Denial: Is it Always Pathological?

First appeared in Huffington Post

Denial is a word that people in recovery use often. It refers to an addict denying his own increasing use and abuse and its affect on his life and the lives of those around him, or an enabler denying the progression and impact of an addict’s escalating addiction.

But is denial always pathological? Are there some times in which denial serves us, or helps us, at least temporarily, to cope with a situation that seems to be more than we are ready to face? Can denial also be in service of preserving our sense of self, our stability, and ability to cope without falling apart? In other words, is the pathological denial that we talk about in recovery a distortion of a natural, human trait?

Q. When does denial become pathological?

  • When it’s a rewrite of reality that is far enough from the truth that it makes us live a dishonest life on the inside or the outside.
  • When it forces others to join with us in living our lie.
  • When it alters reality to such an extent that we lose touch with “normal”.
  • When it alters reality to such an extent that it makes others feel crazy.

In this article we’re going to look at the difference between denial that seeks to rewrite reality and emotional numbness that is a natural outgrowth of psychological or emotional trauma.

Unconscious and Conscious Denial

The most unconscious form of denial is when we block our awareness to such an extent that we don’t even take in something that’s happening. On September 11, for example, Susan called her boss over to witness what she was seeing from her window at work in New York City, as the second plane flew straight into the second building and destroyed it. Her boss, who was standing right next to her, insisted that it was an optical illusion. He simply could not take in the reality of the situation. This kind of denial makes the people around it feel like banging the side of their head against the heel of their hand. They are essentially being told that what they are seeing right in front of them doesn’t exist. It’s crazy-making. It makes us doubt our sense of “normal” and question what we see in front of our eyes, or feel in our guts to be true.

A more conscious form of denial is a distortion of reality in which we “rewrite” situations or behaviors that we find disturbing or don’t want to deal with. For example, the alcoholic in our life isn’t drunk again, she simply has the flu; she is overworked, overstressed, or overanxious and just trying to relax. What’s the big deal? We use a sort of twisted reasoning to make someone’s behavior more palatable or manageable than it feels. We don’t want to connect the addict’s increasing unmanageability, or our own chronic anxiety, to living with substance abuse or process addictions. This kind of denial is complicated. It requires constant upkeep, because a lot of little things that relate to what we’re denying keep cropping up in front of us, and we need to keep rewriting as we go. Again, it’s crazy-making. It makes us doubt our sense of “normal” and question what we see in front of our eyes or feel in our guts to be true.

When Does Denial Become a Quality of Character?

An unfortunate feature of both of these types of denial, conscious and unconscious, is that they do not necessarily disappear when the addict either sobers up or leaves the picture. When spouses, for example, spend years saying that there is no pink elephant in the middle of the living room, they all too often, come to believe it themselves. Their habit of rewriting their gnawing and ever-growing awareness that addiction is subsuming their once manageable lives gets generalized into rewriting any aspect of life that bothers them. Or threatens their sense of who they are. Or who they need to think they are, in order to feel safe. Or secure. Or not as insecure. Or superior. Or not as inferior. Or whatever.

These types of denial distort reality. And they put family members in a terrible bind: they feel both hurt and envious, jealous because the denier seems to have such an easy time keeping her anxiety at bay and hurt because her sense of the truth is being insulted and, well….denied. Children, in their desperation to belong and assuage their anxiety, may wind up joining their parent in their distortion of reality, in order to remain close to them. At some level they know that they risk losing their parent’s approval and love by callings things as they see them. This kind of denial becomes a subtle force that divides families.

Emotional Numbness Related to Loss

But when is denial not so bad? After all, we know that we could die at any moment, right? No one has an ability not to die. But we do sort of deny that ever-present fact as we wander through our lives moment by moment, because we need to do things like plan for a future or an IRA. There is, of course, always the possibility that that future might not come, but we keep that awareness at bay. And we deny, at least to some extent, that those we love could be taken from us in an instant, because being aware of that all the time could just be too overwhelming and immobilizing to deal with.

What about the death of a loved one? Is it denial that carries us through the first months when we still feel that the person who died isn’t really gone? Is it spirituality and a sense of contact with a world beyond what we see? Or is it emotional numbness, a natural reaction to trauma and a first stage of grief and loss? The stages of loss, according to Jonathon Bowlby, British psychoanalyst, are: numbness; yearning and searching; disorganization; anger; despair; and reorganization.

Numbness is a natural, human response to extreme, emotional shock. We see this in its most extreme form in some WWll concentration camp victims, who became so pervasively numb that in certain cases, it grew into a quality of personality that lasted a lifetime. We see this in lesser forms in the loss of loved ones, whether to death, divorce, or addiction. This kind of numbness is not the same as denial, as it does not involve a distortion of reality. It is a coping mechanism built into our human nature. It may contribute to a pathological form of denial if loss is not eventually accepted, but this numbness is in service of our survival. It can give us a chance to work through our overwhelming sense of grief toward accepting a loss and reorganizing our lives. This kind of numbness is also something we see in recovery as we work through the stages of grief associated with addiction and develop a new sense of self and life without the substance, addict, or behavior in the driver’s seat.

The Perfect Storm

Is there a perfect storm, a confluence of responses to trauma that can contribute to pathological denial? Living with addiction is a traumatizing experience. We freeze like deer in the headlights, frightened or even terrified as a family member regularly morphs between a kindly Dr. Hyde into a monstrous Dr. Jekyll. And does this trauma send us into a kind of emotional and psychological shutdown that mimics denial, or in some way contributes to it?

A salient feature of trauma is that the prefrontal cortex temporarily shuts down when we’re traumatized. In this state, we are not able to do our best thinking. However, our limbic system, where we process emotions and brace for fight or flight goes into high alert, so we’re feeling a lot and thinking a little. Hence, there is a sort of perfect storm. We are experiencing strong and disturbing feelings that we wish to explain to ourselves, but our capacity to think is undermined because we’re in a high-stress, fear-based state. So we grab at what feels soothing and assuages our ever-growing anxiety that our lives may be spinning out of control. These forms of denial generally stay fairly unconscious unless, through some process of therapy and recovery, they become translated into words and elevated to a conscious level where they can be shared, talked over, thought about, and reflected upon.

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