(Previously published in The Hindu)
Leading medical authorities such as WHO (World Health Organization) and the American Medical Association now recognize alcoholism as a disease, with definite and predictable symptoms.
Alcoholics Anonymous defines alcoholism as 'cunning, baffling, powerful'.
What makes the disease so baffling is the typical symptom of denial in an alcoholic. Ask an alcoholic if he has a problem with drinking, and he will most often deny, justify or evade the issue.
Drinking is an accepted behaviour in society. Unfortunately, in the case of two out of ten persons who drink, alcohol slowly deviates from a harmless to a devastating activity. The person is then branded as a 'drunkard' and a social stigma is attached to him.
'Ask an alcoholic if he has a problem with drinking,
he will most often deny, justify or evade the issue'.
Though society allows drinking, the victim of alcoholism is stigmatized. He is looked upon as a bad, even evil person and is considered morally and mentally inferior deserving of punishment and rejection. This sets the stage for denial.
As the disease progresses, the alcoholic needs to drink more often and the quantity of consumption also increases. To protect himself from social stigma, he begins to hide his bottle and sneaks drinks. Repeated 'denial' by hiding the bottle and drinking alone makes him lonely in his obsession.
Everything and everyone, which was hitherto important in his life, becomes secondary. The alcoholic begins to reject everything, which he feels may threaten his continued use of alcohol.
As his condition develops, his self-image starts deteriorating. He is unable to keep track of his drunken behaviour and loses contact with his emotional self. To survive, his defence systems continue to grow in the face of increasing problems. The greater the pain, the stronger the defence systems become; this whole process takes place without his conscious knowledge. Finally, he becomes a victim of his own defences.
'Denial is the self-deception that prevents alcoholics from admitting to themselves or
to others the destructive nature of their addiction'.
Not only is he unaware of his highly developed defence system, he is also unaware of the powerful feelings of guilt, shame and self-hatred buried underneath, sealed off from conscious knowledge, but explosively active. Because of this, his judgment is progressively impaired.
The problem gets compounded by the fact that these defences, by locking in the negative feelings, have now created a mass of free-floating anxiety, guilt, shame, remorse and fear which become chronic in course of time.
To protect himself from the negative attitudes of society and from the uncomfortable feelings of guilt and low self-esteem within himself, he begins to reject the reality of the problem. It is a rejection of reality within and around the alcoholic.
Denial is the self-deception that prevents alcoholics from admitting to themselves or to others the destructive nature of their addiction.
Denial takes many forms. Ask an alcoholic about his problem and he will respond with any one or a combination of these defence mechanisms: Simple denial ("I don't have problem") to blaming and justifying ("I drink because of stress at office/home"); rationalization and intellectualizing ("everybody drinks, it helps me think"); minimizing ("I drink but its not so bad"); diversion ("Tell me about your new car"), hostility ("what right do you have to ask me?") .and so on.
Some Denial Mechanisms:
"I don't have problem"
"I drink because of stress at office/home"
"Everybody drinks, it helps me think"
"I drink but it’s not so bad"
"Tell me about your new car"
"What right do you have to ask me?"
Professional addiction counsellors at Hope Trust are trained to break these defence systems with the help of factual information gathered to facilitate intervention sessions, in which the family also participates.
Treatment centres have well-defined protocols and clear strategies to break the denial. The door to recovery is thus opened.
Denial has to be overcome for recovery to begin. Because real, long-term sobriety cannot be based on falsehoods - it has to have a solid foundation of truth.
(Rahul Luther is Executive Trustee of Hope Trust)