Let’s talk about DENIAL. What Denial? I’m Not In Denial. (see it?)

Jun 12, 2023 | Uncategorized

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Lady with sticky notes attached to her striped sweater I have learned so much from the people around me. The way they go through life teaches me a lot about how to handle myself or to help others. What I’m talking about today is rethinking what we think we may already know and learning something.

I have a good friend with a family member who is with cancer. This is not the first family member with this challenge in the last few years. So, I’d place her gently in the Oh-no, here-we-go-again category of people who are faced with or have a loved one with cancer. Long and arduous.

My friend is pragmatic in nature, which may be why we are good friends. There is a certain amount of stoicism when bad news arrives, followed by the What-can-I-do’s.  

One day, in my concern and in support, I gently asked how she was doing. Her reply to me was, “I have retreated into a state of denial and am trying to stay there as long as possible.”

My immediate reply was: “Denial can be a good thing because it protects us.” 

Denial can be a good thing because it protects us.

My goodness, where did that come from? That kind of talk goes against years of professional education and attentive caregiving. In my work as a patient advocate, I am forever encouraging folks to step into that which is before them and allow me to guide them. My job is to journey with and teach people how to navigate through that which frightens or confounds them.

My social work and counseling education and experience will have me guarded. My antennae go up. I am detecting and assessing the extent of that denial because the Big “D” can be detrimental to a person’s well-being – or their situation. It is well known that denial can prevent people from taking needed action or from planning. In fact, my training and my experience will have me looking for signs of denial as it can have a bearing on my work with patients and their loved ones. Group dynamics can be impacted. Outcomes can be negatively affected.

With a snootful of psychosocial training, that has certainly been the case for me. (I can hear it now) Denial can cause harm to your clients, the very presence of denial or someone remaining there too long certainly be dangerous.

So why in the world would my first reaction be to reassuringly tell my friend that denial is protecting her, thereby condoning where she was?

Maybe it is time I explore denial’s bad rap. Maybe it’s time to give voice to the other side. I want to understand, I want to help my friend, so let me revisit what I think I know.

I allowed myself a little rabbit hole excursion on the internet. Finding information about denial should not be difficult because denial is so common, prevalent, and a well-documented state of being. Maybe I’ve been only looking at one side, thereby limiting my understanding -and response – by only seeing one side.

What I found was this: I had been giving denial too little credit and a one-sided credit. I, we, could look at denial as a tool and as the coping mechanism that it can be.

Denial is helpful as we try to make sense of what’s happening around us.

I began with the fundamentals as I’d first learned them and how I’d come to adopt my stance.

Denial was first described by the famed psychoanalyst Sigmund Freud. He described denial as a psychological defense mechanism in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence. 

It has been no surprise then that denial is the first of the Five Common Stages of Grief, as we learned from Elisabeth Kubler-Ross, whose transformative work also changed the world.

A person in denial is likely trying to protect themself from a truth that is too painful for them to accept at the moment. Sometimes short-term denial is essential. It can give someone time to organize themselves and accept a significant change in their life. 

Denial can, however, cause problems in our life, particularly if it keeps us from addressing a problem or making a needed change. In some cases, it can prevent us from accepting help, getting needed treatment, or making a necessary change.

In my work as a patient advocate, I’d most frequently regarded denial as problematic, even harmful. For example, if someone stays in denial about a health condition and never sees a doctor about it, the problem might worsen. 

One of the ways that I could effect change was in my response to encountering it. I’d always operated from the idea of “We’ve got to get ahead of this thing” or “If we don’t identify and take immediate action, we may lose some of our options, our power”.  I would focus on those kinds of concerns as I worked on behalf of my clients. 

There is relief in revisiting what we think we know because there can be more to learn.

I found some solid benefits of denial during my revisit. In my internet rabbit hole travels, there was a particularly relatable section found in “5 Times Denial May Be Good For You”, by David Spero, RN. Allow me to share some positive impacts of denial. He writes, and I share my concurrences in bold:

Here are five ways in which denial can be good.

  1. When you’ve suffered loss or trauma, denial buys you time. Dr. David Kessler, who wrote two books on grief with the fabled psychiatrist Dr. Elisabeth Kubler-Ross, says, “Denial and shock help us to cope and make survival possible. There is a grace in denial… It is nature’s way of letting in only as much as we can handle. It helps us pace our grief.”
  2. Denial allows you to keep going. Sometimes, other people are depending on you. You have work you really need to do, art to create, battles to fight, and love to share. Denial can let you focus on tasks at hand instead of realities you cannot change.
  3.  Denial keeps you out of depression, and depression feels terrible and cripples your life and your relationships. It’s as disabling as any physical illness. So, if I am depressed about, say, having a rapidly progressing chronic illness, or catastrophic climate change, it may do me good to forget about it for a while and focus on the things I can change.
  4. Denial can help you stay in the moment. By ignoring, forgetting, or disbelieving painful things that happened, or frightening things that may happen, you are free to experience the present moment and live it to the fullest.
  5. Denial is way better than running around doing a lot of stupid things trying to avoid what’s coming. Given a terminal diagnosis, would your remaining time be better spent chasing after a series of expensive quack therapies, healing relationships with your family and friends, having fun, or creating an album of memories for you and your descendants?” 

Those were his words on that last one, but I do like the idea of considering and remembering that we have options, even during trauma and pain, to put the fear down and live. 

Trying to find a way to help someone we love who is in denial may prove to be a challenge, but there are some ways to make it easier for both parties. We can

Learn as much as we can
Whatever our loved one is going through, be it grief, trauma, or something else, we must find out as much as we can about the event. This may help us understand and empathize with them, to embrace the magnitude of what it may be for them, and to realize how much they need the space.

See it differently
(Hello, that is what we are covering today, class!). Denial can offer benefits. Knowing why denial is present – and what it is for – can help us to be more compassionate. The example I was given was this: “In the same way you wouldn’t want to pull off a bandage before someone’s wound has started the healing process, you may not want to fight the denial.”

Be gentle
Remember that the person may not have the capacity to deal with reality head-on at that very moment. It’s OK if we express our concern and allow that person their space. We could plant some seeds that could become useful later.

Practice non-judgment
We don’t have to condone any self-harming behavior, but we can still provide a safe place to help them process the pain. Show up the way you would want someone to show up for you. Afford them dignity and grace.

My revisiting denial proved to be a sort of denial counterbalance. I realized that denial is not all bad, nor is there something wrong with the people in it or feeling it. I regained balance by studying the good aspects of denial. 

Personally, I have always dealt with uncomfortable emotions and situations by finding what it is that I can do, and this exercise served up more of that. I can better support those I love and encounter now by understanding the bad and the good parts of denial, by being there, and by affording them space with grace.

As for my friend who is hurting, I have furthered my understanding of denial and why she may be where she is. My job is to focus on being attentive and with a watchful eye and listening ear. She is where she needs to be, for now. 

Nancy Ruffner is a consulting Patient Advocate, speaker, and coach who often shines a light on the emotions of caregiving, navigating a complex healthcare system, and the challenges of aging. Complimentary Consultations toward engagement. Visit nancyruffner.com.


*Image by wayhomestudio on Freepik