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Denial and Substance Abuse

Understand the truth about Denial and Substance Abuse

Denial and Substance AbuseWhether they have personal experience with substance use problem or not, most people are familiar with the concepts of denial, co-dependency and enabling as these terms have entered mainstream over the past 50 years. Those who have been dealing with substance use for any length of time may have been told they or their loved one were in denial or that they are enablers or co-dependent.

These labels are not only inaccurate, but they do nothing to help the substance user or the family. Instead they systematically shift the responsibility for the substance user’s problematic behavior to those around them, who are the very people who are powerless over the actions. This is one of the biggest issues the concept of denial and substance abuse.

The theory of denial and substance use was first identified by Dr. Sigmund Freud to describe how an individual rejects something they find too uncomfortable to accept, such as death of a loved one, a terminal illness or traumatic experience. Like many of Freud’s theories, denial has been controversial. Unscrupulous therapists have used psychoanalysis and the denial theory to convince people of false traumatic experiences such as molestation, incest and rape. More recently the denial theory has been used by the treatment industry to ensure even those who reject the idea they have the addiction disease can be coerced into treatment.

While it is understandable a person may go through a period of denial when facing the death of a child or his own terminal illness, there is no date to support the idea that people are unaware of their behaviors or of the consequences of their behaviors. As substance use requires prior thought, planning and action, like all behaviors, the idea that a person is unaware they are partaking in the behavior is absurd, which is why the idea of denial in substance abuse is seriously flawed.

Behaviors we do repeatedly may become automated but this does not mean they do not require prior thought. It means we process the thought more rapidly than other behaviors. So if denial is not referring to a person being unaware of a behavior, then what is a substance user denying? Treatment professional say substance users in denial are unaware of the problems that substance use has caused them and others. They also say those suffering from an addiction deny they are addicted and are, therefore, powerless to stop on their own. How convenient for a treatment professional: Those in denial of their addiction need treatment services, especially if they believe they can stop on their own.

For example, John drinks eight drinks and drives home. On the way home he crashes his car and gets a DWI. In this case John certainly knows he drove after drinking, and he knows his ability to drive was compromised, which contributed to the accident (he may tell people otherwise, but this is not denial, it is lying). As part of his sentence John is required to attend an outpatient treatment program that tells him he must accept he is an alcoholic, and therefore, he is powerless to stop drinking. Even though John drinks an average of five or more drinks nightly and has been arrested for DWI, he insists he is not an alcoholic. He says he will keep drinking but will not drive after more than two drinks. What is your opinion, he is in denial of his alcoholism?

Those who believe the disease theory of alcoholism will say John is an alcoholic and not in control of his drinking. But let’s look at it differently. Each of these conclusions requires personal judgment based on morality and personal opinions of right and wrong. Many people see drinking alcohol as morally bad, and drinking give drinks as excessive because it is not something they choose to do and it is judged excessive in our culture.


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