Why Would Someone With An Abuse Problem Deny It?

It happens. You're shocked, disappointed, yet anxious to help. You find out that someone close to you is taking drugs, abusing prescription medicines or drinking to excess. You have evidence of the problem and what it's doing to the person's life. It worries you.

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You confront the person. Based on your proof, you expect an admission of the problem, maybe a few apologetic tears. You hope your confrontation and the subsequent admission will help stop or slow down the abuse. But when the encounter arrives and you present your evidence, the person you care about looks at you with a straight face and denies everything.

You're stunned and frustrated. You ask, "How can you deny this?" In response you get anger or a nonchalant shrug of the shoulders. How can someone you care about, in the face of your conclusive evidence, blatantly lie to you?

It's called denial, and there are no simple answers as to how to deal with it. Yet, if you truly care about and want to help this person with an addiction problem, there are things you should understand, and then things you can do.

One starting point is to understand that denial is not morally wicked. The vast majority of chemically-troubled people are not bad. Thinking that way will only make you angry. Engaging an addicted person with a hostile attitude usually gets you the same thing in return. Think how defensive you get even when mildly confronted with some of your past behaviors.

Second, and this important, ask yourself what might be driving the denial. It may be a powerful emotion such as shame - the person is guilty about the abuse problem and can't bear to admit to it. Or it could be fear of the consequences of admitting the truth - the loss of respect, a job, a family that might happen. Sometimes it's anxiety, being unsure of how you and others would react to an admission of the truth. Any of these can be powerful reasons not to come clean about chemical abuse.

Illogical thoughts also propel people to deny the problem. A response might be, "I don't have a problem because I'm not as bad as others I've seen." Such statements are comparison errors driven by whatever remnants of pride the person still feels. But rather than view such remarks as flat-out denial, consider them as a partial admission. Someone responding in such a way to your accusation is actually admitting to the problem, but minimizing its seriousness. That partial acknowledgment is a starting point and one that needs to be cultivated.

The key to helping someone with a chemical or alcohol abuse problem is building trust. Think about how long it would take you to trust someone enough to disclose some of your deepest, darkest secrets. The same thing applies for the individual abusing chemicals. It's going to take a new level of trust, one the two of you probably don't have at this point.

Winning such a level of trust requires building an empathic relationship. That means learning to listen deeply and withhold judgments. It means getting to the point where you understand the dependent person's state of mind.

That can be difficult because you feel frustrated, angry and disappointed. You've probably made a number of judgments, almost all of them negative, about this person, even though you still care about him or her. It's easy to fall into the strong-arm approach, playing the heavy and trying to force admission of the problem. Don't do it. It's been shown that heavy confrontation is ineffective and linked with relapse.

While nothing works consistently in overcoming denial, most of us respond well to understanding. Get the addicted person to talk and talk. And don't fall for the idea that if you listen, you enable or encourage the abuse. Empathy is not enabling. Genuine empathy understands, but it doesn't condone.

Your goal is not to harshly confront denial, but to understand what drives it. Most people open their hearts if they feel understood. And when that happens, you'll have a much better chance at getting the addicted person closer to a program with a counselor or other mental health professional and closer to recovery.

Dr. Taleff is the Alcohol and Drug Program Coordinator for the University of Hawaii at Manoa.