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Dr. Jeff Kane: Denial

 

Gina announced to her cancer support group, “I’m so tired of medical appointments and treatments and side effects. At this point I’m going to just live my life as though I don’t have cancer.”

Another member said, “Don’t you think that’s being in denial?”

“You bet it is,” Gina replied. “Denial is the only thing that works for me now.” She reopened her law practice and enjoyed what she could of her final months.



Denial is refusal to acknowledge what’s demonstrably so. Psychologists don’t think of it as necessarily negative, but often a valuable “defense,” and for good reason: it works. When we’re hit with an emotionally overwhelming message, we might as well say, “I’m not ready to hear this.” So we don’t. In her classic book “On Death and Dying,” Dr. Elisabeth Kubler-Ross listed denial as an almost universal reaction to news of a life-threatening diagnosis. “You’ve got someone else’s chart, doc.” “The tests must have been wrong.”

She wrote that in time people do digest the reality, albeit in palatable nibbles. And once they realize its ultimate undeniability they commonly get angry: “Why me? I’ve done everything right! What not that ne’er-do-well down the street?” “You should have caught it earlier. I’m gonna sue.”




Kubler-Ross wrote about denial in healthcare terms, but it occurs following any bad news. “I don’t believe I’m being fired.” “Ha! There’s no way you’re going to divorce me.” “It can’t be! That’s a brand new battery.”

And, like with illness, after it finally sinks in anger arises. “You were a terrible boss anyway.” “I’ll take you for all you’re worth, you slime.” “You’re a crook!”

The reason I raise this issue is that we’re currently drenched in a perfect storm of bad news. It consists of, for example, the pandemic, along with its wake of ruinous effects: more deaths than America suffered in World War II, fear of contagion, diminished social contact, business closures, loss of livelihood, financial strain, and mental health erosion. And we were already wrestling with political unrest, wildfires and other environmental catastrophes, widespread homelessness, and misinformation run wild. I’m tempted to suggest that under such an onslaught, our sanity demands that we exercise some degree of denial.

But it’s not a permanent fix. Kubler-Ross pointed out that while denial is a fine defense, it always bears an expiration date. Reality stubbornly persists despite whatever our view of it. When we finally acknowledge what’s actually been happening, we express the attendant emotions we had repressed. And when we’re at long last drained of emotion, we’ve reached what Kubler-Ross called “acceptance.” Here nothing is terrible or terrific; it just is. That’s when healing actions begin.

Jeff Kane is a physician and writer in Nevada City.


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