Key Takeaways:
Alcohol use disorder is a serious health condition. Many people who live with alcohol use disorder have difficulty accepting or recognizing their problem with drinking.
There are many reasons that people with alcohol use disorder may engage in denial, including shame and a lack of education about alcohol addiction.
Friends, parents, and spouses of people with alcohol use disorder should be empathetic and supportive when talking to the person and confronting their disorder.
Denial is a defense mechanism that is common among people with alcohol use disorder. Even people who experience problem drinking but don’t qualify for a diagnosis may experience denial. Denial may lead someone with alcohol use disorder to refuse to talk or even think about their drinking habits.
This can be very frustrating for the loved ones of a person with alcohol use disorder. Loved ones may try to help them. But they may refuse to talk or deny that their drinking is a problem.
If you’re a friend, parent, or spouse of someone with alcohol use disorder, read on to learn about how to help someone in denial.
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Denial and alcohol use disorder
Alcohol use disorder is a condition that affects almost 30 million Americans over the age of 12. People with alcohol use disorder were previously labeled as “alcoholics,” which is a term that professionals no longer use.
People with alcohol use disorder have a hard time controlling their drinking. They drink more than they intend to and keep drinking even when it’s harming the people and things they love.
In the world of psychology, denial is typically understood as a defense mechanism. This means that people sometimes use denial (and other defense mechanisms) to avoid facing realities that are too stressful or painful to deal with.
When it comes to alcoholism, denial is an unconscious process. It causes a person to refuse to acknowledge the severity of their problem with alcohol. It is unconscious because the person is not aware that they are doing it. Denial is a common part of alcohol use disorder. It can appear on a spectrum. Some people with alcohol use disorder may acknowledge their problem. Others may be unable to accept the reality of their behavior.
In many ways, denial explains why people continue to use alcohol despite the problems that drinking causes in their lives. And research shows that denial is one of the top reasons that people with alcohol use disorder don’t seek treatment.
Some of the ways that someone with an alcohol use disorder may engage in denial include:
Lying: The urge to continue drinking may be so strong that the person lies about their drinking habits. This may be to avoid being scolded by their family and friends. Or it may be because they are aware that their drinking is a problem. They may start hiding where they’ve spent their time or deny that they’ve been drinking when they have.
Blaming: The person with alcohol use disorder may blame other people for their drinking and fail to take responsibility for their actions. For example, they may tell you that they didn’t intend to drink at the bar but that their friends “made” them. They may even blame you for their alcohol use, saying something like, “You made me so mad that I just had to have a drink.”
Comparing: The person with alcohol use disorder may compare their own drinking habits to others’ (worse) habits. For example, they may say something like, “My friend drinks so much that he can’t hold down a job. My drinking is not that bad.”
Rationalizing: The person may try to use their own logic to explain their drinking behaviors. For example, they might insist that they only drink when they have a stressful day at work. They may try to excuse their problematic drinking in this way. They may say something like, “If I start having real health problems like cirrhosis — that’s when I really know that I have a problem. But for now, it’s under control.”
Dismissing: Finally, people with alcohol use disorder may simply dismiss the topic of their drinking whenever it comes up. This includes simply telling you “not to worry about it” when you try to discuss their drinking with them.
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Why do people deny that they have a drinking problem?
You might ask, why would someone experience denial about a dangerous illness like alcohol use disorder? Unfortunately, there is no complete theory of denial as it relates to addiction. We need more scientific research to be able to say for sure what factors lead to denial in people with alcohol addiction.
Some of the most common reasons for denial in alcohol use disorder are listed below in more detail.
Shame
Shame about drinking and alcoholism can lead someone to be in denial about their behavior.
For example, someone with alcohol use disorder may have grown up with a parent with alcohol use disorder. They may feel ashamed that they’re now engaging in the same behaviors. But research shows that having a parent with alcohol use disorder greatly increases your chances of having it too. And a genetic predisposition to the disease is not your fault.
Lack of education and societal views
People who misuse alcohol may not have accurate information about alcohol use. People who use substances like heroin or methamphetamines may be more likely to recognize that they have a problem. Using these substances is typically frowned upon, so it may be more difficult for people who use them to rationalize their behavior.
Drinking alcohol, however, is normalized in our society. This may make it easier for people with alcohol use disorder to rationalize their drinking. They may try to convince themselves or others that their drinking is within the “normal” range. They also might not have up-to-date information about how much alcohol is considered “normal” use.
Neurological deficits
New research shows that brain science may also contribute to someone’s lack of insight about their drinking. Some experts now say that the same areas of the brain that are affected by addiction may also be responsible for self-awareness. This could contribute to why people with alcohol use disorder often have a difficult time being aware of and confronting the severity of their addiction.
The role of family and friends
You’re not to blame for your loved one’s alcohol use disorder. The causes of alcohol use disorder are varied and complex. Sometimes, though, family and friends contribute to their denial.
If you love someone with alcohol use disorder, you want to do everything in your power to help them. This is a natural and human reaction. Sometimes, loved ones may make excuses for the person’s behavior or even enable them to continue drinking.
For example, if your spouse with alcohol use disorder is too drunk to drive, you may call their workplace and lie that they’re sick. Or friends may continue to invite someone with alcohol use disorder out to bars because of their fun personality.
These are ways that loved ones can unintentionally contribute to a person with alcohol use disorder’s denial about their drinking.
How to help an alcoholic in denial
One of the most important things you can do if your loved one is in denial about their alcohol addiction is to stop enabling their behavior. Think about your feelings and your own level of denial about their disorder. Are you ready to accept that your loved one may have a problem with drinking? If not, then you may be excusing or rationalizing their addiction and contributing to their denial.
Other things you can do to help someone who’s in denial about alcohol use disorder are discussed below.
Talk to them openly and without judgment
Don’t attack them or try to force them to accept their addiction. Rather, express your concerns in an empathetic way. Let the person know you care about them. Tell them that your only wish is for them to be happy and healthy. Reflect their answers instead of arguing with them. Try to see the situation from their point of view.
Ask open questions about how alcohol has affected their life
Leave your opinions out of the questions. Phrase questions in a way that invites the person to self-reflect and tell their story. For example, rather than saying, “Don’t you think you would feel better if you hadn’t drunk so much last night?” try saying, “How do you feel? How do you think you might have felt if you hadn’t drunk last night?”
Help your loved one access professional support
Many professionals are trained in helping people with alcohol use disorder get over their doubts and denial about their disorder. People with alcohol use disorder may be more receptive to hearing an outside person or expert, rather than a loved one, confront their denial.
Take care of yourself
Remember that alcohol use disorder is a serious disease. You don’t have to carry the sole responsibility of helping your loved one. Make sure you practice healthy self-care.
The bottom line
Denial is a common part of alcohol use disorder. This can be frustrating for loved ones who want to help the person recover but are repeatedly pushed away. If your loved one is in denial about their alcohol use, it’s important that you don’t enable their behavior. Confront your own feelings of denial, talk to them with empathy, and take care of yourself.
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References
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National Institute on Alcohol Abuse and Alcoholism. (2020). Understanding alcohol use disorder.
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Rotunda, R. J., et al. (2004). Enabling behavior in a clinical sample of alcohol-dependent clients and their partners. Journal of Substance Abuse Treatment.
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Substance Abuse and Mental Health Services Administration. (n.d.). SAMHSA's national helpline.
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