Denial Can Endanger Your Health

Everyone has psychological defenses. The defenses a mentally healthy uses again anxiety are not a problem. When stress hormones are released, we feel alarm. But our parasympathetic nervous system kicks in and down-regulates alarm to interest.

But a person who lacks the programming needed to down-regulate alarm uses psychological defenses that are a problem. The heavy-duty psychological defenses needed to obliterate anxiety distort reality.

When the parasympathetic system cannot bring alarm down to a tolerable level, psychological defenses step in to block awareness or to distort reality, or both. We see this in our leaders. When reality threatens their political success, our leaders attack reality. Their constant attack on reality has caused a pandemic of craziness.

It’s easy to think people who distort reality evil. Perhaps some are. But some distort reality in order to be protected from the effects of mild — or not so mild — mental illness. So, perhaps it is in our best interest to examine the mild — and the not so mild — mental illness going on these days.

You, like all of us, have psychological defenses that you, like all of us, are not aware of that distort reality. It is not a question of whether we distort reality. It is a question of how much, and if much, how dangerous is our distortion.

As a therapist, I have yet to meet anyone who is totally sane. The more unable a person is to regulate anxiety, the more they need to distort reality. What I propose is we use what is written here to examine how psychologically defended from reality we are, and how psychologically defended from reality the people are who we mistakenly regard as sane, and follow.

There are different levels of defense. Psychiatrist George Valliant, professor at the Harvard Medical School, classifies defenses into pathological, immature, neurotic, and mature in his paper titled “Ego Mechanisms of Defense and Personality Disorder”

Pathological Defenses

If grossly unable to regulate anxiety internally, the person must take a sledgehammer to external reality and to internal realities that are in conflict.

A person who uses pathological defenses appears irrational or insane to people who are not mental health professionals, unless they use the same defenses, and distort reality in a similar way.

• Denial of reality: refusal to accept reality because it is too threatening; or arguing against an anxiety-provoking stimulus by claiming it does not exist; or refusing to acknowledge unpleasant reality; example: escaping anxiety about COVID by claiming it is a hoax.
• Distortion of reality: gross alteration of reality according to one’s own needs to protect their highly vulnerable self-esteem.
• Conversion: conflict within the person becomes expressed as a physical symptom.
• Splitting: segregating internal realities that are in conflict so that only one of the conflicting realities is in awareness at any time thereby keeping internal conflict our of awareness.
• Concrete thinking: black-and-white (all good vs. all bad; safe vs dangerous) thinking avoids anxiety caused if unable to tolerate ambiguity.
• Devaluation: seeing others as inferior and unworthy (even as having no right to exist) while elevating one’s own self as superior and entitled.
• Denial with delusional projection: the belief that they are being persecuted by people who assert the reality they deny. Here is a recent example of denial combined with paranoid projection. On Monday, it was revealed that Bill Crews, one of Fauci’s aides ran an anti-Fauci web site and blog. The Daily Beast says Crews believed Fauci is part of an anti-Trump conspiracy and called Fauci an “attention-grubbing and media-whoring . . . mask nazi.” The Daily Beast quotes a Crews blog as stating “I think we’re at the point where it is safe to say that the entire Wuhan virus scare was nothing more or less than a massive fraud perpetrated upon the American people by ‘experts’ who were determined to fundamentally change the way the country lives and is organized and governed. If there were justice, we’d send and [sic] few dozen of these fascists to the gallows and gibbet their tarred bodies in chains until they fall apart.” Crews has resigned.

Immature Defenses

These defenses are characteristic of personality disorders in a social context. The person reduces anxiety using mental operations typical of a child whose caregiver is both intolerable and depended upon.

• Fantasy: retreat into fantasy as the solution to a conflict or use of a fantasied relation to alleviate loneliness.
• Projection: disowning feeling and attributing it to another person; example: “I hate him becomes he hates me.”
• Introjection: the reverse of projection; taking ownership of another person’s attributes
• Passive aggression: indirect expression of hostility.
• Acting out: behavior driving by emotion the person is unaware of.
• Projective identification: behaving in a way that causes another person to experience a disowned feeling or urge.
• Wishful thinking/magical thinking/illusion of control: avoiding anxiety through belief that superstition, magic, or religious faith will produce the desired outcome.
• Withdrawal: avoidance as a way to escape anxiety.

Neurotic Defenses

These defenses are less entrenched and can usually be recognized by the person if clearly pointed out.

• Intellectualization: distancing from the emotional factors when making a decision.
• Reaction formation: believing the opposite because what is true causes anxiety; covering up an attitude that is unacceptable by doing the opposite.
• Dissociation: disconnecting emotional interest.
• Displacement: redirecting aggressive behavior to a safer target.
• Somatization: like conversion, escaping anxiety by transforming it into a physical symptom.
• Repression: making desire unconscious.
• Obsessive control: having to be in control of every situation to avoid anxiety.
• Rationalization: toying with reality to come up with a desirable view of reality.

Mature Defenses

Unlike other defenses, mature defenses may be conscious and intentional ways to reduce anxiety; they may provide social benefits.

• Humor: sweetening unpleasant truths through witticism.
• Sublimation: like displacement, except healthier because the aggression is discharged acceptably, such as in sports.
• Suppression: consciously delaying gratification.
• Altruism: bringing pleasure to others for personal satisfaction.
• Anticipation: planned control of a situation to avoid anxiety.

Unconscious Operation Of Defenses

For a psychological defense to completely extinguish anxiety, it has to work unconsciously. Signal anxiety is experienced when we are worried something a defense is hiding will be revealed. If we go farther and become aware of what is hidden, the cat is out of the bag; our defense falls apart.

So defenses work in the background until someone, usually a therapist, is able to point out both the defense and the information defended against. Then, once aware of the defense and the information defended against, the defense is defeated, and we are aware of the information.

Generally, we are not happy about that. Once aware of something we wanted to remain blind to, we may have to deal with that information in a way we don’t like.

As I said at the beginning, we all have defenses. All defenses distort reality. The question, then, is whether the distortion is a big deal or not. For example, denial of COVID can cost a life, your life or the life of a person you interact with.

If a person has no ability to tolerate uncertainty, they can be driven to deny a life-threatening fact. They avoid intolerable anxiety by claiming the virus does not exist.