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continued:

Denial: When it helps, when it hurts

Situations in which denial can be harmful

But what if you had continued to be in denial about the lump and tried to forget about it entirely? What if you never sought help? If denial persists and prevents you from taking appropriate action, such as consulting your doctor, it's a harmful response.

Consider these examples of unhealthy denial:

  • A college student witnesses a violent shooting but claims not to be affected by it.
  • The partner of an older man in the end stage of life refuses to discuss health care directives and wills, insisting that he's getting better.
  • An administrator periodically misses a morning meeting after drinking excessively the night before, but insists there's no problem because the work is still getting done.
  • 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 might prevent 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 might need time to work through what's happened and adapt to new circumstances. But it's important to realize that denial should only be 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. If you feel stuck or if someone you trust suggests that you're in denial, however, you might 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 friend or loved one.
  • Participate in 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 to cope with the situation rather than trying to pretend it doesn't exist.

When a loved one needs help moving beyond denial

You might find it incredibly frustrating when someone you care about is in denial about an important issue. 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. Ultimately, this may give your loved one the security he or she needs 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. Seaward BL. Managing Stress: Principles and Strategies for Health and Well-Being. 6th ed. Sudbury, Mass.: Jones and Bartlett Publishers; 2009:88.
  2. Benkel I, et al. Using coping strategies is not denial: Helping loved ones adjust to living with a patient with a palliative diagnosis. Journal of Palliative Medicine. 2010;13:1119.
  3. Managing traumatic stress: Tips for recovering from disasters and other traumatic events. American Psychological Association. http://www.apa.org/helpcenter/disaster-tips.aspx. Accessed March 15, 2011.
  4. Rabinowitz T, et al. Nothing is wrong, doctor: Understanding and managing denial in patients with cancer. Cancer Investigation. 2006;24:68.
  5. Telford K, et al. Acceptance and denial: Implications for people adapting to chronic illness: Literature review. Journal of Advanced Nursing. 2006;55:457.
  6. Creagan ET (expert opinion). Mayo Clinic, Rochester, Minn. March 19, 2011.
SR00043 June 25, 2011

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