Denial: why a person with an addiction genuinely cannot see the problem

When someone tells you “I'll stop whenever I want”, they are not lying to you — they believe it. That is denial: a psychological defence mechanism that the illness builds into their thinking.

How denial works

The illness affects the mind: a particular way of thinking develops that keeps the use going by justifying it. This is not cunning, and not manipulation in the ordinary sense — the person really does see the picture differently from the way you see it.

That is why the problem is usually recognised first not by the person who is ill but by those closest to them: relatives, friends and colleagues at work. They themselves accept that they are ill much later — a year or two, and sometimes ten years, after their family first told them.

Denial has another prop: comparison with the extreme case. People look for the signs they associate with alcoholism and drug addiction — cirrhosis of the liver, memory loss, physical wasting, dementia — and do not find them. If none of that is there, the conclusion is a simple one: “I'm not like that”.

The phrases that give denial away

“I drink like everyone else.” “I haven't got a single one of the signs.” “I'm working, nobody has ever seen me drunk.” “I'll stop on my own, I'm just going through a hard patch.” “It's because of you, because of work, because of this country.” “Once I've finished this job, I'll stop.”

What all these phrases have in common is that every one of them contains a grain of truth. That is precisely why arguing with them is pointless: disprove one and denial will produce the next, and so on without end.

What the family can do

Do not try to argue them round with logic. The exchange “you're ill” — “no, I'm not” has no winner: denial is stronger than any argument you can make, because what it is defending is not an opinion but the use itself.

Talk about facts and about yourself rather than about a diagnosis: not “you're an alcoholic”, but “last week you didn't come to your child's birthday, and I didn't know what to say”. A fact cannot be argued away as easily as a label.

Most importantly, do not wait for an admission before you act. Families spend years waiting for the person to work it out for themselves. Usually they do not, and that is why it is the family who picks up the phone first. There is nothing wrong with that — it is how most of the stories that ended well began.