is an individual who addresses substance use issues as a career. These professionals can assist loved ones in developing a plan using the skills and techniques necessary to conduct a properly planned intervention. Assistance can be provided by outlining a script to make sure points are outlined without being influenced by emotions or judgment.
When to Involve Authorities or Emergency Help
In certain circumstances, it is necessary to involve emergency personnel. Law enforcement may be called in the incidence of violent behavior. Alcoholic individuals often struggle with impulse control. When emotions run high, especially while under the influence of alcohol, it is possible for the alcoholic to reach violently. When violence occurs, it may be a good idea to involve law enforcement to protect the safety of friends and family as well as the alcoholic individual. Although it is often difficult to call the police on a loved one, it is important to remember that there are consequences to this behavior.
Emergency medical assistance can be necessary when dealing with someone with Alcohol Use Disorder. If this person presents with signs of suicidal intent, the best option is hospitalization. Admitting this person to the hospital protects their personal safety. Another example of when medical attention is necessary is when the person presents with signs of alcohol poisoning. Symptoms of this are poor coordination, cold sweats, slurred speech, irregular heartbeat, or unconsciousness. If this occurs, emergency personnel should be contacted immediately.
When to Seek Professional Help
There are signs to look for when deciding to seek professional help. Multiple unsuccessful attempts to quit can indicate that professional assistance is necessary. Additionally, when alcohol dependence begins to interfere with quality of life. This can be seen through loss of interest in daily activities, loss of professional assets, financial stress, and risky or dangerous behaviors.
It is common for those with Alcohol Use Disorder to struggle with mental health concerns such as anxiety, depression, or other mental illness. When symptoms of these disorders present, it can be a good idea to seek help from a professional. An online therapist directory or online therapy platform could help. In-person therapy, along with a psychiatrist, can assist in treating symptoms of both mental illness and alcohol Use Disorder. In some circumstances, inpatient treatment may be a necessary step in treating Alcohol Use Disorder. This allows individuals to receive short or long-term treatment in a safe and controlled environment.
In My Experience
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