Rob Ford has admitted he sometimes "gets hammered" and that he smoked crack while in a drunken stupor — and there's that damning video in which he threatens to kill someone in an inebriated, obscenity-laced rant — but the Toronto mayor continues to deny he may have a substance-abuse problem.
It's an assertion supported by his family.
But such disavowals are not convincing to addiction experts.
They say denial, minimizing and other behaviours are common traits among those with alcohol or drug dependencies.
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Dennis Long, co-founder and executive director of Breakaway Addictions treatment services in Toronto, said in his view "what we're seeing in the current situation with Mayor Ford is clearly a case of denial."
Not everyone who is addicted to alcohol or drugs engages in denial, but some go to extraordinary lengths to avoid the consequences of their actions, he said, even in the face of concrete evidence of serious problems that jeopardize their personal and work lives.
"He's just digging in his heels and saying 'Nope, nope, nope,"' Long said of the 44-year-old Ford.
"And that kind of behaviour's not that uncommon."
Speaking generally, he said: "People will lie and they will frequently try to minimize their behaviour, particularly if they're in a situation where somebody's judging their behaviour in a very clear way.
"So when confronted with that judgmental approach, which is very clearly happening here, a lot of people circle the wagons and say, 'OK, really it's not a problem.' And in almost every case it is."
Family says 'he's got a weight problem'
Ford has been repeatedly urged by many Toronto city councillors, several federal and Ontario politicians, and members of the public to get help.
Yet, publicly at least, Ford's family and close associates dispute the notion that the mayor has an alcohol or drug addiction that he can't control.
'He's got a huge weight problem and he knows that. And I think that is the first thing he has to attack.' - Diane Ford, mother of Rob Ford
In a TV interview this week, Ford's mother Diane and sister Kathy agreed his behaviour isn't "acceptable."
"He's got a weight problem" that affects his demeanour, argued his mother. "He's got a huge weight problem and he knows that. And I think that is the first thing he has to attack."
"Robbie's not a drug addict," added Kathy Ford. "I know because I'm a former addict — or an addict if you'd want to say" — and her brother "couldn't function" if he were hooked on booze or drugs.
"If you want to consider binge drinking once every three months and you get totally plastered, which he just makes a fool out of himself a fine," she said. And while her brother "does not drink every night," when he does consume alcohol, he goes "full tilt."
On Friday, Ford's closest ally, brother Doug, continued to staunchly defend his sibling. The city councillor told a Toronto radio station that "Rob (should) seek a little bit of counselling," go on vacation for a week or two, and lose 50 or 60 pounds.
Because "he's a good, good man and he's an honest man, it would be tough to beat Rob Ford," his brother said.
People around him are important
Long said what the people around someone with a substance abuse-problem do and say is important, because it could enable addictive behaviour.
"If everybody close to you says you've got a problem and you've got to get it fixed, then chances are it will happen," he said. "If not, it's a huge barrier.
"It's very hard to make an impression on somebody when the people he trusts most are saying you're fine."
Ford has denied he has a substance-abuse problem and has steadfastly refused to step down as mayor of Canada's largest city or to take a leave of absence. Indeed, he has said he still intends to seek re-election next year.
Dr. Raju Hajela, a Calgary family physician who specializes in addiction, said denial is a psychological defence mechanism that includes rationalization to provide an explanation for one's behaviour — for instance, 'If you had a life like mine, you would drink too' — and minimization: it's the 'yeah, but' syndrome. 'Yeah, I did this, but it's not a problem.'
"Of course, there is a disconnect because the emotional response is so dysfunctional," he said. "Rob Ford demonstrated that when he said it was so hard for him to acknowledge that he had used crack. It was so embarrassing to him."
Feelings of shame are typical among people struggling with addiction, and that can lead to all kinds of other behaviours — including anger, Hajela said.
Besides the secretly recorded video of Ford's tirade inside a house, which the mayor said occurred while he was inebriated, there have been some explosive verbal and borderline physical dust-ups with the media since he took the chain of office in 2010.
"Rage is a common response in anyone who's not dealing with their feelings," said Hajela. "Shame is a very common feeling for people with addiction because they don't feel they're good enough and then they try hard to prove that they are, by doing whatever.
"And whenever there's a challenge to their authority in any way, then anger is the response."
Some commentators have said there seems to be a lack of understanding by Ford that his behaviour is jeopardizing the running of a city with a $10-billion annual budget and hurting its global brand.
His long-coming public apologies have been narcissistic and self-centred, said Hajela — "It's all about me, me, me,"' he said of Ford.
Long said the response is not surprising.
"When people find themselves cornered — and he is and people are bringing all kinds of pressure on him — of course, they become self-absorbed. Because it's all about self-preservation: 'I have to get myself out of this.'
"You saw that to a certain extent in Mayor Ford's apology. Basically what he said was, 'I'm sorry' and then he went on to say 'I know I have a problem and it won't happen again and I'm just going to stop it.'
"To use a clinical term," said Long, "it's bulls....t."
Often say they can stop
Alcoholics and drug addicts often believe they have their drinking or drug use under control and can just stop and make the problem go away, the experts say.
'Addiction is a complex condition that has all kinds of interacting forces that happen to the individual, and just simply saying, 'OK, I won't do that anymore' rarely, if ever, works.' - Addiction counsellor Randy Long
"We hear it all the time. Are they successful? Very, very rarely," despite wanting to change their behaviour and saying they're prepared to do it, Long said.
"But addiction is a complex condition that has all kinds of interacting forces that happen to the individual, and just simply saying, 'OK, I won't do that anymore' rarely, if ever, works."
Still, it's critical to realize that kicking an addiction is not a matter only of will power, which is a common misconception, said Hajela, a former president of the American Society of Addiction Medicine.
"Addiction is a chronic brain disease, where the substance use and behaviours are manifestations of the brain problem," he said. "Treatment involves helping people get honest and to appreciate it's their brain that's giving them this information.
"That's why recovery requires so much support and building up a recovery circle and having meetings that people can go to."
Long said in his view Ford needs to acknowledge he has a problem — one that is too big for him to fix himself — and to seek professional help.
"And that's pretty ego-destroying, in and of itself," he said. "He's going to have to admit the fact that he got himself into a mess and he can't get himself out of it."
Ford's lawyer, Dennis Morris, said Friday the mayor is considering his options amid mounting pressure to step aside and seek help or to resign.
One of those options is going into rehab, but "it's best we hear from his lips," Morris told the Associated Press.
"When you go left, he goes right."