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Groesbeck, C.J. (1988). Denial and Defense in the Therapeutic Situation: Theodore L. Dorpat, M.D., Jason Aronson, New York, 1985, 293 pp., $30.00.. J. Amer. Acad. Psychoanal., 16(2):239-242.

(1988). Journal of American Academy of Psychoanalysis, 16(2):239-242

Denial and Defense in the Therapeutic Situation: Theodore L. Dorpat, M.D., Jason Aronson, New York, 1985, 293 pp., $30.00.

Review by:
C. Jess Groesbeck, M.D.

This book is an attempt, in psychoanalysis, to integrate a comprehensive clinic theory of denial and defense. Denial and Defense in the Therapeutic Situation develops around the most primitive kinds of defenses and elaborates on them in connection with psychoanalytic theory. Dr. Dorpat argues that denial, not primal repression or splitting, is the basic defense. This is the most significant, central contribution and rationale of the book. The basic method has been clinical and the author develops a “cognitive arrest theory of denial,” the major hypothesis being that denial brings about an arrest of cognition regarding something disturbing to the subject. In that arrest, the individual interrupts normal thought processes, i.e., of thought formation, and this prevents the construction of realistic verbal representations of the complex being denied.

There then follows the individual's need to develop a cover story or screen concept to conceal the deficit of the cognitive arrest.

It is felt that denial is the basic aspect of all defensive activity and is central to understand any clinical psychoanalytic process.

The author then hypothesizes that Freud was mistaken in stating that repression was the primary defense. Denial is the most essential and basic factor. Freud and others had the mistaken notion that ideas and percepts are first admitted to consciousness and are then expelled, like a container. He demonstrates the contrary to that, that at a presymbolic or free linguistic level, the denier aborts the cognitive process per se in transforming embryonic forms to verbal thought.

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