Bipolar patients, especially when manic, frequently deny that they are ill. The importance of recognizing denial as a pathologic coping strategy in mania was emphasized in the early psychoanalytic literature, by Deutsch in 1933 (cited by Lewin [4, p. 46]) and by Lewin in 1950 (4, pp. 51–55, 58–60). Goodwin and Jamison (5), however, emphasized that denial may be a normal response to serious illness for the manic-depressive patient.