Denial - See No, Hear No, Speak No

Denial - See No, Hear No, Speak No

Podcast 9 - See No, Hear No, Speak No

ABA technical concepts covered in this podcast: Behaviour adaptation; avoidance and escape behaviour; positive reinforcement; verbal behaviour reinforcement; choosing target behaviour; functional behaviour; operant conditioning; coping behaviour.

Presenters - Bobbi Hoadley, Cathy Knights.

Bobbi and Cathy confront denial without confrontation. Along the way they see it is much more than a river in Egypt.

See no evil, hear no evil, and speak no evil. We're going to talk a little bit about denial. A big behaviour. Like all behaviour it occurs on a spectrum. It's a necessary behaviour, a coping strategy. There's a lot of human suffering adapting our behaviour. Denial is a way of managing a situation without having to commit to it, such as I'll think about that tomorrow. It's considered to be a necessary part of grieving, and many life events. It can be a good coping strategy, helping you get through an issue, you can come out of the situation and learn from it.

An example - you're in a situation at work where you've been asked to team up with someone who is quite counterproductive. You've been assigned to do a job with them and a finite period of time, you might be in a bit of denial about the behaviours of that person. It's giving them the benefit of the doubt in order to get the job done, a strategy to keep an eye on a goal or task at hand. Events that create a lot of human suffering - it's is almost necessary.

Persons with acquired brain injury sometime think there's nothing wrong with me and I'm okay. They're very much not aware of how much has changed in their brain. Often we'll label it as a loss of insight. Insight behaviours they came to the injury with or not. Insight into consequences, feelings of others - so there's lots of insight behaviours and whatever those behaviours were prior to injury they'll probably be able to gain back. After an injury, denial is often there in the first year, and its' a real impediment to rehabilitation. I'm not going to work on this as there's nothing wrong with me. Often when I'm called in, I'll say this person isn't quite ready yet for behaviour change. Some people with acquired brain injury really need to get out in the real world again understanding how their interactions with the environment have changed. You won't get a good opportunity for rehab when someone is unaware. So I'll say, call me in a year, as soon as they begin to understand that there's a problem.

Some people get pushed into a corner early on. After the acquired brain injury, things get quickly set as neurons re-wire together. A lot of people will look at denial and try to confront it, repeatedly and the person ends up fighting against it. It can be family members, friends, and professionals. If we just let the person have it for as long as it takes, it would be better. Denial is an adaptation specifically for the purpose of coping. If denial lasts longer than would be considered healthy for the person, than it becomes an insight problem.

Why is it so hard for women to leave an abusive relationships? Often because of the denial behaviour that helps them to be able to cope. Or one of the hardest jobs for human beings, is parenting. When I realized I could lose the infant in my arms, denial was the better option. Don't hold it against someone, it's a symptom, and as such you have to understand what it is the person needs help coping with.

Some people use the tactic to their benefit. When you haven't really learned to cope with feelings, such as men, sometimes with their wives, they can use denial behaviours, as they are more reinforcing than trying to explain feelings. Or there's the ones where "I never did that". Generally we would want this to be a temporary tactic and come out of it ready to problem solve.

Strategies for someone stuck in denial - if it has no solution in the moment, don't punish it and don't reinforce it. You don't want to give too much credibility but you don't want to take away someone's hope. Don't spend time on it - don't elaborate; simply acknowledge and move on.

Another tactic is just questioning - asking more about their situation. Is there any solution to the problem or, whatever it may be. Or substance abuse - if you have evidence, you can share it and say have you considered this? Provide support for what the coping is. If a person is stuck because of grief - it's better is to deal with the grief, and how can they cope better with the grieving.

Counter denial with a reality statement that's empathetic, such as it is really hard to live without that parent. Typically, you defend the safe spot you're in, as opposed to allowing another person to change it. You need the opportunity in the environment to be weak and vulnerable, to become safe and strong.