“Fatal Denial” and How to Deal With It During the COVID-19 Epidemic
Psychiatrists and other mental health professionals deal with the defense mechanism of denial all the time. We know this to be a very basic defense mechanism which protects the individual from anxiety as well as from other painful emotions including depression. In the course of doing psychotherapy we chip away at this defense mechanism as we help the patient strengthen other methods of coping and dealing with the issues in their life. At various times all people will use a this mechanism as we usually don’t think about our mortality most of the time.
Currently during the COVID-19 pandemic we are seeing situations where many people are apparently using this defense mechanism as they choose not to wear masks, abide by social distancing and practice other behaviors which clearly endangers their lives as well as those of loved ones and other people. Watching the TV news, it is clear that this is quite common and wide spread. I am sure that these individuals do not believe they are truly endangering themselves or other people. They will use various rationalizations and will not or cannot acknowledge the life-threatening nature of their behavior. I believe that we should label this for what it is: “Fatal Denial.” Since the overwhelming majority of people who are using Fatal Denial are not in therapy nor are they motivated to be in therapy, we need to find a way to address this very serious problem.
The answer to this dilemma problem is to first personally and publicly identify the very dangerous mechanism that is widely being used. Mental health professionals need to take an active role explaining to the public how many people are denying a life-threatening situation by using Fatal Denial. Perhaps this can be done in conjunction with our medical colleagues who as a group have a generally trusted relationship with the public. I would also like to see a nationwide campaign of public service announcements where doctors (perhaps psychiatric and non- psychiatric physicians)as well as other mental health professionals and nurses appear on television expressing concern about the wide spread fatal denial that is leading to people not taking the proper protections and thereby endangering their lives and the lives of others including their loved ones.
In addition, trusted, popular public figures (whether they be entertainers, sports figures or even politicians) should appear in a wide spread series of public service announcements on TV, billboards and posters strategically located such as at the front door of a supermarkets or other stores or restaurants urging those entering to wear a mask and socially distance themselves. The reality is that many people would be more influenced by such a poster than by the entreaty of the young person at the door of a store or a waiter or a lifeguard at a beach or even by a police officer, asking them to do the right thing.
As psychiatrists and physicians, we have to call Fatal Denial for what it is and what it means. We have to mobilize our profession organizations as well as the media to try to break through this deadly defense mechanism of Fatal Denial.