Understanding Denial with Compulsive… | Counseling | Therapy

Understanding Denial with Compulsive Problematic Behavior

Richard (Rick) Snyderman , LPC, CADC, CSAT, NCC — Therapist, director of group therapy

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It is common to hear the question “why are you doing this?” from the loved ones of people with different compulsive behaviors. The hope behind this inquiry is to help loved ones gain insight into the reasons the person they care about continues to act out on their problematic compulsive behaviors. Understanding denial with problematic compulsive behaviors allows for greater awareness about the pervasiveness of compulsivity and why it may be hard for them to quit.

We can all relate to when we hear something shocking for the first time, we do not always believe it is true. For example, you may be told something tragic or have been diagnosed with a chronic medical condition, and your first reaction may be to deny it before working toward accepting it. The reason is due to our mind’s attempt to self-protect us from perceived harm. When it comes to compulsions, denial works the same way. The difference is that denial is more pervasive with compulsions and can resurface even after the compulsive person comes to accept their condition. Additionally, with problematic compulsive behaviors, breaking through denial can be a slow process whereby the person with the compulsions can bargain back and forth. This level of ambivalence can occur on almost a daily basis, ultimately setting the person up for continued acting out on their compulsion. Another important point to highlight here is that compulsions present themselves as having a payoff, especially in the beginning, which is why people continue to engage in it.

One of my most famous examples is that if the first time you drank a tasty beer and got splinters in your throat chances are you will not do it anymore. The same metaphor can be applied to eating your favorite food (i.e. chocolate cake) and then getting violently ill afterward. If someone has an compulsion, they may continue to justify the continued use of eating that cake by thinking it made you sick because of where you bought it. The reason for this is that people with compulsions think they have the illusion of “control” over the compulsive behavior which prompts continued engagement in it. For the compulsive person, the reason the illusion of control is so great is because the “reward” or outcome being sought (i.e. feeling euphoric or less negative) makes the “risk” of the continued engagement appear worth it because the negative consequences may only occur intermittently. So back to our example, the person may also attempt control by purchasing the cake somewhere else and the same ill-fated result happens again. Most may be convinced, by this point, not to continue eating it then. But, the compulsive person may continue to rationalize it by composing a number of different explanations such as the amount they ate, where they ate it, or what ingredients in the cake specifically made them ill. Despite whatever rationale is used to resist changing the compulsive behavior (i.e. eating chocolate cake), all roads still eventually end up the same way; getting violently sick. Most folks may have gotten off this proverbial bus after the first or second time something negative happened, but someone with a compulsion will continue to try to consume that cake in any way possible (control) because they “like it” so much (reward). This process of understanding denial can take several months or years before the person with the problematic sexual compulsivity, and/or their loved ones, accept that they cannot do it anymore because the “pain” of doing it (consuming the cake) is worse than the “pain” of not doing it (not eating it). When the negative consequences of the alleged rewarding behavior exceed the anticipated benefits is when denial breaks and the process of recovery can begin. Also, with compulsions, the denial can break one day and then reoccur the next, which is why compulsions and dependence has also been called “the disease of denial.” It is the only disease that tells you that you don’t have it!

You may now be wondering, what is the reason behind all this denial when it comes to a disease that is just as progressive, chronic, and potentially fatal like any other one? Below are some possible explanations to help you understand denial better.

· Survival. Dopamine, which is the neurotransmitter in our brains that rewards you for engaging in behaviors vital for survival, originates in the limbic system part of our brains. This is the same part of the brain where our impulse to eat when we are hungry, drink when we are thirsty, and our innate need to protect ourselves comes from. With continued stimulation of dopamine levels in the reward center of the brain, people with compulsive behaviors can conflate the need for “survival” or “peace of mind” with the need for the pleasurable effects of their “drug” that occurs in this same region of the brain. This process lends itself to the distorted feeling of death or severe unrest if the person with problematic compulsivity does not partake in their vice. The experience of cravings and urges to drink, get high, or act out also comes from the amygdala and hippocampus; both of which are responsible for learning and memory and located in this same brain region.

· Stigma. Whether it is being dependent to a substance, gambling away more money than you can handle, or acting out sexually with another person while in a committed relationship, there is a stigma associated with acting out on one’s compulsions that extends beyond social acceptability. Because of the combination of the compulsive behavior serving to help the afflicted person “feel good” or “feel less bad,” this disease compels them to seek refuge in the compulsions to the extent that most others, including themselves, would deem to be at unacceptable levels. As a result, an alternate persona develops (i.e. double life) to attempt to both put up with “normal” appearances while also secretly getting their fix and thus enabling their own levels of denial.

· Avoidance of negative consequences. The longer a person who is compulsive is able to maintain the positive effects of their compulsive behavior without negative consequences such as financial problems, relationship conflicts, legal issues, or negative emotional effects, the longer the false belief sets in that they can manage their compulsions successfully. By default, this process keeps their denial intact.

· Guilt/Shame. Underneath the compulsive behavior is the feeling of guilt and shame, especially when the person realizes that they cannot control their use compared to others who may engage in these pleasurable behaviors successfully (without a negative consequence). When it comes to compulsions, the same behavior that caused the feelings of guilt and shame, is the same behavior that compulsive people turn to in order to alleviate it. This process is also known as “insanity;” doing the same thing and expecting a different result.

These are just some of the rationales to help you in understanding denial with compulsions. However, just because you may understand it intellectually, dealing with your own or another person’s compulsive behavior can be a tough road to navigate. If you would like to talk about this further, please schedule an appointmentt at or (215) 922-5683. Therapy near me.

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