Denial as a Symptom of Alcohol Use Disorder

People with alcohol use disorder almost always refuse to admit the truth or reality of their condition in a phenomenon known as denial. A person with alcohol use disorder has impaired insight into their condition, so it's a common sign that can keep them from seeking treatment. Friends and family members can also become involved in denial.

Signs of Denial in Alcohol Use Disorder

Honesty is often the first thing to go in the course of alcohol use disorder. The lies take several forms of denial behavior.

• Blame: The person blames drinking on other people, situations, or bad luck. "She makes me so mad I have to have a drink." "If my job weren't so frustrating, I wouldn't need a drink." "It's just bad luck that the cop stopped me after I left the bar."
• Concealing: The person begins to hide the drinking from others and denies it when asked about it. "No, that's just breath freshener you smell." "Yes, I stopped at the bar, but just to say hi to the guys."
• Defensiveness: The person defends drinking as a choice. "It's my body and my life, it's nobody else's business."
• Dismissiveness: The person refuses to talk about the drinking or dismisses it as not a real problem. "Let's not talk about this now, okay?" "Stop nagging me about drinking."​
• False agreement: The person agrees that there's a problem and to take action, but never does. "Yeah, I need to cut back." "This is my last drink."
• Making comparisons: People with alcohol use disorder often excuse their drinking to themselves or others as a normal pattern or not as excessive as another person's. "I don't drink as much as Charlie, and he's not having any problems." "At least I'm not drunk all day like my dad was."
• Rationalization: The person explains excessive drinking in a way that makes it more acceptable. "I only had two." "I haven't had a drink in a week."

Development of Denial

The person with alcohol use disorder covers up and denies the drinking because of feelings that there is something different or "wrong" about it. Somewhere inside, they realize that their drinking means more to them than they're willing to admit.

A Defense Mechanism

As the disease progresses and the drinking begins to cause serious problems, the denial likewise increases. Drinking sprees can create problems at work, relationship losses, or even arrest for driving while impaired, but the person denies alcohol's role.

Usually, by the time the disease has gotten to the crisis point, a person with alcohol use disorder has developed a support system of family and friends who unwittingly enable the denial. They can display secondary denial, making similar excuses for the drinking and its consequences.

Protecting and Rescuing

Family and friends often cover for loved ones, doing the work that they don't get done, paying the bills that they don't pay, rescuing them from their scrapes with the law, and generally taking up the responsibilities they have abandoned.

• He can't come to work today, he's got a virus.
• We've got to get him out of jail; he'll lose his job—then what will we do?
• It was my fault, Officer. I said some things I should not have said.

By doing these things, family and friends are protecting the person from the consequences of their actions. The person never experiences the pain caused by their drinking.

Although drinking has placed the person in a helpless, dependent position, they might continue to believe they're independent. That's because well-meaning family, friends, co-workers, employers, clergymen, and counselors may have rescued them from their problems.

Secondary Denial

The roles these enablers play to "help" the person can be just as obsessive and harmful as the person's drinking, which often is a subject of denial for loved ones.

With enablers in place, a person with alcohol use disorder is free to continue in the progression of the disease—until they hit bottom. Then, most people with the disorder finally admit to a problem. But if enablers always cushion the person's falls, the person will never realize the severity of the problem. Online self-assessments can help you determine if you have been enabling a person with alcohol use disorder.