Substance use disorder patients rarely manage to reduce or stop their consumption.
Willpower does not heal emotions. so even if they stop, the unresolved feelings eventually overpower their self-control and they relapse. By promising to heal themselves, they employ partial denial – they may admit that there is a problem, but deny that it is severe enough to require professional therapy.
Denial is seldom a deliberate lie. Many people internally convince themselves into believing that they do not have a problem. Others honestly believe they can heal themselves and truly intend to fulfil their promises. However, most people have a further self-perpetuated fear of being separated from their substance and resort to lying or bending the truth to prevent it from being removed from their life. The prospect of going for treatment and having the substance instantly placed beyond their reach creates anxiety and forces them to deny the true extent of their problem.
Partners, friends, family members and co-workers sometimes participate in the denial process. They are called co-dependents. They do not abuse any substances, but they protect the abuser by hiding the problem from others or perpetuating or enabling the cycle in some way. They frequently take care of and protect the person with the disorder by performing duties on their behalf. This reinforces the process of denialism because the behaviour of the co-dependents gives them a reason to think that the situation is still under control and, of course, the person with the disorder prefers to keep things as they are, and the addiction cycle perpetuates.
Co-dependents themselves feature in the cycle of denial – they justify their act of enabling the person by denying or diminishing the problem in their own minds. They employ an automatic mental defence mechanism to shut down reality and to focus on thoughts presenting their acts as worthy and necessary. This misleads them to support the affected person’s denials when an external person tries to intervene in the cycle.
There is a popular view that people only stop denying a problem when they hit “rock bottom”. The term “rock bottom” sounds like the lowest, harshest level of life, but this can be misleading. Every person has their own version of “rock bottom”. It need not be extreme, like homelessness. It can be reached at any point where they lose something they value more than the relationship to the substance. Even just the loss of a good friend may be the turning point for some. To stop the denial, they need to know that they have reached their personal level of “rock bottom” and often that realisation can be helped along simply by having a conversation with a registered psychotherapist or a trusted friend.
People in states of denial frequently resist treatment. Someone with a serious substance problem may well be aware of it, but deny the severity and downplay their need for the actual treatment. They offer many arguments to avoid it. In many cases, people who try to help are not skilled enough, so they are easily defeated and the problem continues. It frustrates helpers and keeps the victims from accepting a path that will improve, even save, their lives.
Denial, whether outright or partial, must be overcome before the affected individuals will consent to treatment. This can be done by means of a mindful intervention by a person or a group of people who are trustworthy and properly prepared for it. The person or group will understand the core issue, express feelings, give support, relate and find a neaningful path for treatment.
You must be well prepared for an intervention. It is a delicate event and denialists will already have a myriad defences in place. You, or the group, will fail if you fumble and it will make your next attempt more difficult, as you will simply be dismissed as ignorant when you approach them again. Do not assume you know enough. General advice can confuse and mislead. The best option is to see an experienced rehabilitation therapist for personal guidance regarding your particular situation.