Denial is a coping mechanism that gives you time to adjust to distressing situations — but staying in denial can interfere with treatment or your ability to tackle challenges.By Mayo Clinic Staff
If you're in denial, you're trying to protect yourself by refusing to accept the truth about something that's happening in your life.
In some cases, initial short-term denial can be a good thing, giving you time to adjust to a painful or stressful issue. It might also be a precursor to making some sort of change in your life. But denial has a dark side. Find out when denial is unhealthy and how to move past it.
Refusing to acknowledge that something is wrong is a way of coping with emotional conflict, stress, painful thoughts, threatening information and anxiety. You can be in denial about anything that makes you feel vulnerable or threatens your sense of control, such as an illness, addiction, eating disorder, personal violence, financial problems or relationship conflicts. You can be in denial about something happening to you or to someone else.
When you're in denial, you:
- Won't acknowledge a difficult situation
- Try not to face the facts of a problem
- Downplay possible consequences of the issue
Refusing to face facts might seem unhealthy. Sometimes, though, a short period of denial can be helpful. Being in denial gives your mind the opportunity to unconsciously absorb shocking or distressing information at a pace that won't send you into a psychological tailspin.
For example, after a traumatic event, you might need several days or weeks to process what's happened and come to grips with the challenges ahead. Imagine what might happen if you find a lump in your throat. You might feel a rush of fear and adrenaline as you imagine it's cancer.
So you ignore the lump, hoping it'll go away on its own. But when the lump is still there a week later, you consult your doctor.
This type of denial is a helpful response to stressful information. You initially denied the distressing problem. But as your mind absorbed the possibility, you began to approach the problem more rationally and took action by seeking help.
But what if you had continued to be in denial about the lump? What if you never sought help? If denial persists and prevents you from taking appropriate action, such as consulting your doctor, it's a harmful response.
Consider these examples of unhealthy denial:
- A college student witnesses a violent shooting but claims not to be affected by it.
- The partner of an older man in the end stage of life refuses to discuss health care directives and wills with him, insisting that he's getting better.
- Someone periodically misses morning work meetings after drinking excessively the night before, but insists there's no problem because the work is still getting done.
- A couple are ringing up so much credit card debt that they toss the bills aside because they can't bear to open them.
- The parents of a teen with drug addiction keep giving their child "clothing" money.
- A person with chest pain and shortness of breath doesn't believe those symptoms signal a heart attack and delays getting help.
In situations such as these, denial might prevent you or your loved one from getting help, such as medical treatment or counseling, or dealing with problems that can spiral out of control — all with potentially devastating long-term consequences.
When faced with an overwhelming turn of events, it's OK to say, "I just can't think about all of this right now." You might need time to work through what's happened and adapt to new circumstances. But it's important to realize that denial should only be a temporary measure — it won't change the reality of the situation.
It isn't always easy to tell if denial is holding you back. The strength of denial can change over time, especially for someone with chronic illness — some periods are linked to less defensiveness, and at other times denial may be much stronger. If you feel stuck or if someone you trust suggests that you're in denial, however, you might try these strategies:
- Honestly examine what you fear.
- Think about the potential negative consequences of not taking action.
- Allow yourself to express your fears and emotions.
- Try to identify irrational beliefs about your situation.
- Journal about your experience.
- Open up to a trusted friend or loved one.
- Participate in a support group.
If you can't make progress dealing with a stressful situation on your own — you're stuck in the denial phase — consider talking to a mental health provider. He or she can help you find healthy ways to cope with the situation rather than trying to pretend it doesn't exist.
You might find it frustrating when someone you love is in denial about an important issue. But before demanding that your loved one face the facts, take a step back. Try to determine if he or she just needs a little time to work through the issue.
At the same time, let the person know that you're open to talking about the subject, even if it makes both of you uncomfortable. Ultimately, this might give your loved one the security he or she needs to move forward. Your loved one may even be relieved when you bring the issue up.
If your loved one is in denial about a serious health issue, such as depression, cancer or an addiction, broaching the issue might be especially difficult. Listen and offer your support. Don't try to force someone to seek treatment, which could lead to angry confrontations. Offer to meet together with a doctor or mental health provider.
April 09, 2020
- Levenson JL. Psychological factors affecting other medical conditions: Clinical features, assessment, and diagnosis. http://www.uptodate.com/home. Accessed Feb. 7, 2017.
- Walsh D. Denial and decision-making capacity. In: Palliative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.clinicalkey.com. Accessed Feb. 7, 2017.
- Swartz MH. The patient's responses. In: Textbook of Physical Diagnosis: History and Examination. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Feb. 7, 2017.
- Starzomska M, et al. Pitfalls in anorexia nervosa research: The risk of artifacts linked to denial of illness and methods of preventing them. Psychiatria Danubina. 2016;28:202.
- Adjusting to life after being held hostage or kidnapped. American Psychological Association. http://www.apa.org/helpcenter/hostage-kidnap.aspx. Accessed Feb. 7, 2017.
- Fang XY, et al. Is denial a maladaptive coping mechanism which prolongs pre-hospital delay in patients with ST-segment elevation myocardial infarction? Journal of Psychosomatic Research. 2016;91:68.
- Breaking through the barriers of denial. Caregiver Action Network. http://caregiveraction.org/breaking-through-barriers-denial. Accessed Feb. 7, 2017.