Denial Management Checklist

January 30, 2016

 By Terence T. Gorski
© Terence T. Gorski, 1999

What denial patterns do you use? (check as many as needed)

1. Avoidance: “I’ll talk about anything but my real problems!”

2. Absolute Denial: “No Not Me, I Don’t Have Problems!”

3. Minimizing: “My Problems Aren’t That Bad!”

4. Rationalizing: “If I Can Find Good Enough Reasons For My Problems, I Won’t Have To Deal With Them!”!”

5. Blaming: “If I Can Prove That My Problems Are not My Fault, I Won’t Have To Deal With Them!”

6. Comparing: “Showing That Others Are Worse Than Me Proves That I Don’t Have Serious Problems!”

7. Compliance: “I’ll Pretend To Do What You Want If You’ll Leave Me Alone!”

8. Manipulating: “I’ll Only Admit That I Have Problems If You Agree To Solve Them For Me”

9. Flight Into Health: – “Feeling Better Means That I’m Cured!”

10. Recovery By Fear: “Being Scared Of My Problems Will Make Them Go Away!”

11. Strategic Hopelessness: “Since Nothing Works, I Don’t Have To Try!”

12. Democratic Disease State: “I Have The Right To Destroy Myself & No One Has The Right To Stop Me!”

Denial Pattern Checklist

<Return To TOC>
Read the list of common denial pattern below and check any that apply to you.

Denial Pattern #1. Avoidance: I Say To Myself: “I’ll talk about anything but my real problems!” Somewhere deep inside of me I am afraid that I might have a problem with alcohol or drugs that is hurting me and those that I care about. But when I don’t think or talk about it I feel OK. So I think about other things and try to keep people from prying into my life where they don’t belong. My drinking and drugging is private and no one has a right to know anything about it. If someone asks about it, I change the subject and start talking about other things that have nothing to do with my drinking and drugging. If nothing else works, I’ll start an uproar by creating a bad crisis and making sure that they get sucked into it. If all else fails I’ll play dumb and pretend that I don’t know what they’re talking about.

Denial Pattern #2. Absolute Denial: I Say To Myself: “No, not me! I don’t have a problem!” When others try to corner me, I tell “the big lie.” I say that I don’t have a problem with alcohol or drugs. No! Not me! Absolutely not! I don’t drink too much! I don’t use drugs!; I’m not addicted! I never get sick or have problems because of drinking or drugging. I am so good at convincing other people that there is nothing wrong that sometimes I actually start believing it myself. When they believe my story a part of me feels really good because I beat them. Another small part of me feels disappointed. There is a small part that wants others to know what is really happening. There is small scared part inside of me that wants help.

Denial Pattern #3: Minimizing: I Say To Myself: “My problems aren’t that bad!” Sometimes my alcohol and drug problems get so bad that I can’t convince myself or others that I don’t have a problem. When this happens I minimize. I make the problems seem smaller than they really are. Yes, I had a small problem with my drinking and drugging. But it only happened that once. It will never happen again. Besides, the problem just wasn’t as bad as people think it is.

Denial Pattern #4. Rationalizing: I Say To Myself: “If I can find good enough reasons for my problems, I won’t have to deal with them!” I try to explain away my alcohol and drug problems by making up good explanations for why I drink and what’s “really” causing my problems. Sometimes I’ll pretend to know a lot about alcoholism and addiction so other people will think that I know too much have a problem. The truth is that I rarely if ever apply what I know to myself or to my own problems.

Denial Pattern #5. Blaming: I Say To Myself: “If I can prove that my problems are not my fault, I won’t have to deal with them!” When the problems gets so bad that I can’t deny it, I find a scapegoat. I tell everyone that its not my fault that I have these problems with alcohol and drugs. It’s somebody else’s fault. I only abuse alcohol and drugs because of my partner. If you were with a person like this, you’d abuse alcohol and drug too! If you had a job or a boss like mine, you‘d drink and drug as much as I do. It seems that as long as I can blame someone else, I can keep drinking and drugging until that person changes. I don’t have to be responsible for stopping.

Denial Pattern #6. Comparing: I Say To Myself: “Showing that others are worse than me, proves that I don’t have serious problems!” I start to focus on other people instead of myself. I find others who have more serious alcohol and drug problems than I do and compare myself to them. I tell myself that I can’t be addicted because I’m not as bad as they are. I know what an addict is! An addict is someone who drinks and drugs a lot more than I do! An addict is someone who has a lot more alcohol and drug-related problems than I do. An addict is someone who is not like me! I tell myself that I can’t be addicted because there are other people who have worse problems with alcohol and drugs than I do.

Denial Pattern #7: Compliance: I Say To Myself: “I’ll pretend to do what you want, if you’ll leave me alone!” I start going through the motions of getting help. I do what I’m told, no more and no less. I become compliant and promise to do things just to get people off of my back. I find excuses for not following through. When I get caught, I tell people that I did the best that I could. I blame them for not giving me enough help. I tell people how sorry I am. I ask for another chance, make another half hearted commitment, and the cycle of compliance tarts all over again.

Denial Pattern #8: Manipulating: I Say To Myself: “I’ll only admit that I have problems, if you agree to solve them for me!” When I my alcohol and drug problems box me into a corner, I start to manipulate. I try to use the people who want to help me. I try to get them to handle all of my problems and then get them to leave me alone so I can keep drinking and drugging. I’ll let them help me, but only if they do it for me. I want a quick effortless fix. If I they can’t fix me, I blame them for my failure and use them as an excuse to keep drinking and drugging. I won’t let anyone make me do anything that I don’t want to do. If they try, I’ll get drunk at them, blame them, and make them feel guilty.  

Denial Pattern #9. Flight into Health: I Say To Myself: “Feeling better means that I’m cured!” I manage to stay clean and sober for a while, and things start to get a little bit better. Instead of getting motivated to do more, I convince myself that I’m cured and don’t need to do anything. I tell myself that I may have had a drinking and drug problem, but I got into recovery and put it behind me.  

Denial Pattern #10: Recovery By Fear: I Say To Myself: “Being scared of my problems will make them go away!” I began to realize that alcohol and other drugs can destroy my life, hurt those that I love, and eventually kill me. The threat is so real that I convince myself that I can’t ever use alcohol or drugs again. I start to believe that this fear of destroying my life and killing myself will scare me into permanent sobriety. Since I now know how awful my life will be if I continue to drink and drug, I just won’t won’t drink or drug anymore. If I just stop everything will be fine. Since everything will be fine, I won’t need treatment or a recovery program. I’ll just quite.  

Denial Pattern #11: Strategic Hopelessness: I Say To Myself: “Since nothing works, I don’t have to try” I start to feel that I’m hopeless. It seems like I’ve done it all and nothing works. I don’t believe that I can change and big part of me just doesn’t want to try anymore. It seems easier just to give up. When people try to help me, I brush them off by telling them that I’m hopeless and will never recover. When people do try to help me, I give them a hard time and make it impossible for them to help me. I don’t understand why people want to help me. It would be easier if they just let me keep drinking and drugging. <Return To TOC>
Denial Pattern #12. The Democratic Disease State: I Say To Myself: “I have the right to destroy myself and no one has the right to stop me!” I convince myself that I have a right to continue to use alcohol and drugs even if it kills me. Yes, I’m addicted. Yes I’m destroying my life. Yes, I’m hurting those that I love. Yes I’m a burden to society. But so what? I have the right to drink and drug myself to death. No one has the right to make me stop. Since my addiction is killing me anyway, I might as well convince myself that I’m dying because I want to. 

Personalizing The Denial Patterns
We can become better at recognizing and managing our own denial if we personalize the denial patterns we selected. This is done by writing a new title and description for each denial pattern we selected in our own words.  

Here are some examples of personalized denial patterns.  
1. (Avoidance) Skating Off The Walls: I know I’m using denial when I refuse to directly answer a question and keep trying to change the subject.

2. (Absolute Denial) Saying It Isn’t So: I know I’m using denial when I tell people that I don’t have a problem even though I know deep inside that I do.

3. (Minimizing) Saying It Isn’t That Bad: I know I’m using denial when I admit that I have a problem, but try to tell people that it isn’t as bad as they think it is.

4. (Rationalizing) Giving Good Reasons: I know I’m using denial when I try to convince people that there are good reasons for me to have the problem and that because there are good reasons I shouldn’t be responsible for having to deal with it.

5. (Blaming) Saying It’s Not My Fault: I know I’m using denial when I try to blame someone else for my problem and deny that I a responsible for dealing with it.

6. (Comparison) Criticizing Others: I know I’m using denial when I point out how bad other people’s problems are and use that as am reason why my problems aren’t so bad.

7. (Manipulating) Getting Over On Others: I know I’m using denial when I try to get other people to handle the problems for me.

8. (Recovery By Fear) Scared Straight: I know I’m using denial when I tell myself that I could never use alcohol or drugs again because I’m so afraid of what will happen if start drinking and drugging.

9. (Compliance) Being A Good Little Boy: I know I’m using denial when I start telling people what they want to hear to get them off of my back.

10. (Flight Into Health) Suddenly Cured: I know I’m using denial when I believe that my problems have suddenly gone away without my doing anything to solve them. 

11. (Strategic Hopelessness) Why Bother: I know I’m using denial when I tell myself that I can never solve my problems and that other people should just leave me alone.

12. (Democratic Disease State) I Have My Rights: I know I’m using denial when I tell other people that I have right to use alcohol and drugs regardless of what happens and that they have no right to try and stop me.
Terry Gorski and Other Members of the GORSKI-CENAPS Team are Available To Train & Consult On Areas Related To Recovery, Relapse Prevention, & Relapse Early Intervention
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Denial Management Counseling (DMC)

January 9, 2016

I once met a person who swore he was not addicted to Heroine. He said he just liked the way it made him feel. He assured me he could stop using heroine ant time he wanted to — he just didn’t want to!
DMC – Denial Management Counseling
<Go To DMC Bibliography>

Learn To Effectively Manage Denial

In The Treatment Of Addiction And Related

Personality And Mental Disorders
Denial Management Counseling (DMC) is designed to help people overcome denial, recognize their addiction, and make a personal commitment to recovery. 
DMC training shows participants how to successfully manage clients exhibiting strong denial and treatment resistance. DMC uses a master treatment plan for interrupting denial resistance and teaching clients to recognize and manage their own denial.
Denial is a normal and natural response for coping with painful and overwhelming problems. DMC provides a practical system for describing the twelve most common denial patterns and guiding clients through a series of exercises that help them to identify and more effectively manage their own denial. 
The structured DMC exercises teach clients how to recognize and effectively stop their denial when it occurs so they can identify and clarify the problems that caused them to seek help. Clients are then guided through the process of making a firm and deep commitment to taking a next step in recovery.
An Overview of Denial Management Counseling (DMC) 

By Terence T. Gorski

March 15, 2001;
Denial is a serious problem that can cause relapse. Many therapists are looking for an effective system for interrupting denial and refocusing clients upon dealing with their addiction. This article will review the basic components of a system called Denial Management Counseling (DMC)[i].
Definition of Denial
Denial is a normal and natural psychological defense that has both benefits and disadvantages. The benefit is that it temporary removes the pain caused by consciously confronting a serious problems and creates the illusion that the problem is being solved. The biggest disadvantage of denial is that it blocks recognition & problem solving. 
Denial results from the natural tendency to avoid the pain caused by recognizing the presence, severity. and responsibility for dealing with serious problems. When Denial is activated, clients start using a set of automatic and unconscious thoughts, feelings, urges, actions, and social reactions that defend against the pain of recognizing the presence, severity, and responsibility for dealing with serious problems.[ii] DMC teaches clients how to recognize and change these thoughts, feelings, and behaviors.
Operational Definition Of Denial
Denial is a set of automatic and unconscious ….

          T = Thoughts

          F = Feelings

          U = Urges

          A = Actions

          R = Social Reactions

That defend against the pain of recognizing

the presence, severity, and responsibility for dealing with a serious problem
The Levels of Denial
Denial operates at four different levels: Clients in level 1 denial lack accurate information or have internalized wrong information about addiction and its related problems. The intervention is to provide new and more accurate information about addiction that will help them see new alternative solutions. 

Clients in level 2 denial are consciously defensive. Whenever they start thinking or talking about their alcohol or drug use an internal argument erupts in their mind. The argument is between the addictive self that wants to keep drinking and drugging and the sober self that wants to stop. The intervention is to use inner dialogue techniques to consciously examine and resolve the conflict. 
Clients in level 3 denial are unconsciously defensiveness. They automatically and unconsciously evade and distort information in a way that guards them from the pain of know they are addicted. The intervention is to teach clients about the common denial patterns and use self-monitoring and directive feedback in sessions to expose the denial patterns.
Clients in level 4 denial are delusional. They maintain the belief that they are social drinkers and recreational drug users in spite of overwhelming and undeniable evidence of serious problems. Because they are delusional, they usually do not respond to the denial management methods used for level 1, 2, and 3 denial. The delusions are often linked to brain dysfunction caused by the effects alcohol or drug use, or to coexisting mental or personality disorders. As these conditions are treated and begin to remit, these clients usual drop into lower levels of denial that can be managed in counseling.
Levels Of Denial

1. Lack of Information: Wrong information about addiction and recovery

2. Conscious Defensiveness: Knowledge that something is wrong but refusal to face the pain of knowing

3. Unconscious Defensiveness: Automatic evasion and distortion that guards against severe pain and helplessness

4. Delusion: Deeply entrenched mistaken beliefs held in spite of overwhelming evidence that they are not true
The Denial Patterns
There are twelve common denial patterns used by clients who enter counseling and therapy. These can be divided into the Big Five and The Small Seven. The following paragraphs give the name of each denial pattern and the dominant theme of it’s related self-talk. Once these self-talk patterns are identified, they can be exposed and challenged using traditional cognitive therapy methods.
The Big Five Denial Patterns are:  

(1) Avoidance (I’ll talk about anything but the problem!); 

(2) Absolute Denial (No not me!); 

(3) Minimizing (It’s Not That Bad!); 

(4) Rationalizing: (I Have A Good Reason!); and 

(5) Blaming (It’s Not My Fault!”).
The Small Seven Denial Patterns are:  
(6) Comparing (Because others are worse than me I don’t have a problem);  

(7) Manipulating (I’ll Only Recover If You Do What I Want!); 

(8) Scaring Myself Into Recovery (Being afraid of the consequences of drinking and drugging will keep me sober!);  

(9) Compliance (I’ll say anything you want to hear if you leave me alone!);  

(10) Flight Into Health (Feeling better means that i am better!); (

11) Strategic Hopelessness (Since nothing will work i don’t have to try!); and 

(12) The Democratic Disease State (I have the right To drink and drug myself to death!).
The Denial Management Systems
Denial management Counseling (DMC) is consists of three related systems:

The DMC Interactional Process is a strategy for therapeutic communication that can be used when talking with clients who are exhibiting strong denial and treatment resistance. When using this strategy, therapists recognize when clients start using denial. They shift the focus of the session from trying to solve the problem to exposing the denial and showing clients how to manage it. [iii]
The DMC Clinical Exercises are a series of structured tasks which be used as the basis of a standard treatment plan for use in individual or problem solving group therapy. This sequence of exercises teaches clients how to understand, identify, and manage their own denial. [iv]
The DMC Psychoeducational Program (also called Denial Self-Management Training) is a standardized education program for denial management that can be taught class room style to people who are having trouble recognizing and managing their denial. When taken together, these three DMC systems provide a structure for building a comprehensive approach to managing denial and resistance that can be used by individual clinicians or as the foundation of a comprehensive denial management program.;

[i] Gorski, Terence T with Grinstead, Stephen F., Denial Management Counseling, Professional Guide, Herald House Independence Press, Independence, MO, 2000

[ii] Beck, Aaron T, Wright, Fred D., Newman, Cory F., Liese, Bruce S., Cognitive Therapy of Substance Abuse, The Guilford Press, 1993

[iii] Amodeo, M.; Liftik, J. Working through denial in alcoholism. Families in Society: Journal of Contemporary Human Services, 71(3):131-135, 1990. (107440)

[iv] Gorski, Terence T with Grinstead, Stephen F., Denial Management Counseling Workbook, Herald House Independence Press, Independence, MO, 2000

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