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The list of books available on PEP Web is sorted alphabetically, with the exception of Freud’s Collected Works, Glossaries, and Dictionaries. You can find this list in the Books Section.

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Hoffer, A. (1987). Denial and Defense in the Therapeutic Situation: By Theodore L. Dorpat, M.D. New York/London: Jason Aronson, Inc., 1985. 293 pp.. Psychoanal Q., 56:570-573.

(1987). Psychoanalytic Quarterly, 56:570-573

Denial and Defense in the Therapeutic Situation: By Theodore L. Dorpat, M.D. New York/London: Jason Aronson, Inc., 1985. 293 pp.

Review by:
Axel Hoffer

Dorpat proposes that denial, not primal repression or splitting, is the basic, primordial defense. He provides, in ten chapters, a comprehensive review not only of the psychoanalytic and psychiatric literature on denial, but also of the work of cognitive psychologists relevant to his thesis. Making use of analytic illustrations, he builds up a cognitive arrest theory of denial and defense, after which he proceeds, in the next four chapters, to examine the importance of defense in interpersonal communication. He asserts that the analyst's disavowal of the reality of his interventions in the "here and now" in the analytic encounter can lead to unwitting collusion. Emphasizing denial in projective identification, Dorpat describes the working through of denial as including the interpersonal dimension of the "internalization of patient-analyst interactions" (p. 245). The last two chapters examine denial and memory pathology in relation to brain function from the perspective of cognitive psychology and neurology. The phenomenon of anosognosia is explained in terms of both psychodynamic and neurophysiological hypotheses.

Dorpat bases his unifying theory of denial and defense on a broad definition of denial as "the unconscious repudiation of some or all of the meanings of an event to allay anxiety or other unpleasurable affects" (p. 2). Apparently preferring (as did Strachey) the term "disavowal" (Verleugnung), Dorpat focuses on denial as a psychic mechanism, reminding us that when patients talk of expelling, rejecting, splitting, casting out, they are speaking metaphorically.

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