Break Through the Alcoholic's Psychological Defenses

For the millions of Americans who must watch their loved ones struggle with a dependence on alcohol, they wonder: How can family and friends break through the alcoholic's psychological defenses—what some experts call the "wall of denial"—so that healing can begin?

An alcoholic can't be forced to get treatment or help, and challenging an alcoholic's defenses about his or her drinking is a formidable assignment, says the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The most important thing that friends and family can do for an alcoholic is to stop enabling the addictive behavior. In plain language, stop trying to solve the inevitable personal problems that stem from alcohol abuse.

Here are some additional strategies from the NIAAA and other experts:

Educate yourself about alcoholism. One resource is Al-Anon, a nationwide organization that offers education and support for families in the same way that AA helps recovering alcoholics.

Talk to the person shortly after an alcohol-related problem has occurred. Choose a time when the person is sober, and speak to the person in private. Be as specific as possible, using examples of how the person's drinking is causing problems. Tell the person what you intend to do if he or she does not get help—moving out, for instance—and be prepared to back up what you say. Draw up a plan of action. One especially helpful step is to present the alcoholic with a written or verbal contract that calls for attending a treatment program, such as the "12-step" group counseling sessions available everywhere. Or, your contract might propose intensive outpatient treatment or an extended stay at a treatment facility.  

Ask a friend or another family member to speak to the person as you have done. Someone who is a recovering alcoholic can be especially helpful.

With the help of a health care professional, you might consider arranging for several people, including family members and close friends, to confront the alcoholic at once. Although a spouse's warnings about the disease can be dismissed as mere nagging, it's harder to continue in denial when faced with four or five deeply concerned friends.