Denial of Addiction – the First Stage of Acceptance

denial of addiction - taking a first step

Denial is the first stage of acceptance …

In our last article, we reviewed what it feels like to be a person developing a substance use disorder (SUD). We are now beginning a series discussing the dynamics and defenses used by people as they develop an SUD. The primary defenses used as addictive disease progresses are denial, justification, deception, and manipulation.


Denial, Justification, Deception, Manipulation

For the family members of folks developing addictive disease, these defenses are known as “the crazy makers”. The “crazy makers” cause frustration, self-doubt, and downright exasperation! But the over-use of defenses is actually a function of a developing brain disease. Knowing this, helps family members and friends develop a healthier, non-personalized approach to dealing with this complex chronic brain disease. 


When we view the defenses of addiction in a factual light, we are better prepared to see the difference between the person we love and the disease.  We are then able to engage and confront the disease process, not the person.  And we can disengage from our own reactive behaviors towards these defenses.


Denial of Addiction – the First Stage of Acceptance

Denial is defined as a “protective defense that keeps people from being overwhelmed by a current painful reality”.  All people use denial as part of any acceptance process. And acceptance begins with denial as the first stage of the process! People developing an SUD use denial to protect themselves from the painful reality. Family and friends also use denial to protect themselves from their loved one’s addiction. In her book, Addiction in the Family, Virginia Kelly, PhD, discusses how the family of someone with addictive disease organizes itself around, “shame, control, and denial”. Because the person with an SUD becomes the focus of the family’s attention.


Before you read on about denial, I encourage readers to take a quick look back at these two articles:

Do You Know How Active Addiction Feels?

Commitment to the Change Process


In the Commitment to Change article, we discussed how a person must be “ready, willing, and able” to make a change. A person developing an SUD is more likely to be “ready, willing and able”, if they feel valued and understood in their circumstances.


denial of addiction child on stairs

The sooner you stop denying, the sooner you can move on and get the help you deserve.

Denial as a defense …

Importantly, a person with an SUD is feeling self-conscious, defensive, confused, and conflicted. They are also questioning their ability to maintain control. This emotional situation is created by the developing disease. In fact, the chaos is an early warning sign that the primary substance is hijacking the “reward center” of the brain.


At this time, The disease process takes over the structure and function of inner brain communication. This reduces access to the cerebral cortex, which plays a key role in perception, awareness, memory, language, and consciousness. In that regard, the primary focus becomes procuring and using the substance. And life begins to focus on using “people, places and things”. Interacting with non-using “people, places and things” falls off to the side.


A person developing a substance use disorder must use denial to cope with the major changes of focus in their life.  To protect the developing physical reliance on the substance, the brain directs the person to deny any challenges to their harmful and risky lifestyle. The person must protect themselves from further negative feelings of guilt, shame and embarrassment. 


Minimizing and Redirecting Denial

One way denial is demonstrated is by “minimizing”.  In other words, they report their substance use as much less than actually occurs. Frequency of using is reported to be much less than is actually happening.  And the amount of time spent thinking about or planning for substance use is rarely discussed. The reality of resource shuffling is reported to be less than it actually is, and it becomes constant source of conflict and stress in family relationships. 


Another way denial is demonstrated by someone with a developing SUD is the re-directing of challenges to their behavior. They talk about someone who they believe “has a much worse problem than me”. These tactics are “denial designed” to throw the challenger off course and end the conversation.


These tactics are well known by family and friends. And the feelings of self-doubt, self-questioning, guilt, frustration and anger are experienced when they challenge the denier. Arguments occur, and oftentimes end up in displays of conflict that are simply dumping of negative feelings.


Everyone walks away feeling unheard and disrespected. More emotional distance occurs, and there is no effective response to the developing brain disease or the negative impact on relationships. Resentment builds and the problem continues to move forward.



How Do Family and Friends Deal Effectively with Denial?

Acknowledge your own denial. How do the above described situations sound like something you have experienced?  Share your responses to these situations along with your thoughts and feelings with another person who understands addictive disease.

Acknowledge and attempt to understand denial is a function of this brain disease.

And know that what starts as denial can move to acceptance-acceptance on everyone’s part.

Start sharing your honest thoughts and feelings with your loved one using “I statements”.

Remove the use of “reactivity” to statements of denial by your loved one. This means no more blaming, shaming, judgments, put-downs or demoralizing comments to your loved one’s statements!

Absolutely refuse to argue about feelings!

Behave consistently with what you verbalize!


Remember this – all people use denial as part of any acceptance process. And acceptance begins with denial as the first stage of the process! The sooner one comes to terms with their problem, the sooner they can move on and get the help they deserve.


At Sanford, we follow a medical model of treatment and believe that addiction is a family disease.  We offer education and support to the family and friends of clients in treatment.  We believe that family and friends can have a positive influence on their loved ones to seek treatment and experience success in recovery.


Sanford House Addiction Treatment Centers




Caroline (Carli) Parmelee-Noffsinger has 20 years clinical experience including: primary therapist and case manager for residential, IOP and outpatient therapy. Carli’s primary role at Sanford House is facilitating the Family Program. She is currently updating and revising the program design and content and hopes to improve upon an already successful approach to family intervention. In her free time, Carli spends time with her horse. She has been a horse lover and owner for most of her life and has facilitated equine therapy sessions. She says, “The back of a horse is good for the inside of a person.” You can reach Carli with questions about The Sanford House Family Program at