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Denial: Learn to cope with painful situations

Situations in which denial may be harmful

But what if the woman had continued to be in denial about finding the lump and tried to forget about it entirely? What if she never sought help? In cases like that, where denial persists and prevents you from taking appropriate action, such as going to the doctor, it's considered a maladaptive — or harmful — response.

Some examples of unhealthy denial:

  • A college student witnesses a violent shooting but claims he's not affected by it.
  • The partner of an older man in the end stage of life refuses to help get affairs in order and tells others that he's getting better.
  • A businessman periodically misses a morning meeting after drinking excessively the night before but insists he's still getting all his work done, so he doesn't have a problem.
  • A couple are ringing up so much credit card debt that they toss the bills aside because they can't bear to open them.
  • The parents of a young daughter with drug addiction keep giving her "clothing" money.

In situations such as these, denial prevents you or your loved one from getting help, such as treatment or counseling, or dealing with problems that can spiral out of control — all with potentially devastating long-term consequences.

Moving past denial

When faced with an overwhelming turn of events, it's OK to say, "I just can't think about all of this right now." You may need time to work through what's happened and adapt to new circumstances. But it's important to realize that denial is a temporary measure; it won't change the reality of the situation.

It isn't always easy to tell if denial is holding you back, but if you feel stuck or if someone you trust suggests that you're in denial, try these strategies:

  • Honestly ask yourself what you fear.
  • Think about the potential negative consequences of not taking action.
  • Allow yourself to express your fears and emotions.
  • Try to identify irrational beliefs about your situation.
  • Journal about your experience.
  • Open up to a trusted confidante.
  • Find a support group.

If you don't seem to be making much progress dealing with a stressful situation on your own — you're stuck in the denial phase — consider talking to a mental health provider. He or she can help you find healthy ways of coping with the situation rather than trying to pretend it doesn't exist.

When a loved one needs help moving beyond denial

You may find it incredibly frustrating when someone you care about is in denial about an important issue, whether it's health, finances or relationships. But before demanding that your loved one face the facts, take a step back. Try to determine if he or she just needs a little time to work through the issue.

At the same time, let the person know that you're open to talking about the subject, even if it makes both of you slightly uncomfortable. Often, people facing distressing issues fear that those close to them will be unable to cope and will abandon them. So, make sure your loved one knows you're available, no matter what happens. Ultimately, this may give him or her the security needed to move forward and take action.

If your loved one is in denial about a serious health issue, such as depression, cancer or an addiction, broaching the issue may be especially difficult. Offer support and empathetic listening. Don't try to force someone to seek treatment, which could lead to angry confrontations. Offer to meet together with a doctor or mental health provider. If the impasse remains, consider counseling for yourself to help you cope with your distress and frustration.

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References
  1. Shockey Stephenson P, et al. Understanding denial. Oncology Nursing Forum. 2004;31:15.
  2. Rabinowitz T, et al. Nothing is wrong, doctor: Understanding and managing denial in patients with cancer. Cancer Investigation. 2006;24:68.
  3. Managing traumatic stress: Tips for recovering from disasters and other traumatic events. American Psychological Association. http://www.apa.org/practice/traumaticstress.html. Accessed April 6, 2009.
  4. Vos MS, et al. Denial in cancer patients, an explorative review. Psycho-Oncology. 2007;16:12.
  5. Miceli M, et al. Further distinctions between coping and defense mechanisms. Journal of Personality. 2001;69:287.
  6. Telford K, et al. Acceptance and denial: Implications for people adapting to chronic illness: Literature review. Journal of Advanced Nursing. 2006;55:457.
  7. The family role in addiction: Denial, enabling and codependency. The Partnership for a Drug-Free America. Accessed April 6, 2009.
  8. Creagan ET. (expert opinion). Mayo Clinic, Rochester, Minn. April 21, 2009.

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June 25, 2009

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