Originally Published in Psychology Today
How does denial impact addiction and recovery?
On the face of things, doesn’t it just seem like the answer to disagreeable feelings isto run for cover in our bat cave, where they can’t pester us anymore? It seems so logical. The trouble is that we don’t quite operate that way. Ironically, recent research reveals that the more we ward off bothersome emotions on a day-to-day basis, the more the unpleasant feelings dwell within us and the more the pleasurable ones seem further out of reach. And addiction, both to compulsive behaviors and mood-altering substances, is a forceful domain where emotional avoidance and psychological hardship traipse hand in hand.
For example, when we evade unwanted experiences inside us, we’re also more prone to grapple with harmful levels of gambling, which, sadly, offer the promise of feelings—like excitement, hope, and happiness—that can provide temporary solace from the real feelings of boredom, hopelessness, and sadness that a person experiences. But we don’t have to spend money to fend off burdensome feelings. There’s also a link between our drive to bypass unsettling emotions and Internet addiction, particularly in the form of online gaming. Does this mean that if you’re a gamer, you must be warding off vexing feelings? Absolutely not! Plenty of people play for the sheer pleasure of it, similar to folks who let loose with the occasional game of blackjack or a few rounds at the slot machine. As long as we have a healthy relationship with gambling or the Internet, we’re cool.
In the world of substance addiction, emotional escapism rips us off with a smile. For instance, a 2015 psychological research study from the University of Texas Medical School at Houston shows that people who stay away from their inner experiences related to cocaine use (such as their feelings) are less likely to stay on track with treatment for cocaine dependence, even when that treatment is well-researched and quite potent. In fact, it’s a truism that substance misuse is a way of “medicating” uncomfortable feelings and that not wanting to face those feelings is a key dynamic in not admitting you have a problem with alcohol or other drugs. “He’s in denial,” is a common plaint of both family members and counselors regarding people with addiction disorders in general.
The fact that the majority of therapists admit to being unclear on how to effectively treat someone with denial speaks to its knotty, intricate nature. Undoubtedly, though, the prospect of releasing denial, admitting to a problem with substances, and letting go of the very thing that offers protection from formidable feelings is thorniest for the person in the grip of addiction. In the course of my work, I’ve had the privilege of walking side by side with numerous people as they explored the role of alcohol and other drugs in their lives. And although their stories are unique, an intertwining theme is the utter humanness of wanting to evade deep unhappiness, anguish, or heartache (to name a few emotions), and to reach for a remedy to take those feelings away. Alongside this understandable drive, other hopes fall in, such as wanting to make life a little more bearable or to feel a little numb inside in order to continue functioning on a day-to-day basis. The tricky catch with this solution is that it works—in the short run. It numbs, enlivens, soothes, or distracts, or all of the above.
Maybe the emotions are so overwhelming that it feels like they will never stop if they aren’t nailed down with something. Or perhaps alcohol and other drugs seem like the only option to cope with unalterable circumstances, such as living in a theater of war, extreme poverty, or an abusive family. But regardless of what ground substance addiction springs from, what makes it especially cruel is that it gives with one hand in the beginning and takes with both hands later. Not only does it stop working, it blocks the ability to heal the very emotions that drive the addiction, and it tends to create new painful experiences on top of everything else. But in the midst of addiction, denial can be a thick cloak that protects us from the downsides of dependence. For anyone with a problem with alcohol or other drugs, I recognize and respect the struggle between continuing what feels safe and familiar, and discarding denial. Yet, as risky as it feels to let denial go, the most profound hazard is holding on to it. I’ve witnessed firsthand the personal vigor and wholeness that infuses people who ditch denial and the false sanctuary of mood-altering substances and, as a result, come up to meet themselves.
But the journey of ditching denial and reaching out for help isn’t a straightforward one. Unobservable influences can impact addiction and the pathway toward recovery. For instance, science suggests that folks who are addicted to alcohol or other drugs can pay attention to drinking or drug use, even before they consciously realize it. In other words, people grappling with addiction can find their minds turned to toward alcohol or another drug of choice against their will, and this can continue even after they are sober. And it makes sense why this happens. Our brains are wired to pair things together, particularly anything that holds significance for us. A song that once was just a pleasant tune can become deeply meaningful and emotionally evocative because it happened to be playing when something memorable occurred, like the first time you kissed your partner. Likewise, alcohol and drug use can link up with reminders of their own. Beer advertisements during the Super Bowl, a certain bar or lounge where drinking used to happen, a particular street related to drug use, or vivid smells that always used to go along with drinking or using—such as cigarettes, the smell of alcohol or drugs themselves, or the aroma of certain foods—are all examples. And when these reminders automaticallypull people’s attention, they can make them more prone to experience cravings and more vulnerable to relapsing.
What’s more, it has been shown that people who unconsciously link drugs and alcohol with their sense of self—with their own being, as though substances are a part of their identity—are more apt to give up on an addiction treatment program sooner. Notably, it’s the unconscious attitude, not the conscious one, that forecasts people’s treatment time.
A Self-Fulfilling Prophecy
But conscious denial of the human capacity to heal can hamper recovery too. Many believe they’re locked in the firm grip of addiction with no hope of a way out. A number of people think they’re not capable of handling life’s stressors and that they “need” alcohol or drugs to carry on. Then they descend even deeper into addiction. For instance, among people who have had a traumatic experience, the belief that they don’t have control over their healing process is related to struggling with symptoms of PTSD, which itself is linked to turning to alcohol to get by. Sadly, this strategy paves the way for an alcohol use disorder.
If you think you might need help, countless people know what you’re going through. What’s more, they know the freedom that comes with getting help and climbing out of the hole of addiction. And if you’re trying to help someone who’s struggling, please know that there are multiple ways to reach a better place, and that even if that person resists the treatment options recommended by their doctor, it pays to explore other options.