Understanding Denial as a Defense Mechanism

Neurotics use a variety of intra-psychic mechanisms to defend against the experience of emotional pain and alleviate anxiety. Almost everyone has heard of these classic “defense mechanisms.” These are unconscious tools that, though powerful, are neither adequate, nor always particularly healthy as ways to mitigate emotional pain. The “symptoms” the neurotic individual brings to the attention of a therapist are the result of residual anxiety — or emotional pain left over after the ineffective use of one or more of the typical “defenses.” At other times, a person might seek help because the “defenses” have become increasingly inadequate or have begun to break down, letting the emotional pain underneath them rise to the surface.

Disordered characters engage in certain behaviors that are so “automatic” that it’s tempting to think that they do them unconsciously. On the surface, these behaviors often resemble defense mechanisms and can easily be interpreted as such, especially by individuals overly steeped in traditional paradigms. However, on closer inspection, these behaviors are more accurately labeled tactics of manipulation, impression-management, and responsibility-resistance. In workshops, I always illustrate the contrast between a true “defense” mechanism and a tactic of manipulation and responsibility-avoidance using the concept of “denial.” One of the 5 most commonly misused terms in mental health (more about this later!), denial can indeed be an unconscious defense mechanism.

Let’s take the example of a woman who has been married to the same man for 40 years and she has just rushed him to the hospital because while they were out in the yard working, he began having trouble speaking and looked in some distress. The doctors then tell her that he has suffered a stroke, is now virtually brain-dead, and will not recover. Yet, every day she is by his bedside, holding his hand and talking to him. The nurses tell her that he cannot hear, but she talks to him every day. The doctors tell her he will not recover, but she tells herself, “I know he’ll pull through, he’s such a strong man.” This woman is in a unique psychological state — the state of denial. She can hardly believe what has happened. Not long ago she was in the yard with her darling, enjoying one of their favorite activities. The day before, they were at a friend’s home for a get-together. He seemed the picture of happiness and health. He didn’t seem that sick when she brought him to the hospital. Now — in the blink of an eye — they’re telling her he’s gone. This is more emotional pain than she can bear just yet. She’s not ready to accept that her partner of 40 years won’t be coming home with her. She’s not quite ready yet to face a life without him. So, her unconscious mind has provided her with an effective (albeit most likely temporary) defense against the pain. Eventually, as she becomes better able to accept the distressing reality, her denial will break down, and when it does, the pain it served to contain will gush forth and she will grieve.

Now, let’s take another example of so-called “denial.” Joe, the class bully, strolls up to one of his unsuspecting classmates and engages in one of his favorite mischievous pastimes, pushing the books out of her arms and spilling them on the floor. It just so happens that the hall monitor catches the event and sternly hollers: “Joe!” to which Joe, spreading his arms wide open and with a look of great shock, surprise, and innocence on his face asks: “Whaaaat?” Is Joe in an altered psychological state? Is his altered state brought about by more emotional pain than he could possibly bear? Does he really not understand the reality of what has happened or think that he really didn’t do anything? Is he so consumed with shame and/or guilt for what he’s done that he simply can’t bear to believe he actually did such a horrible thing? More than likely, no. Joe is probably more concerned that he has another detention coming, which means another note to his parents, and possibly even suspension. So, he’s got one long-shot tactic to try. He’ll do his best to make the hall monitor believe she didn’t really see what she thought she saw. The hallway was crowded. Maybe it was someone else. Maybe it was just an “accident.” If he acts surprised, innocent, and righteously indignant enough, maybe, just maybe, she’ll begin to doubt herself. He hopes that unlike him, she might be just neurotic enough of a personality (i.e., has an overactive conscience and excessive sense of guilt or shame) to think she might have misjudged the situation, maybe she’ll even berate herself for jumping to conclusions or for causing a possibly innocent party emotional pain. This tactic may have worked before. Maybe it will work again.

This preceding example is based on a real case. It is noteworthy that when “Joe” realized that he simply couldn’t manipulate the hall monitor, he reluctantly stopped denying, saying: “Well, maybe I did do it but she had it coming because she’s always talking bad about me.” Now, we could engage in some discussion about the other tactics Joe is using to continue the game of manipulation and impression management, but the most important thing to recognize is that unlike what happens in the case of real psychological denial as a defense mechanism, in Joe’s case we don’t see an outpouring of anguish and grief when the denial ends. The reason is simple. Joe was never “in denial” (the psychological state) per se. He was simply lying, and he eventually stopped lying because it wasn’t getting him anywhere. He moved on from lying to excuse-making and playing the victim, which are also effective tactics of manipulation and impression-management.

I can’t stress enough that the “denial” of the unfortunate elderly woman mentioned above is nothing like the “denial” of Joe the school bully. One is a defense mechanism, the other a manipulation and responsibility avoidance tactic. One is an unconscious mechanism of protection from deep emotional pain; the other is a deliberate, calculated lie. Yet many use the same term to describe these very different behaviors. It is distressing to me how often even mental health professionals presume that there is only one type of denial and how often they assume that whenever denial is involved that it’s of the defense mechanism variety. I often hear them speak of clients who are still “in denial” about one problem behavior or another when what they’re really describing is a client who is still “lying and manipulating” as part of the game of impression management and responsibility-resistance. Again, “denial” is one of the most misused terms in mental health.