Stripping Away Denial

When coping with an injury, denial can be remarkably unhelpful.

Posted May 02, 2010

The first reaction of many people, myself included, when faced with a major injury is: "It didn't happen to me." This is often closely followed by: "If it did, it's not so bad." Somehow if we say it didn't happen, it won't have happened or at least, if it happened, it won't be as challenging as it actually is. Denial may be our first defense against catastrophic change, but when it comes to dealing with an injury, denial can be remarkably unhelpful.

The doctors and therapists who work in rehabilitation are quite aware of this tendency. One of the first things required of a person who goes into an acute rehab facility is to start doing things for themselves. This makes it harder to deny the change that has occurred. Is this cruel? No. It can be psychologically painful but it is far from cruel.

When we are injured, the only way, literally the only way, to find the path to healing is to start from where we are. The sooner we take a hard, unafraid look at the reality of the situation - the sooner we strip away denial - the sooner we can begin to work. And the more we know about our injuries, the less likely we will be to do ourselves further harm when we do work.

Denial is an amazing human capacity. I saw a man, bitter, angry, unwilling to face the truth of his stroke for a couple of years. Let's call him "Henry". Henry kept trying to push the stroke away with his anger - as if staying angry could, in some way, lessen the impact of what had happened. Nursing his anger, Henry kept denying his experience. Denying his experience, Henry made no serious attempt to rehabilitate and stayed stuck.

We think about denial as "protecting" us from difficult situations. Denial in this case was creating the exact opposite of the desired effect. Denial was gluing Henry in place with his injury, preventing him from alleviating the very thing he was trying to protect himself against.

After a couple of years, for complex reasons, and with a lot of encouragement, Henry decided to let go of the anger. He stopped denying the reality of his injury and begin to work with what he had to try to gain more function and make a life.. When Henry stopped pushing away the experience and started looking clearly at the "truth" of where he was, he was able to pay attention to what he could do to help himself.

By looking at the "truth" I mean acknowledging all the aspects of the injury just as they are - not avoiding them or telling ourselves they are something else. Having a profound injury is not a "punishment." It's not an "opportunity." It's not a "mistake." It's not "fair" or "unfair." It is simply what happened. The more we can look directly at every piece of the experience without labeling it, the more readily we can solve the problems and meet the challenges it creates. And the more we can do the work required within safe and reasonable limits.

The greatest opportunity for many of us to strip away denial post injury and face the "truth" of our injuries occurs when we go home from rehabilitation. At home denying our experience also presents the greatest risk that we will overestimate what we can do, push ourselves too hard and hurt ourselves. Going back to our lives can put us face to face with the detailed comparison between what we could do before we were injured and what we can do now, if we are willing to look.

Looking is hard. Being patient with the real pace of recovery is hard. We often need encouragement and support. When we go home into their care our families and friends can help us. But it's not our loved ones' job to make us face our injuries - to tell us how "bad" things are. Nor is it their job to try to "protect" us from the truth of our injuries by compensating for what we cannot do and pretending our injuries don't exist.

What our loved ones can do is stand beside us as we strip away our denial and face what's "true" for us today. Their acceptance of us - their willingness to love us all along our journey - can give us strength. Our loved ones help us most if they do not label or judge what has happened - if they neither deny nor catastrophize our injury. Together, all of us can strip away denial and start healing.

About the Author

Alison Bonds Shapiro, M.B.A., works with stroke survivors and their families, and is the author of Healing into Possibility: the Transformational Lessons of a Stroke.

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