concurring.
I concur fully in the reasoning and result of the court’s opinion in this case. However, an additional significant reason also supports my decision to join in that result.
The pivotal point for the trial judge, and the Court of Appeals’ majority, appears from the record to have been mother’s failure to meet a pre-condition for therapy imposed by the second of the court-appointed professionals, Mr. Jensen of the Center for Behavioral Intervention. In 1984, mother had pled “no contest” to a misdemeanor charge of *272sexual abuse involving a child.1 Mr. Jensen required that mother admit that she was a child abuser before he would provide therapy.2 In a report to the trial court, that professional attributed mother’s failure to meet the pre-condition to her “total denial” of the specific alleged sexual deviancy.3
The trial court held that the failure to currently admit deviancy, notwithstanding the professional’s description of mother’s intransigence as a product of “total denial,” was equal to a refusal to visit the children,4 and that a refusal to visit the children equaled wilful neglect of the children without just and sufficient cause. Thus, the court found that an adoption, without mother’s consent and over her objection, was permitted by the wilful neglect exception in ORS 109.324.
The term “denial,” however, can have a specialized meaning in psychiatry contrary to the meaning apparently applied by the trial court and the Court of Appeals. Because the record contains no evidence or other demonstration that mother’s “total denial” is a voluntary act on her part, performed without what the law might view as just and sufficient cause, petitioners have not shown by clear and convincing evidence that her “denial,” in the form of inability to undertake therapy with Jensen on his terms, demonstrates “wilful” neglect. See Moody v. Voorhies, 257 Or 105, 111, 475 P2d 579 (1970) (“[t]he father did not make the choice to be *273mentally ill” and, thus, his neglect did not satisfy the statutory exceptions for an adoption without a parent’s consent).
The meaning of the term “denial,” as normally employed within the disciplines of the mental health profession, is different than the meaning apparently employed by the trial court and approved by the Court of Appeals’ majority. The Diagnostic and Statistical Manual of Mental Disorders 393-94 (3rd ed rev 1987) (DSM III-R) indicates that a person in a state of “denial” fails to acknowledge some aspect of external reality that would be apparent to others.5
In psychiatry, “denial” may connote not merely a refusal to admit something, but also an inability to admit it, frequently even a repression of the problem from conscious memory. See Taber’s Medical Dictionary, 472 (16th ed 1989); Katz, Psychoanalysis, Psychiatry and Law, 156-57 (1967); Sweeney, The Family Hero, 51 OSB Bulletin 39 (1991) (denial described as loss of ability to express feelings because “it hurts so much”). Thus, within the discipline of the professional using the term and where the issue is the state of mind accompanying a person’s omission, “total denial” is not always, or even usually, equal to a wilful “refusal.” Therefore, petitioners have not shown by clear and convincing evidence mother’s wilful neglect.
Unis, J., joins in this concurring opinion.No issue is raised in the record as to what effect, if any, may be given to the mother’s conviction based on her “no contest” plea. The decision below turned on mother’s current “total denial” of deviancy.
As noted in the court’s opinion, Dr. Kjaer, previously appointed by the court, but no longer involved at the time of the adoption, indicated that therapy could commence in the presence of denial but that it would be more costly and time consuming absent an initial admission.
As noted in the court’s opinion, in his report, Mr. Jensen stated that visitation “should not depend on [mother] entering therapy.” (Emphasis added.) He outlined a detailed supervised visitation schedule for use in the event the court modified its decision that mother must be treated before visitation could resume. He stated that the schedule should be followed “unless the boys expressed no interest in seeing their mother, or their behavior deteriorated significantly following visits.” Jensen’s assumption, and mine, is that the children will continue to live with father, a living situation where their needs are being met.
The record discloses extraordinary effort by the mother to visit her children except for her manner of dealing with the issue, discussed herein, that caused the trial court to regulate visitation by her.
Our cases consider DSM III-R an authority that ‘ ‘ [a] judge can turn to * * * for assistance.” State v. Huntley, 302 Or 418, 432, 730 P2d 1234 (1986). See also State v. Moen, 309 Or 45, 75, 786 P2d 111 (1990) for a similar use of DSM III-R.