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Dorpat, T.L. (1983). Denial, Defect, Symptom Formation—and Construction. Psychoanal. Inq., 3(2):223-253.

(1983). Psychoanalytic Inquiry, 3(2):223-253

Denial, Defect, Symptom Formation—and Construction

Theo. L. Dorpat, M.D.

The purpose of this paper is to demonstrate the relationships between denial, psychological defects, and symptom formation. In the psychoanalytic and psychiatric literature the term denial has been used in the narrow sense to refer to a unitary defense mechanism and in a broad sense to refer to a unifying concept of different defenses (Weisman, 1972). In this paper I shall use the word denial in the broad sense to refer to the unconscious repudiation of some or all of the total available meanings of an event to allay anxiety or other unpleasurable condition. “Denial” covers situations in which individuals in words, act, or fantasies attempt to avoid painful reality. Denial is the reality-repudiating aspect of what defenses do. This point of view is congruent with the concept that denial is a basic substrate of all defensive reactions (Fine et al., 1969).

Many clinicians limit the concept of denial to cases of explicit verbal negation, apparently unaware that the denial may be implicit as well as explicit and that implicit denial occurs far more frequently than does the relatively primitive defensive action of explicit denial.

In an earlier paper (1983) I postulated that denial involves a cognitive arrest.

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