If a chronic pain patient is not willing to admit that certain issues are actually affecting his/her pain, the prognosis of the pain may be negative. It is challenging to deal with a patient who is in constant denial. That affects the doctor-patient relation.
Denial can be a defense mechanism shielding one’s image and protecting the person’s deeply-seated ego. It is very difficult for a patient to admit that he or she is depressed or has anxiety, as if it belittled the patient or decreases his/her integrity.
The doctor often finds difficulties in reaching out for this type of patient. These patients are usually apprehensive and guarded and will “go on the offensive” should the doctor tell them that they may be depressed. The society has a prejudice that a depressed person is “crazy” or a patient with a chronic pain who is walking with the help of a cane is “disabled”. The society plays a negative role as well. Education is essential.
Examples of Denial:
“The pain is under control and I can manage”
“Cancer is not spreading, I can handle it”
“I am not depressed”
“My sex life is great”
“Why should I see a psychologist, I am not crazy”
“Nobody can help with my pain”
“Stress and lack of sleep has nothing to do with my pain”
“My weight has nothing to do with my pain”
“Smoking is not harmful to my body”
“I just drink socially”
“I use drugs just for fun. It has nothing to do with my pain” Resolutions for Denial:
Work on he concept of denial
Your doctor should not confront your denial statements.
Pain is whatever the patient says it is. Understand the physiology of pain and the relationship/co-existence of pain and depression/anxiety
Look for a supportive physician
Ask for stress management training for you and loved one
Learn relaxation techniques, imagery, counseling, and biofeedback
Know yourself and your limits.
