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The Dilemma of 'Denial'

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Updated November 26, 2003

Someone posted a message on the Forum in 1999 about her experiences with treatment for depression and a drinking problem. You should read the whole message to get the full story, but here's an excerpt:

Eventually the depression drove me to see a psychologist. I had a lot of stresses in my life and had been overwhelmed trying to deal with everything alone. The therapist said I was "self-medicating" with alcohol and that an anti-depressant would be much more effective, in conjunction with counseling of course....

Unfortunately before I got a chance to have the prescription filled I did a really stupid thing and had something to drink before work. (I work evenings.) The federal gov't requires random drug/alcohol tests in my line of work, and my number came up that day (it's kind of like a lottery). I wasn't drunk; the Breathalyzer reading was only 0.042 and the blood test even lower, but it was irresponsible of me to drink at all before work and I knew I faced suspension. (Generally there is a 15-30 day suspension for safety violations.) I also knew I would never behave in such a manner again, and in fact I lost interest in alcohol totally for quite some time....

I found out that "alcoholism treatment" involves telling people they're incapable of controlling their urges ("powerlessness") and that their behavior isn't a bad choice but a "disease" which makes them do things against their will, AND IT'S INCURABLE.... I was told I must go to AA meetings and ask a "higher power" to remove my defects... and NEVER believe in my own power....

After 3 months (and 40 negative tests) I had a back-to-work conference. The counselors reported that I was "not accepting the treatment" and "refusing to admit I had the disease of alcoholism"... I was denied a return to work at that time. I was kept out a total of 7 months.

Her story is by no means unique. One of the biggest problems with some treatment programs is the catch-22 of "denial." If you deny that you have a drinking problem that means that you must have a drinking problem. You are just "in denial." The fact that you deny a drinking problem is often used as evidence that you are really an alcoholic.

As I stated in my bulletin board reply, I frequently recommend 12-step groups to people who have chemical dependency problems. There is evidence that many people are able to resolve drug and drinking problems without help, but many are also helped by Alcoholics Anonymous and similar 12-step groups. Some of the principles found in AA (such as the "serenity prayer") are useful for all of us, whether or not we have any problem with chemicals.

A guide for another Mining Co site, Ann Wayman,  has written the book Powerfully Recovered which affirms the value of 12-step programs, but takes issue with the way that some of the ideas have changed over time. Wayman asserts that she is "recovered" rather than "recovering." She backs this assertion with evidence that the founders of AA never intended that people should see themselves as perpetually powerless and continually in need of assistance.

As a part of one of my "day jobs" I co-lead a stress management group at a residential drug abuse program. We teach these "recovering addicts" about ways to manage stress so that they have some additional tools to prevent relapse. In addition to learning behavioral stress management techniques such as relaxation training, they also learn cognitive stress management techniques. I teach them a version of the rational emotive approach of Albert Ellis. Ellis and others contend that we set ourselves up for stress with beliefs which are too rigid or too strong. An example of such a belief is "There is one right way to do anything and I must find it." This statement is not true.  There are usually often many ways to accomplish your goal.   People with this "irrational belief" set themselves up for lots of grief.

12-step groups often teach that there is only one way to resolve a drinking or drug problem - their way. Research shows that this is not true. In fact, North America is unique in offering such a monolithic approach to chemical dependency treatment.  Most societies offer many different approaches to recovering from an alcohol or drug problem. 

If you think you might have a drug or alcohol problem, one of the first things you should do is to stop using your drug-of-choice for two weeks.  If the problem involved binge use rather than daily use, then you should attempt to either eliminate or moderate your use.  If you are unable to modify your own substance use, then try one of the different self-help groups listed in the Chemical Dependency Resources or find a treatment program or a therapist with experience in substance abuse issues.

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