denial

Meaning: In psychoanalytic theory, the ego uses defense mechanisms, usually unconsciously, to reduce anxiety from conflict among the id, the superego, and reality. Denial is the defense in which a person refuses to acknowledge an external fact or its emotional significance, even when the evidence is plain. It lowers distress in the short term but can block coping and action. A second sense appears in the Kübler-Ross model of grief, where denial is commonly listed as the first stage, followed by anger, bargaining, depression, and acceptance.

On the MCAT: Expect a short vignette, such as a person who receives a serious diagnosis and keeps making plans as if nothing were wrong, or someone who insists a breakup never happened. You choose the defense mechanism from a list that may include repression, projection, displacement, reaction formation, rationalization, regression, sublimation, and suppression. The cue for denial is that the person rejects the reality of the event itself, not just the feelings about it.

Common confusion: Students mix denial up with repression and rationalization. In repression, the threatening thought or memory is pushed out of conscious awareness. In denial, the person still faces the current external fact but refuses to accept it. In rationalization, the person accepts the facts and supplies a more acceptable explanation for them. Suppression, unlike denial, is a conscious decision to set a thought aside.