Nurses working with terminally ill or bereaved clients and their families need to understand the defence mechanism of denial and how it helps people to cope with unacceptable physical and psychological threats

Sigmund Freud (1961) identified the ego as the reality component of the personality that governs problem solving and rational thinking. As the level of anxiety increases, the strength of the ego is tested, and energy is mobilised to confront the threat. Anna Freud (1953) identified a number of defence mechanisms which can be used in the face of threat to physical or psychological integrity. Among these defence mechanisms is the commonly used and important mechanism of denial.