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Answer by David Chan, M.D. from UCLA, Stanford oncology fellowship:
A certain amount of denial is healthy in life. We can’t go day by day fearful of possible disaster.
I take care of cancer patients and do my very best to present to them the seriousness of their situations in an open and frank manner (except for the rare patient who responds to my question about wanting to know in the negative).
After the initial shock about what is happening to them, the very large majority of my patients, unless disabled by disease or treatment side effects, return to many of their daily activities and duties, including work, family, exercise, social commitments, and so on.
I’m more than impressed that my patients don’t do what many imagine they would do in a similar fix. They don’t go into their bedrooms, close the blinds, lie down, shut off the lights, and curl up in a ball on their beds, and never come out.
And why is that? Because they, like all of us, have denial. This is the belief that whatever is happening, it’s not going to happen to them. Denial is like many things in life: A healthy dose is good, but a lot of it may be bad.
We all have certain degrees of denial. We get on airplanes because although we know they can crash and burn, we understand the statistics and don’t think it will happen to us.
I’ve skied off very steep avalanche chutes because I didn’t think I’d fall and break my neck or back even though years earlier I came within 2 inches of hitting a tree with my head instead of my shoulder, which resulted in a fracture dislocation. I recently had a bit of a rough whitewater rafting adventure in Wyoming. The guide was explaining that if the raft flipped over in the rapids, that we were to get out from under it and then try to hang onto the sides with our feet facing down river. I thought he was being overly dramatic and was sure it wasn’t going to happen, so I had a great time. If I thought that was going to happen, I’d have been scared to death.
My cancer patients also have denial. Yes, they are scared. Who wouldn’t be? But even when the prognosis is terrible, at the end of the day, the very large majority don’t believe it will happen to them or at least that it won’t happen to them any time soon. That’s a healthy way to cope and allows them to function day to day under very tough circumstances.
Denial is bad is when it’s out of control. It’s like binge-eating, addiction to alcohol, compulsive gambling, or extreme risk-taking. Too much of a good thing is bad. Too much denial in a serious medical situation will cause the patient to forego treatment, and that has obvious dire consequences.
Denial: When it helps, when it hurts
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