Saturday, January 15, 2011

Alcohol in the Workplace: Tinkering with the Employee's Denial

As you become an expert on alcohol in the workplace, you will need to become an expert with assessment and helping an employee-client, who may be diagnosable as alcoholic. Invariably you will bump into your employee-client's "model of denial". This is a critical juncture in your assessment interview. All alcoholics have a model of denial. This is a construct that assists the alcoholic in preventing self-diagnosis. 

It is a myth that denial is absolute in alcoholics. Denial is a defense mechanism and it is therefore employed to do battle against self-diagnosis. Non-alcoholic drinkers deny alcoholism of course, but they do not use denial in the classic psychodynamic sense of the term. It is logical and realistic to view all alcoholics as having--if not the ability to self-diagnose their illness--at a minimum, a fuzzy idea about the nature of their problems and whether drinking is in some way linked to them or associated with them. This is all that is needed to help alcoholic employees examine their "denial construct". 

So where to begin? At an appropriate point in your assessment interview, you should define denial in the following way to make an impact and help the employee move toward self-diagnosis--your goal.

Here is the definition that I finally arrived at using after testing a few other presentations to help employees move past denial. I don't simply rattle this off the tip of my tongue, however.  I piece it out in  my discussion with the employee until he or she finally gets it all. I like this definition because it seriously erodes or creates useful anxiety in the employee-client, enough at least to further the interview to the next step. That next step might be a MAST (Michigan Alcoholism Screening Test) done verbally, or some other next step in the interview and assessment process.

So alcohol and workplace intervention is enabled by the following presentation by the EA professional:
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Are you familiar with the term denial and how it works with regard to alcoholism? Here's what I have observed in many people over the years. When considering the definition of alcoholism above, many people focus on the symptoms that they do not have more than the ones they do have. Unlike cancer, where any symptom would cause alarm, symptoms of alcoholism often get ignored if other symptoms can be shown to not exist. This process is called “comparing out” of the definition, and it is a natural part of denial.

Here’s a better way to understand denial. Alcoholics usually maintain a definition of alcoholism that serves to exclude them. Alcoholics usually focus on symptoms of addiction that they do not have and use this information to avoid their self-diagnosis. Alcoholics then change their definition over time to exclude symptoms that they begin to experience.
You can hear this definition discussed in the following video. (FYI: This video is available for purchase in several different formats as a useful tool.) It "stirs the juices" in employees, family members, and of course alcoholic employees in denial. It is also embedded in the Reasonable Suspicion Training Course for (DOT and non-DOT) Training of Supervisors.