Denial refers to both the complete lack of awareness of a distressing thought, emotion, or memory and avoidant processes aimed at reducing awareness of threatening content. Denial processes may occur consciously, as in the case of intentional suppression, or nonconsciously and automatically, as in the case of emotional dissociation or repression. Contemporary views have emphasized variations in the timing and the focus and scope of attention (e.g., a fleeting experience of threat followed by an attentional shift to more benign contents).
Traditional conceptualizations of repression assume only maladaptive health consequences. This view assumes that repressed thoughts and memories push for indirect symbolic representation in the form of somatic symptoms, and that only conscious awareness of the repressed contents can alleviate these symptoms.
More recent conceptualizations have emphasized the costs and benefits of denial-like processes as well as their variability across time, situation, and ethnicity. Much of this work has centered on individual differences. One group of individuals, identified by either questionnaire or behavioral measures as repressive copers, exhibits an unusual ability to avoid or reduce conscious awareness of threatening content. Repressors also exhibit impoverished recall for negative emotional events.
In threatening laboratory situations, repressors show elevated stress responding in autonomic and hormonal indicators. However, repressors appear to cope unusually well with acute real-life stressors (e.g., the death of a spouse or sexual abuse). During bereavement, repressors evidenced a short-term somatic cost (initial elevations in arousal and somatic complaints) but also a long-term advantage (reduced grief and return to normal levels of somatic symptoms).
A related personality dimension known as self-enhancement is characterized by self-deception and an overly positive or self-serving bias. Self-enhancement is associated with increased self-esteem but also social liabilities, such as narcissism. Self-enhancers are viewed favorably in initial social contacts but less favorably over time. However, self-enhancers are also rated favorably by long-term close friends and report broader social networks. Like repressors, self-enhancers have also been found to cope extremely well with acute stressors.
The relatively automatic and nonconscious nature of repressive coping and self-enhancement are contrasted by more deliberate, conscious denial processes, such as suppression. Laboratory studies have emphasized the maladaptive nature of deliberate suppression. The suppression of specified thoughts has been shown to increase cognitive processing of those thoughts and to lead to form of rumination. Similarly, deliberate emotional suppression in the context of threatening stimuli has been shown to increase autonomic responding. Complimentarily, a large number of studies have demonstrated health benefits, such as decreased medical visits and improved immunocompetence, following the anonymous written expression of traumatic or emotionally distressing events.
It is important to note, however, that disclosure and suppression are not necessarily ends of the same continuum. Recent studies have again pointed to important variability across situations as well as age and ethnicity. For instance, expressing emotion predicts a worse outcome to bereavement, and among older immigrant adults, emotional inhibition appeared to have salutary health consequences for Eastern European ethnic groups.
- Bonanno, G. A., Keltner, D., Holen, A., & Horowitz, M. J. (1995) . When avoiding unpleasant emotion might not be such a bad thing: Verbal-autonomic response dissociation and midlife conjugal bereavement. Journal of Personality and Social Psychology, 46, 975-989.
- Consedine, N., Magai, C., & Bonanno, G. A. (2002). Moderators of the emotion inhibition-health relationship: A review and research agenda. Review of General Psychology, 6, 204-238.
- Lazarus, R. S. (1985). The costs and benefits of denial. In A. Monat &C R. S. Lazarus (Eds.), Stress and coping (2nd ed., pp. 154-173). New York: Columbia University Press.
- Weinberger, D. A., Schwartz, G. E., & Davidson, R. J. (1979). Low-anxious and repressive coping styles: Psychometric patterns of behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369-380.
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