Denial

Among the more than six million alcohol and drug addicts who need treatment but do not receive it, the psychological construct of denial may be part of what prevents them from receiving this treatment. Denial is a primitive defense mechanism that originated from the psychodynamic school of psychology. Psychoanalysts generally define denial as an unconscious refusal to accept unpleasant experiences that are occurring. Denial is a way the ego, part of the psyche, protects the individual from experiencing overwhelming emotions and threats to self-identity. An example is when a driver continues to drive under the influence of alcohol or drugs and when he or she gets caught a second time and says, "The cops must have my car tagged." This statement reflects the use of denial as a way the individual's ego protects him- or herself from the unpleasant consequences of drinking and driving.

Most of us, however, use denial in everyday life. It is a universal mechanism in the face of unpleasant and overwhelming sensations. An initial "This is not happening" occurs for individuals in perceived overwhelming situations (e.g., car accidents, fires, deaths, perceived violations of safety or security). When the initial shock is over, denial may diminish as the reality of the situation begins to creep in. Denial can be both an adaptive and a maladaptive defense mechanism. An adaptive use of denial may be when someone's feelings are hurt in a situation and the person may refuse to acknowledge hurt feelings to prevent a scene. Later, the person may think about how his or her feelings were hurt and process these feelings. Eventually, individuals who use denial begin to see the reality of what happened. Facts and evidence help an individual "break through" the magical thinking and acknowledge that reality is different. When this occurs, the individual can see the reality he or she was refusing and begin the process of coping with it.

Denial becomes a maladaptive function when facts and evidence of reality do not "break through" the individual's misperceived reality. A person can become stuck in the distorted reality of denial. Human beings, in general, do not like to see themselves as causing pain to others, and denial is one way to protect this image. Denial severs an individual from reality, and a misconstrued reality takes its place.

Denial comes in many patterns. Absolute denial is the most primitive and global pattern that exists. Statements like "I don't have a problem" or "I can stop anytime I want" suggest an absolute denial pattern, as statements like these reflect a global refusal that substance use is problematic or consequential. Other patterns exist, in which denial is a part of other defense mechanisms. Rationalization is one such mechanism that involves giving reasons for events or reactions. Denial is part of rationalization. There is a refusal to see reality for what it is on a conscious level, but on an unconscious level, reality may be seen for what it is but is "rationalized" away. An example may be the driver under the influence, who, even after a second offense, "rationalizes" he or she can drive, because he or she had seven drinks in 4 hours as opposed to the usual ten. Other common patterns of denial that may be used include minimizing, blaming, intellectualizing, displacing, and repressing.

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