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Coping with stress
Published in Silvia Bonino, Coping with Chronic Illness, 2020
Denial, for example, is a very primitive and potentially dangerous mechanism, because it does not allow us to take note of reality, which is a necessary condition for finding suitable ways to deal with it. Despite this, in some situations it is not only frequent, but cannot even be considered pathological, provided it is transitory. Denial is widespread in the early stages of disease, especially in the face of diagnosis, when the patient clings to everything (such as improbable laboratory errors and incorrect assessments by the doctor) to believe that what is happening to them is not true. Denial can be favored by the objective uncertainty and diagnostic difficulties that often accompany many chronic diseases in their early stages (see Part VI).
Surviving and Thriving in Medicine
Published in Clare Gerada, Zaid Al-Najjar, Beneath the White Coat, 2020
Denial is one of the most primitive of the defence mechanisms, as it is one of the first to occur developmentally. Denial is essentially the refusal to accept reality or fact and instead act as if a painful event, thought or feeling did not exist. It provides the capacity to detach from disturbing emotional states. It is perhaps one of the most commonly used defence mechanisms, used in everyday life. The culture of medicine encourages denial, as it emphasises the need for self-sacrifice and denial of personal needs over others, as epitomised in the first line of the GMC’s Duties of a doctor, namely, Make the care of your patient your first concern. Doctors also use a classic defence triad to avoid admitting they are unwell, which is also often seen in addiction. These are denial (I can’t have an alcohol problem because I don’t get withdrawal effects), minimalisation (I drink the same amount as my spouse) and rationalisation (I only drink in the evenings to relax, and I can stop at any time).
Introduction to Addiction Section
Published in James M. Rippe, Lifestyle Medicine, 2019
Joji Suzuki, Elizabeth Pegg Frates, Irena Matanovic
Lifestyle Medicine practitioners are going to treat patients who are smoking, who are drinking, who are using cannabis, and who are using opioids. Knowing the treatment options, identifying people in need of assistance, and recommending appropriate follow up are all important aspects of Lifestyle Medicine practice. There are assessment tools that can be used prior to the clinic visit. In addition, there is a methodology of counseling patients that will open up the conversation for discussions about these habits, which are often hidden from physicians. Patients and family members are in denial themselves, in many cases. Thus, the role of the Lifestyle Medicine practitioner is to be a non-judgmental source of information, inspiration, and support for those individuals who are struggling to stay drug- or alcohol-free.
Perceptions and experiences of control among people living with motor neurone disease: a systematic review and thematic synthesis
Published in Disability and Rehabilitation, 2023
Nicola Glennie, Fiona M. Harris, Emma F. France
However, from the plwMNDs’ perspective, reducing their focus to the present time is probably quite effective in helping to control the overwhelming and disempowering effects of a future with MND. Greenaway et al. interpret this as a state of “active denial or non-acceptance” [35,p.1006] but the findings from our synthesis would suggest that perhaps these people are not denying they have MND but are distancing themselves from it and the future as a method of controlling the situation. Denial can be an effective coping strategy. Indeed, research into Parkinson’s disease, a similarly chronic and progressive illness, has suggested that acceptance and denial may be intertwined, with denial not necessarily being maladaptive [13]. Therefore, it appears that further research is needed to bridge this gap between the clinician’s wishes to plan for future care and plwMND who perhaps use focusing upon the present as a control strategy that works for them.
Impaired self-awareness and denial of disability in a community sample of people with traumatic brain injury
Published in Disability and Rehabilitation, 2022
Anneke Terneusen, Ieke Winkens, Sanne Smeets, George Prigatano, John Porcerelli, Ray Kamoo, Caroline van Heugten, Rudolf Ponds
The use of defense mechanisms was not in line with our hypotheses. Patients with more severe ISA made more use of the denial defense and less use of the projection defense relative to the other defenses, while DD was not associated with any of the defenses. It is important to note that the process of translating the TAT stories before scoring might have influenced the results. Moreover, denial is scored when patients fail to respond to certain aspects of the pictures [46]. Individuals with high ISA scores simply might not attend to all relevant stimuli or do not perceive them as threatening due to their cognitive impairments. Furthermore, defense mechanisms can be placed on a developmental continuum with denial being the most immature defense, followed by projection and then identification [46]. Since cognitive performance was more compromised in patients with more severe ISA, their ability to use more mature defenses may have been reduced as well. This is in line with the findings of Cramer [46], who found that ‘cognitive weakness’ was one of several behavioral correlates in the use of denial in young adults.
Patient perspectives on managing uncertainty living with multiple sclerosis
Published in Journal of Communication in Healthcare, 2020
Alex R. Pearce, Samantha B. Meyer
Being diagnosed with an unpredictable, chronic and potentially debilitating neurological condition was identified as life-changing and difficult to accept. Many participants described going through a denial period immediately after diagnosis – often avoiding participation in communication with their physician and reporting not feeling ready to accept the uncertainty that this new diagnosis presented. When you’re sitting in the middle of it, you’re kind of like “I’ve got it, I don’t need to know any more about it” - P4I didn’t want to do these things - learn about the drugs, or reading, I just wanted to proceed with my life. I was diligently, as a pharmacist, taking my injection every day but I wasn’t researching any further or contacting anybody else - P8