Denial as a Symptom of Alcoholism

Deciding to seek help for alcohol addiction can be extremely difficult, but it can be even more challenging if the affected person is displaying denial as a symptom of alcoholism.

This page will explain in depth why denial is such a common symptom of alcohol, how to tell whether someone is in denial and what you can do to help.

What is Alcoholism?

Alcohol is one of the most addictive legal substances available, and alcohol addiction is commonly known as alcohol use disorder (AUD), alcohol addiction or alcoholism.

This is when the affected person is unable to control their alcohol consumption. They may regularly drink large amounts of alcohol despite the negative effects and are often unable to cut down or stop drinking completely despite their best efforts. [1]

You may be surprised at how easy it is to become at risk of developing an alcohol addiction.

If a woman regularly drinks more than three drinks in one day or more than seven drinks in one week, she is at higher risk of becoming addicted. If a man regularly drinks more than four drinks in one day or more than 14 drinks in one week, his risk of addiction is also increased.

It can be difficult to stop drinking alcohol once you have become addicted, as you will likely experience severe cravings and also a range of withdrawal symptoms as your body and brain have become so dependent on this substance.

One of the biggest barriers to recovery from alcoholism is the symptom of denial.

Is Denial a Symptom of Alcoholism?

While not everyone struggling with alcohol addiction will be in denial, it is an extremely common symptom of alcoholism.

This is when the affected person will refuse to acknowledge or accept that their alcohol use has become problematic. They will deny this fact to friends, family, colleagues and even themselves. [2]

To anyone outside this situation, denial may seem illogical. After all, the problems caused by alcohol addiction are staring them right in the face – declining physical and mental health, draining finances, loss of employment, arguments with family and friends… the list goes on.

But despite these consequences, the affected person will insist and believe that they do not have a problem.

Denial can be difficult to navigate, as it can prevent them from seeking treatment for their addiction.

What are the Signs of Denial in Alcoholism?

Denial as a symptom of alcoholism comes in many forms.

It is not simply a matter of the affected person saying, ‘I don’t have a problem.’ They may deny their addiction in several ways, the most common of which are detailed below.

1. Rationalisation

When confronted about their alcohol use, some people may attempt to rationalise their behaviour to make it seem more acceptable.

They may say things like, ‘I hardly ever drink, which is why I drink so much on special occasions.’ ‘I had to keep up with buying rounds.’ ‘Drinking with work colleagues is how I can progress in my career.’

They may truly believe these reasonings, particularly if they are in denial, which can make it very difficult to seek help.

2. Blame

The affected person may not deny that they are drinking too much, but they may attempt to shift the blame onto another person or situation.

‘My job is so stressful; I have to drink to cope.’ ‘My kids are crazy; alcohol is the only thing that helps.’ ‘I have the worst luck; that’s why I got caught drinking at work.’

To truly recover, this person needs to realise that only they have control over their actions.

3. Defensiveness

Many people become defensive when challenged or confronted about their behaviours around alcohol, particularly when they are in denial.

They may say, ‘You always think I’m drunk.’ ‘Why do you keep going on about this?’ ‘It’s my life; I can do what I want.’

By confronting them, you are challenging their perception of themselves and their behaviours, and a lot of people will react defensively as a way to protect themselves.

4. Avoidance

Completely refusing to discuss the issue and avoiding the subject entirely is another sign of denial in alcoholism.

‘Let’s talk about something else.’ ‘Speaking of alcohol, did you see that new bar that opened up in town?’

This tactic is aimed at shutting down the conversation and sending a signal that the person does not want to discuss the topic.

5. Dishonesty

Lying and being dishonest are other ways that the affected person may attempt to conceal and deny the extent of the problem.

They may say things like, ‘I only had one drink. ‘No, I was vomiting because of a stomach bug. I wasn’t drunk.’

It can be very difficult to reason with someone who is being dishonest, and it can be very hard to gain a true perspective of the problem.

6. Comparison

By comparing their drinking behaviours to those of others, the affected person may attempt to show that their actions are normal or even better than others around them.

‘All my coworkers go to the pub after work.’ ‘Everyone drinks while they watch the football.’ ‘Robert drinks much more than I do, and he’s fine.’

This is a way to deny both to you and themselves that they have a problem with alcohol.

7. False agreements

This is when the affected person may appear to agree with what you are saying, but it is simply a way to shut the conversation down with little confrontation.

They may say, ‘You’re right; I need to get my drinking under control. I’m going to stop.’

After a while, these statements simply become words as the actions are never followed through.

8. Dismissiveness

The affected person may dismiss any concerns shared, telling others that they are ‘worrying too much about nothing’ or ‘creating problems where there are none.’

This can make you feel like you are in the wrong for bringing it up, and some people even begin to doubt their intuition and thoughts.

As a result, you may avoid bringing up this topic in the future.

What are the Reasons for Denial in Alcoholism?

If someone is addicted to alcohol, they may know deep down inside that something is wrong.

But admitting that they have a problem may feel impossible.

They may not be ready to give up drinking alcohol – the very thought of it could feel terrifying and overwhelming. It can be easier to deny that there is a problem for themselves and others.

Denial can often be a defence mechanism, a way to deny the consequences of their behaviour and blame it on something else. [3]

This is particularly common if friends or family members are enabling the affected person, as denial can go both ways.

Some people also experience damage to their brains due to alcohol addiction. This can make it more difficult to perceive problems and understand exactly what is going on.

This may be related to a condition known as anosognosia in some cases, which is explained in more detail further on this page.

What is Anosognosia, and Could it be Related?

Anosognosia is a mental health disorder that requires professional treatment.

Someone with anosognosia is unable to understand or perceive that they have an illness. As a result, they will refuse treatment as they do not believe they need it. [4]

It is thought that around 50% of people with schizophrenia may also be suffering from anosognosia, preventing them from seeking help or taking their prescribed medication.

More research is needed to understand how anosognosia develops, but some people believe it is due to damage in the area of the brain that processes self-reflection.

Anosognosia may come and go over the years or become a permanent condition.

So could this disorder be related to denial as a symptom of alcoholism?

While some people with alcohol addiction may also be living with anosognosia which contributes to their denial of the problem, the main difference is that someone with anosognosia is physically unable to process the idea that they have an illness.

They are not simply in denial – they have no way of understanding it as their brain is wired differently.

In most cases, someone in denial of their alcohol addiction will not be suffering from anosognosia.

What are the Other Symptoms of Alcoholism?

While denial is one of the most common symptoms of alcoholism, there are other signs that someone’s alcohol use has spiralled out of control and become a problem.

Knowing what else to look for can help you to break through the barrier of denial and convince your loved one that they have an alcohol addiction.

Other symptoms of alcoholism include:

• Experiencing frequent cravings for alcohol
• Building a tolerance to alcohol
• Drinking on inappropriate or dangerous occasions
• Getting into legal trouble due to alcohol
• Getting into financial difficulties due to alcohol
• Frequent arguments with family and friends about alcohol
• Spending a lot of time thinking about and drinking alcohol
• Withdrawing from friends and family
• Prioritising alcohol use over other activities, hobbies and responsibilities
• Failing to meet expectations at work or school
• Spending time with people who drink a lot of alcohol

Even if your loved one displays many of the symptoms listed above, they may continue to deny that they have a problem.

Depending on your situation, you may need to learn how to live with an alcoholic in denial, as well as work out other ways to help them see the truth.

How can I Help an Alcoholic in Denial to see the Truth?

While you should not put too much responsibility on yourself to help an alcoholic in denial to see the truth, it’s natural that you may want to do anything you can to help.

Firstly, it’s important to ensure that you are not enabling your loved one.

Are you potentially allowing the addiction to continue through your actions or even encouraging it, for example, by giving them money or concealing any consequences?

It can be difficult, but you need to let them experience and deal with the consequences of their actions. This way, it will be much more difficult to deny that there is a problem.

Additionally, do your best to remain supportive.

We understand that it can be extremely frustrating to watch someone you care about remain in denial of such an extreme problem, but continue to use loving and supportive language, as this will keep the lines of communication open.

You should also ensure that you are aware and educated about their professional options, such as rehab clinics and treatment programmes.

This can keep your loved one aware of the steps they can take when they feel ready to seek help and ensure that support and advice are always at hand.

How is Alcoholism Treated?

Once you have received a formal diagnosis of alcohol addiction, you will need to begin treatment as soon as possible.

Depending on the extent of your addiction, you may be referred to an outpatient treatment programme or a 30, 60 or 90-day stay at an inpatient rehab clinic.

Regardless of whether you attend treatment as an inpatient or an outpatient, your treatment will follow the same basic structure.

The first step to treating alcoholism is to complete a detox programme. This is an effective way to treat the physical side of addiction, as it will flush all traces of alcohol from your system.

A detox must be done slowly and gradually to avoid overwhelming your system and triggering life-threatening withdrawal symptoms. For most people, it will take between 7 and 10 days.

Next, you will begin counselling. It is recommended that you attend counselling during your treatment for at least three weeks, as this allows time to build a bond with your therapist and develop healthy new skills.

It can also be extremely helpful to continue your counselling after you leave treatment, either privately or as an NHS patient.

Finally, you will receive guidance and support in relapse prevention and assist in designing a plan that will reduce your chances of relapse after rehab.

As relapse is so common, it’s important to be prepared and know how to pick yourself up and try again.

References

[1] https://www.nhs.uk/conditions/alcohol-misuse/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736262/

[3] https://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1018&context=clsowo_facpub

[4] https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Anosognosia

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