Introduction
Denial is one of the protective mechanisms of the human psyche, which consists of the fact that an individual refuses to recognize the existence of facts that make him suffer. He refuses to accept reality as it is and distorts it in his perception so that it does not cause him pain. An important feature of this psychological defense is that a person discards painful information even before the stage of its awareness.
Sigmund Freud introduced this concept into psychology. As part of his research, he came to the conclusion that denial is the most primitive psychological defense that occurs in the early stages of the formation of the psyche. Also, he argued that this protective mechanism is present in one form or another in almost all animals capable of experiencing fear and pain. In 1895, 39-year-old Freud, together with his mentor Joseph Breuer, published the work “The Study of Hysteria,” in which this phenomenon was described in sufficient detail (Di Giuseppe et al., 2018). Using the cathartic method of psychotherapy developed by Breuer, scientists ensured that patients voiced thoughts that, at the same time, refused to consider their own. They recognized that these thoughts obey the laws of logic but still considered them irrelevant, inaccurate, or inapplicable specifically in their case. The study notes that patients often renounced thoughts and memories that had already been returned, pushing them back into the unconscious.
Even small children resort to denial. When they are scared, they hide with their heads under the blanket, and because of this, it seems to them that all dangers (no matter fictional or real) cease to exist. Adults are more likely to use denial to protect themselves from stress. They deny failures, addictive behavior (their own or someone else’s), health problems and the need for treatment, the attitude to death, the loss of a loved one, and other painful knowledge. Hence, the target behavior is denial – when a person rejects to accept specific alterations in their lives. It is vital to change this pattern in order to facilitate the processes of acknowledging the inevitable and improving one’s condition. Considering the ever-growing role of psychology in human life, it is interesting to dwell on this defensive mechanism and introduce specific interventions to promote a change.
Literature Review
Defense Mechanisms Iin Cancer Patients
Denial is a common mechanism of the psyche in people with severe diseases. Oncological diseases affect the psyche in two ways: the first – depletes the central nervous system, and causes asthenia (pathological fatigue) and irritability; the second – forces a person to think about his illness to pay attention to himself. Thus, the second way is the subjective perception of oncology by the patient himself, how the disease affects the mental status of a person only by its presence (Di Giuseppe et al., 2018). When faced with an oncological diagnosis, most people initially react with shock and disbelief, then with anxiety, anger, and depression. Di Giuseppe et al. (2018) established that there is a hierarchy of defense strategies used by cancer patients as their condition progresses. They are high-adaptive, mental inhibition, disavowal, and image distortion (including both minor and major) defenses that were more frequent in these people rather than in different groups of patients.
The early detection of maladaptive protective functioning can contribute to proper psychotherapeutic intervention and prevent exacerbation of the disease. This study found that patients with fewer symptoms of depression had a longer life expectancy after a cancer diagnosis than patients with severe depression (Di Giuseppe et al., 2018). It signifies that specific interventions could be introduced to address the distress symptoms and improve one’s condition. The researchers suggested psychological help that aims to provide moral support for a speedy return to mental balance. First of all, the specialist analyzes the type of personality and, based on the findings, prepares an individual plan of correctional work with the patient (Di Giuseppe et al., 2018). In some severe cases of depression and aggressive attitude toward oneself, the participation of a psychiatrist and the prescription of medications may be required.
It’s Not Denial, It’s Stigma
The following study focused on denial in criminals who committed sexual violence. Delinquents often see themselves as an object of someone’s influence, as a victim of circumstances (bad parents, teachers, friends, financial difficulties, etc.), and this prepares the ground for deviation from the norm, which they do not reject. Denial of responsibility, as it were, breaks the connection between the subject and their actions, and removes the question of guilt and the consequences of the act (Ware & Blagden, 2020). In addition, violators tend to consider only acts with a material composition as criminal, that is, causing real damage. The researchers studied the behavioral pattern of men with sexual convictions and identified that denial makes them less vulnerable (Ware & Blagden, 2020). It implies that by not accepting their guilt, criminals receive more support from their families and other stakeholders. However, the evidence backing up the theory that these people are prone to committing more sexual crimes is still lacking.
Even if the violator admits their responsibility for wrong actions and is ready to acknowledge that they have caused harm to someone, they try to focus on the victim’s personality, presenting their act as retribution or punishment. As an intervention, these people are suggested to work with a psychologist that can help them accept the guilt and find out the underlying reasons for such behavior. It is recommended to undergo long-term psychotherapy in order to change the behavioral patterns and find meaning in life (Ware & Blagden, 2020). It takes a while to make criminals plead guilty as they avoid getting a life-long sentence. However, helping them accept the situation allows for behavioral change and avoidance of such cases in future.
Men with Sexual Convictions and Denial
The other study presented evidence of how denial is observed in people with alcohol abuse. Such people tend to deny their addiction and find numerous excuses. They believe that they have the right to consume drinks after a busy day or do it because of problems at work or complex relationships with loved ones (Harding, 2021). Addicted people believe that they drink no more than others and can stop at any time. They believe that occasionally having a couple of wine glasses is not damaging. A person who abuses alcohol has a toxic brain lesion, the so-called alcoholic encephalopathy, to one degree or another (Harding, 2021). In mild cases, it manifests itself in a decrease in memory, attention, and productivity of mental activity; in severe cases – in progressive dementia.
One of the suggested interventions for such individuals is a lie detector. Addicted people can pass a lie detector test, which will confirm that they are telling the pure truth, but this is only their truth, which has nothing to do with reality. Therefore, the researchers introduced denial management counseling which aimed to prove its efficacy by observing the reduction in the number of those denying the problem (Harding, 2021). A psychologist helped the respondents understand that alcohol does not make a person more courageous or intelligent; on the contrary, it leads to the degradation of personality. They also provided support when a person began to doubt the need for treatment. After having at least 12 sessions with a psychologist, it was established that the participants became less prone to denying the problem and could openly speak about alcohol consumption (Harding, 2021). Hence, the efficacy of psychotherapy cannot be underestimated as it shows the changes in one’s behavior.
Conclusion
In conclusion, denial as a defensive mechanism can be seen in numerous people with different conditions. These include cancer, alcoholism, and even involvement in criminal activity. Denial is a psychological mechanism as it allows one to feel protected for some time. It is a direct refusal to admit that something happened in the past or is happening now. Due to this approach, a person tries to ignore things that they cannot cope with, so it is often used to describe situations in which people cannot face the truth and admit the obvious truth. However, when people know the problem but still reject it, they have inner conflicts. Based on the literature review, the most effective intervention is psychotherapy because it enables individuals to accept the issue. Moreover, it lets one change the behavioral pattern and speak about feelings and emotions. In addition to counseling, lie detectors are common, specifically in the field of crime investigation, yet it is not effective in cancer patients. Considering the tricky nature of this defensive mechanism, it is vital to introduce psychological treatment to the abovementioned fields so that the exposed groups can have access to support.
References
Di Giuseppe, M., Ciacchini, R., Micheloni, T., Bertolucci, I., Marchi, L., & Conversano, C. (2018). Defense mechanisms in cancer patients: A systematic review. Journal of psychosomatic research, 115, 76–86. Web.
Harding, S. (2021). It’s not denial, it’s stigma: A case study. Journal of Addictions Nursing, 32(4), 263–265. Web.
Ware, J., & Blagden, N. (2020). Men with sexual convictions and denial. Current Psychiatry Reports, 22(9), 51. Web.