Grief Psychologist Corner: "Denial - Friend or Foe?" - Helping Grieving People –When Tears Are Not Enough by J. Shep Jeffreys, Ed.D., C.T.

Grief Psychologist Corner:

Denial — Friend or Foe?*
By
J. Shep Jeffreys, Ed.D., F.T.

We humans use denial to keep out or soften terrible news. Too often the use of denial is criticized as “running away from reality” and we may be perceived as weak and lacking the ability to face the painful truth of what has or is going to happen. Families with a very sick loved one in the hospital may overhear the staff saying, “They really don’t get how serious this is; they’re in denial.” However, unless denial creates medical problems or family dysfunction, it serves as a very important and useful shock absorber. Denial allows us to absorb the horrible reality in small doses or push pain away – at least for a while. It provides us with the freedom to not totally deal with a grief reaction right away so that we can take care of other needs.

We also use denial when we avoid grieving people. I was told a story about a man in a bereaved parents support group that demonstrates one way that people react to the grief of a neighbor:

After his son was killed, he noticed that people he knew in the community would play what he called the “Safeway Samba.” When he went shopping, for example, a neighbor he spotted would quickly slip into the next aisle. As the father called out and tried to catch up with the neighbor, the person would pop back to the first aisle. After a period of aisle hopping he realized that neighbors were avoiding him. People in the group nodded, smiled, and recalled similar experiences.

The “Safeway Samba” became those bereaved parents code word for being avoided by others who were not able to make contact.

Such avoidance is actually typical and understandable on the part of both the bereaved as well as their friends and neighbors. People who can’t cope with other people’s grief aren’t “bad.” Contact with grieving people can eat away at a person’s own normal denial system and avoidance serves the function of keeping away the painful reality of what could happen to me. Sadly, this can often result in painful isolation for grieving people.

Humor is another common way to soften, cover up and to avoid the full impact of the reality of our own mortality and that of our loved ones. Death and injury are the basis for many comic strips and stand up comedian jokes.

Another way to keep the painful reality of death and loss away is simply not to talk about it or avoid the subject. I have heard the following ancient Persian folk tale in many different versions. It illustrates the very human need to run away from death.

A wealthy prince in ancient times was preparing for a magnificent banquet and sent a servant out into the garden to gather flowers for the tables. When the young man entered the garden he shrieked with horror for there stood Death. It raised its hands. He raced back into the palace and begged his master to save him from Death. The prince said, “Run to the stables and take my fastest horse and flee to Samara. It is far from this place, you will be safe there!” The prince watched as the servant boy disappeared towards Samara. The prince then angrily strode into the garden where Death stood and demanded, “How dare you enter my grounds and frighten my servant?” “But Sire,” Death replied, “I was only expressing my surprise at seeing him here, for I have an appointment with him tonight — in Samara.

When patients and doctors avoid talking about the gravity of an illness; when families do not want the loved one to know how serious things are; or when death, grief and painful change are simply avoided topics, we hear the word denial used. However as mentkioned earlier, some avoidance and use of humor are healthy responses to loss. We need our denial systems to allow ourselves time to get used to the idea that the loss is irreversible, or that the biopsy is malignant, or that life as we have known it will never be the same.

If denial is the shock absorber for painful loss and crisis the question still remains – How much denial is healthy? When is joking helpful and when is it not? While we must respect the rights of a grieving person or family or a workplace group to formulate some form of a denial system — denial can be problematic. This occurs when there is failure to: (a) get medical attention and follow medical advice (b) take needed safety precautions, (c) make necessary legal arrangements, (d) complete unfinished business and say goodbye or (e) maintain vigilance against suicidal or other harmful behaviors.

If a seriously ill person doesn’t want to “talk about it” or even have a conversation about Advanced Directives, these wishes need to be respected. Loved ones should gently re-introduce the topic during a later conversation. For many in our society, especially health care providers, death represents failure and defeat. It can result in guilt and self-reproach as part their grief response. It is easier simply not to talk about it, distract ourselves, and get to it later. Some people hold on to the hope that a very sick and/or dying person is going to be okay in the face of medical information to the contrary and obvious worsening of the patient’s condition.

In a family where a man was rapidly losing ground to cancer, his wife and children were able to continually adjust their expectations about his decreasing level of participation in family activities. Yet, his own parents and siblings steadily maintained that he would be fine and that there was no cause for concern. The unfortunate result of this strong resistance to the reality of the man’s medical condition was that his wife and children received little or no support from those relatives. The lack of support left this family with continuing major conflicts in the aftermath of this man’s death.

People who lose a loved one require their own timing as to when and to what extent they accept that the deceased is gone and is not coming back. It is not unusual for a family member to return home after the burial and pick up a ringing phone with the hope that it “might be Mom.” “But we just buried Mom!” “I know, I just thought maybe it was a mistake.” This is not crazy or unusual. The head knows but the heart is not ready to let go yet.

Holding on in the face of reality may take the form of keeping the room, house, clothing and other personal effects exactly as they had been. Denial of the terrible truth is what we humans do. Adults as well as children can engage in fantasy thinking –“She’s just on a long trip.” “He’s still away at school.” This is made even more difficult when there is no body recovered as in war, explosions, air and sea disasters. The denial may last a lifetime. The lack of a physical body and the inability to know that life has truly ceased for the loved one leaves the survivors with an eternal question that may never be answered.

Please remember that some denial and humor are healthy responses to loss. We need our denial systems to allow us time to get used to the idea that our loved one is gone forever, that the X-ray contains bad news, that the physical disability is permanent or . . . that prayers were not answered.

NOTE: This article was originally published in LIVING WITH LOSS: Hope & Healing For the Body, Mind and Spirit magazine in its summer 2007 issue, Vol. 22 (No. 2). This citation must be included on all copies.