You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Dorpat proposes that denial, not primal repression or splitting, is the basic, primordial defense. He provides, in ten chapters, a comprehensive
review not only of the psychoanalytic and psychiatric literature on denial, but also of the work of cognitive psychologists relevant to his thesis. Making use of analytic illustrations, he builds up a cognitive arrest theory of denial and defense, after which he proceeds, in the next four chapters, to examine the importance of defense in interpersonal communication. He asserts that the analyst's disavowal of the reality of his interventions in the "here and now" in the analytic encounter can lead to unwitting collusion. Emphasizing denial in projective identification, Dorpat describes the working through of denial as including the interpersonal dimension of the "internalization of patient-analyst interactions" (p. 245). The last two chapters examine denial and memory pathology in relation to brain function from the perspective of cognitive psychology and neurology. The phenomenon of anosognosia is explained in terms of both psychodynamic and neurophysiological hypotheses.
Dorpat bases his unifying theory of denial and defense on a broad definition of denial as "the unconscious repudiation of some or all of the meanings of an event to allay anxiety or other unpleasurable affects" (p. 2). Apparently preferring (as did Strachey) the term "disavowal" (Verleugnung), Dorpat focuses on denial as a psychic mechanism, reminding us that when patients talk of expelling, rejecting, splitting, casting out, they are speaking metaphorically. Dorpat's "cognitive arrest theory" states that the denier aborts his or her cognition process before transforming presymbolic and embryonic forms of thought into verbal thought. In short, denial prevents the formation of verbal ideas; it does not involve the expulsion, rejection, or splitting of ideas. His review of Freud's concepts of decathexis and anticathexis leads Dorpat to conclude th