Denial is a refusal to accept the painful reality which can change our perception. In fact, it is automatic and unconscious responses or reactions that may cause relapse in any disease. It has its own pros and cons. It may temporarily remove the grief and any emotional pain by creating a misperception that the problem is solved. But at the same time its blocks acceptance. In our lives, when we face losses e.g. death of loved one, relationship loss or any other kind of loss may result in denial.
The approach of denial changes, when it is associated with any kind of addiction. People use poor choices of being alcoholics and addicts to deal with denial about their mistakes, regrets, and shame. Even the same pattern is followed by those people who are suffering from chronic disease like Diabetes and Heart diseases. It is observed that alcoholics and addicts made following common statements to deny their realities.
“I can quit anytime, whenever I decided to quit”
“I drink to forget my problems”
“Anybody in my situation would drink”
There are four levels of denial:
- Lack of information
- Conscious defensiveness
- Unconscious defensiveness
- Delusional state
The severity of addiction makes denial stronger. This situation becomes painful and bewildering for the family and friends. Indeed, “denial is the hallmark of drug addiction”. That’s why denial management is the essential and critical protocol of addiction recovery. In other words, denial management is inevitable for addiction treatment. It is also a long-lasting part to avoid relapse.
Conscious awareness is the first step in effective denial management. Immediate recognition of denial thoughts is mandatory for its management. Some experts suggest that for effective denial management it is very important to manage all feelings, thoughts, and actions which are directly and indirectly related to each denial pattern. Although denial is a shock absorber and it helps us to avoid all kinds of emotional pain (shame, guilt, and regret) yet in an addict’s life it may create hindrance in his recovery.
An addict can use these following denial patterns.
- Avoidance ( I will talk about anything but the problem!)
- Absolute denial: (NO not me!)
- Minimization: (it’s not that bad!)
- Rationalization: (I have a good reason!)
- Blaming: (it’s not that my fault!)
- Comparing: (Others are worse than me!)
- Manipulation (I will only recover if you do what I want!)
- Recovery by fear: (Being afraid of the consequences of drinking and drugging will keep me sober!)
- Compliance: (I will say anything you want to hear if you leave me alone!)
- Flight into health: (feeling better means that I am better!)
- Strategic hopelessness (since nothing will work I don’t have to try!)
- Democratic disease state: (I have the right to drink and drug myself to death!)
For effective denial management, one should learn to recognize denial patterns promptly. Whenever we get awareness that we are using denial patterns, we may turn it off by doing these easy steps pause, relax, reflect, and decide. Pause and observe the real manifestation of denial patterns. Acknowledge your state. Then by doing any relaxation activity like deep breathing, you can relax your body and consciously imagine that the stress is going out from your body; then reflect your experiences by asking “do I really want to keep using denial or do I look at the realities of my life. As a final point, you decide whether or not you will keep using denial. By doing all these steps you will have to take responsibility for the consequences.
In principle, graceful acceptance is the antidote of denial. Here in willing ways, we develop an insight in our patients by using the tools of structured intervention and detailed work on denial management.