They asked me to contract certain muscles in my stomach, and I was like, what muscles?
I'm Angela Duckworth.
I'm Steven Dubner. And you're listening to No Stupid Questions.
Today on the show, is denial a helpful method of dealing with grief?
I think that every single one of us has been in denial at least once.
Not me. Never denied anything.
Angela, we have a question here from a listener named Anna, which I think you will find very interesting and fairly provocative.
Are you ready? Yeah.
So Anna writes that she's 23 years old.
She's a biology research associate, and she wants to know, is there recorded evidence of denial having a comforting effect on the negative physiological responses to grief?
This sounds like not a question that people just ask out of pure academic curiosity.
This is true. She writes, literally, there is a story behind my question.
When she was quite young, around nine years old, a beloved family member passed away.
She writes, though he was sick and the family suspected his death was nearing, the news still came suddenly and felt unexpected.
My family was driving towards Disney World when we got the call.
We finished our day at the park and made plans to return home the next day to attend the funeral.
But for the entire day at the park, she writes, after receiving the news, I felt horribly sick.
I had a headache, stomach ache, felt motion sick.
And then she writes, I pretended in my head that my beloved uncle who had died was still alive.
He's alive, I said over and over to myself in my head.
Suddenly my stomach ache and my headache ebbed and then they were gone.
Repeating denial words over and over to myself made me feel physically better.
Though I was just nine years old, I knew that denial didn't make the happier fiction playing in my head true.
I stopped repeating.
He's alive in my head.
And guess what happened?
My stomach ache and headache returned almost instantly.
This is sounding like a true crime case for a psychology TV show that hasn't been made yet.
I spent the drive home and most of the funeral being violently ill.
I'm curious if there are any studies on or literature about the physical comfort that denial brings in the stages of grief, or maybe I was just a very odd child who had an abnormally severe physical reaction to grief.
Angela, what do you make of this?
Well, I think this question that Anna asks is partly about grief.
It's also partly about attention, because what denial is, is moving your attention away from something.
And in most cases, I think away from something that's painful.
She also hints at the stages of grief idea that, you know, a lot of people have heard of.
This is the famous Elizabeth Kubler Ross, the model that she popularized, yes?
Actually, you probably know more about it than I do.
I don't know whether there's a lot of scientific basis for it, but what are the stages of grief?
There are five of them, right?
Yeah, so I do know this.
And you're right. It is a popularization.
There is very little empirical evidence that this is either universal or even typical, right?
Or I would almost say I hesitate to use the word useful because who's to say what's useful for someone.
But Elizabeth Kubler Ross was a famous Swiss American psychiatrist, and she was popular for this model about the stages of mourning.
The argument came to be that people who were in grief or in bereavement would go through five separate sequential stages of mourning, denial, anger, bargaining, depression, and finally, acceptance.
But we should say that her career was spent helping patients who were dying, terminal patients, confront their own death.
And so this was developed largely from her observations of her dying patients.
So it somehow got ported over to how we grieve for other people.
So like a lot of the conventional wisdom or dogma about grief and bereavement, there just isn't a lot in the way of empirical evidence to support it.
What always made me a little bit reluctant to pay too much attention to this five -stage model is that if one is grieving and doesn't feel one of those stages or steps, then one might feel that they are somehow failing to experience it the quote right way.
And I should also say, I don't think she meant it to be this universal model that needs to be followed like a blueprint.
But anyway, it has come to be thought of as a universal way of dealing with grief.
And going back to Anna's note, the first distinct stage of mourning is, yes, denial.
The sort of like nothing happened, this alternative reality that you create for yourself where there was no tragedy.
I think another problem perhaps with this five stages of grief is that you think of them as kind of being lock step.
So for example, you're on your way to the funeral and all of a sudden you're experiencing an episode of denial.
And then you're thinking like, oh no, did I go back to the first step because I thought I had already gotten through anger and bargaining.
So I think there could be some issues there.
But as I said, I think this is a question, not only about grief, which spares none of us, but also about attention, focusing on one thing that's going on and neglecting everything else that's going on.
That's what attention is.
It's like a spotlight.
Maybe a better analogy would be that your attention is like a pen light.
It's like a tiny pinprick of light in a very dark room.
And when you cast your attention onto the water bottle that's sitting next to your laptop, previously you hadn't thought about the water bottle at all.
Now all of a sudden, the water bottle looms large.
The same thing, by the way, happens when you think about how attention works when it sweeps across the vast dark landscape of your internal mind.
I mean, I could dredge up a memory for you, Steven.
I'll do it right now.
Can you remember a time where you had a stomach virus when you were in elementary school?
Did you ever have a stomach virus when you were a little kid?
I don't remember. Although I did have one about two months ago and it depressed the crap out of me.
What happened? I was traveling.
Being sick away from home is the worst.
It's kind of my greatest fear, honestly, and it happened.
Oh, that is so terrible.
Well, Steven, look, I dredged up this unpleasant memory of when you were sick and you were away from home.
And until I dredged up that memory, until I adjusted the pen light of your attention to that memory, it was there.
You just weren't paying attention to it.
Thanks a lot. Yes, yeah, you're welcome.
So the idea of denial is that the pen light of your attention is being directed away from something.
It just tends to be the painful things that were motivated to not think about.
And the thing about human attention is get ready to drink.
Danny Kahneman would often say, nothing is as important as what you're thinking about while you're thinking about it.
So the pen light of attention illuminates some tiny, tiny fraction of reality.
And while it's illuminated, it's real.
And when it's not illuminated, it's not real.
It's why I think if you're for a moment going to just pretend that your loved one is still alive, then of course you don't feel bad anymore.
When Anna talks about the physiological response she had to this grief, or I don't know if we'd say it's physiological response to grief, per se, or stress.
But what can you tell us about that generally?
Yeah, there is a distinction there.
And there's more research on the stress response.
And the big difference is that when you experience stress, it's a threat that you think is current.
Grief is an experience of something that you lost in the past.
So there are differences, but they're both stressful.
They're both adversity.
And we have a physiological response to adverse events that befall all of us at one point or another.
You know, maybe our heart rate changes, maybe our breathing rate changes.
And I think that when Anna is having a physical response to grief, like literally nauseous, it really just underscores that the mind -body connection is real.
And when you are thinking and feeling certain things in your mind, your body is going to express or respond to those things.
This is typical. In the case of Anna, what's really interesting to me, which you highlighted here, is that she could turn her physiological symptoms on and off by acknowledging or denying the grief.
To me, though, a big question that I'm totally in the dark about is the universality of denial.
Is it really so common?
Is that a natural human response to bad outcomes?
And if it is, what would be your explanation for why that is?
I think that every single one of us has been in denial at least once.
Not me. Never denied anything.
Yeah, that's right.
Except for you, Stephen.
I mean, think of it this way.
I feel like everything that's on Netflix these days is some like perverse, dark, dystopian, twisted tale.
I tried to watch Succession, which you recommended.
Ozark, Squid Game. And I find myself, when I'm sitting next to Jason and he insists on putting on another episode of Breaking Bad, literally looking away from the screen.
You know, I remember in all those Rocky movies, like Rocky 1 through Rocky 24, every time there was the fight scene, I would put my hands over my eyes or I would shut my eyes tight and I would put my hands over my ears because it was really hard for me to watch.
That's denial. You know, there's a thing they make now.
It's called, what is it?
Remote control. And you can actually change the channel, turn it off.
Well, tell that to Jason because he really loves Breaking Bad.
But I find it disturbing.
And so, when you put your hands over your eyes or you turn away from something like, say, for example, you're driving in your car and there's like roadkill and you just avert your eyes, that's denial.
That's selective attention.
That's taking the tiny pen light that illuminates your conscious awareness and like directing it to something that takes away the pain.
That's an adaptive, universal human behavior.
And I'll tell you that many people are familiar with the marshmallow test, which we've discussed before.
It's an experimental paradigm for little children.
So four -year -old children are given this question, do you want one marshmallow now or two marshmallows later?
Children in this waiting time have only one job to do.
And that is to do nothing until the experimenter comes back in the room.
Then you get two marshmallows, right?
So some children stare at the marshmallow.
They start sniffing the marshmallow.
More successful children look away from the marshmallow.
Just like Angela Duckworth and Breaking Bad comes on TV.
I have to say, if I think about all the people I know, friends, family, acquaintances, et cetera, if I were to name someone who's at the top of the list at being very good at denial, I think it would be you.
I mean, I've known you for a while now and we talk about things in our lives, sometimes on mic, but often not.
Sometimes on the phone.
I think we reserve the grisliest stuff for our phone calls.
Yeah. But I have to say, you will tell me about something really sad or even tragic.
And then it's as if there's a switch.
The negative switch is off and you're back.
And I wouldn't call that denial.
Actually, I would just call that super speed processing of negative stuff.
And honestly, I'm in awe of it.
Now there might be others who think, no, no, no, you need to live longer with that grief or that sadness or that tragedy.
Personally, I'm of the opinion that what you do is great.
I would like to be more like you in that regard.
Can you make me more like you?
You are right that I am in the express lane when it comes to negative emotion.
I'm like, got it. Good.
Now I'm going to merge it back into the positive emotion lane.
My therapist tells me that I am a super speedy processor and I don't know that she wants me to ruminate more.
But she did ask me recently, how are you feeling?
And she has noticed, and I have to agree, that I tend to go so quickly to the intellectualizing, to like looking things up on Google Scholar and then processing it from a third person standpoint.
It's probably a good thing to be able to be feeling something and maybe actually not going as quickly through it.
As I think you know, I have scoliosis and I remember going to this physical therapist when I was, I don't know, probably a teenager, but I remember it vividly because they asked me to contract certain muscles in my stomach.
And because my back had developed these really strong opponent muscles, probably in response to the curvature, I was like, what muscles?
She was like, oh, do this.
And I was like, what?
And I feel like that sometimes when my therapist says, and then how are you feeling?
And I was like, what do you mean?
I can tell you what I'm thinking.
I can tell you what it means.
I can also cite the literature.
But that's a very different question than just, what are you feeling?
Do you have people in your life who are frustrated with your seeming low level of quote, feeling in that circumstance?
I don't have a lot of people telling me like, hey, I wish you would be more in touch with your emotions.
I think for other people, by and large, it's a good thing for them.
It's like, when you tell me we have an 11 o 'clock show to do, Stephen, I am going to show up at 11 o 'clock and pretty much come what may, like a submarine hermetically seal off anything that doesn't have to bother you.
And, you know, when I reflected upon this comment that my amazing therapist made to me, immediately I started intellectualizing, of course.
And I was thinking about Anders Ericsson, our common friend who studied world class experts before he died.
I remember that there was an NFL coach who asked Anders Ericsson a question, and it was about quarterbacks.
His intuition was that what makes a truly great quarterback, a truly great quarterback, is not the ability to make a like Hail Mary pass or to be great under pressure.
But really what it was is the reliability of that person, whether it's raining or snowing, whether they've had a good day or a bad day, whether the last seven plays went well or they went terribly.
You kind of had this predictability that this person was going to have a narrow range of response that would be generally productive.
To me, that's what it means to be a professional.
I could be having a good day or a bad day, but if we have an 11 o 'clock call, I'm going to be on that 11 o 'clock call and I'm going to do what I was meant to do.
What would you say are perhaps the shortcomings of that approach?
Well, let's see, what are the problems with, and I'm not even sure that what I'm describing is denial in the classic sense, but I think when the speed of our emotional vehicle is going at a different speed than somebody else's, we're annoyed.
Wait, who are you saying gets annoyed, the person who's still processing or the one who's already done?
Either one. If somebody's kind of speeding past you and you're like, hey, hold on a second, I haven't even been allowed to experience this feeling.
On the other hand, I think if you're the car that's kind of whizzing down the emotional highway, then you're kind of annoyed by the person who's still quote unquote wallowing in their emotions.
I think there is a desire for people to be synchronized with us.
Still to come on No Stupid Questions, Stephen and Angela discuss when denial is helpful and when it's dangerous.
Yeah, that's not happening.
Everything's fine. Before we return to Stephen and Angela's conversation about grief and denial, let's hear some of your thoughts on the subject.
We asked listeners to let us know about the tools that they have found most helpful during periods of grief.
Here's what you said.
My mom died at age 68, about five and a half years ago.
And while her death was unexpected, she had suffered from two chronic illnesses, one of which had caused her to lose her sense of smell.
And ironically, it's this same sense of smell that has become the best tool for me in my grief toolbox.
I'll go into my closet and grab her perfume bottle, which I had saved.
And smelling her signature scent allows the floodgates to open for me to just spend time crying and grieving.
I've heard that our sense of smell is most strongly tied to memory.
And it's been very helpful in handling my grief about her death.
Hi, Stephen and Angela, what helps me the most during times of grief is structure and productivity.
I need something to focus my otherwise negative energy on as I work through the grief process.
When my brother was killed in action in 2011, I worked with the city to establish a local Veterans Memorial Park that honors all service members.
And although it was a sad time in my life, I didn't allow it to become a dark time in my life.
And what came out of this situation is now a focal point for the community, a long standing memorial for all who have served past and present.
And for that, I'm grateful.
This is Gordon in Burlington, Vermont.
The most intense grief I've ever felt was being with my father when he took his last breath.
It was just the two of us.
A deep feeling of loss overcame me and I sobbed and sobbed.
Then as if I'm Q, I recall a friend having recently said, you finally grow up when your father dies.
I didn't grasp it then.
But in that moment, I understood dad was passing the baton as if in a relay, all we had shared together remained.
But it was now up to me to carry it on.
My grief turned to gratitude.
That was respectively Kate Kish, Zach Gallinger Long and Gordon McFarland.
Thanks to them and everyone who sent us their thoughts.
Now, back to Stephen and Angela's conversation about the psychology of denial.
So, you know, we've talked a lot about my mom.
I think she was, when I was a young child, the portrait of benevolence and wonderfulness.
But I will say this, my mother was a paragon of denial when the three of us were growing up.
I think for her it was what Freud and his daughter Anna Freud would have called the defense of denial.
Because for Freud, the general idea was that human beings suffer and this suffering comes from deep unresolved conflict.
And that pain is something we defend ourselves against.
And the defense that he would say is more immature, you know, maladaptive is denial versus more mature defenses like people who use humor or altruism against pain.
But when we were little, my mom owned this little needlepoint wholesale company.
And it was called Lee's Needle Art.
And I would call Lee's Needle Art and I would get transferred to my mom.
And my mom would say, what's wrong?
And I would say, Annette's being mean to me.
And my mom would just be like, some version of, yeah, that's not happening.
Everything's fine. And I think that it was understandable.
You know, she has to defend herself from pain.
But I think if you ask me the question, hey, what's wrong with denial?
Why did Freud think that this was an immature or psychotic even defense mechanism?
It's because not paying attention to reality can be very bad for obvious reasons.
If you're crossing a street, you don't acknowledge there are cars whizzing by, you can get crushed.
But what are the non -obvious reasons?
What are the psychological reasons?
So why does somebody on the way to a funeral think for a moment, maybe this loved one isn't dead?
Why is it when I call my mother, she's like, there is no problem.
It's to remove that pain.
But why do we have pain?
Why do we have suffering?
It is an alert. It is telling you that something is wrong and you have to actually do something.
So going back to Anna, who wrote this note to us, what would you make of this tactic?
She found that she was successfully able to mute the physical pain by denying.
She doesn't tell us so much about whether and how she processed the pain and the reality later.
But it sounds like it was effective in the short run.
Does that mean it's necessarily damaging in the long run or no?
I don't think it's necessarily damaging in the long run.
What Anna's doing there isn't that different from any of us putting our hands over our eyes and watching a horror movie or something like that.
Now, Freud not only said that there are defenses that really end up creating their own problems, denial being the canonical one.
There's something actually which seems like denial but isn't and actually gives us a sense of what Anna might be doing in this anecdote.
And that is called suppression.
So suppression is also a defense.
It is a mature defense, however, and I want to tell you that I learned this from George Valiant, who himself was trained as a Freudian psychoanalyst and leader was a Harvard psychiatrist.
So George says suppression is for the moment, putting something out of your mind, taking that pen light of attention and moving it away to something else.
The difference is that you know what you're doing.
The difference is that you have suspended reality intentionally and you know that at some point you're probably going to come back to it.
He did this longitudinal study of Harvard students that were followed for the rest of their lives and he tells a story of this young Harvard graduate and he's in a submarine and the submarine sinks to the bottom of the ocean and there's a very limited amount of oxygen.
And what you do in those situations is you have to be very still and very calm because the more you panic, the more oxygen you use up.
But then again, what else would you do?
So he tells a story of this young man who essentially is able to draw his mind away from the fact that he is on the cusp of suffocation and death, but he knows that's what he's doing.
So suppression is a close cousin of denial, but in denial, you really are unable to get out of that alternative reality and come back.
And in suppression, you are.
I want to bring this back for a minute to denial and grief.
When my own mom died, so I was an adult, I was maybe 35, something like that.
And honestly, I wasn't expecting to feel much grief because she was in her 80s.
We'd had a very close relationship with some contention, but then we did reconcile.
And there was a huge generation gap.
My mom was 40 something when I was born because I was the youngest of eight and I respected her.
She was very smart, very tough, very hardworking.
She had a lot of excellent qualities, but also I just didn't feel super close to her because she was so much older than me.
And so when she died, which wasn't unexpected, and I was with her along with most of my siblings when she died, I just didn't expect to feel that much.
So I set Shiva for my mom.
And