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Pharmacy Links

AFTER CANCER: FEELINGS. DENIAL AND REPRESSION

March 12, 2009

What Is the Difference between Denial and Repression?

Denial is an abnormal refusal to acknowledge the known truth. If you refuse to believe that there is any reason to have follow-up or if you deny the presence of a new lump, you are said to be in denial.

Repression is the rejection of painful or frightening ideas from conscious thought. You may have a high chance of recurrence, but you are doing well now. You are said to be repressing thoughts of recurrence if, while you are enjoying an activity, you put out of your mind thoughts about potential future problems. You know and accept all the truths, but you do not let yourself think about them all the time.

Many people use the term “denial” when they are really referring to repression.

Is Denial Healthy?

Denial is unhealthy if it keeps you from doing the right thing. Denial that prevents you from taking steps to avoid or minimize problems is harmful. If you were treated for malignant melanoma (a type of skin cancer), and you continue to spend hours in the sun with your skin unprotected, you are denying your vulnerability. Consequently, you are missing one important and easy way to help keep yourself healthy. Using sunscreen does not mean that you are vulnerable and afraid; it means that you are taking control of your situation as much as possible.

Healthy denial can bring you physical and/or emotional comfort in painful or hopeless circumstances. The story of a young woman with aggressive cancer who was deteriorating rapidly illustrates how denial can be healthy. She was bald and jaundiced (yellow from liver failure). She had done everything possible to fight her cancer and had accepted that her death was near. She shared her sadness about dying. The interesting thing was that she always acted as if she looked wonderful, referring to her pretty skin and thick hair. She knew exactly what her situation was, but her physical appearance was so abhorrent to her that her mind protected her. Her denial did not change any of her decisions. It simply shielded her from the pain of acknowledging her physical deterioration and helped her to live fully within the severe constraints of her terminal condition.

Is Repression Healthy?

Repression can be a healthy, adaptive way of dealing with a painful reality. Repression can allow you to take steps to recover or stay healthy, while minimizing the negative impact of these actions.

Fear of recurrence can be a debilitating problem, destroying your quality of life even when things are going well. Understanding and sharing this fear will diminish it, but not make it disappear completely. Repression of any remaining fear will free you to live your life most fully. Effective repression enables you to minimize your fear of recurrence between checkups, but it does not misguide you into believing you no longer need them or can ignore symptoms. Repression allows you to forget when it is safe to forget.

Repression is a dynamic process. When you are due for a checkup or develop a worrisome symptom, you will be less able to repress your fears. Accept the anxiety as part of a mechanism that is working well.

Repression is a healthy way of coping with physical and emotional pain as long as it does not prevent you from doing the right thing.

As you can see, repression and denial can be good or bad, adaptive or maladaptive, depending on how they are used. Repression is not inherently good or bad, any more than a drug is inherently good or bad; it depends on how it is used.

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