Lets Talk About Denial: not a river in Egypt

Denial, the topic for this week’s discussion, is unfortunately not a river in Jordan. While not a river, it is a characteristic that at times seems to be as resistant to change as the most torrent watercourse. Denial has been described as many things in many ways by many people and still I find the Webster’s Dictionary definition of denial to be the most meaningful and accurate:

“an assertion that an allegation is false…disbelief in the existence or reality of a thing…self-denial…[and] the reduction of anxiety by the unconscious exclusion from the mind of intolerable thoughts, feelings, or facts” (1977).

The readings and following class discussion illuminated just how varied and vast denial can manifest itself, especially with alcoholics and addicts. The discussion concluded that denial may be noticeable in the form of 1) an individual not being able to accept what is in front of him; 2) a coping mechanism to deal with facts as presented; or 3) the inability to see consequences of one’s behavior. Also based on the class discussion, things a counselor can look for to discern if a person is in denial are 1) if they consistently miss or avoid scheduled sessions, or while in sessions they continually change the subject; 2) if clients appear to reject logic or reason; 3) clients demonstrate incongruence, that is their non-verbal expression and actions are inconsistent with what they say; and 4) clients demonstrate the various defense mechanisms associated with alcoholism, addiction, and denial.

These defense mechanisms can be in the form of projection, (“I don’t have a problem –you have a problem.”) rationalization, (“It helps me relax/concentrate/forget” or “I’ll stop as soon as the pressure lets up”) justification, (“Everyone I know does it”) suppression or repression, (forcing down memories of using behavior and negative consequences as a result of that use and behavior) and one that sometimes gets overlooked, geographic escapes (my life is unmanageable – but it’ll get better if I move to another place.)

The text also offered some useful information in understanding the phenomenon of denial. On page 30 of the text Assessment of Addictive Behavior, Tarter, Alterman, & Edwards (1985); Tarter & Edwards (1986); Tarter, Hegedus, Goldstein Shelly, & Alterman (1984) suggest that “…neuropsychological deficits among alcoholics, particularly deficits in accurately perceiving internal cues of physiological arousal and emotion and in appraising the significance of environmental events, may underlie what has been described as ‘alcoholic denial’ ” (cited in Donovan & Marlatt 1998).