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The denial that fuels addiction: How do people who need alcoholism treatment end up being such liars? People who need alcoholism treatment, drug treatment, teen drug treatment, or gambling treatment tell incredible lies. Addicts lie when they have to, and they lie when they don't have to. They lie to get out of trouble, and the lies get them into more trouble. They lie to increase their pleasure and they lie to wallow in their self-pity. Alcoholism treatment is necessary to show the addicted person the truth about the extent of their alcohol or drug problem. Why do people need alcoholism treatment? The disease of alcoholism or addiction must lie, and it must continue to lie, or it cannot exist. Alcoholism cannot live in the light of the truth. You can't tell the truth to yourself and continue be an alcoholic or drug addict. With the truth, you would realize the problem, and get some help. All of the lies exist to protect the alcoholic or drug addict from a painful truth. The truth is, we are out of control, and if we keep up the addictive behavior, we are doomed. The truth causes us great anxiety so we defend ourselves from the truth. We distort the truth just enough to feel like nothing is wrong. The reason alcoholics need alcoholism treatment is they are lying to themselves and they don't know it. They couldn't tell you the truth if they wanted to, because they don't know what it is. This self-delusion grows gradually over many years. People who need alcoholism treatment think they are fine even when they are dying. MINIMIZATION The first lie we tell ourselves is called minimization. This is where we take reality and make it smaller. We think the problem is not that bad. If an alcoholic takes an eight ounce glass and fills it up with ice, and takes a shot glass full of whiskey, and pours it over the ice, and holds the glass up to the light, they will be disappointed. A shot glass full to the brim with whiskey makes a disgustingly small dent in an eight ounce glass. If you are an alcoholic, you are not going to use a shot glass. If you have a shot glass at home, it is gathering dust. You are going to pour your whiskey until you see some color in that glass. Now, if we were to take this drink, and measure how many shots are in it, we are going to find four, maybe five, shots in the glass. Here's how we minimize: We think, and believe, that this is a drink, one drink, but it's not one drink, it's really four drinks. We can do the same thing with beer cans. If you are a beer drinker, you have a considerable collection of empty beer cans at the end of the week. When you take the garbage out, you have got, maybe two big plastic trash can bags full of cans. As you are going out to take out the garbage, you may think, "Boy, I hope the garbage person doesn't think I'm drinking all this beer." At that time, you may put one of the bags on your garbage pile, and the other one on your neighbor's pile. Those of you who are into cocaine, remember when you have just picked up your stash. You have this nice big pile of cocaine on your kitchen table. You feel self-satisfied. You have more than enough. Your treasure chest is full. You are content. You feel a great peace. This is going to last a long time. But, the next morning you're wondering who got into your stash. Where did it all go? You used it all that’s where it went. We can minimize about our mounting problems. Everyone gets a couple of DWI's don't they? Almost everybody gets a divorce. It's not so bad to spend a couple of nights in jail. We're a good person, we're not bad, we were just unlucky, the cops were after us. We take what is real and make it look smaller. We lie to ourselves, and we believe the lie. RATIONALIZATION The next lie we tell is called rationalization. This is where we have a good excuse. Probably the most commonly used excuse for drinking is, I had a hard day. It follows, therefore, that if I had such a hard day, I deserve to get blasted. Anyone, who had the hard day that I had, would need to relax. Let's have a few beers, a couple of joints. In rationalizing we may blame our problems on someone else. "If you would just lighten up," we might say, "I could straighten things out." We may think remorsefully of all we could have been, if we had been born wealthy, or been given the right brakes. We look at all those successful people and we hate them. We never had such a chance, we tell ourselves. There's no God. If there was a God, where was God when I needed God. DENIAL The last type of lie that we tell ourselves, and this one is the most characteristic of chemical dependency is denial. Denial is a stubborn angry refusal to see the truth. Here we refuse to see what is right before our eyes. We block out what is real until we really don't see it at all. The best way to show you how this works is to give you an example. You are walking down the street and it is a very hot day. It's ninety-five degrees in the shade. Sweat is pouring down your face. As you walk up the road, watching the heat waves rise up off of the asphalt, people are standing along side of the road with pails full of ice water. As you pass each of them, they throw their bucket full of reality in your face. "Your wife's divorcing you! That's your third DWI! The boss won't put up with you anymore! You're in trouble with your parents again!" You see the pails of water, you see them throw them in your face, you hear the words that are shouted at you, but you do not experience the full reality of what's happening, you don't get the full emotional impact of the problems. With your whole life falling apart, you are walking up the street as if nothing was happening at all. The people around you are amazed. Why doesn't he see? Why doesn't she understand? Why can't they see what's happening to them? HOW TO BEGIN TO LIVE IN THE TRUTH A key component of alcoholism treatment is uncovering the truth. Recovery from addiction demands rigorous honesty. You can't see what's happening to you because you are lying to yourself. You can't see the truth because you believe the lies. You are completely fooled. In treatment the full reality of what has been happening to you will be before you. It will be painful, but the truth will set you free. Treatment is an endless search for the truth and you must be willing to listen to what others say. You must try to be open to what people tell you about yourself and your actions. We reflect to each other what we see. We will try to find the truth together. What we cannot do alone, we can do together. THE GREAT LIE It is important for you to know how the psychology of chemical dependency gets going. In childhood we come to believe in the great lie. This lie is at the core of alcoholism or drug addiction. We do not hear this lie from our parents or from our friends. We don't hear it from our teachers or from television. It is more powerful than that. We hear this lie inside of our own thinking, inside of that most personal part of ourselves. The lie is this: If you tell anyone the whole truth about you, they won't like you. Once we hear this lie and believe this lie, we know that we will never be loved for who we are. Therefore to get any of the good stuff out of life at all, we have to pretend to be someone that we are not. We try to be someone else. We watch those people who are popular and we copy them. We are very careful about what kind of clothes we wear. We copy people's mannerisms and their fine little gestures. We find ourselves cocking our heads in a certain way when we laugh or smile. We are hoping to fool the people. We hope that they cannot see the real me. We want them to see the pretend me. HOW THE GREAT LIE WORKS As this coping behavior occurs, it works. Some people do like us for the new me we are trying to be. We become pleased to know that we are not going to be alone. The people we are fooling will love us. We begin to wear specific costumes and to play certain roles. We may wear the nice girl costume or the cowhand costume. We may wear the hippie costume or the yuppie costume. We know it is a costume, we know it's not us, but the people are fooled, and the lie goes on. WE NEVER FEEL ACCEPTED You must look carefully at what is happening. We have fooled people into liking us--but they don't really like us--they don't know us; we are keeping who we are secret. As we keep doing this, making this effort to be loved, our emptiness grows, our pain increases. We try hard. We copy everyone that looks cool. We put on the best false front we can, but in time, we realize it isn't going to work. We feel more and more lonely and isolated. We have known all along, that we weren't going to be loved, not for the real us. No one was going to love us. THE PROMISE OF THE DISEASE When we are lonely enough in this process, when we are isolated enough, when we are hurting enough, the illness comes along and offers us a smorgasbord of answers to our pain. Sex, money, power, influence, drugs, gambling, and alcohol, are all there, and more, and we feed on this cafeteria of sin. For a while, things get better. All these things relieve the pain for a little while. We find ourselves irresistibly drawn to this table of wrongs. We spend more time doing it. We eat, drink, stuff, cram, push and shove. We find more and more of our life centers around the use of these things. We get up on the table and stuff ourselves. We begin to lose our morals and values. We eat, and consume, and vomit, and stuff ourselves even more. In time, there is never enough. There is not enough sex. There is not enough money. There is not enough power. There is not enough booze. AA says, one drink is too much and a thousand is never enough. TRUTH Finally, we begin to get sick from this cafeteria of wrongs. We realize an awful fact: The answer is not in these things. It is a terrible point of grief when we finally realize that the answer is not in our drug of choice. This is not a happy time, but by now, we are addicted, we can't stop. You may be addicted to sex, and you want to stop what you are doing, but you can't stop. You may be addicted to money, and you want to stop chasing money, but you can't stop. You want to stop drinking. You promise yourself that you'll stop, but you can't stop, you're addicted. Somehow, by the grace of God, you finally come to treatment. Maybe you are ready to surrender, I hope so, because if you aren't, you are in for a lot more misery. If you are ready to surrender, if you are ready to try something new, this program is for you. A Program of Rigorous Honesty One of the things you must be willing to do is tell the truth all the time. Nothing else will stop the great lie. God says, "The truth will set you free." You are enslaved to your addiction, but the truth will set you free of your chains. In alcoholism treatment or drug treatment, probably for the first time in your life, you will have the opportunity to get honest. If you don't, if you hold anything back, you will return to chemicals. You don't have to tell everyone the truth, but there is a psychological law at work. The law is this: The more you can share the closer you can get, and the closer you can get the more you can share. As intimacy grows, you tell more of the truth. In your Fifth Step, you will tell someone the whole truth at one time. You will tell them exactly what happened. Time after time we have had new comers decide to hold something back in their Fifth Step. They didn't want to tell that one thing. Invariably these people get drunk because they don't prove to themselves that people will like them if they tell the whole truth. They keep the emptiness, loneliness, and isolation. The pain grows and sooner or later they relapse. It is vitally important that you find out the truth about yourself. God created you in perfection. You are God's masterpiece. You were created in the image of God. God loves you and wants you to be happy. For some of you this will be difficult to hear, difficult to believe. How could God love you? Where was God when you needed God? If there is a God, where is God? These are the questions that need to be answered. 1. Have you ever tried to cut down on your drinking? 2. Have you ever felt annoyed when someone talked to you about your drinking? 3. Have you ever felt bad or guilty about your drinking? 4. Have you ever had a drink in the morning to settle yourself down? 5. Have alcohol or drugs ever caused you family problems? 6. Has a physician ever told you to cut down on or quit use of alcohol or drugs? 7. When drinking/using drugs have you ever had a memory loss (blackout)?
If the patient answers any one of these questions yes that’s a red flag for alcoholism. If they answer two questions yes, that’s probable alcoholism. Make sure you don’t just ask the patient. Remember alcoholics live in a series of carefully constructed lies designed to keep them from feeling the fear of the truth.
Red flags for Adult Alcohol/Drug Abuse: 1. Tremor/perspiring/tachycardia. 2. Evidence of current intoxication. 3. Prescription drug seeking behavior. 4. Frequent falls; unexplained bruises. 5. Diabetes, elevated BP, ulcers; non-responsive to treatment. 6. Frequent hospitalizations. 7. Inflamed, eroded nasal septum. 8. Dilated pupils. 9. Track marks/injection sites. 10. Gunshot/knife wound. 11. Suicide talk/attempt; depression. 12. Pregnancy (screen all)
Laboratory Red Flags for Alcohol/Drug Abuse 1. MCV-over 95 2. MCH-High 3. GGT-High 4. SGOT-High 5. Bilirubin-High 6. Triglycerides-High 7. Anemia 8. Positive UA for alcohol or illegal drugs.
Red Flags for Adolescent Alcohol/Drug Abuse 1. Physical injuries; MVA, gunshot/knife wound, unexplained or repeated injuries. 2. Evidence of current use, e.g. dilated/pinpoint pupils, tremors, perspiring, tachacardia, slurred/rapid speech. 3. Persistent cough (cigarette smoking is a risk factor) 4. Engages in risky behavior, e.g. unprotected sex. 5. Marked fall in academic/extracurricular performance. 6. Suicide talk/attempt; depression. 7. Inflamed, eroded nasal septum. 8. Track marks, injection sites. 9. Sexually transmitted diseases. 10. Staph infection on face, arms, legs. 11. Unexplained weight loss. 12. Pregnancy (screen all)
Laboratory Red Flags for Adolescent Alcohol/Drug Abuse 1. Positive UA for alcohol illicit drugs. 2. Hepatitis A-B-C. 3. GGT-High 4. SGOT-High 5. Bilirubin-High.
Questions to ask the Adolescent Patient: 1. When did you first use alcohol/drugs on your own, away from family/caregivers? 2. How often to you use alcohol/drugs? Last use? 3. How often have you been drunk or high? 4. Has your alcohol/drug use caused you problems with: your friendships, family, school, community? Have your grades slipped? 5. Have you had problems with the law? 6. Have you ever tried to quit/cut down? What happened? 7. Are you concerned about your alcohol or drug use?
Questions to ask the Parent/Caregiver: 1. Do you know/suspect your child is using alcohol/other drugs? 2. Has your child’s behavior changed significantly in the past six months: sneaky, secretive, isolated, assaultive, aggressive, hostile? 3. Has school, community or legal system talked to you about your child? 4. Has there been a marked fall in academic/extracurricular performance? 5. Do you believe an alcohol/other drug assessment might be helpful?
Call 1-800-992-1921 if you or someone you know has an alcohol, drug or gambling problem. Click here to search for books on addiction:
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