The reluctant recoveree: The do’s and don’ts of managing denial in your gambling-addicted loved one
Patrick had been coming to see me for psychological therapy for 8 months to get help with his gambling addiction. During that time, we had managed to put his gambling into remission, work on his emotional well-being and spend some time looking at how to address his many broken relationships. Despite his relative success in giving up his addiction, there were some strange inconsistencies. Although he appeared dedicated to the point of almost ‘clinging’ to therapy, it would usually be difficult for him to engage in the work during our sessions. He would not be particularly forthcoming and there was often a sense of ‘pulling teeth’ when trying to create a rich dialogue. Although he was honest about his occasional lapse back to gambling, there was no sense of him feeling better or proud of himself during those periods when he was not gambling at all.
At home, he was having damaging arguments with his wife. He would tell me it was because of her inability to trust him despite him doing ‘everything he should’. At work, he was struggling with procrastination and lateness, but then again, had lost the job he loved due to gambling. This made it easier to justify his inability to fully enjoy his current employment. His financial situation did not seem to get any better despite his regular income and repayment of gambling debts.
It felt as though Patrick’s life remained unusually stuck despite his reported steps of progress. He seemed bored and low in mood. I pointed out to him a few times that intuitively something felt ‘off’ in a hope that he would open up a bit further. This suggestion was always met with shock and surprise and a range of explanations that were so eloquent that I would usually arrive at the conclusion that I was most likely wrong. As outpatient Psychologists, we will only ever be able to work with what is presented to us and since he was so keen to keep coming, we would instead review his progress, set some new goals, and then keep going.
One day he came in looking particularly sheepish and disclosed that throughout our many months of therapy, he had failed to tell me that he was also using cocaine on a nearly daily basis. Nobody knew about this habit, and he relayed that it was only in the last few weeks when it had become evident to him that he would need to kick this habit too if he actually wanted to get better. He was also starting to have some pressure from his wife who was nearing 40 and who wanted them to start a family. He knew in his heart that he would not want to be a drug-addicted father. Suddenly it was all making sense. The early attempts to get him into a gambling rehab that was met with an absolute refusal. The reluctance to attend a joint medical assessment that his wife had tried to initiate in order to gain enthusiasm to get fitter for parenting. His high levels of boredom and up-and-down mood.
Unbelievable as it sounds, I actually think he thought he had been very honest even before this point. From everything I could tell, it was only now that the penny had dropped for him. Despite the many thoughts that had entered his mind over the last many months and years, his denial had been so strong that he had ‘successfully’ managed to push the facts out of his mind. His inner narrative had been that it was ‘helpful’ to keep taking the cocaine since he felt it worked as ‘medication’ for him to let go of the gambling.
So what was the moral of this story?
Patrick was a smart man with a lot going for him. He had a supportive wife, who loved him and had accepted his gambling addiction. She was prepared to stand by him throughout his attempts to get better. He himself was keen to stop gambling, had the money to go to treatment and even kept coming to treatment. Despite all these efforts working in his favour, it took him close to 8 months to emerge from under his thick cloak of denial!
There is no way for me to ascertain what led him to finally realise that his cocaine use was a problem too and that he would need for that to change. Patrick too reported that he had no clue how he was able to be that disconnected from himself and his behaviours. Yet he was. Even he himself could not tell exactly why or when he started feeling that he would need to come clean.
Some takeaways from this case example:
You do not control other peoples’ levels of denial about their addiction. Even they themselves may not have ‘access’ to their own truth quite yet
Denial is not an insignificant or negligible part of addiction. Indeed, it is a very KEY FEATURE of what an addiction is all about. So much so, that if it wasn’t for the denial, the treatment of any addiction would be considerably more straightforward. Denial also enables the addiction to grow strong and powerful due to the many levels of self-rationalisation that tend to exist.
The inability to stay honest and in touch with one’s own feelings creates a breeding ground for addiction. The addiction fuels further compartmentalisation and deceit. This cycle needs to be broken but it is not your job to break it for them.
Addicted people can nip in and out of denial, particularly preceding a lapse. This will create an obstacle to treatment engagement and hence also recovery itself
Why can they not just admit themselves to rehab and get well?
Many loved ones seek out advice on the basis that everything is straightforward in treating addiction- if only their loved one could once and for all realise that they have one. This is not said to mock you guys who live with and love someone who is addicted. It is said lovingly to save you a ton of pain. It is important to recognise that a rehab experience, quite likely, will not be a silver bullet for instant recovery. Yes, there are times (particularly with drugs and alcohol) when detoxification certainly does add to the clarity of thinking and an increase in motivation. Yet, there needs to be some baseline motivation to stop long term or the entire rehab stay may end up a huge waste of time and money.
Is there a good way to relate to the denial?
To save yourself a lot of frustration, it could help to read the following section. Many of the intuitive responses of loved ones tend to centre around the need to ‘disprove’ the lies of the addicted person. As a result, family members frequently get a bit obsessive themselves and end up spending all their time gathering evidence that they hope is going to finally lead to the ‘showdown’ with their addicted family member. This usually ends up adding further to the pain. By the time your evidence is solid, and they still deny any wrongdoing, the conclusion tends to be that they are doing what they do ‘in cold blood’. This hurts more than anything.
Your do’s and don’ts
DO…
#Speak straight but try and minimize your own levels of emotion Try to avoid drawing conclusions and just state the observable facts such as ‘I have noticed you never come home when you say you will anymore….’ The children and I used to be able to rely on us all going out Sunday mornings, but now you seem to always be too tired…’ Choose times when you are able to keep the communication calm and coherent, as opposed to angry and attacking, even if you have every right to feel and act that way.
# Draw up your own lines in the sand! It is ok and important to have good boundaries. Without them, you will be going under together with your addicted partner.
DO remember that NO amount of what you feel constitutes ‘evidence’ of their betrayal, lies and inconsistencies is necessarily going to make them go ‘you got me! I am addicted and I just didn’t realise..’. And when they don’t want to acknowledge their status as addicted despite your mountains of evidence, you might feel even more let down…
#Set realistic expectations: When listening to loved ones' stories, understandably their experience is one of exhaustion and distress. To watch someone you love and care about on a highway to self-destruction is no joke. It creates pain, anger, disbelief and disappointment. Still, what people often hope for- does not happen. Certainly not in the way of a sudden ‘unveiling’ of your family member- now as someone with perfect insight, consistent dedication, regret and honesty.
Whilst change over time is perfectly possible, it does not tend to be an overnight transformation. If your expectation is that the process will be something like a lizard changing its skin over a week or two, I am afraid you may be in for a rude awakening. The process is usually more drawn out than that (although there of course will be exceptions!) and is not necessarily consistently going in the right direction. This is still ok.
The great news is that once the ‘shedding’ has started the lizard would be unable able to patch back pieces of its skin onto its body. Similarly, people in recovery cannot start to add back the full cloak of denial and think it will stick. It will come off again and it is now just a matter of time.
. The real process probably resembles the peeling of an onion, more than a lizard shedding its skin. Multiple layers will need peeling off gradually, and in the process, there will be some wet eyes and a bit of stinging. But at least you will get closer and closer to the core.
Don’t:
#Expect a favourable and reasonable response (and sometimes even a response at all). Most people have some basic expectations in relationships with other people. If you confront someone with something that does not make sense, most people hope that the ‘truth’ will be explained to them. If we express concern or distress, you rightfully expect that your family member will care about that and make attempts to change. However, when dealing with addiction, much of this will not apply. Your questions will fall on deaf ears. Your collections of evidence will be refuted as nonsense. During my work in inpatient settings, I have seen individuals who would refute the blood test that showed clearly that they had been using while they were on the wards by saying things like; ‘It must be something wrong with my metabolism’ ‘I cannot believe that you doctors mixed the tests up’.
I am not saying this to encourage anybody to put up with abuse or long-term refusal to change, but merely to save you some trouble by realising that this will not work like a court trial. Just because you have the best line of evidence you are not going to win. They will accept responsibility on their own accord.
In the meantime, you’d better relay what you need to get off your chest but suspend any hopes for fruition. That way you can feel free within and not cling to expectations, while still potentially planting small seeds in their head that you are finding their behaviours unacceptable long term.
#Don’t threaten consequences you cannot follow through with! Many addicted partners operate at their peak of emotion when delivering threats and suggesting desperate solutions e.g., ‘go to rehab or I’m moving out’ . Whilst your reaction is very understandable, try to do the bulk of your reasoning and planning when you are calm and can detect your own legitimate boundaries i.e, the type of behaviours that will need to result in you leaving them or whatever you feel that you will be genuinely able to follow through with. Empty threats will lead to them learning that your words don’t mean anything.
At least one of you needs to have consistency between words and actions and you are likely to be the one more able to do so right now.
#Don’t take on the role of crime scene investigator, court trial judge or undercover detective You might find yourself working full time to gather the evidence with which you think is going to ‘get them’ finally. Not only is this likely to backfire (since they will almost invariably meet you with refusal and more lies) but you will also be burning yourself out by investing a lot of valuable energy while they are continuing to do very little about their state.
#Don’t remove consequences for their addiction. Examples might be: covering for them, doing bail-outs, helping them construct excuses to other people. They need to experience all by themselves how the addiction is impacting their lives.
Can things ever change for them?
They absolutely can! But only as a result of their own motivations changing and a deep-seated change toward wanting to be something other than what they currently are. When their desire to be present, honest and live in connection with reality starts to out-do their eagerness to escape from themselves and their destruction, you will usually see a gradual process towards wanting to change. Do not allow your own busyness with trying to get them to change, to allow you to lose sight of the obvious; It is their addiction and they need to want to get into recovery!
Finally, get your own professional support if possible as this will help you deal with the many difficult feelings you may be experiencing.