Is the Human Capacity to Deny Reality True Mental Illness?

The undiagnosed epidemic of normalized indifference

I was in my second year of my doctoral studies in clinical psychology, working as a counselor at a public school, when I received a concerned call from parents about their 14-year-old daughter. They had heard about my individual work with adolescents and reached out directly, hoping I might offer a different perspective than what they'd found elsewhere.

Their daughter, they explained, was struggling. With both the girl's and the school's permission, we arranged to meet once a week outside her regular class schedule. She had intentinoally cut her arms once, and a deepening sadness and isolation had already prompted her parents to send her to a therapist. Her family doctor had prescribed Prozac. Despite ongoing therapy and medication, in her parents' estimation, she was doing worse, not better, which is why they sought my involvement.

This was during the aftermath of 9/11 and around the time of the Iraq invasion. The world seemed saturated with turmoil—school shootings, terrorist threats, and the constant fear-inducing coverage from American media. While most students possessed a built-in capacity to dissociate from internalizing the world's pain, focusing instead on typical teenage concerns, she seemed deeply affected by the state of the world.

In our sessions, I was applying Cognitive Behavioral Therapy techniques I had learned in my training. She was self-monitoring between sessions, and we were methodically identifying patterns in her thinking and behaviors that I believed exacerbated her pain. I was still young and naive enough to believe there was a disease called "depression" and that she suffered from this disease. It was my responsibility, I thought, to help her overcome it.

One day, as I was guiding her through cognitive restructuring of what I had labeled as "irrational thoughts," she said something I will never forget:

"Why are you trying so hard to make me feel better? Did it ever occur to you I prefer to feel this way?"

She continued, her words cutting through conventional wisdom:

"Everyone around me is so scared of my darkness. They want to give me drugs to change how I feel, to talk it out... But I find all of you and your ability to disconnect from the pain of the world deeply troubling. What have we become that we are not impacted deeply by war, poverty, suffering, and human beings hurting each other? I would rather not live than deny reality."

Not the words of a typical 14 year old!

She spoke about her art as an outlet—her poetry had already won a national contest and been published—and how she preferred to feel deeply, even if it made her different from her peers and complicated her social connections. She assured me she was fine—perhaps more fine than those of us who had learned to look away.

Her words transformed my approach. I realized her emotional experience was not some malady that had to be removed. Instead, I chose to understand it and even embrace it with her. She indeed was unique, and those aspects of herself should not be judged or denied, but rather accepted and even celebrated.

As our sessions progressed, I discovered she had cut herself only that one time after feeling deeply judged by her parents. Apparently, she had an older sister who was a social butterfly, and her parents' constant comparisons had led to a heated argument. With her permission, I helped her parents better understand what she was going through and how best to respond to her needs.

She was eventually able to discontinue the Prozac that had been providing an emotional numbness she found aversive. She also stopped seeing her therapist. Once we all stopped acting like she needed to feel different, she became more accepting of the range of emotions she experienced. This in itself was curative.

Together, we learned to strike some balance in life—one could feel deeply about the pain in the world while at the same time embracing the love and beauty that exists. This made all the difference. It was through this relationship with this remarkable young woman that I learned a profound truth: the desire to rid ourselves of painful emotional experiences often creates much more damage than their presence.

Her words have stuck with me ever since, challenging the fundamental assumption behind much of mental health practice: that happiness, or at least the absence of distress, should be our default state. What if, instead, her "depression" was actually a form of clarity—what researchers would later term "depressive realism"—a refusal to participate in our collective denial of uncomfortable truths?

That conversation marked a turning point in my understanding of mental health. I remember walking out of my office afterward and seeing the school hallways with new eyes. I watched the students who were "doing well"—laughing, socializing, focused on their next test or sports game. These same teenagers who seemed unbothered by the news that bombs were dropping on innocent people halfway across the world. I witnessed a student get bullied while others watched with detached expressions. And I began to wonder: Was their adjustment actually a form of pathological disconnection?

I took a hard look at myself too. How had I learned to disconnect from the pain of others? How had my training taught me to categorize emotional responses as either "functional" or "dysfunctional" without questioning the context that sparked them? I began to feel increasingly uncomfortable with what the mental health industrial complex was becoming and how I was being molded within it.

Why don't we attach a mental illness label to someone who is detached from human suffering? Why isn't it considered pathological to deny reality in order to maintain comfortable illusions?

We diagnose the teenager who feels deeply about world events with depression, but we consider it normal when someone walks past a homeless person on the street and thinks, "I'm hungry... let's go find a good restaurant."

We medicate the child who can't focus in a sterile classroom, but we praise the adult who can compartmentalize away the suffering of others to focus on productivity. Our diagnostic systems have no category for "pathological indifference" or "reality detachment disorder," yet these might be the most dangerous psychological adaptations of our time.

Depressive Realism and Collective Denial

The concept of depressive realism, first proposed by psychologists Lauren Alloy and Lyn Yvonne Abramson, suggests that individuals experiencing depression actually make more accurate assessments of reality than their non-depressed counterparts. While traditionally viewed as having a negative cognitive bias, depressed individuals might instead be refusing the positive illusions that help most people navigate an often harsh world.

My experience with that young poet made this abstract theory viscerally real. We were conditioning people—including ourselves—to deny aspects of reality that were unpleasant and dark. Worse than that, we were actively pathologizing the sensitive souls who were reacting appropriately to a troubling world. We were teaching people not to feel, to detach from the pain of others, to view their own fears, struggles, and emotions as symptoms requiring treatment rather than natural responses to genuine problems.

This realization coincided with the rise of "decrease stigma" campaigns that were ostensibly increasing awareness of "mental illness." While possibly well-intentioned by some advocates, these efforts ultimately reinforced the dangerous idea that emotional distress was primarily a brain disorder rather than a reasonable reaction to unreasonable circumstances. This framing drove countless people to judge their natural emotional responses as symptoms of mental disorder requiring professional intervention and medication. In my assessment, the situation has deteriorated dramatically since then, spiraling into what can only be described as a self-perpetuating system of pathologizing normal human experiences—a system now entirely out of control.

The Struggle Creates Suffering

Over the decades of my clinical practice, I've witnessed a troubling pattern: more people suffer from trying to escape their emotional reactions than from the presence of the emotions themselves. The is in part cultural.

Think about it…

The person who numbs through drugs and alcohol isn't suffering primarily from sadness or anxiety—they're suffering from their desperate attempts to avoid feeling those emotions. The young girl who starves herself isn't battling fat; she's trying to starve away her insecurities. The individual struggling with panic attacks isn't incapacitated by fear itself but by the fear of fear—the terror that the next attack might strike at any moment. The sensitive person who has been chronically invalidated and told their reactions are "dramatic" learns not to trust themselves, leading to self-harm, harsh self-criticism, and self denial.

Yet what does our mental health system offer these individuals? More ways to eliminate their “symptoms” (which are emotions and thoughts). More medications to blunt their feelings. More techniques to distract from discomfort. Modern medicine and the therapy industrial complex have largely colluded to "rid them of symptoms" rather than helping them understand and integrate their emotional experiences. This approach doesn't heal—it often maintains and sometimes worsens the condition.

Perhaps that's the point?

More customers.

More people buying what we're selling.

More individuals dependent upon a system promising relief that never quite materializes. The business model works brilliantly: convince people their natural reactions are pathological, then sell them the "cure" for a condition that wouldn't exist if we hadn't pathologized it in the first place.

What I've learned from that young poet and countless others since then is that true healing comes not from escaping emotions but from accepting them. The judgment of emotions and thoughts, the desperate desire to escape them, to drug them, to avoid them—this is the actual problem. When we teach people to fear their own internal experiences, we create a war within them that cannot be won. You cannot defeat a part of yourself. You can only learn to listen to it, understand it, and integrate it.

The individuals I've seen make the most profound recoveries aren't those who successfully eliminated their “symptoms”. They're the ones who developed a different relationship with their experiences. They learned to view “their depression” not as an enemy to vanquish but as a messenger carrying important information. They came to see “their anxiety” not as a defect but as a natural alerting system that, while sometimes miscalibrated, was trying to protect them. They recognized that their anger, sadness, fear, and even despair were not signs of weakness or illness but aspects of their humanity responding to a world that can be beautiful, terrifying, unjust, and heartbreaking—often all at once.

Depressive realism offers us a profound counterpoint to our culture's relentless pursuit positivity and happiness. Perhaps some forms of "depression" are not disorders at all but a dropping away of the self-protective illusions most of us maintain. Perhaps the sensitive souls among us—the ones who feel too deeply, who cannot numb themselves to the world's pain—are not broken but are instead seeing clearly what the rest of us work so hard to ignore.

I don't mean to romanticize suffering. Pain is real, and for many, it becomes unbearable. But our approach to alleviating that pain matters tremendously. When we pathologize natural human responses to difficult circumstances, when we teach people to fear and avoid their own emotions, when we suggest that the goal of human existence is to feel good all the time—we set them up for a lifetime of struggle against themselves.

That 14-year-old poet taught me what years of doctoral training couldn't: sometimes the most healing thing we can do is not to change how someone feels, but to sit with them in their pain, to validate the wisdom in their perspective, and to help them find meaning in their experience rather than simply trying to escape it.

In a world that increasingly denies reality—whether through digital distractions, substance use, consumerism, or psychiatric medications prescribed to help people tolerate intolerable circumstances—perhaps what we need most are more people willing to see clearly, feel deeply, and speak honestly about what they find. Not to wallow in darkness, but to acknowledge it exists, to understand it, and perhaps, through that understanding, to find a more authentic way forward—together.

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