The danger of denial

BMJ 2004; 329 doi: (Published 09 September 2004) Cite this as: BMJ 2004;329:631
  1. Des Spence, general practitioner (
  1. Glasgow

    Have you ever caught a glimpse of yourself in a mirror and thought, “Oh, that's just a bad angle.” How many of us men have seen the top of our head in the monitor of a security camera and said to ourselves, “It's just a very bright light.” In psychobabble this is known as denial, one of the most popular of the “coping strategies.” I like using denial as a strategy, as it is easy, convenient, effective, and applicable to almost every life situation. My vanity about my baldness and weight is a source of amusement to my friends and family and is harmless. However, what happens when our denial affects other people, even lots of other people, such as our patients?

    I used denial in my relationship with the pharmaceutical industry and how this relationship affected my practice and patients. I wanted to believe that all the “freebies” and “fees” were justifiable and that my frequent contact with the industry did not affect my practice. Yes, I tended …

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