Is denial an element of bipolar disorder

Ned_led16

Hi there.
I am doing a project on psychology and law for my Degree.
Is denial an element of bipolar disorder?
On the on-line definition on Wikipedia it doesn't say it is.

I am writing my essay now and i was sure it was - any help would be great

If mODs have an issue with this post ill delete it.
Im not seeking medical advise for a real person! I am seeking advise
for a project, but if thats not allowed i will delete immediately as i dont want to upset the mods as boards is such a great tool for study and education.

http://www.bipolar-symptoms.info/the-bi-polar-disorder-sufferer-and-denial/
The above website says denial is a factor - but wiki does not.

Thanks

JuliusCaesar

There isn't necessarily agreement about what 'denial' is. I skimmed the Wiki, but couldn't see it. In my experience, I wouldn't have thought 'denial' is anything that springs to mind when I think about BPD.

busttropical

Are you asking if people with BPD deny that they have it? I guess some might because of the stigma around mental illness and all that, but ive read more about people who embrace it, and enjoy the hypomania especially..

Im in the middle of an essay on it myself by the way and I haven't come accross one paper that talks about denial, hope you're barking up the right tree here!

Ned_led16

I found this article are they wrong?

Frequently the bipolar disorder patient is in complete denial about the fact of his or her own bipolar symptoms and this is quite understandable. Who want to believe they have bi polar disorder or any other mental illness for that matter?
Inside of one’s own head it is not possible to be fully objective. Others can tell a person what they witness but convincing the bi polar disorder patient that he or she is indeed a sufferer is extremely difficult for a number of reasons. The extreme mood swings that mark bipolar symptoms, depression and euphoria are usually long established by the time friends and loved ones suggest that the bi polar disorder patient has this mental illness. Since the sufferer is used to this disturbing existence it becomes nearly impossible to accept that these mood swings are indeed symptomatic of bi polar disorder.
Also it is very difficult for most people to accept criticism of any sort, be it about their behaviour, appearance or intellectual ability. This is doubly so in the bi polar disorder patient who experiences anxiety and distressed at an increased level compared to people with bipolar symptoms. It is easy then to protect oneself from what is wrongly perceived as criticism by going into denial about bipolar symptoms.
Furthermore, many creative, artistic people tend to suffer from bi polar disorder. However it is during their manic episodes that they are at their most creative and this makes it unlikely that the artist or poet suffering from bi polar disorder will seek help for his or her illness. Many bi polar disorder patients in fact fear diagnosis in case medical treatment deters his or her creativity and intellect, a myth.
It is only when the bi polar disorder patient begins losing relationships and jeopardizing employment opportunities that acknowledgement of bipolar symptoms finally appear.

Odysseus

That above sounds ok to me, but a lot of people do not possess a significant insight into their illness, but with saying that I would not classify their denial as a core part of their illness. People with depression often do not have any strong insight into their symptoms, however I would see that as a core element/criteria for depression. Does that make sense?

The Black Oil

Out of interest, Odysseus, how do you know when someone has a strong insight into their mental illness?

Odysseus

Black Oil wrote: »

Out of interest, Odysseus, how do you know when someone has a strong insight into their mental illness?

Sorry it took so long to reply. Interesting question and when you look at it, it may seem like a basic question; however, I think it is a tad more complex. Insight is one of those terms that I really don't use in relation to my work, as it wouldn't be a psychoanalytic term. When posting here I try avoid using psychoanalytic concepts and tend to use more general psych language.

I was discussing this tonight with some students, does lack of insight equate denial? When I posted the above I suppose I was thinking about whether the client has some concept of their symptoms, in relation to bipolar I was thinking about whether the person can articulate what life is like for them when they are not well, if they even acknowledge they are ill. Do they possess an understanding of how their illness impacts on their lives? Are the able to identify when they start to become unwell? If the answers are postive to the above, the I would be thinking of how does their "insight" appear on an objective level. That would be the level I was thinking of when I posted the above?

I think in more severe cases you have to factor in when the person has the ability to identify the above on a functional basis, rather than just seeing it as lack of insight or denial.

What do you think yourself Black Oil?

krd

Ned_led16 wrote: »

Many bi polar disorder patients in fact fear diagnosis in case medical treatment deters his or her creativity and intellect, a myth.

I'm afraid it's not a myth. In the case of artists - the mania, and even the crushing lows, could be the source of their sparkle. Without the extraordinary experience, they may lose the ability to create extraordinary work. I suppose the drugs could have the effect of being like Botox for the mind.

Mania's can be exhilarating and productive. Depression's can be contemplative. Lars Von Trier's last two films. Antichrist, and Melancholia. Were the product of a depression he went through. They're both incredible works of art.

Art created by people on a more even keel tends to be mediocre - the artistic equivalent of vanilla scented toilet freshener. I mean I like the smell of vanilla, but all the time?

Now the medication for bi-polar may not have a negative effect for everyone, but I have seen people turned into tongue lolling, over-weight, dullards, on whatever it was they were on.

Sid_Justice

Black Oil wrote: »

Out of interest, Odysseus, how do you know when someone has a strong insight into their mental illness?

In my opinion it would in cases where the individual recognises and accepts they have a mental illness/condition/disorder. They recognise and understand characteristics of their illness and accept that certain treatments work or have the the potential to work.

Person who appears that they have good insight but don't
Hi my name is Sid I suffer from schizophrenia. I am really just lonely though and when I'm with friends the voices don't bother me. I take some tablets and they help me relax and feel less anxiety.

Person with good insight
Hi my name is Sid and I suffer from schizophrenia. I sometimes hear voices that tell me to do things but I know they're just hallucinations. But when I'm off my meds I can't really tell. I take tablets and they reduce the number and power of the auditory hallucinations.

The way I've painted the caricatures there makes one look like someone who is very compliant with medical treatment and dependent on medication and an other who isn't. I don't think that's true though.

krd

JuliusCaesar wrote: »

There isn't necessarily agreement about what 'denial' is. I skimmed the Wiki, but couldn't see it. In my experience, I wouldn't have thought 'denial' is anything that springs to mind when I think about BPD.

Denial, is very straightforward. Think of denial in the Kubler-Ross model.

A doctor tells a patient they have cancer, and they only have a few months to live. The patient loudly protests that they do not have cancer - even when the doctor has the x-rays and test results in front of them. The patient may even shout at the doctor, calling them a liar.

Denial is something that's really common. People will deal with a problem by convincing themselves they do not have a problem. They literally block it out of their minds.

Alcoholics will deny, and believe they're own denial, they have a drinking problem - interventions, where a group of family members and friends confront the alcoholic are often what it takes, to convince them.

Sid_Justice

I think that example depicts a person with denial as suffering severe delusions about reality. Denial can be a lot more subtle. For example a person who over eats may be convinced their obesity is due to a hormonal imbalance or a genetic predisposition and be in denial it's overeating and sedentary life style. They might have a lot of evidence to support their claim (articles from journals about the link of genuine links of obesity to pituitary or hypothalamic disorders).

Denial is also a normal defence mechanism to bad news or 'noxious' information.

irishh_bob

what about situations where people find themselves on the recieving end of psychological bullying and part of that bullying involves labelling the victim as having psychological problems , despite the fact that the bully has no professional qualifications and is only levelling theese accusations at thier victim as a means of inflicting distress and pain on thier target , if the then victims succumbs to depression and buys into the idea that they do indeed have mental problems , can theese false diagnosis result in someone contacting an actual condition and what was once made up , becoming real

krd

irishh_bob wrote: »

what about situations where people find themselves on the recieving end of psychological bullying and part of that bullying involves labelling the victim as having psychological problems , despite the fact that the bully has no professional qualifications and is only levelling theese accusations at thier victim as a means of inflicting distress and pain on thier target , if the then victims succumbs to depression and buys into the idea that they do indeed have mental problems , can theese false diagnosis result in someone contacting an actual condition and what was once made up , becoming real

There's a few things to that. I'm from rural Ireland. Anyone who doesn't fit in (Ie. if they're not ignorant, talk with a bockety accent, have a head that looks like a potato they're "cracked in the head").

Spreading rumours about someone being "cracked in de head" is a very common form of paddywhack bullying. I'll be honest, I hate the bockety people of rural Ireland. I hate it even more when they take their bocketiness to urban areas where I live and work.


A real problem about denial, is if you know it exists, how do you know you're not in denial. How do you know.

I believe...And this is nearly an unacceptable view - because it's so unpalatable. I believe, families, sometimes for one reason or another, will very deliberately drive a family member to despair and even suicide. I even have a suspicion that schizophrenia can be induced with enough torment.

A teenager might be in a family home. And they may be flying into rages, and then into periods of deep depression. The family may want to force the teenager into some form of treatment (get them doped up on medication) - the family will say the teenager is behaving crazily. But in reality, the rages may be a healthy response to the real infliction of torment and bullying. The family may be quite deliberately goading the teenager into rages and depressions. Then maybe, if the teenager's brain is constantly experiencing a roller coaster of extreme emotional experiences, maybe it will become dysfunctional and they will become genuinely bi-polar.

RD Laing, said something interesting about paranoia. We have a word for someone who believes they are being persecuted when they are not. But we don't have a word for someone who persecutes, but believes they are not.

irishh_bob

krd wrote: »

There's a few things to that. I'm from rural Ireland. Anyone who doesn't fit in (Ie. if they're not ignorant, talk with a bockety accent, have a head that looks like a potato they're "cracked in the head").

Spreading rumours about someone being "cracked in de head" is a very common form of paddywhack bullying. I'll be honest, I hate the bockety people of rural Ireland. I hate it even more when they take their bocketiness to urban areas where I live and work.


A real problem about denial, is if you know it exists, how do you know you're not in denial. How do you know.

I believe...And this is nearly an unacceptable view - because it's so unpalatable. I believe, families, sometimes for one reason or another, will very deliberately drive a family member to despair and even suicide. I even have a suspicion that schizophrenia can be induced with enough torment.

A teenager might be in a family home. And they may be flying into rages, and then into periods of deep depression. The family may want to force the teenager into some form of treatment (get them doped up on medication) - the family will say the teenager is behaving crazily. But in reality, the rages may be a healthy response to the real infliction of torment and bullying. The family may be quite deliberately goading the teenager into rages and depressions. Then maybe, if the teenager's brain is constantly experiencing a roller coaster of extreme emotional experiences, maybe it will become dysfunctional and they will become genuinely bi-polar.

RD Laing, said something interesting about paranoia. We have a word for someone who believes they are being persecuted when they are not. But we don't have a word for someone who persecutes, but believes they are not.

excellent post , agree with you about the victims of suicide who are often driven to it by thier immediete family

i myself was the victim of bullying in the workplace while working overseas as a twenty year old , while it was sectarian in nature primarily , thier was a lot of jibes about my needing to see a mental health professional for alleged attitude problems etc , the same person who levelled this at me once told me she would piss herself laughing if i got my head kicked in by a horse ( was working on a stud farm at the time ) so in hindsight , it is a tad ironic that such a person would accuse others of needing professional help but anyhow , i eventually suffered a mental breakdown in 1999 and at the start , i went so far as to buy into every false diagnosis this amateur psychologists threw at me , i now suffer with clinical depression and for all i know other things and i assure you i was perfectly fine prior to this horrendous experience but i genuinly believe that lies can become reality , i.e , you can start to subscribe to phoney appraisals and the results can be long lasting

its times like this that i wonder if denial can be a weapon to defend against false flag operatives

krd

irishh_bob,

Bullying is really a psychological thing. It's psychological violence. It's attacking someone's mental health. And it can leave deep and lasting scars.

The funny thing is, bullies are not considered to have a mental health problem - usually because they can function so well. Where their targets (if they end up suffering depression) are considered to be mentally unwell.

People are bullied until they're depressed, and then put on antidepressants. Why aren't the bullies put on antibullisants?

Actually, often when I've seen bullying, the bullies have seemed to my eyes to be stark raving mad. Often their reasons for bullying are so delusional, there isn't really any way they could be considered sane.

irishh_bob

krd wrote: »

irishh_bob,

Bullying is really a psychological thing. It's psychological violence. It's attacking someone's mental health. And it can leave deep and lasting scars.

The funny thing is, bullies are not considered to have a mental health problem - usually because they can function so well. Where their targets (if they end up suffering depression) are considered to be mentally unwell.

People are bullied until they're depressed, and then put on antidepressants. Why aren't the bullies put on antibullisants?

Actually, often when I've seen bullying, the bullies have seemed to my eyes to be stark raving mad. Often their reasons for bullying are so delusional, there isn't really any way they could be considered sane.

bullies often use projection as one of their weapons

i.e , an arrogant bully will accuse thier victim of arrogance
an unstable bully will accuse thier target of being unstable , needing help etc

as for your point about bullying victims being wrote off as having had problems prior to thier workplace experience , strongly agree , thier is a culture of painting bullys as assertive go getters nowadays who just tell it like it is , by the same token , management tends to potray victims of bullying as having pre existing mental health problems and therefore they exagerated the seriousness of the bullying , managment is by and large hopeless and at worst dishonest in dealing with this phenomenon

they remind me of the impotent and spineless doctor in one flew over the cuckoos nest who gormlessly tells jack nicolsons charechater that nurse ratchett is one of the finest employees in this institution :eek:

Sid_Justice

What has bullying got to do with bipolar disorder?
You seem to be telling us a personal story to rant about bullying.

JuliusCaesar

Stay on topic!
JC

Odysseus

krd wrote: »

Denial, is very straightforward. Think of denial in the Kubler-Ross model.

A doctor tells a patient they have cancer, and they only have a few months to live. The patient loudly protests that they do not have cancer - even when the doctor has the x-rays and test results in front of them. The patient may even shout at the doctor, calling them a liar.

Denial is something that's really common. People will deal with a problem by convincing themselves they do not have a problem. They literally block it out of their minds.

Alcoholics will deny, and believe they're own denial, they have a drinking problem - interventions, where a group of family members and friends confront the alcoholic are often what it takes, to convince them.

Kubler-Ross who holds very little influence in bereavement circles today, even though the medical profession use it a lot. However, to my point I would see denial as far from simple or straightforward. In order for something to be denied, it has to be acknowledged first, where is this happening? What mechanisms are involved in it? How do we differentiate it from other similar mechanisms etc?

Just thinking on it now with Kubler-Ross I don’t even know if I would call it denial, as your example is a very conscious example. I would need to think on it, but can a person be conscious of their denial and still be in denial? A though for bedtime!!!

Though it is part of everyday life and can have protective functions, initially it can help the psychical apparatus from being overwhelmed, it can then become pathological.

Denial in addiction is interesting; however, a lot of traditional treatments can focus on it too much, where the primary aim of initial treatment is to break through the wall of denial, getting the person to admit they are an addict. In my experience, the confrontation used in such methods is highly abusive. If you where to use that level of confrontation in any other type of treatment, people would walk out of the group

krd

Odysseus wrote: »

Kubler-Ross who holds very little influence in bereavement circles today, even though the medical profession use it a lot. However, to my point I would see denial as far from simple or straightforward. In order for something to be denied, it has to be acknowledged first, where is this happening? What mechanisms are involved in it? How do we differentiate it from other similar mechanisms etc?

Kubler-Ross, can applied to other forms of grieve; losing a job, a relationship breakdown, losing the ability to walk through an accident. I think calling it a cycle gives the impression it's something that has a neat progression.

It's interesting to know about the cycle if you experience a traumatic event, and find yourself going through rages, depressions, etc. I don't know, anger may be appropriate, and acceptance may be inappropriate in certain given situations, where the event can be altered through some action.

Just thinking on it now with Kubler-Ross I don’t even know if I would call it denial, as your example is a very conscious example. I would need to think on it, but can a person be conscious of their denial and still be in denial? A though for bedtime!!!

Denial is something strange. You tell one person bad news, they'll accept it straight away, another may refuse to believe you - for no other reason just they don't want to believe you.

If you can block out the consciousness of a situation, you're not concious of it. That's putting the thoughts out of your head, thinking up excuses, creating an alternative narrative, then you're not really conscious of either the truth or the denial. There isn't cognitive dissonance. Cognitive dissonance is like an alarm bell going off - tells you something is wrong. So you can either chose to explore it, find the root - or create a narrative that makes it vanish; I'm not pregnant, I'm just putting on a little weight. I'm not an alcoholic, I drink less than my doctor. There's an interesting definition of alcoholism, in paper written in the early 70s by a doctor who was attached to Trinity college. He defined an alcoholic as someone who drinks in excess of 25 pints of beer, or two and half bottles of vodka a day.

An example of denial. A young woman I knew, who was living with her parents. She became pregnant - she didn't want to be pregnant. First her periods stopped, and she went to the doctor - the doctor asked her some very standard questions, like was she still having her periods, and she said she was . So the doctor said, well if you're having your periods you can't be pregnant. She goes away happy. After about four months she's obviously pregnant. Her family bring up the subject - at which she flies into rages, and denies she is pregnant - she says she's just putting on weight. They force her to go to the doctor, and again she tells the doctor she's still having her periods. At this point the family give up. She continued to deny being pregnant right up to going into labour and giving birth. I don't think she was lying or playing some kind of game.

That's an extreme example, but it's not uncommon for women who have an unwanted pregnancy to be in denial for the first few months.

Though it is part of everyday life and can have protective functions, initially it can help the psychical apparatus from being overwhelmed, it can then become pathological.

Protective for who? It's one personality trait I really don't like having to deal with. You have two options when you encounter a problem; deal with it or deny it. There's also "shoot the messenger". Denying a problem, is the flaky "soft skills" way of dealing with problems, which is fine for some people. It leads to chaos.

There are three kinds of untruths.

Lies: The person knows the truth but tries to conceal it.

Bullsh1t: The truth is completely immaterial to the person.

In denial: The person is unaware of the truth. And is believing what they want to believe.

It's can be hard to believe, that in the instance of denial, the subject is not conscious of the truth. But, when you consider paranoia. It's easier to accept the subject believes they are being persecuted - fear and anxiety appear as very real. I believe denial is very similar to paranoia. Though someone in denial may be much higher functioning than a paranoid, until it starts to cause dysfunction, then it becomes pathological.

Denial in addiction is interesting; however, a lot of traditional treatments can focus on it too much, where the primary aim of initial treatment is to break through the wall of denial, getting the person to admit they are an addict.

What if you're not an addict?

Mary-Ellen Field, Elle Macpherson's former adviser was giving evidence at the Leveson inquiry into press standards, in England, the other day.

The News of the World were intercepting Macpherson's voicemails. Macpherson's became convinced Field was leaking stories to the press. Macpherson was also convinced Field was leaking the stories because she was an alcoholic.

http://www.guardian.co.uk/media/2011/nov/22/leveson-inquiry-steve-coogan-marina-hyde?INTCMP=SRCH

Fittingly, in those circumstances, Coogan was adamant that this was not "the Steve and Hugh show". In fact, if jaw-dropping tales from the world of showbiz were what you were after, far more dramatic fare was provided by Elle Macpherson's former brand manager. In her account of how she was "bullied" into a totally unnecessary five-week spell in rehab, Mary-Ellen Field reminded us that celebrity can be another country. They do things differently there. Field has a nice line in tart incredulity, at one point suggesting, almost apologetically, that the tale sounded "like a B-movie". But in truth the story that unfolded could function with barely a tweak as a biting showbiz satire. It goes like this: when presumably phone-hacked stories about Macpherson's disintegrating relationship began appearing, the model wrongly suspected that her business associate – who worked for accountancy firm Chiltern – had been loose-lipped. Her reaction? An intervention.

"She [Elle] put her arms around me and cried," Field told the inquiry, "and said that she knows what it's like to be an alcoholic." Field alleged Chiltern went along with Macpherson's solution – to send her to the wildly expensive Meadows clinic in Arizona. Despite not being an alcoholic, and having a severely disabled son, she gave into them, in fear of losing her job.


"Elle had made out like it was a spa or something," Field observed of the Meadows, "but it was a grade 1 psychiatric facility with men with guns in holsters who were parading around the place." Her so-called "intervention" had been "like one of those CIA renditions, except they don't hold you in chains". After many days of what sounded like psychological assault, the clinic accepted she was not an alcoholic. Nevertheless, both Macpherson and then Chiltern sacked Field after her return.

I think denial can be a factor in group think. A family of tormentors can become convinced that person they're tormenting is the one who is sick (bi-polar or whatever). They can have a complete blindness to how their actions are contributing to the situation. That they're actually provoking the rages and depressions.

In my experience, the confrontation used in such methods is highly abusive. If you where to use that level of confrontation in any other type of treatment, people would walk out of the group

What if you can't walk out of the group? Like someone I knew who had been to one of those American teen "rehab" clinics. In group therapy, no one was allowed leave - even to go to the toilet. They'd be forced to soil themselves (I have my suspicions, that that in itself may have been part of a "breaking down" technique - part of the therapy).

Imagine you're given no other option but to admit you have a problem - or admit to a specific problem. I know in the American clinics they'll force teenagers, who've ever only drank an odd beer, or smoked the odd joint, into admitting they're alcoholics and drug addicts.

And a place like the Meadows clinic, Arizona, you can't just get up and walk out the door.

Odysseus

krd wrote: »

Kubler-Ross, can applied to other forms of grieve; losing a job, a relationship breakdown, losing the ability to walk through an accident. I think calling it a cycle gives the impression it's something that has a neat progression.

It's interesting to know about the cycle if you experience a traumatic event, and find yourself going through rages, depressions, etc. I don't know, anger may be appropriate, and acceptance may be inappropriate in certain given situations, where the event can be altered through some action.



Denial is something strange. You tell one person bad news, they'll accept it straight away, another may refuse to believe you - for no other reason just they don't want to believe you.

If you can block out the consciousness of a situation, you're not concious of it. That's putting the thoughts out of your head, thinking up excuses, creating an alternative narrative, then you're not really conscious of either the truth or the denial. There isn't cognitive dissonance. Cognitive dissonance is like an alarm bell going off - tells you something is wrong. So you can either chose to explore it, find the root - or create a narrative that makes it vanish; I'm not pregnant, I'm just putting on a little weight. I'm not an alcoholic, I drink less than my doctor. There's an interesting definition of alcoholism, in paper written in the early 70s by a doctor who was attached to Trinity college. He defined an alcoholic as someone who drinks in excess of 25 pints of beer, or two and half bottles of vodka a day.

An example of denial. A young woman I knew, who was living with her parents. She became pregnant - she didn't want to be pregnant. First her periods stopped, and she went to the doctor - the doctor asked her some very standard questions, like was she still having her periods, and she said she was . So the doctor said, well if you're having your periods you can't be pregnant. She goes away happy. After about four months she's obviously pregnant. Her family bring up the subject - at which she flies into rages, and denies she is pregnant - she says she's just putting on weight. They force her to go to the doctor, and again she tells the doctor she's still having her periods. At this point the family give up. She continued to deny being pregnant right up to going into labour and giving birth. I don't think she was lying or playing some kind of game.

That's an extreme example, but it's not uncommon for women who have an unwanted pregnancy to be in denial for the first few months.



Protective for who? It's one personality trait I really don't like having to deal with. You have two options when you encounter a problem; deal with it or deny it. There's also "shoot the messenger". Denying a problem, is the flaky "soft skills" way of dealing with problems, which is fine for some people. It leads to chaos.

There are three kinds of untruths.

Lies: The person knows the truth but tries to conceal it.

Bullsh1t: The truth is completely immaterial to the person.

In denial: The person is unaware of the truth. And is believing what they want to believe.

It's can be hard to believe, that in the instance of denial, the subject is not conscious of the truth. But, when you consider paranoia. It's easier to accept the subject believes they are being persecuted - fear and anxiety appear as very real. I believe denial is very similar to paranoia. Though someone in denial may be much higher functioning than a paranoid, until it starts to cause dysfunction, then it becomes pathological.




What if you're not an addict?

Mary-Ellen Field, Elle Macpherson's former adviser was giving evidence at the Leveson inquiry into press standards, in England, the other day.

The News of the World were intercepting Macpherson's voicemails. Macpherson's became convinced Field was leaking stories to the press. Macpherson was also convinced Field was leaking the stories because she was an alcoholic.

http://www.guardian.co.uk/media/2011/nov/22/leveson-inquiry-steve-coogan-marina-hyde?INTCMP=SRCH

Fittingly, in those circumstances, Coogan was adamant that this was not "the Steve and Hugh show". In fact, if jaw-dropping tales from the world of showbiz were what you were after, far more dramatic fare was provided by Elle Macpherson's former brand manager. In her account of how she was "bullied" into a totally unnecessary five-week spell in rehab, Mary-Ellen Field reminded us that celebrity can be another country. They do things differently there. Field has a nice line in tart incredulity, at one point suggesting, almost apologetically, that the tale sounded "like a B-movie". But in truth the story that unfolded could function with barely a tweak as a biting showbiz satire. It goes like this: when presumably phone-hacked stories about Macpherson's disintegrating relationship began appearing, the model wrongly suspected that her business associate – who worked for accountancy firm Chiltern – had been loose-lipped. Her reaction? An intervention.

"She [Elle] put her arms around me and cried," Field told the inquiry, "and said that she knows what it's like to be an alcoholic." Field alleged Chiltern went along with Macpherson's solution – to send her to the wildly expensive Meadows clinic in Arizona. Despite not being an alcoholic, and having a severely disabled son, she gave into them, in fear of losing her job.


"Elle had made out like it was a spa or something," Field observed of the Meadows, "but it was a grade 1 psychiatric facility with men with guns in holsters who were parading around the place." Her so-called "intervention" had been "like one of those CIA renditions, except they don't hold you in chains". After many days of what sounded like psychological assault, the clinic accepted she was not an alcoholic. Nevertheless, both Macpherson and then Chiltern sacked Field after her return.

I think denial can be a factor in group think. A family of tormentors can become convinced that person they're tormenting is the one who is sick (bi-polar or whatever). They can have a complete blindness to how their actions are contributing to the situation. That they're actually provoking the rages and depressions.





What if you can't walk out of the group? Like someone I knew who had been to one of those American teen "rehab" clinics. In group therapy, no one was allowed leave - even to go to the toilet. They'd be forced to soil themselves (I have my suspicions, that that in itself may have been part of a "breaking down" technique - part of the therapy).

Imagine you're given no other option but to admit you have a problem - or admit to a specific problem. I know in the American clinics they'll force teenagers, who've ever only drank an odd beer, or smoked the odd joint, into admitting they're alcoholics and drug addicts.

And a place like the Meadows clinic, Arizona, you can't just get up and walk out the door.

I didn’t say it was circular; I spoke of treatment bereavement circles as in those who work primarily with that experience. By which I mean hospice facilities would not see Kubler-Ross as being a useful intervention around grief, loss and bereavement, I wouldn’t be a fan but they tend to focus on people like Strobe & Strobe and the whole dual process model. Personally I think KR is too simplistic and misses the core of the experience; additionally then you have ill trained people thinking the person is in the wrong stage and that they should be at a different stage.

I would say in the example you give that there is a lot more going on there than denial, as I said in order for something to be denied it has to be acknowledged at some level.

It can be protective within traumatic situations initially, where it saves the psyche from being overwhelmed by the trauma; of course if it is not acknowledged/ brought into the world of language it then can become pathological. Not being conscious of something does not equate not being aware of it at some level.

Within addiction treatment thankfully it is moving away from the focus on denial. Also thankfully our treatment centres do not engage in such unethical practices over here. I would be a fan of his work but 12 step centres situating teenager who took drug as addicts has give Staunton-Peel a lot to write about, in his various books on treatment in America.

Out of interest why do you find denial difficult to work with or at least dislike it?

JuliusCaesar

If you're interested in denial, then I think the answer to the 'how' can be found in the psychology of emotion. Power & Dalgleish propose a plausible mechanism in their book.

Ned_led16

I think the important thing is that people who are suffering from bipolar disorder are often in denial like persons with drug addiction problems.
So to me this is a fundamental distinction between illness to the body opposed the mind.
Perhaps denial does circumnavigate physical illness but to a lesser extent. We have all heard about people avoiding the Doctor.

What does a psychiatrist or psychotherapist do when they think a patient is bipolar when they know the client will have another manic episode when this is positioned to them?

However in my hypothetical scenario the patient knows he is unwell - seeks medication from the Doctor - seeks therapy from the counsellor, posseses all traits of mania and depression (bi polar), but refuses to accept that they suffer from an illness called bipolar disorder. How do you save a man from himself? I have read literature which states the average diagnosis takes 20 yrs in the USA. Thats a lot of sick people without proper care and treatment, failed by society. However i am starting to believe that even if the patient was not in denial that the treatement options available are disastrous globally!

I think anyone who intentionally persuades a false diagnosis through the concept of denial is clearly not a concerned, genuinely loveing family member. A person who would do this is perhaps ill themselves or a victim maybe [paranoid or delusional! I'm sure there are evil people out there who do this but not in my scenario.

Also to blame a psychological break down on an isolated name calling event or clinical depression is difficult to comprehend. Ok i agree repeted bullying over long periods of time could materially contribute - but to state its a cause in fact is unconvincing. Someone who is on the edge can fall with a minor impact. Cause in fact is very differnt to the material contribution test.

krd

Odysseus wrote: »

Out of interest why do you find denial difficult to work with or at least dislike it?

I had a longer answer, but didn't post it.

It think denial can be very complicated. In my longer post I compared it to Descartes demon - it actually is Descartes demon (and ye can all use wikipedia, cantcha)

It's not just something that can happen in the initial stages of a trauma - but it can be used as a coping mechanism for an ongoing trauma or problem. I don't think it's healthy - I am aware of instances where I have been in denial, and it would have been far better for me not to have been.

It can be used as coping mechanism for life in general. The narratives, and fantasies effectively creating a bubble. The ugly side of it being, that bubble will be fiercely protected. Anything, or anyone, who even inadvertently pricks the bubble will be met with anger and aggression.

One way to go through life, is to smile and agree with everyone - and just keep your mouth shut when any incongruities manifest themselves.

The thing is, my big problem, you can never quite know when you're dealing with someone who is living in a fantasy bubble. And you can never be quite sure - how to avoid pricking it. It can be like a mine field - you never know if you're next step is going to be on a mine.