WEBWATCH  - - DENIAL AFTER DIAGNOSIS

By Shirley Butler –

 

Denial is defined as a failure to realize the existence of problems or the implications of behaviors, actions, or moods. The condition is very prevalent among those having been diagnosed with diseases or medical problems requiring surgery, especially among cardiac patients. Type-A personalities, in particular, often rationalize their destructive behaviors, minimize their heart disease, persuade themselves that they have recovered quickly and completely from any malady, and even fail to acknowledge and deal with new problems that arise.

 

Spouses and other loved ones often participate in and complicate this denial. Spouses may also wind up minimizing their own needs and feelings in order to support their mate, or find themselves in the difficult position of trying to convince a person in denial that they need to re-evaluate their behavior. Even cardiologists and other health care professionals can be a party to a patient's denial. News of serious disease can elicit different reactions from patients of my condition.

 

The one extreme is total denial of the disease, recovering fast but without any changes in their lifestyle to prevent recurrence.

 

The other is acceptance of the disease, taking full control and fighting it.

 

In between denial and positive acceptance are anxiety, mistrust, resignation and withdrawal. It has been shown that working out the negative feelings and developing and maintaining a positive attitude can have an effect on the disease course.

 

Among women with breast cancer, those with support groups and counseling fared better and outlived those without support twice as long. Patients who were hospitalized with less anxiety and depression were also discharged earlier. A positive attitude helps to plan a healthy lifestyle, with better compliance to treatment.

 

Psychological factors may also influence physical health directly. Many methods for dealing with denial exist; in general, a patient should be confronted gently, rather than attacked. Objective sources, such as books, magazine articles, and physicians, can be employed to help the patient recognize their situation. In the early stages of a problem, denial can be helpful to the patient in dealing with the fear and trauma of the situation; eventually, though, it must give way to a feeling of motivation and responsibility. Chronic, self-destructive denial may even require counseling as a last resort.

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