Denial is a strong defense that gives the addict a sense of power and minimization related to his or her illness. When addiction takes over, Berni Fried believes that the addict tends to minimize and deny that there are any negative consequences related to his or her use. It is only when the addict experiences negative consequences that he is able to recognize that there may be an issue related to his or her addiction. Through direct pain such as medical, legal, or emotional, an addict is forced to feel the ramifications of his or her use. Sometimes with emergency room visits, incarceration, divorce or blackouts, the addict can finally see that there may be a problem.
“Hitting Bottom” is a common term used in Alcoholics Anonymous describing the point that the addict is unable to continue to use freely without negative consequences. This is often the point that the addict is forced out of denial and into reality through a painful experience. According to Berni Fried, this can often include legal issues or emotional breakdowns. Unfortunately, for some addicts “the bottom” of addiction includes being sent to jail or ultimately, death.
When an addict is in enough pain and recognition of his or her consequences, there is often an opening for change. This is the point, says Berni Fried, where there is a possibility that the addict will seek treatment of some sort, whether it be therapy or inpatient/outpatient treatment. Unfortunately, denial is elusive and powerful. There is a limited amount of time to try to intervene on the addict’s denial process. This process of admission is critical and the first step in an addict’s process towards recovery.
This is when the addict admits that there is unmanageability associated with his or her use. This is the opening that the addict needs to begin to change and recognize that his use is creating unmanageability in his life. Often times, with the twelve steps of Alcoholics Anonymous, the first step is the recognition and the ability to admit and begin the process of change. Berni Fried believes that when the addict takes responsibility and power over the unmanageability of his or her life, the addict can start to transform their life and the lives of the people around them. Treatment needs to include the addict’s ability to take responsibility for the consequences and the unmanageability in his life.
At this entry point, according to Berni Fried, the addict can begin support through 12 step meetings, psychotherapy, and small process groups. The addict can begin to feel that he is not alone; the possibility of a sober life is possible at this stage. A feeling of hope and possibility begins to replace the emptiness and despair. The addict feels that he can have a life free from the obsession to use and the sadness associated with the trapped life of addiction.