Monday, September 24, 2012

Denial: Defense mechanisms by Sigmund Freud



The ego deals with the demands of reality, the id, and the superego as best as it can. But when the anxiety becomes overwhelming, the ego must defend itself. It does so by unconsciously blocking the impulses or distorting them into a more acceptable, less threatening form. The techniques are called the ego defense mechanisms.

While all defense mechanisms can be unhealthy, they can also be adaptive and allow us to function normally. The greatest problems arise when defense mechanisms are overused in order to avoid dealing with problems. In psychoanalytic therapy, the main goal is to uncover these unconscious defense mechanisms and find better, healthier ways of coping with anxiety and distress.

One of the most wide known defense mechanisms is denial. Let’s review it in more details.

About denial

Denial involves blocking external events from awareness. If some situation is just too much to handle, the person just refuses to experience it. As you might imagine, this is a primitive and dangerous defense -- no one disregards reality and gets away with it for long! While this may save us from anxiety or pain, denial also requires a substantial investment of energy. Because of this, other defenses are also used to keep these unacceptable feelings from consciousness.

Denial is an outright refusal to admit or recognize that something has occurred or is currently occurring. A person who is a functioning alcoholic will often simply deny they have a drinking problem, pointing to how well they function in their job and relationships, while victims of traumatic events may deny that the event ever occurred. A person may faint at a horrible real-life occurrence, such as the death of a loved one. Or, that same person might intellectually know that a person has died but refuses to “accept it” while she may still wait for 5 o’clock, the usual time her husband came home from work.

On a lighter note, a student may refuse to pick up her final grade from a difficult class because she knows it is not an acceptable grade. She simply denies the reality of the grade.

As a defense mechanism, denial becomes more difficult to maintain as one matures. Its use requires much energy and the mind looks at other possibilities of defense.

Anna Freud also mentions denial in fantasy:  This is when children, in their imaginations, transform an "evil" father into a loving teddy bear, or a helpless child into a powerful superhero.

Subject of denial

The subject may use:
  • Simple denial: deny the reality of the unpleasant fact altogether
  • Minimization: admit the fact but deny its seriousness (a combination of denial and rationalization)
  • Projection: admit both the fact and seriousness but deny responsibility by blaming somebody or something else.
Research

Denial (also called abnegation) is a 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. The theory of denial was first researched seriously in details 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. Thus, when parents are informed of the death of a child, their first reaction is often of the form, "No! You must have the wrong house, you can't mean our child!"

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.

Types of denial

Denial of fact

In this form of denial, someone avoids a fact by lying. 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

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.
  • 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.

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

Denial of impact

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.

Denial of awareness

This type of denial is best discussed by looking at the concept of state dependent learning. People using this type of denial will avoid pain and harm by stating they were in a different state of awareness (such as alcohol or drug intoxication or on occasion mental health related). This type of denial often overlaps with denial of responsibility.

Denial of cycle

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 denial

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

Treatment of denial

Denial is treated differently in different types of therapy. In psychoanalytic therapy, denial is regarded as an obstacle to progress that must eventually be confronted and interpreted. Timing is important, however. Psychoanalytic therapists wait until clients appear emotionally ready or have some degree of insight into their problems before confronting them. In the humanistic and existential therapies, denial is considered the framework by which clients understand their world. Not directly confronting denial, therapists assist clients in exploring their world view and considering alternative ways of being. In cognitive-behavioral therapies, denial is not regarded as an important phenomenon. Rather, denial would suggest that an individual has not learned the appropriate behaviors to cope with a stressful situation. Therapists assist individuals in examining their current thoughts and behaviors and devising strategic ways to make changes.

Traditional treatment programs for substance abuse and other addictions view denial as a central theme. Such programs teach that in order to overcome addiction, one must admit to being an alcoholic or addict. Those who are unable to accept such labels are informed they are in denial. Even when the labels are accepted, individuals are still considered to be in denial if they do not acknowledge the severity of their addictions. From this perspective, progress cannot be made until individuals recognize the extent of their denial and work toward acceptance. However, there is much controversy in the field of addictions regarding the role of denial and how it should be addressed. Traditional programs stress direct confrontation. Other professionals do not insist on the acceptance of labels. They believe that denial should be worked through more subtly, empathically focusing on the personal reasons surrounding denial and seeking to strengthen the desire to change. This subtle form of addressing denial is known as motivational enhancement therapy, and can be used with other types of disorders as well.

Sources and Additional Information:


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