Refusing to accept a painful reality that alters the perception of ourselves is a psychological defense called denial. Denial is a set of automatic and unconscious thought. Denial is a serious challenge that can cause relapse. Denial is a normal and natural psychological defense that has both benefits and disadvantages. The benefits are that it temporary removes the pain and shame caused by consciously confronting a serious problem and creates the misperception that the problem is being solved. The biggest disadvantage of denial is that it blocks acceptance and problem solving.

Denial begins as a result of painful events such as the loss of a family member, the end of a relationship, or other similar types of events. But when it comes to denial that is associated with addiction or alcoholism, the cause is almost always self-denial of some type. As people make mistakes or do things they regret in life, they tend to minimize the pain and embarrassment caused by poor or unlucky choices by denying the severity of the problem. Consequently, denial becomes a way of life for addicts and alcoholics. Some common statements made by alcoholics who deny their disease include: “I could quit anytime I wanted to.” “I’d quit using if people would quit ragging on me.” “If you were in my situation, you’d drink, too.” Typically, the more severe the addiction, the stronger the denial. This is often baffling and frustrating to family members and others who care about the addicted person.

Denial Management is a critical part of the initial treatment for alcoholism or addiction and an ongoing, lifelong part of a well-founded relapse prevention plan. Understanding denial and how it is managed is an essential part of this process. And in management of denial, awareness is always the first step toward management. Denial operates at four different levels, 1. Lack of information   2.  Conscious defensiveness 3. Unconscious defensiveness and 4th is delusion. And there are 12common denial patterns used by patients.

  1. Avoidance 🙁 I will talk about anything but the problem!)
  2. Absolute denial: (NO not me!)
  3. Minimization: (it’s not that bad!)
  4. Rationalization: (I have a good reason!)
  5. Blaming: (it’s not that my fault!)
  6. Comparing: (Others are worse than me!)
  7. Manipulation 🙁 I will only recover if you do what I want!)
  8. Recovery by fear: (Being afraid of the consequences of drinking and drugging will keep me sober!)
  9. Compliance: (I will say anything you want to hear if you leave me alone!)
  10. Flight into health: (feeling better means that I am better!)
  11. Strategic hopelessness 🙁 since nothing will work I don’t have to try!)
  12. Democratic disease state: (I have the right to drink and drug myself to death!)

To effectively manage these denial patterns, we must learn to recognize and stop denial quickly when it occurs. Our chances of doing this get better as we learn how to recognize and manage the thoughts, feelings, urges actions and social reactions that are associated with each denial pattern. Whenever we become aware that we are using denial, we can turn it off by pausing, relaxing, reflecting, and deciding. We pause and notice that we are using denial. We don’t do anything about it. then we relax by taking a deep breath, slowly exhaling, and consciously imagining the stress drain from our body; then we reflect upon what we experiencing by asking: “Do I really want to keep using denial, or do I want to look at what is really going on so I can decide what I want to do about it?; Finally we decide whether or not you will keep using denial or not. When making this choice, remind yourself that you will be responsible for the consequences.

In denial management family members can help their loved one by allowing the addicted loved one to experience the consequence of his or her drug abuse. Family intervention is also another technique for managing denial.