Let’s examine the some of the basic characteristics of addiction and mental health issues that contribute to barriers to short, medium, and long-term treatment.
Addiction and Mental Health Treatment: Barriers and Challenges
Denial plays a huge part in why some people won’t initially commit to a long-term treatment process. There are several different variations of denial.
Denial of Problem: Preventing Enrollment
Denial can be referred to as a refusal to admit the truth or reality. In psychology it refers to a type of defense mechanism where people subconsciously reject aspects of reality that they are not comfortable with. Those who are addicted to alcohol or drugs can have little insight into their own condition as a result of denial. Most people will experience at least some level of denial about things that make them uncomfortable, but the addict develops a more rigid type of denial that can be difficult to penetrate.
This often contributes to treatment stopping before it even starts because the addict or alcoholic refuses to even admit they have a problem that needs to be addressed. There is really no difference between and alcoholic in denial and someone who is depressed being in denial of their mental illness. When either denies that their is even a problem, an intervention is almost always necessary to encourage them to get help.
Denial as a Negative Coping Mechanism
A defense mechanism is an unconscious psychological strategy that people use to help them cope with reality and protect their ego. The ability of the people to protect themselves in this way can be beneficial but sometimes a defense mechanism will prevent people from enjoying life. One of the most commonly used defense mechanisms is denial. Addicts who suffer from denial will refuse to acknowledge that they have a problem. When they do this they are not lying. Their denial can be so strong that they just can’t see that it is substance abuse that is their real problem.
Again, this form of denial prevents alcoholics, addicts, and people suffering from mental illness in getting help. This is a common and significant barrier to enrollment in treatment and will almost always require a formal or familial-based intervention.
Denial of ‘Powerlessness’ – How this Impacts the Treatment Process
Once an individual enrolls in treatment, denial may still play a huge roll in disrupting the concept of both short-term and long-term treatment. When the idea of powerlessness is not adopted, treatment will be viewed as restrictive, punitive, and even demeaning. Treatment by its very nature is designed to keep people with substance abuse disorders safe from their: (i) impaired control over drug use, (ii) compulsivity, (iii) willingness to continue using despite negative consequences, and (iv) cravings. There are rules and regulations in place that protect people with substance abuse disorders from all of the aforementioned aspects of their own addictive pathology.
When your loved one complains about aspects of the treatment program, this is the first sign that the idea of powerlessness is not being internalized. This is not an indicator that your loved one is not engaging a recovery process – it is the proof that your loved one is not engaging the recovery process. When denial takes this shape, strong Family Treatment can be very helpful in assisting loved ones to hold firm boundaries and support the ongoing requirements for treatment.
Resistance after Intervention
Here’s a short video on dealing with resistance after an intervention:
Addressing treatment resistance after an intervention in denial is complicated and difficult to understand. However, when denial contributes to the decision about the length and type of treatment for addiction that is chosen, it critical to be educated about how to deal with Resistance in order to set the right boundaries and ensure a proper course of treatment is engaged.
Tabytha Dyne is a professional in both the mental health and drug and alcohol recovery field. She has worked extensively in both the public and private sectors and has given many presentations on the subject of alcohol and substance abuse. She has worked for the past 10 years providing direct service education for individuals impacted by SUD and behavioral health issues.