Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Denial: Learn to cope with painful situations

Denial is an unconscious coping mechanism that gives you time to adjust to distressing situations. But when you stay in denial, it can interfere with treatment or tackling life challenges.

By Mayo Clinic staff

When someone says you're in denial, it generally means you aren't being realistic about something that's happening in your life, something that may be obvious to those around you. Indeed, when you're in denial, you seem to be pretending that something isn't happening or isn't true.

In some cases, though, a little denial can be a good thing. Being in denial for a short period can be a healthy coping mechanism, providing time to adjust to a painful or stressful issue. But denial has a dark side. Being in denial can prevent you from effectively dealing with issues that require action, such as a health crisis or financial problems.

Find out when denial can help — and when it can be a roadblock.

Understanding denial and its purpose

Denial is a common type of defense mechanism that occurs in reaction to a trauma or perceived threat. It is a way of coping with emotional conflict, stress, painful thoughts, threatening information and anxiety by refusing to acknowledge that something is wrong — in essence, denying the existence of a problem. You may be in denial about something happening to you or happening to a loved one.

In its strictest sense, denial is considered to be an unconscious process. You don't generally decide to be in denial about something. But some research suggests that denial may sometimes have a conscious component — on some level you might be choosing to be in denial.

In either case, when you're in denial, you:

  • Refuse to acknowledge a stressful problem or situation
  • Avoid facing the facts of the situation
  • Minimize the consequences of the situation

Common reasons for denial

You may be in denial about anything that makes you feel vulnerable or threatens your sense of control over your life, such as:

  • Mental illness or addiction
  • Chronic or terminal illness
  • Financial problems
  • Job difficulties
  • Relationship conflicts
  • Traumatic events

Situations in which denial may be helpful

It may seem that refusing to face facts is never a healthy way to cope. In some cases, though, a short period of denial may 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 instance, after a traumatic event, you may need several days or weeks to fully process what's happened and come to grips with the challenges ahead. Consider, for instance, what might happen when a woman discovers a lump in her breast one night as she's lying in bed. She feels a rush of fear and adrenaline as she imagines it's breast cancer and immediately leaps to the conclusion that she's going to die. So she decides to ignore the lump, hoping it'll go away on its own. But when it hasn't gone away two weeks later, she consults her doctor.

This type of denial is considered an adaptive — or helpful — response to stressful information. The woman initially denied the distressing problem, but then as her mind absorbed it, she came to approach it more rationally and she took action by seeking help.

Next page
(1 of 2)
References
  1. Shockey Stephenson P, et al. Understanding denial. Oncology Nursing Forum. 2004;31:15.
  2. Rabinowitz T, et al. Nothing is wrong, doctor: Understanding and managing denial in patients with cancer. Cancer Investigation. 2006;24:68.
  3. Managing traumatic stress: Tips for recovering from disasters and other traumatic events. American Psychological Association. http://www.apa.org/practice/traumaticstress.html. Accessed April 6, 2009.
  4. Vos MS, et al. Denial in cancer patients, an explorative review. Psycho-Oncology. 2007;16:12.
  5. Miceli M, et al. Further distinctions between coping and defense mechanisms. Journal of Personality. 2001;69:287.
  6. Telford K, et al. Acceptance and denial: Implications for people adapting to chronic illness: Literature review. Journal of Advanced Nursing. 2006;55:457.
  7. The family role in addiction: Denial, enabling and codependency. The Partnership for a Drug-Free America. Accessed April 6, 2009.
  8. Creagan ET. (expert opinion). Mayo Clinic, Rochester, Minn. April 21, 2009.

SR00043

June 25, 2009

© 1998-2010 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger