Meetings of the New York Psychoanalytic Society

February 26, 1952. THE ROLE OF PERCEPTION IN THE MECHANISM OF DENIAL. Louis Linn, M.D.

Dulling of perception or intellectual functioning acts to facilitate denial; and if the capacity for denial weakens as accuracy of perception rises, then conversely anything which interferes with perception facilitates denial. Among the examples given are senile patients whose transitory psychotic episodes occur at night when the stream of orienting perceptions is diminished. Patients receiving electroshock treatment regularly show altered and blunted perception of reality with some degree of euphoria when previously distressing ideas are remembered without their former associated affects. With more electroshock, and the concomitant changes in the brain, a greater blunting of preconscious memories and sensory perceptions results.

With progressive and generalized organic impairment of the brain, external stimuli tend progressively to assume the qualities of unstructured stimuli and primary process mentation occurs. In some functional psychological states, obtunding of perception may occur which then can lend itself more easily to repression. This is aided by weakening of the discriminating function of the ego. The converse may occur when inexact perception is brought about by denial. Frequently, if not usually, denial represents the first stage in a complex system of defense: there is first an attenuation of perception of reality which then facilitates repression.

In discussing Dr. Linn's paper, Dr. Sydney G. Margolin finds in this understanding of denial a new psychoanalytic sign added to those useful in the study of organic brain disease. Dr. Charles Davison compared the presence of the mechanisms of projection and denial in infancy and in old age on the basis of incomplete myelinization in the former and neural degeneration in the latter. Dr. Mortimer Ostow suggested that it is an intense repressive countercathexis against an unconscious fantasy which prevents full affe