Death by denial

'For certain patients, illness and the bodily changes it causes mayverify premorbid views of the Self as ugly, evil, or bad. Medical interventions would be resisted because the 'improvements' in appearance afforded by treatment would no longer conform to these internalized, fixed, and distorted views of the self. The denial of illness and subsequent refusal to get well may both derive from a need to maintain not simply a consistent view of the self, but a long-standing, pathological view of the self."

By Richard Druss, M.D., The Psychology of Illness (American Psychiatric Press, 1995).