If You Want to Understand Addiction by Steven C. VanGelder
Denial Chapter 1
It is helpful, even crucial to understand the enigma of addiction by first understanding denial. If I was asked to use three terms that are most important to understand addiction, denial would be one of them. The remaining two descriptors would be the words “chaos” and “narcissism.” We will address those terms in later chapters.
Anna Freud, in 1936, listed the “Defense Mechanisms,” a term mentioned earlier by her father Sigmund. The Freud’s marvelous skills of observation found there to be twelve such responses that humans can manifest under the state of anxiety. And like the psychoanalysts like to believe, these thinking and response processes are largely unconscious processes. The ego defense mechanisms are manufactured by the human brain through the unconscious, to protect us from that which we find too painful to face. The problem with these defenses is that they are not thought out and selected before being utilized. In theory, every human holds the potential for the employment of these defense mechanisms. In practicality, it is evident we that have all succumbed to these ego defenses of one kind or other at one time or other. The problem with these mechanisms is that they are not thought out. When a human being is acting prior to the thinking process or when the process of rational judgment is superseded, we can find ourselves in trouble. The thinking process begins with perception; looking accurately at what we are seeing. Following our ability to accurately perceive, we categorize. This means classifying what we perceive as compared to what we know. Once we are comfortable with what we are experiencing, we can identify options as to what to do about it. The process of choosing an option evokes many systems, to include values, wants, needs, consequences, risks, etc. From the choice of option, we must then choose how to implement the chosen option, mobilizing the body to carry the action out.
Denial is a process by which “A person cannot see or believe what others can easily see or believe.”Remember, denial is a natural process that is there to protect us from that which we find too painful to accept.There are many examples of how the onset of denial has served as a protective factor in a valuable way.For instance, an athlete who has had a tragic loss of a leg and told he or she will never compete again. The athlete’s denial mechanism may not accept that reality.We have seen examples where athletes go on to perform major feats in sports with a single leg.A more common example is the loss of a loved one.The stages of grief put forth by Dr. Elizabeth Kubler Ross lists denial as the first stage a person goes through in the process of grieving a loss.There are many people who while they know their loved one is no longer among us and who know the details of the person’s death, carry on as if that person was still in their lives.Such practices as keeping the person’s bedroom exactly how the person lived in it, is an example. The mechanism of denial in the process of grief is protective. The full impact of reality does not shock us into such desperation that we collapse physically or mentally or be so overwhelmed as to commit suicide. Rituals such as talking to gravestones or setting the deceased persons place at the table, might appear strange to some but not if we understand the comfort that denial provides us.
It is important to understand that denial is natural. Using harmless, even helpful instances of denial tends to be most helpful in driving home the point of its process as unconscious. As the unconscious process of denial is a first most important characteristic to understand, there is a second important characteristic. Denial can be progressive. Progression is defined as “The process of developing or moving toward a more advanced state.” Of course not everyone’s denial progresses. Some people go through the stage of “this isn’t happening,” but move on through the pain of the reality experiencing the full effects and the understanding of that reality. Yet others fall into progression. The difference in progression or non-progression may lie in what kind of painful reality it is about and how badly the unconscious does not want to face it.
When we talk about the progression of denial we begin with what is termed simple denial. Simple denial pertains to not seeing or believing. In the extreme case, a person may be standing next to a haystack size of evidence, but to that person, there is no haystack. The staunch supporter of a politician may gloss over entirely, hard evidence of the politician’s red-handed improprieties. You may be familiar with the monkey that has his fingers in his ears, eyes shut and making noises with his tongue. This is how the unconscious delivers simple denial. The underlying motive of the unconscious is either reality being too painful to believe or wanting to believe so badly that what you believe is the reality. In many cases, as reality becomes apparent this denial is broken. Or, it progresses.
If simple denial progresses, we may experience a condition called minimizing. Minimizing recognizes that the reality is present but the significance of it is reduced to inconsequential value or plainly “no big deal.” I have heard such minimizing in my career experiences as “I only cheated on my spouse once.” Or, “Though I cheated on my taxes, I paid more in taxes than the next guy.” The unconscious in this respect has relieved the individual of his pain by the conviction that the behavior is insignificant, therefore quasi-acceptable. Full reality has a way of coming around full force and this may break an individual’s minimization of the behavior. Or, it can progress to rationalizing.
Rationalizing, is a form of denial that probably every one of us has done at some time or other.Rationalizing is a favorite type of denial that is often a quick “go to”, by the unconscious.An easy way to look at rationalizing is to substitute the words justifying or excusing.The ego is bruised when we think or act in ways that are contrary to our values system.It is a painful state when we have screwed up and we know it. Rationalizing comes to our rescue with the lightning fast thought process that “It’s okay because,” or “Maybe it’s better that,” or even “Well they deserved it anyway.” I once heard a man who was philandering on his wife with many women. He rationalized that “A man who has as much macho as I have, cannot be satisfied by one woman.” “Such a man should not be limited.” The important point to understand is that this man was entirely comfortable in his belief. His unconscious protected him from the reality of his actions that went even beyond his religion and his love for his wife.
Another quick “go to” by the unconscious in the progression of denial is projection. To understand this type of denial, imagine a film projector. An image is taken from one place and shot out to another. How many times have you blamed somebody else for something that happened to you? Hours or days afterward, maybe you came to the realization that you were actually the architect of your own misery. Or maybe you continued to be justified that it was the others’ fault. Projection is often lightning fast. I remember when I was a kid just learning to ride a bicycle when I rode the bike into a neighbor’s curb and tumbled off. I immediately felt the neighbor should be sued for putting a curb there. Courtrooms are full of cases where someone ignored the “Slippery When Wet” sign on the floor of a building and are now suing the building’s owner for their injuries. I can not begin to count the number of clients I have had who blamed the consequences of their misdeeds on the upbringing by their parents.
A curious and less often seen type of denial is referred to as intellectualizing. I have often had some difficulty getting people to understand this defense mechanism. My best shot at explaining it is this: “I am too smart to have a problem like this”. Remember the television show “Cheers?” Cliff Clavin was a simple fellow who was insecure and had a limited existence. The post office he worked for was pretty much his entire world. He lived with his mother and when a woman talked to him he would babble like an idiot. Cliff sat next to Norm drinking beer every night. But Cliff knew everything about every subject you could bring up. Most of it was off the top of his head and usually wrong. Cliff had pretty much no life. But his unconscious protected his low self-esteem by convincing him that he was a knowledgeable man. Intellectualizers can be recognized by using big words that are not actual words. They are notorious for not being listeners but overbearing tellers. Intellectualizers are quick to tell you how wrong you are and how right they are. They are often vague and lack detail or facts to back up their contentions.
A defense mechanism I have witnessed in only the most extreme cases of the progression of denial is called diversion.In this process, the subject that is uncomfortable to the person is quickly changed to something else.Don’t confuse this with a conscious strategy such as that used by politicians, called pivoting. Pivoting is a well-developed conscious skill at getting away from something you don’t want to talk about and into another.The ego defense mechanism of diversion is also well practiced but as the other types of denial, it is unconscious.I worked with a woman once who was a severe alcoholic.It was impossible to discuss her alcoholism for as much as a minute before she was taking the conversation someplace else. And I can assure you how foolish you can feel after you have been sucked down this rabbit hole and you don’t realize it until minutes later or after the conversation is over. The ego protects itself with diversion by manufacturing a reality in which if it’s not talked about, it doesn’t exist.
Finally, we come to a type of denial that is an ugly and hurtful type of diversion. This is diversion-anger. To be sure, anger is an emotion that can emerge in many ways, for many reasons. The mechanism of diversion-anger has a specific purpose. If someone gets a face-full of anger when getting too close to a subject the other someone is sensitive and sore about, the subject of the interaction is changed…radically. The emphasis then becomes on the hostility and not whatever the person is tender about. Admittedly, some practice anger by choice. Yet, in the case of diversion-anger, the person’s unconscious is self-taught through experience early on, that anger works to avoid that which you don’t like. Your unconscious doesn’t have to deal with what it doesn’t want to if it turns to anger.
Now that we have gone over the many faces of denial, I bring you the reader back to the subject of addiction. How does the psychological phenomenon of denial apply to addiction? Denial as we have seen is a natural psychological phenomenon that each of us carries the potential for. Denial is a protection against the harshness of reality. Denial can be harmless, even sometimes helpful. The contrary case is when denial prevents someone from seeing the damage that a behavior is doing to him. A person may engage in a behavior that is placing him in great danger and that behavior may be continued by that person until it eventually takes his life. Even though everyone who loves him has warned him of the danger and the need to change the behavior.
To first address the denial of addiction it is helpful to look at E. Morton Jellinek’s famous “Curve on the Progression of Alcoholism” (refer to Appendix A.) Jellinek identifies three phases in which an alcoholic goes through the process of getting more pathologically sick and dysfunctional. His model cites milestone symptoms and behaviors through the stages. As I have taught from this curve for many years, I have described the initial phase as the “No Problem” phase. The person on the initial phase of the curve uses the chemical or other relief agent taking pleasure from it, just as those around him. Only with this person, differences start to become noticeable. The individual may be first to the party and last to leave. Or maybe turning to the relief agent in such times that are not normal times and situations for its use. Beginning to drink beers in the truck at lunch time as opposed to waiting for the after-work get together might be a sign. The denial of the first phase of addictive disease may go like this; “The kind of bad things have not happened to me like they happen to people who have a problem.” This is what makes working with adolescents who have addictive disease difficult. Many have not had the “bad things happen;” yet. In the first stage, minor problems go on unrecognized by the person with the progressing illness, believing he or she is a normal enjoyer of the relief agent. Others around the first-stage person may not recognize a problem progressing either; yet. The type of denial in the middle phase of addictive disease I refer to in my lectures, as the “I have some problems” phase. By this time the person on the curve is finding that life has gotten more difficult in usually several different life areas. The person may be having financial difficulties or maybe lateness to work is becoming a problem. The marriage or relationship may be taking a downturn. There may be the stress and cost from a “driving under the influence conviction.” Maybe responsibilities the person had been prompt on previously, are now not being attended to. This second phase is key, as a transition phase in the individual’s character, behavior and lifestyle. This period is when we find compensatory behaviors being developed and employed. Compensatory behaviors may be understood as alternative ways of coping as opposed to the most common way or most effective way. This is where we would see more excuses. Lying is a compensatory behavior. Simply telling people what is nicer to hear than the truth is a viable alternative to causing conflict. Lying works to keep your life simple and allow you to continue doing what you are doing without hassles. Addiction is much about survival and lying helps you survive. Interestingly, lying is progressive as well. As people become wary of your statements and when consequential things happening to you are of a more serious nature, lies must become more sophisticated. As Joseph Goebbels alleged, “The bigger the lie, the more people will believe it.” It has been my experience that some people, certainly many with addictive disease have conditioned themselves to lying as a compensation mechanism to the point where the first thought and first response is a lie. Truth would be a second thought; used only if the payoff is better. In this case, we might even consider lying itself as an addiction.
When we talk about manipulation, we should go to the simple meaning of the word. To manipulate is to work or manage something as if it were a tool. Someone may manipulate a lever to operate a machine. But the word has taken on a negative connotation to mean using a person for exploitation. The person in the second phase of addictive disease manipulates as a compensation mechanism to make him or her feel as though they are getting by okay. So, as long as I can take out credit cards to make payments on this credit card that you know about, I am okay. As long as I can schedule my cocaine use three days ahead of my probation appointments, I won’t fail a urine test. I can continue to use and sell drugs because I think I can get mom to post bail. If I check into rehab and just do the time there, everyone will forgive me. These are manipulations of time, scheduling, people, resources and systems that allow those in the second phase of addictive disease the comfort that he has some problems but the problems are manageable because of these compensation efforts. And when I solve the problems I will be okay.
Other compensation mechanisms cited by Jellinek include geographic escape; the belief that if I move away I leave the problems behind.Promises and resolutions comprise a compensation mechanism in the later part of the second phase.The promises made to others and perhaps to himself, brings relief and comfort that all this will be over.But by this time, the individual has neither the knowledge nor the alternative healthy coping mechanisms to make the promises good.So he fails.Promises are broken again and again.Another compensation mechanism mentioned by Jellinek is lowering standards. By this, we are referring to lowering the quality of the social group, lifestyle or living situation in such a way that it reinforces a powerful type of denial. Namely, “Everybody I know does what I do. Therefore what I do is normal.” We can spend a great deal of time on compensation mechanisms, yet for purposes of brevity, we will examine one more; avoidance. If you don’t want to hear your family members tell you how bad you look, don’t go see them. If your problems are so numerous as to be unmanageable; avoid them. Go get high and keep getting high as long as you can. Keep running. If you have difficulty comprehending avoidant thinking, consider this example. You are hanging onto a shrub on a steep incline with a twenty foot drop. Your friends tell you to let go because you will die up there if you do not let go. But, “While I know I will have to crash sometime, I am safe at this moment by avoiding it.” For a person with addictive disease that moment of safety by avoiding can rack up into days, weeks, months, even years.
We mentioned there are three phases in the Jellinek Curve; the third being the chronic phase. The word chronic refers to something that is persistent or long lasting in its effects. In my lecturing I have used several metaphors to describe the chronic phase of addictive disease. But probably the most descriptive might be this. “Now I know my problem.” “I have an addiction.” I know what it is doing to me, to my family, to my self-respect and to my future. But, “Now I must live to use and use to live.” “To not turn to my relief agent today is not an option.” “The only way I will get through today is by using (it).” This is a tragic and dangerous condition. We could go as far as to describe this as slavery.
Physical dependence is one but only one of the ways a person is enslaved in the chronic phase. The body can tune itself to certain substances, resulting in painful sickness unless the drug is maintained in the bloodstream. The opioid drugs and sedatives to include alcohol are most notorious for physical dependence. It can be argued that certain other drugs such as nicotine have a physical dependence with the withdrawal effect of agitation and craving. A physically dependent person spends most or all of his day chasing the administration of the drug to prevent getting sick.
Psychological dependence is common among all relief agents including behavioral agents such as gambling, hair plucking and internet overuse. The psychologically dependent person has lost to a great degree the coping skills that most of us take for granted. The use of the agent makes the world a tolerable place. As the agent has been supplying temporary and artificial feelings for so long, natural feelings are alien; often amplified and uncomfortable. Natural coping such as feeling emotions and problem solving in response to those emotions have become beyond the dependent user’s capability. As mentioned earlier, “To not turn to my relief agent today is not an option.” “I would not survive.” Again consider the thought process of the person in the metaphor clinging to the shrub. My work with people with addictive disease has led me to observe another factor that keeps people stuck in the chronic phase. And that is loss. Jellinek in the chronic phase on the curve mentions some of these losses. He cites such milestones as physical deterioration, inability to initiate action, impaired thinking ability, all alibis exhausted, loss of family, loss of job, loss of morals and more. We can extrapolate beyond these milestones to look at the addicted person’s life in this late phase. By this time, probably nobody trusts what this person says. There are losses such as the driver’s license. This may sound like a trivial loss, but if you live in a locality where there is not adequate public transportation, and there are many, how can you get a normal life back with a job. How can you get to your probation office, or your mandatory outpatient counseling and urine tests. A crucial factor we will discuss later in the book in more detail is having obtained a criminal record. A stained record that will obstruct you from getting a job, or an apartment, or a loan, or a decent relationship (dating now may include background checks) can be crippling. Let us not leave out the emotional losses. Many in the chronic phase of addiction have lost their self-respect, lost their self-esteem, lost hope for a better life and as we will discuss in much detail, lost what is most precious; their spirit. Imagine what being the only family member not invited to the wedding in the family does to your self-esteem and your spirit.
Living a life in such depletion of the common emotional resources that so many of us have and take for granted is a unique and desperate kind of denial. That is, the denial that my life is over and all I have is my (agent) to numb me out and put it to sleep for a little while. Tomorrow, I do whatever I have to, to do the same thing. All I will ever have is the numbing agent, lifestyle, people and self-identity that goes with it. How many times I have seen people in a dingy bar; the same faces day after day, sometimes not speaking to each other but all sharing the same reality; all we have is each other. The denial of the chronic phase of addictive disease then is simply this; “All I can do is keep it going until it collapses.”
We could not complete our understanding of denial without attending to power of cultural influence.To be sure we can look at many cultures of the world and how denial is a way of life in any respective culture.In many places in the world, children are reared to uphold their honor; the honor of their families and of the honor of their people, by taking on their burdens themselves.I quickly think of Asian cultures where personal honor is of highest importance.Latino males are raised to be strong and independent.Various cultures within the United States follow these same lines of child rearing emphasizing strength and not relying on others.To admit you have a problem is to admit you are weak.We can look at what I call “traditional families” to see this kind of cultural practice.As this country was getting established, families lived in villages.Even in urban areas there were pockets of ethnic groups and cultures that made up villages within cities.In these times, people were very visible to each other.They knew each other’s business. Dad worked hard long hours and it was the job of the woman of the house to make sure the family was proper (especially as others saw them).There could be no alcoholism, no developmental disabilities, no mental illness, no child molestation, no physical abuse, you get the idea; in this family. It was swept under the rug as the family had to look proper. Being identified with any such social and familial problems could wreck the family’s reputation; something that could not be allowed. You could become excommunicated from the church, the community and the family at large if you did not maintain denial.
Consider, here in the United States children are taught mantras from birth forward. In many places children get the message that asking for help means weakness. If you cannot solve your problem by yourself, it means you aren’t trying hard enough. “You’re a loser.” Mantras and beliefs even more damaging, include statements such as “Why can’t you be like your brother.” Restrictions against having a problem that requires help can get you restricted in our society from opportunities in education, vocation or sports. It may even get you excluded from a share of the inheritance. The mass media has contributed to this cultural denial in a big way. Movies, advertisements, posters, magazines all depict the strong, independent person as the character type you want to be seen as. The ultimate message is, if you have a problem that persists, that you cannot solve on your own, it means you should “act as-if.” Acting “as-if” gets you by, by attaining others’ approval. I have worked with many people in the military who have had to “act as-if,” to be able to avoid scrutiny or job termination. Consequently, problems that need help, or need treatment go on unattended to year after year. To please all of these potential critics, including ourselves, we live in a closet, purporting an archetypal existence. I would remind the reader that this cultural denial process as in the aforementioned areas of denial is a largely unconscious process. We are conditioned to believe these values, beliefs and mantras from early ages.
Denial then, is important to understand if one is to understand addiction. If you have someone in your family or friendship or workplace you are concerned about in regard to addictive disease, be ready to observe denial. Your loved one will almost certainly pooh-pooh your concerns. This may go on for a very long time, even as the person gets observably worse. Understand that it is not because they do not love you or because they do not doubt your sincerity. It is because their unconscious processes that keep them safe from painful reality do not allow them to see it. Use patience and timing. You will hopefully get your chance to drive the point home (usually following some kind of crisis).