Denial is a defense against an uncomfortable reality. In the case of addiction, this includes the very fact that addiction has taken hold, as well as all the harmful consequences that come with it and which encompass every aspect of life. It is a form of self-deception or self-delusion that fends off the truth of the situation, keeping it at psychological arm’s length.
At its most florid, addiction denial may well strengthen despite — or sometimes because of — the intervention of others who may see only too clearly the progressive self-destruction of their loved one. By nature, addiction is self-serving and self-perpetuating.
Under the threat, say of a doctor encouraging admission even to the comfortable environment of a luxury treatment centre, the resistance to change their drinking or drug use or habits, the essence of denial, may stiffen. However, any delay in the acceptance of much-needed help, only encourages the condition to worsen.
Addiction denial adopts a number of guises. These include the simple, outright rejection that addiction is indeed the issue; sometimes fiercely delivered with elaborate arguments, perhaps supported by concocted evidence meant to indicate that their drug or alcohol use is not as bad as all that.
This is called minimisation and is a tactic whereby the person tries to convince themselves and others that they are consuming far less of a substance like alcohol or engaging in behaviour like gambling than they are in fact doing. This may be bolstered by secrecy and deception to conceal the actual amount or frequency of alcohol or drug use from any concerned others.
Addiction denial may also take the form of comparisons: “I am nowhere near as bad as so-and-so.” There may be attempts to explain away the behaviour as a temporary aberration or as being clearly the fault of another person or situation, such as work.
Such rationalisations imply that if those people or circumstances changed then so would the behaviour in question. The onus of responsibility for change is shifted elsewhere. The purpose is to keep hold of the substance use or behaviour at any cost; a drive that is increasingly reinforced by adaptations in the brain.
There are two emotions in particular that help to sustain addiction denial: shame and guilt. It is very difficult for the individual to face up to what they have become as a result of addiction and to how they may have behaved under its influence.
Breaches of personal values, as in the loss of control, dishonesty and possibly illegal behaviour, play a part. Denial offers continuing avoidance of these powerful emotions while at the same time ensuring their perpetuation and intensification. Shame and guilt are frequently implicated in the onset of addiction, so while not only deferring the recognition and processing of such emotions, denial compounds them.
The fact that a person shows up at a private in-patient addiction treatment centre seeking help might, on the face of it, suggest that denial of the problem has by now completely dissolved. Unfortunately, this is seldom the case. Many people will approach treatment hoping to enter recovery without having to do all that is necessary to initiate and then sustain it, this may result in more negative consequences.
While not necessarily being conscious of doing so, they will hope to get away with as little change as possible. As is consistent with addiction, they may look once more for the “quick fix” in treatment as the rewards of recovery are as yet in the future and unknown. The treatment team in any private rehab centre will be well aware of this possibility.
It can be as difficult for the family to come to terms with the reality of a loved one’s addiction as it can be for the individual with the condition. Families, whether as individual members or as a whole, often skirt around the addiction in their midst or make all manner of adjustments to allow for it, often looking the other way or employing rationalisation and minimisation just like the addicted person.
Facing the distressing reality of a loved one’s condition is difficult. So families are inclined to disbelieve or play down the evidence of addiction they encounter every day. Without always recognising it, they too are also generally full of fear, anger, shame and guilt. They may try to manipulate, control or fix the addicted person to ward off these feelings.
Addressing the family’s part in the life of an addiction is an essential part of treatment whether delivered in a top luxury rehab centre or some other facility like an executive rehab. Understanding denial and acceptance of reality is a good starting point.