When Dealing with a Cancer Diagnosis, Denial is Common

"Denial" is one of those words you hear in the cancer world. As in, "Well, she's just in denial." You have a very important person in your life who has cancer. Are you in denial about the cancer? Is this person you care about in denial? How can you tell? Denial in people with serious illness is a psychological dynamic. The person in denial is, for some reason, temporarily blocking a truth that is too unpleasant to think about. Very bad news is hard to absorb. One thinks, "I have cancer? Can't be! They've made a mistake, switched the x-rays." Or, "My husband has lung metastases? Well, there's always more chemotherapy!"

The thing is, this blocking of the truth is temporary. Defenses like denial help a person to reduce anxiety about a serious problem by explaining it away, minimizing its importance, refusing to believe it is true, or blocking the thought of it from the mind. And the anxiety is lower for a while. However, the problem is still there.

Denial has a bad reputation. But it is a very effective defense mechanism that we all use at times. Denial buys us time to adjust, so the bad news can sink in slowly. And we know the denial is over when we find ourselves crying at a sticky-sweet wedding commercial because we're realizing that a loved one won't be around to see our first grandchild get married.

When Is Denial Healthy?

Denial is as denial does. So, take a look at what the person who is allegedly "in denial" actually doing? Is he showing up for doctor appointments? Is she taking the medications as prescribed? Is he interacting with people as usual?

If a person with cancer or a concerned loved one is otherwise functioning well, then there's no ethical or emotional reason to break through their denial. It may help you resist the temptation to confront the person to know that breaking through someone's healthy denial backfires, resulting in a rift in the relationship or urging them to assume a more "dug-in" position.

It's hard to cope with a serious illness. People with metastatic cancer, multiple sclerosis, or other chronic illnesses, can't spend all day every day thinking about the losses they're experiencing as a result of their illness. Neither can their caregivers. One hospice counselor puts it this way: "You can't think about dying every day. It's like staring into the sun. It can only be done for a few seconds. The rest of the time, you're living."