Russell G C
Department of Psychology, University of Plymouth, England.
J Adv Nurs. 1993 Jun;18(6):938-40. doi: 10.1046/j.1365-2648.1993.18060938.x.
Denial is typically viewed as maladaptive in clinical practice, despite ample evidence of its adaptive role in personal and health crises. The failure of health professionals to embrace the positive aspects of denial lies deeply rooted in cultural beliefs, which have been reinforced in more recent times by misapplication of clinical theory. Denial is a form of self-deception that protects the individual from threats to the self and involves exaggerated perceptions of control and self-efficacy. Social-psychological research suggests that such biases in cognitive appraisal are the norm and not exclusive reactions to crises. It is proposed that denial has the following functions during crises: denial protects the integrity of the self-concept by distorting reality in a self-enhancing way, promoting a sense of mastery and control; this in turn leads to lower levels of anxiety, which may enhance decision-making under conditions of stress. Psychological health appears to be contingent, at least in part, on an ability to see the world through 'rose-tinted glasses'. Health professionals should be aware, therefore, that whilst trying to promote psychological well-being we do not ask patients to be unrealistically realistic.
在临床实践中，否认通常被视为适应不良，尽管有充分证据表明其在个人和健康危机中具有适应性作用。医疗专业人员未能接受否认的积极方面，这深深植根于文化信仰之中，而近期临床理论的错误应用又强化了这种信仰。否认是一种自我欺骗形式，它保护个体免受自我威胁，并涉及对控制和自我效能的夸大认知。社会心理学研究表明，这种认知评估中的偏差是常态，并非对危机的独有反应。有人提出，否认在危机期间具有以下功能：否认通过以自我提升的方式扭曲现实来保护自我概念的完整性，促进掌控感和控制感；这进而导致较低水平的焦虑，这可能会增强压力条件下的决策能力。心理健康似乎至少部分取决于能否透过“玫瑰色眼镜”看世界。因此，医疗专业人员应该意识到，在努力促进心理健康的同时，我们不能要求患者不切实际地保持现实。
