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12 Ways to Know If You're in Denial

Updated: Jan 12

“Denial ain't just a river in Egypt.”

—Mark Twain


Denial is a defense mechanism

We use denial to shield ourselves from the terrible truth of our disease. But when I deny my disease, I cannot begin to treat it.


In most people,

denial is a useful way to keep away the pain of reality when it becomes too much to bear. John D. was a patient of mine with terminal cancer. He had undergone surgery, radiation, and two rounds of chemotherapy. Both of us were aware that he was down to his last few days. It was all he could do to get from his wheelchair to the exam table. Yet, we spoke sincerely about, when “this was all over,” how he was going to Jamaica and enjoy the sandy beaches and warm water. He knew the reality he was dealing with, but a pleasant and distracting fantasy helped him bear the pain of that knowledge.


Denial is a tool.

But for us, denial becomes an essential tool to keep the reality of our addiction hidden from ourselves and others. It becomes a mountain of impenetrable lies that prevents the recognition of our powerlessness. It helps us turn a blind eye to the consequences of our using on others. Denial protects us from our disease, from its intolerable consequences, and from our fear. To reach even Step One, the grip of denial must be broken by honesty.


You may hear your denial in these words.


  1. I don’t have a problem—you have the problem!

  2. No, I didn’t forget where I parked my car. I’m sure I’ll remember in a minute.

  3. I don’t need to drink, I just like it.

  4. Sure, I drink Scotch every day, but you drink iced tea every day. What’s the difference?

  5. I know you don’t understand this, but I need to drink. I’m special like that.

  6. Yeah, I drink a lot, but not all that much really. Certainly not as much as my brother.

  7. If you had my wife, you’d drink, too.

  8. He arrested me for a DUI, but I only had two beers.

  9. Yeah, I have a drinking problem, but it doesn’t hurt anybody but me.

  10. I know I have a problem with drugs, but so did my mom and she lived to be ninety-six.

  11. Sure, I’m an alcoholic, but I can handle it.

  12. Am I addicted? Sure, but I’m going to quit tomorrow.


Honesty breaks denial

It’s not by accident that honesty is the spiritual principle behind the First Step of AA. To begin the path that leads to sobriety, I must acknowledge that my disease has taken control of my life. As long as I live in the shadow of denial, I can’t find acceptance of my powerlessness, of the pain I have inflicted on others, or how unmanageable my life has become, As a child of God, honesty, trust, and hope are within me, but the darkness of denial keeps them from the light of day.

Bill’s Story


Bill, an anesthesiologist from Augusta, was not an alcoholic. “Definitely not an alcoholic,” he told us as we welcomed him to his first day in rehab. “I’m here in rehab just to be sure.”


It was hard not to laugh at our new friend.


“I mean, I love you guys, but I’m not like you at all. Sure, I drink some, but the Hospital Board overreacted when they sent me to rehab.”


Mike and I both groaned. Mike got up to make another pot of coffee. It was getting late, but morning was not something we had to worry about tonight. Bill was turning out to be a hard sell.


“So, you’re not an alcoholic?” I asked Bill for the umpteenth time.


“Me? Heck, no. I can quit any time I want. They thought they smelled it on my breath in the operating room, that’s all.”


“But we all agree it would be a real problem if an anesthesiologist showed up in the operating room drunk, right?” I asked.


“Of course, but I’d never do that,” said Bill.


“Never,” quipped Mike.


“Bill,” I said, “my patients dying of cancer would come up with the most elaborate schemes to deny the fatal nature of their illness. We’d talk about going to Disney World or Jamaica when it was all they could do to go from bed to chair. A man who knows he’s about to die still needs to get out of bed, pull on his pants, and prepare for the day. For Earth People, denial is a useful tool. But for us, it’s poison.”


“I’m not dying of cancer,” said Bill. “I just drink too much.” The first hint of understanding and acceptance settled on his face. “You know I’d never compromise the safety of a patient. Never.”


“We know,” said Mike, “but you’ve got to quit drinking.”


“I know,” said Bill, “but I don’t know how.” He looked helplessly at Mike and me. “A river in Egypt, huh?”


“A river in Egypt, called denial,” said Mike.


An excerpt from “A Spiritual Pathway to Recovery from Addiction, A Physician’s Journey of Discovery.”


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