What to say to an addict in denial?
Getting beyond an addict’s defenses
Addiction is chronic and progressive disease. When we are ready to address issues with drugs or alcohol, friends and family may be faced with great deal of confusion, frustration, and they may not know what to do.
It is a challenging task to try to help to someone that may not want to be helped at all. The person having the problem often fails to recognize that there is one, and trying to have a simple heart-to-heart conversation can sometimes seem offensive to the person in trouble. So, how can you get beyond the walls of defense?
Defense mechanisms may require professional help
Addicts in denial often use defense mechanisms and are unwilling to seek treatment. These mechanisams are really strong feelings that often require a more focused, structured approach. This is when the guidance of a professional interventionst, psychologist, licensed clinical social worker, or addiction specialist is needed.
To help us understand more about the process, we called in a professional. Steve Danzig, LCSW, LADC, CCS, BRI-I is a masters level clinical social worker, a licensed alcohol and drug counselor, a certified clinical addiction specialist and a founder of DANZIG Interventions and DANZIG Counseling Services. With his 20+ years of experience as a clinical social worker, he is more than qualified to understand the complexities of human behaviour.
Explaining denial and its solutions
In this Q&A, Steven helps explains to us the feelings of denial that addicts are going through – and the defense mechanisms they use – so you’ll be able to understand their behavior. Plus, Steve will talk more thoroughly about some strategies for addressing common defense mechanisms. Finally, he’ll explain when and why professional help is needed.
If you have a friend or family with addiction issues, please read the whole interview. We hope to provide you with some basic information on what you can do when faced with denial, but if you still have any questions, please address them in the comments section below. We will make sure to provide you with a personal, prompt response.
ADDICTION BLOG: To begin, what is a defense mechanism?
DANZIG INTERVENTIONS: Defense mechanisms are used by many people, often unknowingly, throughout the course of a day. They may be even unnoticeable at times due to the individual not really knowing they’re using them. A defense mechanism is a way of someone diverting your attention away from the truth. Away from feelings, hurt, trauma, addiction, infidelity, theft, etc. They can be very subtle like a very plausible excuse for why something has changed or why they were late coming home, to verbally and physically violent outbursts. The objective of defense mechanisms is the same regardless. It’s to get people to stop looking at the issues the individual is facing. To hide something from you.
ADDICTION BLOG: What are some examples of defense mechanisms that addicts use?
DANZIG INTERVENTIONS: When you are asking your teen if they used alcohol over the weekend and they give you a quick answer, “really? That’s just not me.” and then change the subject immediately after, “I did really well on that test.”, that is a defense mechanism. Folks will deny the existence of an issue. Project onto another person. In other words they may blame someone else for their issue, “well if you didn’t…then I wouldn’t have to…”
These are common, easily identified forms of defense mechanisms. There are other deeper levels which may indicate the presence of deeper psychological issues as well.
ADDICTION BLOG: Why do defense mechanisms surface in an intervention?
DANZIG INTERVENTIONS: In a formal intervention, the identified patient, “IP”, is typically an individual with a problem that needs attention. However, the IP either does not want help or does not yet recognize that there is a problem. Generally speaking an intervention goes very smooth or it doesn’t. The defense mechanisms surface immediately during an intervention. From the moment the IP enters the area where the intervention is being help, the defense starts. If the intervention is going to be difficult the IP will enter into a diatribe of reasons why the alcohol, drugs, food, sex, etc. is not the problem. It’s my relationship, my boss, my car, my classes, the list will go on and on as to why the person uses and somewhere in their mind they truly believe that if all of these life circumstances were different that they wouldn’t need chemicals to help them through their grueling day to day existence. The focus of an intervention is to help the IP understand that they may certainly have difficult situations in life, as we all do, but their response is exacerbating those issues in addition to creating so many more.
ADDICTION BLOG: How often are addicts convincing themselves that there is no problem? How does the brain do this?
DANZIG INTERVENTIONS: Someone with an addiction has mastered the art of convincing themselves that neither they nor the substance are the problem. The problem is everything else. The brain goes through a sort of restructuring when an addiction is present. I say addiction because there is a difference between someone who is dependent on a medication and someone who has an addiction. Addiction indicates the presence of the undesirable behaviors: lying, stealing, legal trouble, family issues, etc.
The brain is extremely complicated to say the least. The best way for lay people to identify with this process is to look at it as another personality of your loved one. Similar to Dr. Jekyll and Mr. Hyde. Once Mr. Hyde is let out he does not want to go back in, he wants to play, in his way. This is a very similar process to the brain functioning of someone with an addiction. Mr. Hyde is in charge now. The job at hand is to help Dr. Jekyll reemerge.
ADDICTION BLOG: What are some good strategies for addressing denial?
DANZIG INTERVENTIONS: Addressing denial can be difficult. But the individual will always contradict themselves at some point. That is your opportunity to try and get to the truth. I tend to avoid the ‘throwing back in their face approach.’ When someone has verbally backed themselves into a corner, this presents you with an opportunity to try and get them to clarify what they just said. Be careful because no one likes to be backed into a corner. They will prepare for a fight. This is why you keep a level head and continue the discussion. Getting through denial is never a one conversation issue. It takes time and planting seeds.
ADDICTION BLOG: What are three (3) of the most effective statements that you can use? What’s worked for you in the past?
DANZIG INTERVENTIONS: 1. “You’re right”. I don’t believe most people want to say this to someone with an addiction. However, in their mind what they are doing is justified. The stigma around addiction is profound in our society. Most people address someone with an addiction as a sub-human. Even parents will get to this point. Someone who is addicted is always prepared for a verbal argument. They become disarmed when they are told, “you’re right”. This assists them in legitimizing their response to the hand they’ve been dealt. That is where change can begin.
2. “I don’t understand.” This statement would be in addition to the first. I say this because many times people will respond to their loved one by saying “I get it”, “I understand.” Addiction is an issue that the IP will tell you, you don’t understand. To a large extent they are correct. Once the individual has become dependent on a substance the brain chemistry has been altered, along with the way they think, act, process information, etc. This is an issue that impacts every area of an individual’s life save none. Most people just don’t have the perspective to identify with such an all-encompassing life.
3. “If you were in jail and had the key, wouldn’t you let yourself out?” It may seem trivial but this statement at the right time in someone’s life can be transforming. I heard this from a very wise woman many years ago. It plants a seed for folks that they might have something to do with their current situation. And that maybe they can do something about it.
ADDICTION BLOG: What are some of the common excuses that addicts or alcoholics continue to make for their drinking or drug use during a relapse, for example? How can family members react to a relapse?
DANZIG INTERVENTIONS: If your loved one has recently come out of a treatment program. Have a contract. The family should be working with the counselor at the treatment center to come up with a contract for when your loved one comes home.
When someone has relapsed they will either come and fess up about it or they will begin the hiding, again. Unfortunately, relapse rates are very high among this population, but that doesn’t need to be the case. The excuses will mimic much of what the family experienced before the individual entered recovery. Coming home late, not knowing where money went, items missing from the home, etc. Most families will not want to believe that their loved one has relapsed, much the same way as they didn’t think that person had a drug problem. Part of a contract should be drug/alcohol testing. If you think your loved one has relapsed or is using again, give them a drug test. You WILL know by the answer they give you.
ADDICTION BLOG: Should a family always seek professional help to address denial? In what cases can/should a family deal with addiction on their own?
DANZIG INTERVENTIONS: If there is someone with an addiction in your life then you are already dealing with them. It may be on a daily basis, but you are unknowingly part of their support network. And not in a healthy way. Addiction is a family issue and involves everyone. A family does not always need to seek professional guidance on issues. However, If you are reading this article and saying, “oh my gosh, this is us” then it’s probably a good idea to consult someone in the addictions field.
Families can start dealing with an individual by asking hard questions and asking for the answer. As defense mechanisms go, you will have found yourself in a 20 minute discussion with your loved one and realize you still didn’t get an answer to the question you asked. When your loved one begins escalating in behavior verbally, it’s time to call someone. It means they are getting more protective of the issue and are working harder to push you off the trail.
ADDICTION BLOG: What are some of the benefits of working with a professional interventionist?
DANZIG INTERVENTIONS: Benefits of working with a professional interventionist is that they will assess the information you give them and determine whether or not you need their services. I have received numerous phone calls over the years from folks who go straight to intervention when they find out someone has an issue. Many times they have simply not asked the individual if they desired to do something about it. A good interventionist will listen to what you say and can usually determine a course of action which may or may not require a full clinical intervention.
However, I have also received the same amount of calls from people over the years that did require professional services of an interventionist and did not utilize that option. Doing an intervention is not just about reading some letters and bullying someone into treatment. It is a very well-orchestrated rehearsed event that takes everything into consideration. Who will be there, who won’t, where will it be, who will read first, second, etc. These reasons and many more are why it is crucial to have an experienced interventionist to work with. You may only have one opportunity to get someone help.
ADDICTION BLOG: Also, what exactly is the role of friends and family in dealing with addiction? How can they best help?
DANZIG INTERVENTIONS: Friends and family are the first line of defense when a loved one is sliding down the path of addiction. Someone who is walking that path will increasingly separate themselves from friends and family. Friends will notice first. The individual will start “replacing” friends for ones that are more tolerant of drug use. Inevitably ones that are engaging in similar behavior.
- If someone’s behavior does feel right, ask. If you feel like they are making excuses, ask. Ask other friends, ask family, ask the individual. If your gut/instinct is telling you something’s wrong, then something is wrong.
- I have stood at many gravesites, many friends and many others because of addiction. In my youth I didn’t think there was anything I could do, so I did nothing. I learned a very hard lesson that I never will stand next to another grave saying “I should have…”
- I think you need to ask yourself when you’re in that position; Do I want someone alive that might hate me? Or wished I’d done anything.
- Do whatever you can. The disease of addiction kills daily. The numbers of people overdosing are completely out of control. You are not helpless.
ADDICTION BLOG: Can an intervention fail? If yes, what are the most common reasons for an unsucssesful intervention and how to prevent them?
DANZIG INTERVENTIONS: Interventions average about 95% successful when performed by a licensed, experienced interventionist, that the IP will go to treatment that day. Generally, the few remaining percent will go to treatment within a few weeks provided there is a plan in place for that contingency. Any interventionist that knows their work will prepare the family with a solid plan in case the IP does not go to treatment.
There are many reasons an intervention will not be successful. One reason is lack of information provided by the family. Usually this involves some co-occurring mental health issue. The family may minimize what is actually going on with the IP. Possibly out of fear that the interventionist may not want to do the job. If an intervention is appropriate then there will be a way to facilitate it. This is what we do.
Another reason for interventions not going as planned is that a family member may change their mind. This typically happens when an intervention is difficult. The parent or whoever feels bad, guilty, or that they’re ganging up on their loved one. And they change their mind. Once they’ve shifted their focus the IP knows instantly. They can feel the energy shift from that person and realize they have an ally. This is very bad.
These reasons are why you need to have an interventionist with experience, that knows family systems, theories, applications of different therapeutic approaches. They will be able to identify the family structure and hierarchy. All families have an alpha and so on. The interventionist needs to know whom to use, who has power and who is back-up.
ADDICTION BLOG: Is there anything else you would like to share?
DANZIG INTERVENTIONS: In addition to why work with an interventionist. One of the biggest reasons is to manage the intervention in the best way possible and selecting the proper treatment program. Over the last decade there has been a proliferation of treatment programs throughout the U.S. If you were to go online and simply look up treatment you will be inundated with the amount of programs. It’s easy to have a beautiful website in a desirable location. There are interventionist that work specifically with some programs and only refer to those programs. This is not a one size fits all. An independent experienced interventionist vets all programs he/she works with. They will make a recommendation based on your loved one and what is they best possible program that will address the needs they are bringing to the table. My philosophy around treatment selection and those programs that I refer to is; “If I wouldn’t send my kid there, I’m not sending yours”.