Denial is an unconscious river in Egypt.
Old joke! Daddy joke! Apologies. I couldn't come up with anything better this morning.
My name is Sam Vaknin. I'm the author of Malignant Self-Love, Narcissism Revisited, a professor of clinical psychology.
And today we are going to discuss denial and what it does to you.
And what's a connection between denial, repression, dissociation, and delusion, this family of counterfactual reality rejecting psychological mechanisms.
Let's start with denial.
If you deny a problem, if you deny that a problem exists, if you deny that you are the one who is having the problem, you will never solve it.
If you deny that you're ill, if you deny that you're addicted, you will never heal. If you deny your role and contribution in your predicament, you will never move on.
And even more so, you will never feel safe, because as long as you deny your involvement and your responsibility, it will happen again. And again and again.
There's no learning with denial.
Denial and learning are antonyms.
If you deny betrayal, if you deny abuse, if you deny infidelity, you will perpetuate your own maltreatment and exploitation.
When you are abused, you need to admit it. When you are betrayed, you need to admit it. When you are cheated on, you need to take action.
Denial is at the root of all failure. Denial is at the root of stunted development, of arrested growth. Denial prevents you from becoming self-efficacious, from having your back, from acting as your own best friend.
Denial is the thing, the psychological mechanism that separates you from success.
And so today I want to focus on denial and compare it to other psychological mechanisms and psychological defenses whose role is to reject reality.
Denial, repression, dissociation and delusion and fantasy.
They come into play when reality is perceived as intolerable, unbearable, unacceptable, unacceptable and hopeless.
And so these psychological defense mechanisms are closely associated with mental states such as depression and anxiety. They're forms of psychopathologies.
Let's start with denial.
Denial is a defense mechanism in which unpleasant thoughts, feelings, wishes, or even events are ignored. They're ignored and this way they're excluded from conscious awareness.
Now that's the major difference between denial and repression. Repression is about forgetting, completely forgetting everything that has happened. The same applies to dissociation.
Denial is about denying. It's about being aware that something has happened or being aware that something is happening and then denying it, negating it, disagreeing with it, reframing it.
So denial is a conscious activity, whereas repression, dissociation are unconscious activities.
There have been scholars who suggested that denial comes into play when repression fails and that denial is involved at the tail end of the process of repression when repression becomes impossible.
When reality pushes back, when reality provides you with too much data to process, when there's too much information out there that you cannot ignore, that you cannot reframe, that you cannot deceive yourself, or you cannot lie about, then repression fails and you need to engage with denial.
So when you refuse to acknowledge the reality of your terminal illness you're denying because you're aware that you're ill, you're even aware that your illness is terminal. But you're denying it.
When you're having financial problems and you keep splurging and you keep spending as if there is no tomorrow, that's a form of denial. You're aware of your financial problems. And yet you keep pretending that they don't exist.
Substance abuse, addictions, involve denial. If you talk to an alcoholic or a drug addict, a junkie, they would tell you, I'm not an addict. I fully control the substance. I can stop it any minute. I'm in charge. I decide how much I consume. You see, the other day I did not touch the bottle.
This is a form of denial.
Similarly, when your partner is cheating on you, when there's infidelity, and you pretend that nothing is happening despite a preponderance of evidence, that's a form of denial.
Denial is a pairing, a combination of conscious awareness of unpalatable, unacceptable facts, and then an unconscious process that rejects these facts, that functions in order to resolve an emotional conflict or to reduce anxiety.
And that is why the clinical term for denial is actually disavowal.
When do we engage in denial? When is denial automatically activated?
Number one, when we are faced with negative affects, negative emotions, shame, fear, catastrophizing, a sensation of threat, looming threat, a menace, anger, envy, unpleasantness.
In all these affective states, in all these emotional states, denial plays a role.
If we are ashamed, we would deny the source of the shame or the confluence of events that gave rise to the shame.
If we are afraid of something, we would pretend to not be afraid. We would create an alternative scenario where we are the ones to prevail.
If we are angry, we would write a narrative or construct a narrative where the anger is actually either justified and constructive or it's not anger it's tough love or something else.
Envy and unpleasantness they are all written away, erased via the mechanism of denial. Denial is a major way to cope with emotions which are potentially overwhelming.
They are never pleasant and they threaten the composure of the individual involved.
And this leads to the next situation known as dissonance.
Whenever we experience dissonance, we engage in denial.
A dissonance occurs when we want to do something very much. We have a drive, we have an urge, to do something, and yet it is considered socially reprehensible or even dangerous, something criminal, something illegal.
So when there's this conflict between our deepest wishes, our deepest drives and urges, and the consequences of our actions, should we gratify these urges, then we have a dissonance.
Freud called it the conflict between id and ego.
So denial is a way to resolve this dissonance. We deny the drive. We deny the wish. We deny the urge. Or we deny that what we are about to do is socially unacceptable, frowned upon, not normative and maybe even criminal.
Another example of dissonance is when new data, new information, conflicts with older information.
When we have two sets of data which are mutually exclusive, totally incompatible. This creates anxiety and dissonance.
And one way to cope with this is denial, via denial. We deny one of the sets of data. We deny the old data or we deny the new data.
Another example. When we hold two beliefs that are contradictory.
For example, the belief that you should not kill anyone, thou shalt not kill, and the belief that you have to kill your enemy.
This creates dissonance and one of the ways to cope with this dissonance is denial.
Egodystony is a state where you feel uncomfortable with yourself, you feel uncomfortable in your own skin, you feel that something is wrong, something is all right, something doesn't fit, that something is wrong, something is alright, something doesn't fit together, something is off-key.
You feel that you're not fully yourself, you feel strange, that's a clinical term.
So ego dystony is a discrepancy with your own self-concept.
For example, if you have a self-concept as a good person and then you do something bad, something evil, you would experience egodystony.
You see yourself as a good person, yet what we've just done is done only by bad people. So this creates ego distonyDenial is a way to cope with egodystony. You deny that what you have done is bad or evil or wicked. You find reasons to justify what you have done. You reframe what you have done or you deny altogether that you have done anything at all.
Denial and egodystony.
And finally, when you have memories, memories which are very difficult, memories which are traumatic, memories which conflict with your self-image, with other memories, with the way you perceive other people, events, your personal history, institutions, etc.
When there's a conflict generated by memories, then you deny.
And in this case, denial is largely an unconscious process, which begins to resemble repression.
When we have memories which we cannot live with, memories which discombobulate us, memories which destabilize us, disorient us, hurtful memories, threatening memories.
What we do then, we repress them.
Repression is unconscious denial.
In repression, the memories are simply forgotten. They're sliced off, they're erased, they are deleted.
And in this sense, repression is very reminiscent of dissociation. We'll discuss dissociation in a bit.
Repression in classical psychoanalytic theory and in all other forms of depth psychology is a basic defense mechanism.
In repression, we exclude painful experiences and unacceptable impulses from consciousness.
We want to do something. We have an impulse to do it. We feel that we are about to lose control.
And yet we know that what we want to do is utterly unacceptable or even risky.
And so repression kicks in.
And the whole thing is submerged in the unconscious.
So the impulse disappears.
Similarly, when you have a painful traumatic experience, instead of remembering the experience, and by remembering re-experiencing, revisiting the experience, instead the memory is repressed, sliced off, forgotten.
Repression is not like denial. Denial is partly conscious.
When you deny that you're in financial trouble, you know that you're in financial trouble. You just pretend that you're not.
Repression, on the other hand, operates only on the unconscious level. It's a protection against anxiety, which is produced by all the aforementioned dissonances and conflicts, objectionable sexual wishes, feelings of hostility, ego-threatening experiences, discrepancies, traumatic memories, and so on.
In all these cases, everything will be drowned in the unconscious, buried there, behind lock and key.
Repression comes into play in many other forms of defenses, I mentioned. Denial is just the first stage in repression, or the last stage, actually, in repression.
In denial, individuals avoid unpleasant realities by first trying to repress them, and then when repression has failed, then negate them with denial.
So repression is stage one, denial is stage two, if and when repression had failed.
Repression is a complex process. It starts with primary repression.
In psychoanalytic theory, primary repression is the first phase of repression.
Ideas associated with instinctual wishes are screened out. They're prevented from becoming conscious. The content, the unconscious content is so threatening, so destabilizing that it is kept hidden and buried via the mechanism of repression.
Primary repression is a very primitive kind of defense mechanism.
In repression proper, the repressed material has been in the realm of consciousness and then has been repressed.
In primary repression, the repressed material has never visited the consciousness.
So let me explain the difference.
There are two types of repression, primary repression where the content is so anxiogenic, the content is so threatening, so dangerous, so counterintuitive, so frightening, so frightening, so frightening that it is automatically repressed. It never reaches consciousness.
And that is primary repression.
Proper repression is when the material, the content has rich consciousness, created a lot of anxiety, maybe even fear, unpleasantness, egodystony and dissonance, and then repression kicked in, sliced off the offensive content and eliminated it so that it's completely forgotten.
So this is repression.
Dissociation is also a defense mechanism. In dissociation, conflicting impulses are kept apart. Threatening ideas, risky feelings, unpleasantness, anxieties and so on are separated from the rest of the psyche. It's a form of compartmentalization, in effect.
Compartmentalization is a defense mechanism in which thoughts and feelings that seem to conflict or to be incompatible are isolated from each other in separate and apparently impermeable psychic compartments.
In classical psychoanalytic tradition, compartmentalization emerges in response to the fragmentation of the ego, which ideally should be able to tolerate ambiguity and ambivalence, but doesn't always succeed.
So dissociation is about keeping apart, keeping apart the two sides of a dissonance.
Repression is about burying, eliminating, erasing, uncomfortable, threatening content, unpleasant content.
Denial is about denying unpleasant content.
Dissociation, compartmentalization, and another mechanism known as isolation, these mechanisms separate the two sides of the dissonance.
If you have impulse number one and impulse number two, and they conflict, dissociation will keep them apart.
If you have two beliefs that conflict, dissociation will keep these beliefs apart.
If you have values that conflict, cognitions that conflict, emotions that conflict, dissociation comes to the rescue and keeps them apart.
Isolation in psychoanalytic theory is a defense mechanism and it relies on keeping unwelcome thoughts and feelings from forming associative links with other thoughts and feelings.
And so the unwelcome thought is rarely activated.
You can see there's a whole iceberg, there's a whole family of defense mechanisms intended to isolate you, to protect you from any contact with mental content, psychological content, that can somehow disturb or disrupt your equilibrium, your ability to function.
In the most extreme case, we have delusion.
When repression fails, we have denial.
When denial fails, we have dissociation.
Dissociation involves compartmentalization and isolation.
But sometimes even dissociation fails.
In this case, the ego, the reality principle, our interface with reality, reality testing, completely crumbles.
At that point, there's no protection. There's no protection from input from reality which could be painful, could be hurtful, could be damaging, could be threatening.
And so the last resort is actually delusion and fantasy.
Delusion and fantasy are one step removed from psychotic defenses such as pathological narcissism.
So we have delusions, fantasies, we have compensatory fantasies which are essentially psychotic. These are common in borderline personality disorder, narcissistic personality disorder.
And if this fails, we have hyper-reflectivity, which is also known as psychosis.
This is the sequence.
Delusion is a highly personal belief or a highly personal idea, a highly personal narrative, a theory about the world and about oneself.
And this theory is not common, it's very eccentric. It is not endorsed by any culture or subculture. It is maintained with conviction in spite of irrationality or evidence to the contrary.
Delusions are very often transient and fragmentary. There is a condition known as delirium.
But sometimes when there is a consistent failure of all other defense mechanisms, the ones that I've mentioned, in this case, the delusion becomes highly systematic and elaborate, becomes a narrative.
In delusional disorders, we have a situation where instead of denial, instead of repression, instead of dissociation, instead of all these mechanisms, there is simply an outright rejection of reality in its totality, and the construction of an alternative reality, a paracosm, a virtual reality, a delusion.
So we could have all kinds of delusions, depending on the trigger, depending which content is intolerable, unpleasant, unbearable, threatening, depending on the locus of the content and the type of the content, the responsive or the reactive delusion emerges.
So we could have delusional jealousy, delusions of being controlled from the outside, the external locus of control, delusions of being controlled from the outside, the external locus of control, delusions of grandeur, grandiosity, delusions of persecution, persecutory delusions, delusions of reference, referential ideation, nihilistic delusions, and somatic delusions, and you name it.
Delusions are not primarily logical errors. They are emotional.
That's why if you argue with someone who is delusional, you're going to get nowhere. You will get nowhere.
Because delusion is not founded on some cerebral systematic hypothesis or theory. It's not the equivalent of a theory in physics.
Delusion is a desperate, desperate attempt to hold back content which could overwhelm the individual and destroy the individual. So it is a last line of defense.
The emotional investment in the delusion, the cathexis in the delusion, is therefore immense because the delusion is perceived as a precondition for survival. It's the delusion or death.
And so of course the individual defends the delusion with all his or her might.
If you try to challenge a delusion, you're perceived as an enemy, because you are threatening the delusional individual's potential possibility, capacity to survive.
Delusions are very important factors in systems for diagnostic classification.
Some researchers believe that delusions may be the most important symptom, even in schizophrenia.
And we are beginning to realize the centrality of delusions and their role.
As the environment becomes more and more dystopian, problematic, harsh, threatening, adversive, adversarial, and adverse, the world we live in, then people become more and more prone to delusions.
Hence, the proliferation of conspiracy theories, for example, which are forms of delusion.
Fantasy in psychoanalytic theories is a figment of the imagination, a mental image, a dream or a daydream.
Persons conscious or unconscious wishes and impulses are fulfilled in some fantasies. This is called a wish fulfillment fantasy.
But fantasies can get out of control, out of hand. They could become delusional fantasies.
Fantasy is the ultimate stage.
When even delusions fail, the individual retreats completely from reality, gives up on reality, creates a bubble, creates a universe, and emigrates, mentally emigrates to this universe, never to be seen again.
This is what the narcissist does. Narcissists create fantasies and then inhabit these fantasies to the exclusion of all of reality.
Fantasy is the last stage before psychosis, and that is why scholars such as Otto Kernberg had suggested that fantasy-prone individuals such as narcissists and borderlines are actually pseudo-psychotic, on the border between neurosis and psychosis.
Fantasies are all pervasive. They're all permeating. They're all encompassing. They're all engulfing. They're all engrossing. They're all all-engrossing experiences.
Whereas delusions are highly specific.
An individual could be delusional about something and totally rational about many other things. An individual can deny something and not deny many other things, accept many other things. An individual can repress some material or content and yet maintain full access to other material and content.
But this is impossible in fantasy.
Fantasy is a full substitute to reality.
If you're embedded in fantasy, you have no access to reality. You have no reality testing.
The impairment in reality testing is total.
The fantasy has its own rules, its own progression, its own evolution, its own underlying narrative, its own raison d'etre, its own progression its own evolution its own underlying narrative its own reason d'etre its own motivations its own cognitions its own emotions it is totally self-sufficient self-contained and in this sense solipsistic.
So the fantasy is the equivalent of saying goodbye to reality. It's like saying, listen, reality. You cause me too much anxiety. I don't like you. You're unbearable. You're intolerable. Reality, I hate you. You are threatening. You are. I don't know. I tried to deny you, but I failed. I tried to repress you, but I failed. I tried to dissociate, but I did not succeed fully. I tried even to become deluded. I tried to deceive myself via delusions, and that didn't work.
So I'm saying goodbye to you, reality, and I'm moving, I'm relocating to fantasy. My new homeland is fantasy andwithin the fantasy, I can fulfill my wishes. I can eliminate threats because in the fantasy, I'm godlike. It is my own creation. I control every parameter.
Fantasy is about control, of course. All these mechanisms are about control, self-control, and control of the environment.
Where control fails, where these mechanisms are proven inefficacious, the only thing that's left is the design of an alternative environment where control is maintained, delusionally, but is still perceived as efficacious. And that is a good definition, actually, of fantasy.
Fantasy evolves. It has a life of its own. It's all-consuming, it metastasizes, it invades all mental functions, cognitive, affective, you name it.
Sooner or later, the individual dissipates, dissolves into the fantasy, becomes the fantasy.
And then once this happens, this is the onset of psychosis. If fantasy is not reined in somehow, if fantasy is not limited via conflict with reality or contact with reality, if fantasy is not harnessed via interpersonal relationships, then this kind of individual becomes more and more increasingly more delusional to the point of completely losing touch with reality and confusing one's internal world with the external world.
At that point, psychosis is the new clinical entity that emerges.