How to Talk to an Addict in Denial

How to talk to an addict depends on where they are in the stages of change. The first stage of change is the pre-contemplation stage; the contemplation stage follows.

Most addicts and alcoholics are not at the pre-contemplation stage. Rarely, someone who is using substances and would be diagnosed with a moderate or severe substance use disorder during an assessment would be unaware of what it is doing to themselves or others.

When faced with an addict or an alcoholic in the pre-contemplation stage, you may find they are in complete denial and see no need for change. Many people confuse this stage with believing the substance user is in denial about having a problem rather than their denial of having to address their issue. When talking to an addict in denial, it’s important to consider the stage they are currently in and how to address the problem properly and productively.

This blog will look at the following:

• What is the pre-contemplation stage?
• What is the contemplation stage?
• The family’s impact on their loved one’s addiction
• What does denial in addiction look like?
• How to talk to an addict in denial
• What to say and what not to say
• Next steps to take

What is the Pre-Contemplation Stage?

A person in the pre-contemplation stage is often in denial because they genuinely believe they do not have any issues or concerns. The barometer in determining whether the substance user is in the pre-contemplation or contemplation stage is the response you receive when confronting them. A person in the true pre-contemplation stage will not react in anger when confronted. 

A person in the pre-contemplation stage would have more of a puzzled or aloof response. Someone in the pre-contemplation would be caught off guard and would most likely not realize they have a problem, nor do they believe they have affected anyone.

A clinician can use specific evidence-based communication strategies to help someone move from pre-contemplation to the next stage, contemplation.

What is the Contemplation Stage?

When someone is in the contemplation stage, and they are confronted, their first reaction would most likely be anger. Anger comes from fear. The fear comes from being found out or challenged. They would act this way because they are not in denial about their problem. They are only in denial about doing something about their situation. The substance user’s fear response also comes from them feeling the family may do something different. The addict or alcoholic knows they need the family’s enabling more than the family needs their addiction.

Once in the contemplation stage, the addict or alcoholic will benefit from recognizing the consequences of their addiction and behaviors. A trained professional can help them process the benefits and the consequences of continued drug or alcohol use. 

The clinician’s goal is to move them out of the sustained talk and into change talk. This means the addict or alcoholic starts to talk about doing something different rather than talk about staying the same. In clinical terms, this is called ambivalence. This occurs when the addict or alcoholic recognizes problems and starts looking at them and possible solutions.

During the contemplation stage, the addict or alcoholic will start to weigh the pros and cons of continued behavior and substance use. When the addict or alcoholic recognizes that the benefits of change outweigh the consequences of staying the same, the substance user moves on to the remaining stages of change.

The Family’s Impact on Their Loved One’s Addiction

As professionals, we have found that talking to them alone can be ineffective if there is no change in their environment and family. Substance users often make decisions based on their maladaptive coping strategies and comfort level. In other words, the addict or alcoholic usually chooses the path of least resistance to solve their problems. If the family provides more comfort than discomfort, the substance user will see less need to do something about their situation.

Families are often able to change their behaviors of enabling and codependency. Doing so can help the addict become accountable for their actions. What usually occurs as a result of this strategy is the addict often makes changes much more quickly and more effectively.

Your loved one is more likely to see the problem and attempt to change when it is their problem and not yours. Consequences and accountability help people look at things differently.

What Does Denial in Addiction Look Like?

Denial can be the outright refusal to believe there is an issue. It can also be recognizing there may be a problem, but it isn’t big enough to address.

Comparisons to others who have lost more than they have is a common justification and manipulation of themselves and others. Many alcoholics feel they do not have a problem because they are still employed.

An addict addicted to opiates may think they are justified because of legitimate physical pain, and they aren’t junkies because a doctor prescribed the medication.

A common denominator behavior in most alcoholics and addicts is the thought that every problem is somebody else’s fault. Many also deny they need professional help and believe they can fix any problem themselves.  Below are a few examples of denial:

• They are resentful of many people, places, and things.
• Believing help is unnecessary; when help is required, the addict or alcoholic thinks they can solve the problem themselves and do not need treatment.
• All their problems are the result of everyone and everything other than themselves.
• They use drugs or alcohol to get back at others (Hurting people hurt others).
• They minimize their substance use. The most common is they try to convince everyone it’s just marijuana, and it’s legal now.
• They downplay their use. They say they only drank a couple of beers when they drank far more than that.
• They are still holding a job; therefore, there is no problem.
• They have no legal issues
• They still have financial resources
• Their wife, husband, partner, or significant other hasn’t left yet.

Regarding holding a job, we have found that even those that go to work every day and on time are still not hiding their problems as much as they or their families want to believe.

We have spoken to the supervisors of some of the best employees who are alcoholics. Never once has one come back and said they were stunned or shocked. They all knew; they just didn’t say anything. Everyone has been on board with them taking a leave of absence for treatment.

Addicts and alcoholics use their job as a barometer. As long as they shine from 9 to 5, they can self-destruct from 5 to 9. This often averages itself out with justification and allows the alcoholic or addict to believe things are not that bad. They are using the job to hide the severity of their problem.

How to Talk to an Addict in Denial

For starters, leave this up to the professionals. Families frequently in the line of fire with the addict don’t get very far. Talking to an addict often ends with broken promises from them and false hope from the family that things will get better.

As professionals, we know in order to move through the stages of change, there has to be ambivalence, seeing the need for change vs. staying the same.

Talking in and of itself rarely accomplishes the leap forward. The addict has to have accountability. If the addict is unwilling to change, the family can speak with their feet and not their lips.

When a family changes behaviors that result in accountability for the addict, it allows their loved one to see things differently and consider a change. It is most effective to leave the talking and the guidance to the professionals. You would never attempt to treat any other medical condition alone; please do not start with addiction.

What to Say and What Not to Say

Do:

• Discuss how their behavior makes you feel: The keyword here is “feel.” People can argue with your opinion. It is far less likely they will argue with your emotions. When talking to an addict, consider directing the conversation to how you feel and not what they are doing. You put them on the defensive when you turn it into an opinion.

• Try to engage them while sober: For many, this can be difficult. Remember, their perception and behaviors are the problems. Even when they are not using substances, they are still unwell. However, it can be helpful to approach them when they are not under the influence. 

Behaviors drive addiction, so you may still get strong reactions regardless of whether or not they are under the influence of substances. There are times when they are under the influence they may be agreeable to enter treatment. This is always on a case-by-case basis, and this is why you should allow a professional to guide you.

• Reiterate that you love them and feel it may be time for professional help: It is always good to have these conversations. One of the most significant assets you will gain from encouraging them to seek help without pushing the issue is preparing yourself for the manipulation when you bring in a professional interventionist.

During a professional intervention meeting, one of the biggest excuses for declining help is them telling you that you went about this the wrong way. They will say that if you had just come to them first, they would have accepted help and since you pulled this stunt, they are not going. Another good reason to have this talk is that, in some rare instances, they may break down and enter treatment. When they don’t, you will then have something to work with at the intervention.

Don’t:

• Berate or blame and tell them what they need to do: Although addicts love to make everything all about themselves, this backfires when conversations are all about them and what they did wrong. These conversations spiral out of control quickly, and their first thought is they are this way because of you. Furthermore, the second you start the conversation by telling them what they need to do, they are immediately on the defensive and ready to blast you with all your faults. They will then flip the script and unload on you about what you need to do.

• Talk to them while Intoxicated: Sometimes this is unavoidable, but engaging while they’re sober is the better option if possible. When the addict is abusing alcohol, it may be best to wait until they are either abstinent or far less intoxicated.

Approaching a severely intoxicated individual does not often end well. This also applies to other substances of choice. It may be challenging to approach an opiate addict who is falling asleep or a methamphetamine abuser fresh of recent use who is erratic and full of energy. Utilizing professional intervention guidance on the best time and place to approach the substance user is always a more effective strategy.

• Make excuses or be soft about the issue: Flipping the script for them is never a good idea; they will do that anyway. They have an illusion of control over the family, and when the family makes excuses for them, it gives them a stronger illusion of that control. 

Making excuses also prevents them from seeing the need for change and takes away their accountability. It also feeds into their belief that their problems are the fault of other people, places, and things. 

When setting boundaries, there is no need to be soft. You’re allowed to change your position. Sending the message that you will not be swayed or manipulated any longer is a choice you, as a family, are allowed to make. The addict is allowed to live the life they choose. The affected family and friends have an equal right to live the life they choose. Being soft exposes your vulnerability and allows the addict to believe your boundaries are weak, can be broken, and are less than real.

Next Steps to Take

Moving a substance user through the stages of change is best accomplished with professional guidance. Families often get farther with their loved one by changing their behaviors that impact the addict’s comfort level. 

Talking alone to your loved one often produces little to no effect.

In order for a person to consider change and engage in change talk, they have to see the benefits of change are greater than the consequences of staying the same.

For many addicts, they see treatment as a negative or a consequence in that they will somehow give up their illusion of control. When a family engages with a professional interventionist that can work with both the substance user and the family, it increases the likelihood the substance user will see a need to do something different and effective.

The following steps are to stop thinking or believing you will make your loved one do something different simply because you feel you had a productive talk. Although these talks, at times, can be helpful, they often result in inaction on the addict’s part.

Find the Right Intervention Program for you and your Family

At Family First Intervention, we recognize that not all intervention programs are designed or created equal. Many wonderful interventionists will come out and talk to your loved one.

How many actually prepare the addict’s family for their recovery?

How many actually support the family after the intervention when the real trials and tribulations begin?

The answer is, unfortunately, not many. Most interventionists treat an intervention as a rehearsal and 12-Step call in an attempt to talk your loved one into accepting treatment.

Addiction affects the family and just about anyone else the substance user comes into contact with.

Addressing only the substance use addresses only a small part of the problem. We know that not every family that calls will be ready to move forward. We also know that only some family members will be on the same page and prepared to hear that they would greatly benefit from changing themselves.

The intervention company should put your needs first and meet you where you’re at as a family. One of their many goals should be moving your family into their own recovery and reducing your reactivity to the substance user.

Families not ready to address their part will still benefit from starting the intervention process if they keep an open mind about addressing behaviors they can change. Please remember that hiring someone just to talk your loved one into treatment is not a professional service, and you should not pay for that. They offer a service through Alcoholics Anonymous called a 12-step call.

Contact us today to learn more about our family-focused interventions and how to get you or your loved one started toward recovery.