How to help a loved one in denial?

Seeing alcohol abuse for a loved one spiral wildly out of control can be more traumatizing for family members than the addict themselves…(it’s true). Our Support Staff are available 24/7. Call: 01603 513 091

The secrecy, bizarre behaviours, aggression even – these are the signatures of addiction and massive denial which can lead to serious negative consequences such as mental illness, and other alcohol related problems.

But there ARE ways to help someone close to you out of that place of colossal denial and spiraling chaos.

The thing is when faced with the option of relieving emotional pain by:

(i) getting that next fix, OR

(ii) doing the work required

An addicted individual will always choose (i). It’s quick, easy, and it allows them to avoid doing any real work or even acknowledging my problems (= more pain).

They’ve repeated this way of coping so much, that it’s become the ONLY way they know how to cope. They truly don’t believe there is any other way.

To help someone in denial we need to:

(i) Convince them that other options exist, that there ARE other ways to cope,

(ii) Address the real underlying problem,

And of course, deal with the chemical/physical addiction too. No mean feat.

How to spot if a family member is in denial of their addiction

Denial refers to downplaying, ignoring and distorting reality. Most people use denial as a coping mechanism and a way of protecting themselves from dealing with reality and accepting the truth about their alcohol abuse problem.

If you have a friend or family member in denial, it means they are having a hard time dealing with their substance use disorder and this may present in the following ways:

  • They try to minimize the role drugs and alcohol play in their life as they assume they are still able to take care of their responsibilities.
  • They compare their substance use to others and assume they are better. They use words like “But I don’t drink as much as …)
  • They constantly blame others for their problems.
  • They say that even when you seek treatment, it will never work.
  • They rationalize that they deserve to take a drink at the end of a long day, and disregard any form of professional medical advice.
  • They insist that drinking or drug use is not a problem.

It is always difficult dealing with a loved one’s substance use disorder and you may need to find a qualified support group or professional help in order to know how you can approach the situation of using denial as a coping mechanism with love and understanding, and above all, you must learn how to remain calm, avoid incorrect assumptions and offer the required amount of support they need.

Denial as a defense mechanism

What is denial?

Denial is one of the many coping skills that a person or friend or loved one will use in order to justify their addiction. It is a defense mechanism that involves the reality of the substance use disorder, and this is usually for purposes of avoiding anxiety and dealing with it.

Defense mechanisms are strategies for coping with distressing feelings, and in the case of substance use which is a form of chronic illness, denial will involve denying the reality as the consequences can be too hard to deal with.

If you, or other family members are dealing with a loved one in denial, take your time to understand them, as the journey to finally accepting they are addicted to substance use and having the ability to accept expert advice and set boundaries can be along and difficult journey.


The first step towards recovery usually involves accepting that there is a problem, and unfortunately, for anyone to reach this point, they must have had a few close calls with addiction so they can decide that enough is enough.

Even having financial problems never changes an addict's lifestyle. The point where addiction becomes a problem will need one to accept they need help.

How can denial cause problems?

Denial is a big problem in your friend or family member’s life because when they are unable to addressing what is wrong in their lives, or even talk about it, the chances of treatment, or even being open to treatment options can be extremely limited.

But denial can also cause problems in their life, particularly if it keeps them from addressing a problem or making a needed change. In some cases, it can prevent them from accepting help or getting the treatment that they need.

Sigmund Freud (1) who was an Austrian Neurologist and the person who founded Psychoanalysis described denial as: 

Refusing to accept and acknowledge facts about external and internal events which includes thoughts, memories and feelings.

Signs of denial

There are a few signs and behavior that a loved one is in denial and they include:

  • When they refuse to talk or speak about the problem.
  • When they refuse to deal with the problem.
  • When they are always finding ways to justify their behavior.
  • When they refuse to answer any questions about their problems.
  • When talking about substance use becomes a big fight.
  • When talking about drug abuse, recovery, and treatment options is impossible.
  • When they always justify their behavior.
  • When they refuse to take control of their health and deny they are doing anything wrong.
  • When any discussions about alcohol and drug abuse is done by force.
  • When they cannot handle what friends and family members are telling them.
  • When they deny any conversation about the negative consequences of their actions.
  • When they keep promising to address the problem but never do.
  • When they deny any form of recovery treatment suggested.

Make your loved one see denial

Now regardless of how hard having a conversation about the alcohol abuse problem for a loved one may be, you must make then understand the consequences if they continue abusing drugs and alcohol. You must however be helpful and look for advanced recovery systems that can help them. Talking to a qualified admissions representative may guide you on how to go about this.

Damage caused by denial

When your loved one is wallowing in denial, it causes more damage than good. This is because the longer they stay in denial and refuse to talk and get their health in check, the worse they get. Friends and family members should try as much as possible to help.

What denial does is to fester the problem. The longer one keeps denying their health and assuming they are okay when they are not, the worse the addiction gets, and sometimes this can be fatal.

Substance abuse

Substance abuse for a loved one is very hard to handle. They have to recognize the problem so they can start a helpful conversation that will cause them to start thinking about healing.

In fact, reducing their alcohol intake is a much better case and sign that they are about to reach a point of acceptance. However, this is rarely the case, and most of them will stay in the denial until a major disaster causes them to make a change.

For example, if one stays in denial about their health condition and never see a doctor about it, the problem will most certainly get worse. Likewise, if they are in denial about symptoms of a mental illness such as anxiety or depression, they may delay seeking help and advice from a doctor or mental health professional.

How to help a loved one in denial with their mental health

A point of concern with denial is that it is the first sign of a major problem for your loved one, and as their addiction gets worse, then they will start to see real life problems as a result of the condition.

As the disease progresses and their drinking begins to cause real problems in their life, remarkably the denial likewise increases. Drinking sprees can create problems at work, relationship losses, or even arrest for driving while impaired, but the alcoholic denies these problems have anything to do with drinking. Some say this is purely a defense mechanism.  (2

Can a loved one really be helped?

Yes, but it is a long and hard journey, and you may be wondering how is this possible? Usually, by the time the disease has gotten to the crisis point, a person with alcoholism has developed a support system of family and friends who unwittingly enable him to continue in his denial. They can display secondary denial, making similar excuses for the drinking and its consequences.

How to approach a loved one with denial using a mental health professional

How You Can Help Your Loved One.

First of all, remember that they aren’t trying to be difficult. The fact that they can’t come to terms with their illness is itself a symptom of the illness.

With that in mind, here are some things you can do to help:

  • Let them know that you are on their side. They probably feel very alone right now. (3)
  • Listen. They don’t want to be told what to do right now. However, they do want to be heard. Be present.
  • Accept that you are powerlessness to convince them that they are ill. Focus on what must be done in the moment.
  • Encourage Your loved one to do things that help reduce symptoms. Do those things with them. Medication refusal is common but you can try meditation, exercise, enjoyable events, grounding activities, etc.
  • Get help if you believe that they are an immediate threat to themselves or others.

How a therapist can help a loved one in moving beyond denial

You might wonder how your loved one with a substance abuse problem doesn’t believe in their diagnosis even after going through therapy. But, do not worry, it happens all the time.

First of all, a person might recognize that they are in distress even if they don’t agree that a mental health issue is the cause. For example, someone might come to therapy complaining about their spouse only to realize eventually that they’re dealing primarily with underlying depression.

Alternatively, people may end up in therapy due to court ordered rehab or family intervention. Perhaps they don’t believe in the diagnosis, but they have shown up anyway. As long as they’re showing up, a therapist can help.

How to helping a loved one move past denial and seek treatment

This is not easy. The first step is that your loved one must be willing to get help. There are many hospitals that are willing to help but they all have their own privacy practices and other parent company rules that are followed when it comes to finding help for a loved one.

Support groups, therapists, treatment facilities and addiction centers can be extremely helpful in this journey. You should try to address your loved one from a point of caring, and not condemnation, as they are trying to come to terms with their addiction.

If you think that your loved one is in denial of their drug and alcohol abuse, then you should call us for tips on how to handle this condition.


Finally, let your loved one know you’re there for them and are worried. Also involve other family members in the process, and try to use “I” statements and avoid using labels such as alcoholic.

Avoid being judgmental, but show support and offer suggestions about ways or places they can get help. These conversations can be tricky and emotional, so you may want to involve a therapist or counselor.

About the author

Laura Morris

Laura Morris is an experienced clinical practitioner and CQC Registered Manager with over twenty years experience, over ten of which have been as an Independent Nurse Prescriber.

She has held a number of senior leadership roles in the substance use and mental health sector in the NHS, the prison service and in leading social enterprises in the field.