Denial

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For the politics of science/history and public policy, see Denialism. For other uses, see Denial (disambiguation).
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Denial, in ordinary English usage, is asserting that a statement or allegation is not true.[1] The same word, and also abnegation, is used for a psychological defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.[1][2]

The subject may use:

The concept of denial is particularly important to the study of addiction. The theory of denial was first researched seriously by Anna Freud. She classified denial as a mechanism of the immature mind, because it conflicts with the ability to learn from and cope with reality. Where denial occurs in mature minds, it is most often associated with death, dying and rape. More recent research has significantly expanded the scope and utility of the concept. Elisabeth Kübler-Ross used denial as the first of five stages in the psychology of a dying patient, and the idea has been extended to include the reactions of survivors to news of a death.[3]

Many contemporary psychoanalysts treat denial as the first stage of a coping cycle. When an unwelcome change occurs, a trauma of some sort, the first impulse to disbelieve begins the process of coping. That denial, in a healthy mind, slowly rises to greater consciousness. Gradually becoming a subconscious pressure, just beneath the surface of overt awareness, the mechanism of coping then involves repression, while the person accumulates the emotional resources to fully face the trauma. Once faced, the person deals with the trauma in a stage alternately called acceptance or enlightenment, depending on the scope of the issue and the therapist's school of thought. After this stage, once sufficiently dealt with, or dealt with for the time being, the trauma must sink away from total conscious awareness again. Left metaphorically upon a back burner or put away in a cupboard, the process of sublimation involves a balance of neither quite forgetting nor quite remembering. This allows the trauma to re-emerge in consciousness if it involves an ongoing process such as a protracted illness. Or sublimation may begin the full resolution process, where the trauma finally sinks away into eventual forgetfulness. Occasionally this entire cycle has been referred to in modern parlance as denial, often confusing the full cycle with only one stage in the cycle.[4]

Unlike some other defense mechanisms postulated by psychoanalytic theory (for instance, repression), the general existence of denial is fairly easy to verify, even for non-specialists. On the other hand, denial is one of the most controversial defense mechanisms, since it can be easily used to create unfalsifiable theories: anything the subject says or does that appears to disprove the interpreter's theory is explained, not as evidence that the interpreter's theory is wrong, but as the subject's being "in denial". However, researchers note that in some cases of corroborated child sexual abuse, the victims sometimes make a series of partial confessions and recantations as they struggle with their own denial and the denial of abusers or family members. Use of denial theory in a legal setting therefore must be carefully regulated and experts' credentials verified. "Formulaic guilt" simply by "being a denier" has been castigated by English judges and academics. The main objection is that denial theory is founded on the premise that that which the supposed denier is denying is truth. This usurps the judge (and/or jury) as triers of fact.[5]

The concept of denial is important in twelve-step programs, where the abandonment or reversal of denial forms the basis of the first, fourth, fifth, eighth and tenth steps. The ability to deny or minimize is an essential part of what enables an addict to continue his or her behavior despite evidence that—to an outsider—appears overwhelming. This is cited as one of the reasons that compulsion is seldom effective in treating addiction—the habit of denial remains.

When a family intervention is conducted to help a person engaged in self-destructive behavior such as alcohol or drug abuse to accept help for his problem, denial is sometimes reduced or eliminated altogether. This is not always necessary, however, for the intervention to be successful in having the person accept help.

Understanding and avoiding denial is also important in the treatment of various diseases. The American Heart Association cites denial as a principal reason that treatment of a heart attack is delayed. Because the symptoms are so varied, and often have other potential explanations, the opportunity exists for the patient to deny the emergency, often with fatal consequences. It is common for patients to delay mammograms or other tests because of a fear of cancer, even though this is clearly maladaptive. It is the responsibility of the care team, and of the nursing staff in particular, to train at-risk patients to avoid this behavior.

Types[edit]

Denial of fact[edit]

In this form of denial, someone avoids a fact by utilizing deception. This lying can take the form of an outright falsehood (commission), leaving out certain details to tailor a story (omission), or by falsely agreeing to something (assent, also referred to as "yessing" behavior). Someone who is in denial of fact is typically using lies to avoid facts they think may be painful to themselves or others.

Denial of responsibility[edit]

This form of denial involves avoiding personal responsibility by:

  • blaming: a direct statement shifting culpability and may overlap with denial of fact
  • minimizing: an attempt to make the effects or results of an action appear to be less harmful than they may actually be, or
  • justifying: when someone takes a choice and attempts to make that choice look okay due to their perception of what is "right" in a situation.
  • regression: when someone acts in a way unbecoming of their age (e.g. whining, temper tantrum, etc.)[6]

Someone using denial of responsibility is usually attempting to avoid potential harm or pain by shifting attention away from themselves.

For example:

Troy breaks up with his girlfriend because he is unable to control his anger, and then blames her for everything that ever happened.

Denial of impact[edit]

Denial of impact involves a person's avoiding thinking about or understanding the harms of his or her behavior has caused to self or others, i.e. denial of the consequences. Doing this enables that person to avoid feeling a sense of guilt and it can prevent him or her from developing remorse or empathy for others. Denial of impact reduces or eliminates a sense of pain or harm from poor decisions.[6]

Denial of cycle[edit]

Many who use this type of denial will say things such as, "it just happened". Denial of cycle is where a person avoids looking at their decisions leading up to an event or does not consider their pattern of decision making and how harmful behavior is repeated. The pain and harm being avoided by this type of denial is more of the effort needed to change the focus from a singular event to looking at preceding events. It can also serve as a way to blame or justify behavior (see above).

Denial of awareness[edit]

This form of denial attempts to divert pain by claiming that the level of awareness was inhibited by some mitigating variable. This is most typically seen in addiction situations where drug or alcohol abuse is a factor, though it also occasionally manifests itself in relation to mental health issues or the pharmaceutical substances used to treat mental health issues. This form of denial may also overlap with denial of responsibility.[7]

Denial of denial[edit]

This can be a difficult concept for many people to identify with in themselves, but is a major barrier to changing hurtful behaviors. Denial of denial involves thoughts, actions and behaviors which bolster confidence that nothing needs to be changed in one's personal behavior. This form of denial typically overlaps with all of the other forms of denial, but involves more self-delusion. Denial at this level can have significant consequences both personally and at a societal level.[8][9]

See also[edit]

Notes[edit]

  1. ^ a b "denial". Oxford English Dictionary (Online, US English ed.). Oxford University Press. Retrieved 2014-05-24 – via oxforddictionaries.com. 
  2. ^ Niolon, Richard (April 8, 2011). "Defenses". psychpage.com. Richard Niolon. Retrieved 2014-05-24. 
  3. ^ Bonanno, George A. (2009). The Other Side of Sadness: What the New Science of Bereavement Tells Us about Life After Loss. Basic Books. ISBN 0465019943. 
  4. ^ Dorpat, T.L. (1983). "The cognitive arrest hypothesis of denial". The International Journal of Psychoanalysis 64 (Pt 1): 47–58. PMID 6853047. 
  5. ^ London, K.; Bruck, M.; Ceci, S.J.; Shuman, D.W. (2005). "Disclosure of child sexual abuse: What does the research tell us about the ways that children tell?". Psychology, Public Policy and Law 11 (1): 194–226. doi:10.1037/1076-8971.11.1.194. 
  6. ^ a b Sirri, L.; Fava, G.A. (2013). "Diagnostic criteria for psychosomatic research and somatic symptom disorders". International Review of Psychiatry 25 (1): 19–30. doi:10.3109/09540261.2012.726923. PMID 23383664. 
  7. ^ Ino, A.; Tatsuki, S.; Nishikawa, K. (June 2001). "[The Denial and Awareness Scale (DAS)]". Nihon Arukoru Yakubutsu Igakkai Zasshi [Japanese Journal of Alcohol Studies and Drug Dependence] (in Japanese) 36 (3): 216–34. PMID 11494588. 
  8. ^ Griffith, Jeremy (2003). A Species in Denial. WTM Publishing & Communications. ISBN 9781741290004 – via worldtransormation.com. 
  9. ^ Rayson, D. (2013). "On denying denial". Journal of Clinical Oncology 31 (34): 4371–2. doi:10.1200/JCO.2013.52.6228. PMID 24166521. 

References[edit]

Further reading[edit]