Substance use disorder patients rarely manage to reduce or stop their consumption. It requires more than willpower. They are troubled by emotions that they soothe with drugs or alcohol. 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 admit that there is a problem, but deny that it is severe enough to require professional therapy.
Denial is not always a deliberate lie. Many patients deceive themselves into believing that they do not have a problem. Others honestly believe they can heal themselves and truly intend to fulfil their frail promises. However, most addicts have an intense fear of being separated from their drug and will resort to lying to prevent it. 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. They also take care of an abuser and perform duties on their behalf. This reinforces the abuser’s denialism, because the behaviour of the co-dependents gives them reason to think that the situation is under control and, of course, the abuser prefers to keep things as they are.
Co-dependents themselves also indulge in denial – they justify their act of enabling the abuser by denying or diminishing the problem in their own minds. They employ a mental defense mechanism to shut down reality and to focus on thoughts presenting their acts as worthy and necessary. This misleads them to support the abuser’s denials when someone tries to intervene.
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 is misleading. Every person has their own “rock bottom”. It need not be extreme, like homelessness. It can be reached at any point where they lose something they value. 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”.
People in denial resist rehab treatment. Someone with a serious abuse problem may well be aware of it, but deny the severity and downplay the need for 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 something that will improve, even save, their lives.
Denial, whether outright or partial, must be overcome before abusers and codependents will consent to treatment. This can be done by means of intervention by a person or a group of people who are trustworthy and properly prepared for it. The person or group will confront the denialists, express feelings, pledge support, relate incidents and convince them to go 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.