We believe that much confusion and uncertainty about the concept of denial has resulted from an unrecognized semantic problem. The concept of denial or disavowal in the scientific sense is quite different from the vernacular meaning of the word. Moreover, the term denial has been applied to defensive operations that differ markedly from the mechanism of defense for which Freud introduced the term. Denial or disavowal as he described it is not necessarily a primitive defense mechanism. It involves the complex activity of an ego that has undergone considerable development. Perception is accurate and unimpaired, but there is defensive failure to appreciate fully the implications of that perception.

The use of denial or disavowal in some situations may be—temporarily at least—adaptive. We have described some of the sources of pathology associated with denial.