Thursday, 16 August 2012

Denial

Denial


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.[1] The subject may use:
simple denial: deny the reality of the unpleasant fact altogether
minimisation: 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.
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 K├╝bler-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!"[citation needed]
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. [2]
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 such behavior
Types

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, 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.
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

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.[3] 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.

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