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Denial

Denial represents a basic or primitive psychological defense mechanism by which a person or persons unconsciously rejects some or all of the meanings of an event or situation.1 Through denial, an individual or even a group of individuals (loved ones, friends, colleagues) avoid awareness of some painful aspect or aspects of reality (health issues, financial issues, relationship issues) in order to decrease anxiety or other unpleasurable emotions such as guilt or shame.1

Denial is present in nearly all who actively have problems with alcohol and denial can take the form of denying there is any problem at all to minimizing difficulties with alcohol use and the effects of use.2 Some common forms of denial are: conscious and unconscious distortion or minimization of the facts of an addiction, ignorance of information on alcohol and drug effects, forgetfulness and blackouts, lying, euphoric recall – remembering only the good times, and wishful thinking. 2,3

People struggling with issues related to alcohol dependence use denial or any number of common psychological defenses – such as humor, acting out or externalizing, rationalizing and/or intellectualizing – to split up the positive and negative aspects of patterns of dependent behavior and move toward treatment and recovery or stronger relationship with the addictive substance.4,5

Defenses such as denial should be confronted only to the degree necessary to assist a person in entering treatment and handling immediate life issues.4 It is important to note that denial may be used not only as a maladaptive defense but also as an adaptive defense mechanism. For example, in cases where a person has experienced significant trauma,  unconscious denial may aid in preventing the debilitating effects of psychological pain or even death. Abrupt confrontation of defense mechanisms like denial may serve to drive people in need away from treatment.

References

  1. Moore, Burness E. & Fine, Bernard D (Editors) Psychoanalytic Terms and Concepts. The American Psychoanalytic Association, 1990 pgs 50-51.
  2. Module 10. Trainer Information Sheets. Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Prevention.
    http://preventiontraining.samhsa.gov/CMHC01/MOD10TR.htm
  3. At Any Age, It Does Matter: Substance Abuse and Older Adults (for Professionals). CSAP's Prevention Pathways: Online Courses. Module 2: Recognizing Alcohol Misuse and Abuse in Older Adults. Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Prevention.
    http://pathwayscourses.samhsa.gov/aaap/aaap_2_pg12.htm
  4. At Any Age, It Does Matter: Substance Abuse and Older Adults (for Professionals). CSAP's Prevention Pathways: Online Courses. Module 7: Barriers to Treatment. Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Prevention.
    http://pathwayscourses.samhsa.gov/aaap/aaap_7_pg8.htm
  5. Howard J. Shaffer*, Gary Simoneau Reducing resistance and denial by exercising ambivalence during the treatment of addiction. Journal of Substance Abuse Treatment 20 (2001) 99-105

This page was last modified on : 10/28/2013

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