I want to explain what I mean when I talk about denial and how it can sabotage chronic pain management.  I believe that denial is a defense mechanism that helps us face painful reality when it is overwhelming or distressing.  It’s an automatic and unconscious reaction that gets turned on when we have to think about or talk about our painful reality.  There are both benefits and disadvantages to using denial.  The benefits make us want to keep using denial in spite of the disadvantages that we tend to experience.
 
The Benefits of Denial

The major benefit of using denial is that it helps us to deal with unbearable pain and overwhelming problems.  If you don’t believe it, talk to people who were near death as a result of a serious illness or injury and then survived.  Ask them if at their worst moment they realized how sick and close to death they were.  Most people will tell you that they didn’t.  It was only as they began getting well that they realized how sick they really were.  Why?  Because at the moment of greatest illness, denial can be very strong and help us to keep hope alive by preventing us from seeing how hopeless the situation is.

You can also see the use of denial when talking with people who have a run a 26 mile marathon.  Somewhere around 20 miles, most runners find that there body rebels and threatens to shut down.  This is called hitting the wall.  Experienced runners get through “the wall” by using denial.  They try to ignore the real physical pain they are experiencing and focus upon getting through the wall and completing the race.  Does it work?  Sometimes it does.  Don’t forget, however, that even the most experienced marathon runners have collapsed because the denial of their exhaustion caused them to push themselves beyond their physical endurance.  In these cases the benefits that denial provides by helping deal with intense pain is outweighed by the disadvantages – the inability to accurately assess the truth of a given situation.

The Disadvantages of Denial

The major disadvantage of denial is that it prevents us from seeing what is wrong and taking appropriate action to handle the situation.  As a result our problems can get worse in the long run because we refuse to recognize what is wrong and to do what is necessary to handle the problem.

When I was about 12 years old I injured myself playing sand lot football with my friends. I was rushed to the Emergency room and got shot up with Demerol.  It sure stopped the pain.  Then I was sent home with opiate pain medication that should have lasted 30 days if I took it as directed.  First of all my parents should have held and dispensed this type of medication but they didn’t see why they should—total denial perhaps.  Secondly, I ran out in about two weeks and used another type of denial—rationalization—to convince myself and my parents that the pain was worse and I really needed it.  I continued this pattern off and on for the next fifteen years or so before I finally came out of denial and sought help.

At times denial was really a blessing for me because it not only helped with painful injuries and a chronic pain condition but it also allowed me to escape from some painful reality of an abusive school system and my father’s alcoholism.  The problem was that as my tolerance built up so did my side effects or negative consequences. 

For people living with chronic pain denial management is crucial for several reasons. One reason is sometimes people get into a problem with their medication management and just don’t see it.  Another is sabotaging an effective pain management program by getting into automatic and unconscious self-defeating behaviors. 

To learn more about chronic pain management please check out our website at www.addiction-free.com and go to our Publications page and for more information and tools for managing denial check out my workbook Denial Management Counseling for Effective Pain Management. If you want to read more about denial for chronic pain management you can find my article From Denial to Effective Pain Management that you can download for free on our Ariticles page.

To check out our July Chronic Pain Solutions Newsletter please click here.