KEY TAKEAWAYS
To help an alcoholic friend in denial:
Helping An Alcoholic Friend In Denial
If a friend is in denial about an alcohol addiction, the main way to help is to avoid enabling bad behaviour [10].
Check if they have symptoms of alcoholism and if so:
Approach The Topic Carefully And Without Judgement
Ask Open Questions On How Alcohol Has Changed Living
Ask the alcoholic friend questions without inputting personal opinions in an open and honest conversation.
Open-ended questions invite the friend suffering from alcohol abuse to self-reflect on the behaviour and explain the root of the bad habits [15].
As the conversation advances, ask for elaboration and base questions on the different answers they give to keep the conversation flowing.
Set Boundaries to Prevent Enabling Them
Setting boundaries when helping an alcoholic friend in denial helps account for personal well-being while helping the alcoholic.
Avoid Codependency
Friends of alcoholics forget to care for themselves while helping the friend get help.
This is called Codependency: when a spouse or friend of an alcoholic becomes too involved in the alcoholic’s wellbeing [16].
Codependency leads to complications like obsessive behaviour, self-blame and mental health issues.
It is possible to support an alcoholic friend without acting as a counsellor or coach.
Give Them Access to Professional Support
The best way to help an alcoholic friend in denial is to help them access professional treatment.
Professional alcoholism recovery programmes include helping alcoholics get over denial about the disorder [17].
There are different treatment options for an alcoholic friend in denial, depending on the severity of the drinking problem and other health problems.
Start by taking the friend to a primary care doctor, who will assess drinking patterns and provide appropriate onward treatment referrals.
Alcohol Addiction Treatment Options Include [18]:
12-Step Program And Mutual Aid Supports:
This is a common treatment approach for alcohol abuse.
Alcoholics Anonymous UK meetings allow the friend to spend time with others with similar problems and reduce the sense of isolation.
It gives access to advice on staying sober.
75% of AA UK members stated that they have been sober for at least two years, based on a 2020 membership survey [19].
There is a strong correlation between the length of membership and the length of sobriety [19].
Behavioural Treatments:
This includes individual, group and family therapy from a mental health professional.
Behavioural treatments help identify the root cause of habitual drinking, and develop skills to reduce drinking.
It helps repair damaged relationships and deal with drinking triggers that cause relapse.
According to Elizabeth Hartney, BSc, MSc, MA, PhD, causes of relapse include stress, persons or places related to the addictive behaviour, negative emotions, seeing the object of addiction, and celebrative events like birthdays and holidays [20].
Residential Treatment:
Rehab facilities provide treatment to those with alcohol use abuse.
The alcoholic resides in a facility for up to 90 days and receives treatments, making it easier to deal with withdrawal symptoms.
The best-performing rehabilitation centres in the UK have success rates between 60% and 80% [21].
Denial And Alcohol Addiction - A Defence Mechanism
Denial, and fear of stigma, are significant barriers to identifying and overcoming alcohol abuse [1].
Alcoholics use denial as a defence mechanism, to avoid facing problems lying underneath the addiction.
Alcoholics are aware of the pain they have caused.
However, the potential pain they face, by owning up to the addiction, seeking treatment, and making amends to those they have hurt, seems like too much to bear.
To cope, they turn to the next drink.
Alcoholics unconsciously maintain denial, as a means to protect the existence of the only coping mechanism they know - the next drink.
There was a time, in the alcoholic's life, when alcohol was ONE way to cope.
Now, it's the ONLY way to cope.
Denial To Self, And Others
A high-functioning alcoholic lies about drinking, to themselves and others [2].
82% of those with alcohol dependence in England are not accessing treatment [3].
Studies have shown that denial is one of the main reasons why individuals suffering from alcohol abuse don’t seek professional support [4].
Those with active alcohol addiction have negative drinking patterns, meaning they drink more than they are meant to, even if it harms health, lifestyle, and relationships [5].
Denial is a defence mechanism that is used to avoid facing a reality that is too painful to handle.
Denial is a part of alcohol abuse and appears on a spectrum [6].
On this spectrum, certain alcoholics accept the problem, while others are unable to acknowledge the harmful behaviour [6].
Denial is an unconscious behaviour in alcoholism that causes the person to refuse to accept how serious the drinking problem is.
Denial occurs because of shame and stigma surrounding alcoholism, or as an excuse to continue drinking, even with the havoc it wrecks on relationships and lives.
Alcohol abuse does not affect the alcoholic alone but relationships with family members and loved ones.
Witnessing a friend’s active addiction impacts your own mental health, and leads to emotions like shame, anger, fear, and self-blame.
It also leads to financial and legal difficulties, relationship neglect, mistreatment, and even abuse.
What Does Alcoholic Denial Look Like?
According to N. Saya Des Marais, MSW, denial in alcoholics presents itself in the following ways [7]:
Why Do Alcohol Addicts Deny Bad Drinking Habits?
A high functioning alcoholic first denies the drinking problem they have due to shame and guilt.
No scientific research arrives at firm conclusions as to what causes denial in alcohol addicts.
But common reasons are shame, enablers like families and friends, lack of education, and chemical dependence [22].
Shame And Guilt
Shame is one reason those with alcohol abuse deny bad drinking behaviour [8].
Based on research in 2015, 29% of participants don’t get treatment due to shame [9].
Alcohol abuse is misconceived as a personality flaw, so alcoholics are blamed for having this illness.
While worrying about what others think, alcoholics stay away from professional help.
Family And Friends Enabling The Habit
The short term desire for a loved one to avoid pain, means friends and family members often end up unconsciously prolonging an addiction problem.
Loved ones unwittingly join the alcoholic in believing that the temporary relief delivered by alcohol, will be enough to solve whatever the current short term problem is.
What they do not realise, is that every time an alcoholic turns to alcohol as a means to cope, the long term pattern of addiction is strengthened. The long term belief, that "alcohol is the answer" is reinforced.
And the resolve to finally face up to the underlying problems, is diminished. Making recovery in the long term, more difficult to achieve.
As alcohol is used as a short term coping mechanism over and over again, the underlying emotional pain built up, can begin to feel insurmountable, for those in active addiction.
In a practical sense, families and friends protect alcoholics by covering for them.
Although loved ones are not directly to blame for alcohol problems, family and friends do contribute to prolonged denial.
Giving excuses for poor behaviour will enable them to continue drinking [10].
Loved ones often call the alcoholic’s workplace to lie that they’re sick, cover bills, help them with run-ins with the law, and take up other responsibilities.
Friends also invite alcoholics to bars to drink, unintentionally contributing to the AUD.
Misinformation
Individuals who lack an underlying understanding of drinking and AUD, frequently blame or label alcoholics unfairly, resulting in feelings of shame [11].
Drinking alcohol is typically normalised in society more than (e.g.) drug abuse, making it easier to rationalise repeatedly turning to drinking as a coping mechanism [12].
Chemical Dependence
Another reason why alcoholics deny bad drinking habits is chemical dependence.
The brain of alcoholics no longer associates alcohol with pleasure but requires it for basic functioning.
This is why alcoholics have a hard time during the withdrawal process.
Chemical dependence makes it hard to recognise the problem and needs to change.
Personality
The personality of the alcoholic increases or decreases the chances of denying the health condition.
Those who are independent, or focus on perfectionism, are hesitant to seek help.
How To Support An Alcoholic Friend Getting Help For Alcohol Use Disorder
Ways to support a recovering alcoholic include [18]:
Denial in alcoholism is complex as there are different reasons an alcoholic hesitates to get the professional help needed.
When helping an alcoholic friend in denial, focus on love, understanding and compassion without enabling bad habits.
If the alcoholic friend is not receptive to help, keep trying and seek professional assistance.
While helping an alcoholic friend in denial, set boundaries and focus on self-care simultaneously.
