Denial
Denying a cancer diagnosis is a normal reaction. It is an emotional defence mechanism that means we don’t have to deal immediately with the reality of a shocking or extremely upsetting situation.
Denial may take the form of:
- Downplaying the seriousness of the cancer
- Comparing the cancer to something trivial
- Having no or minimal emotional response to the news of the diagnosis
Denial can be a useful way of handling the news of a cancer diagnosis of someone you love, because it is too hard initially to accept that they have cancer. However, if the denial goes on for weeks or months, or causes problems in communication, it needs to be dealt with. Avoiding the reality of a situation can stop people from doing things that they need to do, like going for treatment or sorting out money problems.
Denial is not an "all or nothing" phenomenon. Most people use denial to one degree or another, denying some aspects of the cancer at least some of the time. This denial may fluctuate widely on a day-to-day, or even a minute-to-minute basis. For example, as a terminal patient becomes more ill, they may start to accept that they are going to die, but you as a carer may start to feel denial (particularly if they have lived longer than originally expected).
Denial can affect the patient and the carer, as well as family and friends. If you are in denial, don’t blame yourself or feel that you must hurry to overcome it.
Denial by a patient
If your loved one is in denial about their cancer diagnosis, it can be difficult to help them. Practically speaking, denial may make it difficult to take care of things like their will or to help them seek the appropriate treatment.
If this is the case, perhaps some things can be talked about or organised without being explicit that you are doing it because of the cancer. For example, you may talk generally about finances, or suggest that you both update your wills.
Some level of denial can be useful for a patient. Unless it is interfering with decisions or actions they need to take, don’t feel you need to hurry them to overcome it. Denial often comes because of fear, so rushing the patient to accept reality may cause them to shut down even more.
It’s important to distinguish between a fact denied (for example, a diagnosis of cancer) and the implications denied (for example, the likelihood of remission is low). While the former may interfere with necessary treatment and needs to be addressed, the latter may simply be a means of maintaining morale in a difficult situation.
If you are worried that your loved one is experiencing unhealthy denial, you can ask a health professional, like a specialist nurse or a psychologist, to talk to them.
Denying a terminal diagnosis
Denial is often used by both a patient and a carer when the patient is diagnosed with terminal cancer.
Research has shown that terminal cancer patients who have come to terms with the fact that they are going to die are about three times less likely to be depressed than those in denial. This shows that although many people use denial as a defence mechanism, it is imperfect, and doesn’t necessarily eliminate distress.
The study also found that dying people who were aware of their prognosis did not necessarily feel hopeless.
Again, talk to a health professional if you think that your loved one’s denial is interfering with their emotional wellbeing. Support is also available for you to help you cope with the fact that someone you are caring for is in denial.
