Does 'denial' really cover our everyday experiences in clinical oncology? A critical view from a psychoanalytic perspective on the use of 'denial'.

The concept of 'denial' emanates from psychoanalytic psychology. Within this framework it is regarded as a primitive defence mechanism related to personality disorder. The concept has been adopted by coping research but invested with quite other implications. Different researchers operationalize 'denial' in different ways which contributes to this confusion. This paper views 'denial' from the different perspectives of psychoanalysis and coping research and, based on a previous qualitative study, it proposes a reconceptualization which distinguishes between three different processes: 'avoidance', 'disavowal' and 'denial'. 'Disavowal', self-deception in the face of accurate perception, is, more than 'denial', regarded as the appropriate concept covering everyday experiences of patients dealing mentally with their strain.