Abstract
Many physicians feel uncomfortable about discussing a diagnosis of alcoholism with a patient. The goal is straightforward enough: the patient must understand that his drinking is a problem and that treatment is necessary. Yet, the patient’s denial of the problem or refusal to consider treatment can thwart even the best-intentioned efforts. An understanding, systematic approach to denial can help the newly diagnosed patient begin to engage in treatment, although he may require multiple confrontations over time before accepting the need for treatment. Repeated discussions with no immediate results may frustrate the physician, but the cumulative effect can disrupt the pattern of alcoholic drinking. Many recovered alcoholics state anecdotally that such an encounter “ruined” their enjoyment of drinking, even though their behavior did not change for some time1.
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References
Cutler DF: Personal communication, 1983.
Bean MH: Denial and the psychological complications of alcoholism, in Bean MH, Zinberg NE (eds): Dynamic Approaches to the Understanding of Alcoholism. New York, Free Press, 1981, pp 55–96.
Paredes A: Denial, deceptive maneuvers, and consistency in the behavior of alcoholics. Ann NY Acad Sci 1973;233:23–31.
Baekeland F, Lundwall LK: Engaging the alcoholic in treatment and keeping him there, in Kissin B, Begleiter H (eds): Treatment and rehabilitation ofthe chronic alcoholic. New York, Plenum Press, 1977, pp 161–195.
Bissel L: Diagnosis and recognition, in Gitlow SE, Peyser HS (eds): Alcoholism: A Practical Treatment Guide. New York, Grune & Stratton, 1980, pp 23–45.
Warburg MM, Cleary PD, Rohman M, et al: Diagnosis and management of alcoholism: A survey of medical residents. J Med Educ (In press).
Clark WD: Alcoholism: Blocks to diagnosis and treatment. Am J Med 1981;71: 275–286.
Wolf I, Chafetz M: Social factors in diagnosis of alcoholism in social and non-social situations. Q J Stud Alcohol 1965;26(1):72–79.
DiCicco L, Unterberger H, MackJE: Confronting denial: An alcoholism intervention strategy. Psychiatr Annals 1978;8:596–606.
Hertzman M: Getting alcoholics out of your office, into treatment, and back into your office. Primary Care 1979;6(2):403–416.
Groves JE: Taking care of the hateful patient. N Engl J Med 1978;8:596–606.
Block MA: Motivating the alcoholic patient, in Gitlow SE, Peyser HS (eds): Alcoholism: A Practical Treatment Guide. New York, Grune & Stratton, 1980, pp 47–71.
Vaillant GE: The Natural History ofAlcoholism: Causes, Patterns, and Paths to Recovery. Cambridge, Mass, Harvard University Press, 1983.
Clark WD: Emergency care of the patient with alcoholism, in Kravis T, Warner C (eds): Emergency Medicine: A Comprehensive Review. Rockville, Md, Aspen Systems Press, 1983, pp 517–531.
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© 1987 Springer-Verlag New York Inc.
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Barnes, H.N. (1987). Presenting the Diagnosis: Working with Denial. In: Barnes, H.N., Aronson, M.D., Delbanco, T.L. (eds) Alcoholism. Frontiers of Primary Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4786-9_6
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DOI: https://doi.org/10.1007/978-1-4612-4786-9_6
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-9155-8
Online ISBN: 978-1-4612-4786-9
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