Denial is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.  The subject may use:
- simple denial - deny the reality of the unpleasant fact altogether
- minimisation - admit the fact but deny its seriousness (a combination of denial and rationalisation)
- projection - admit both the fact and seriousness but deny responsibility.
The concept of denial is particularly important to the study of addiction. The theory of denial was first researched seriously by Anna Freud. She classified denial as a mechanism of the immature mind, because it conflicts with the ability to learn from and cope with reality. Where denial occurs in mature minds, it is most often associated with death, dying and rape. More recent research has significantly expanded the scope and utility of the concept. Elisabeth Kübler-Ross used denial as the first of five stages in the psychology of a dying patient, and the idea has been extended to include the reactions of survivors to news of a death. Thus, when parents are informed of the death of a child, their first reaction is often of the form, "No! You must have the wrong house, you can't mean our child!"
Unlike some other defense mechanisms postulated by psychoanalytic theory (for instance, repression), the general existence of denial is fairly easy to verify, even for non-specialists. On the other hand, denial is one of the most controversial defense mechanisms, since it can be easily used to create unfalsifiable theories: anything the subject says or does that appears to disprove the interpreter's theory is explained, not as evidence that the interpreter's theory is wrong, but as the subject's being "in denial". However, researchers note that in some cases of corroborated child sexual abuse, the victims sometimes make a series of partial confessions and recantations as they struggle with their own denial and the denial of abusers or family members.
The concept of denial is important in twelve-step programs, where the abandonment or reversal of denial forms the basis of the first, fourth, fifth, eighth and tenth steps. The ability to deny or minimize is an essential part of what enables an addict to continue his or her behavior despite evidence that - to an outsider - appears overwhelming. This is cited as one of the reasons that compulsion is seldom effective in treating addiction — the habit of denial remains.
Understanding and avoiding denial is also important in the treatment of various diseases. The American Heart Association cites denial as a principal reason that treatment of a heart attack is delayed. Because the symptoms are so varied, and often have other potential explanations, the opportunity exists for the patient to deny the emergency, often with fatal consequences. It is common for patients to delay mammograms or other tests because of a fear of cancer, even though this is clearly maladaptive. It is the responsibility of the care team, and of the nursing staff in particular, to train at-risk patients to avoid such behavior.
Types of Denial
Denial of fact
In this form of denial, someone avoids a fact by lying. This lying can take the form of an outright falsehood (commission), leaving out certain details to tailor a story (omission), or by falsely agreeing to something (assent, also referred to as "yessing" behavior). Someone who is in denial of fact is typically using lies to avoid facts they think may be painful to themselves or others.
Denial of responsibility
This form of denial involves avoiding personal responsibility by:
- blaming - a direct statement shifting culpability and may overlap with denial of fact
- minimizing - an attempt to make the effects or results of an action appear to be less harmful than they may actually be, or
- justifying - when someone takes a choice and attempts to make that choice look okay due to their perception of what is "right" in a situation.
Someone using denial of responsibility is usually attempting to avoid potential harm or pain by shifting attention away from themselves.
- Troy breaks up with his girlfriend because he is unable to control his anger, and then blames her for everything that ever happened.
Denial of impact
Denial of impact involves a person's avoiding thinking about or understanding the harms his or her behavior has caused to self or others, i.e. denial of the consequences. Doing this enables that person to avoid feeling a sense of guilt and it can prevent him or her from developing remorse or empathy for others. Denial of impact reduces or eliminates a sense of pain or harm from poor decisions.
Denial of awareness
This type of denial is best discussed by looking at the concept of state dependent learning. People using this type of denial will avoid pain and harm by stating they were in a different state of awareness (such as alcohol or drug intoxication or on occasion mental health related). This type of denial often overlaps with denial of responsibility.
Denial of cycle
Many who use this type of denial will say things such as, "it just happened." Denial of cycle is where a person avoids looking at their decisions leading up to an event or does not consider their pattern of decision making and how harmful behavior is repeated. The pain and harm being avoided by this type of denial is more of the effort needed to change the focus from a singular event to looking at preceding events. It can also serve as a way to blame or justify behavior (see above).
Denial of denial
This can be a difficult concept for many people to identify with in themselves, but is a major barrier to changing hurtful behaviors. Denial of denial involves thoughts, actions and behaviors which bolster confidence that nothing needs to be changed in one's personal behavior. This form of denial typically overlaps with all of the other forms of denial, but involves more self-delusion.
Harassment covers a wide range of offensive behaviour. It is commonly understood as behaviour intended to disturb or upset. In the legal sense, it is behaviour which is found threatening or disturbing.
DARVO is an acronym to describe a common strategy of abusers: Deny the abuse, then Attack the victim for attempting to make them accountable for their offense, thereby Reversing Victim and Offender.
"...I have observed that actual abusers threaten, bully and make a nightmare for anyone who holds them accountable or asks them to change their abusive behavior. This attack, intended to chill and terrify, typically includes threats of law suits, overt and covert attacks on the whistle-blower's credibility, and so on. The attack will often take the form of focusing on ridiculing the person who attempts to hold the offender accountable. [...] [T]he offender rapidly creates the impression that the abuser is the wronged one, while the victim or concerned observer is the offender. Figure and ground are completely reversed. [...] The offender is on the offense and the person attempting to hold the offender accountable is put on the defense."