Can denial ever be a good thing for heart patients?

by Carolyn Thomas  @HeartSisters

When my little green car started making a funny PING! noise recently, I tried to talk myself out of what I was hearing.  “I don’t think it’s quite as bad as it sounded yesterday . . .”  And when my heart attack symptoms became more and more debilitating, I tried to talk myself out of them, too.

And besides, hadn’t the E.R. doctor emphatically diagnosed those symptoms (central chest pain, nausea, sweating and pain down my left arm) as merely acid reflux just two weeks earlier? In both cases, I guess I was being unrealistically hopeful. But as writer Margaret Weis once warned:

“Hope is the denial of reality.”

Denial has a bad name. To be “in denial” – whether it’s about a niggling noise coming from under the hood or about something as serious as a health crisis – is to be called foolhardy or just plain stubborn. But in some cases, according to Mayo Clinic expertsa little denial may actually be a good thing. Being in denial for a short period can even be a healthy coping mechanism, giving us time to adjust to a painful or stressful issue.  

Refusing to face reality might seem blatantly unhealthy – and certainly ignoring  symptoms that could be heart-related is never a good ideaSee also: Denial and its deadly role in surviving a heart attack

Sometimes, though, if something shocking or distressing has already happened, a temporary period of denial can be helpful. Being in denial gives our minds the opportunity to unconsciously absorb shocking or distressing information at a pace that won’t send us into a psychological tailspin.

For example, here’s a health scare scenario from Mayo Clinic that may seem familiar:

“After a traumatic event has occurred, you might need several days or weeks to fully process what has happened and come to grips with the challenges ahead.

“This type of denial can be a helpful response to stressful information. You initially deny the distressing problem. As your mind absorbs it, however, you can come to approach it more rationally over time.”

It’s even acceptable to say something like:

“I just can’t think about all of this right now.”

When we’re in denial, we:

  • refuse to acknowledge a stressful problem or situation
  • avoid facing the facts of the situation
  • minimize the consequences of the situation

Refusing to acknowledge that something’s wrong is a common way of coping with emotional conflict, threatening information, stress, painful thoughts, or anxiety. We can be in denial about anything that makes us feel vulnerable or threatens our sense of control, such as:

  • a chronic or terminal illness
  • depression or other mental health conditions
  • traumatic events
  • addiction
  • financial problems
  • job difficulties
  • relationship conflicts

After surviving my 2008 heart attack, I was in utter denial at first.

I felt simply unable to get my brain wrapped around the fact that what had just happened to me had actually happened. And I suspect that my family and friends were feeling the same. All of us wanted – and needed – to be hopeful that things would soon get back to  “normal” once again.

When my stunned co-workers came to visit me in hospital while I was recuperating in the Coronary Care Unit, I assured them quite cheerfully that I would definitely-for sure-absolutely be right back at work in two days max. I remember how they looked around that big white room – machines beeping, lights blinking, wires and tubes attached to my body – and just silently shook their heads in wide-eyed disagreement.

It took days, even weeks, before the reality of a chronic, progressive disease diagnosis  really began to sink in. And it was much later, after the influx of daily visitors, get well cards, flowers and casseroles gradually slowed to a trickle before that cheerful happy face I’d pasted on could begin to fade.  My protective veneer of denial – which until then had kept me feeling almost freakishly chipper as I told and retold my dramatic heart attack misdiagnosis story to shocked listeners – was no longer needed.

Perhaps I was then finally ready to “get” my new reality – which felt at the time like a delayed reaction to the initial trauma, but now makes far more sense to me.

This scenario, according to Mayo Clinic, is common when we need time to work through a traumatic event and its accompanying feelings, and to adapt to that new reality. But it’s important to realize that denial should only be a temporary measure — it won’t change the reality of the situation.

 “Denial is a coping mechanism that gives you time to adjust to distressing situations — but staying in denial can interfere with effective solutions, or your ability to tackle challenges.”

If we’re in denial, we are not being realistic about something that’s happening in life – something that might be clearly obvious to those around us.

Suggestions from Mayo Clinic to get past denial include:

  • Allow yourself to express your fears and emotions.
  • Journal about your experience in writing.
  • Open up to a trusted friend or loved one.
  • Participate in a support group.
  • Honestly ask yourself what you fear.
  • Try to identify irrational beliefs about your situation.
  • Think about the potential negative consequences of not taking action.

What to do if the person in denial is not you, but somebody you care about?

It can feel maddeningly frustrating to be around someone who is in denial about an important issue – like heart patients who won’t take their meds, change an unhealthy diet or quit smoking. But Mayo Clinic experts suggest that before demanding that our loved ones “just face the facts”, we might want to first take a step back.

“Try to determine if he or she just needs a little time to work through the issue. At the same time, let the person know that you’re open to talking about the subject at hand, even if it makes both of you slightly uncomfortable. Ultimately, this may give the other person the security needed to move forward and take the next step.”

Find out more about denial from Mayo experts. But remember that denying your possible heart attack symptoms is dangerous. Learn why at:

Denial and its deadly role in surviving a heart attack

The weirdness of post-heart attack stun

Knowing and going: act fast when heart attack symptoms hit

Downplaying symptoms: just pretend it’s NOT a heart attack

Surviving the crisis: the first stage of heart attack recovery

The new country called heart disease

NOTE FROM CAROLYN:  I wrote more about how women adapt to learning they have heart disease in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from Johns Hopkins University Press (and use their code HTWN to save 20% off the list price).

5 thoughts on “Can denial ever be a good thing for heart patients?

  1. Pingback: RReddyHealth
  2. Thanks to Joan, Beamie and Mirjami for taking the time to leave such thoughtful comments on this topic. I think it’s encouraging that for at least two of you (Beamie and Mirjami), your cardiac events were many years ago – and yet you’re still here, alive and kicking. Maybe there’s something to this theory of denial being somehow self-protective in adjusting to the diagnosis?


  3. Hi,

    But denial is a kind of optimism. In my case I could not have lived 27 years with heart disease and angina pectoris without denial. From the beginning after my triple bypass I did not go to the doctor (I have not had a cardiologist for me) every time when I had had a heavy angina pectoris attack. I did not even always take a nitro. I did not want others to notice how I feel. I think my heart is used to this pain and there is a kind of protection in my heart. Nobody can understand this but I believe in it. Like Sherrie I would say: Some day we all have to die.


  4. I was in denial because I couldn’t remember anything. Sudden cardiac death? When? Meds for the rest of my life? Why? Heart problem? You’ve got to be kidding!

    11 years later, I’m still in some form of denial. I still don’t remember a dang thing about it, and in order to survive and live a normal life I find I have to do things that wouldn’t necessarily be recommended for a heart patient. It’s like standing at the end of a diving board and taking the leap: Maybe I’ll die, and maybe I won’t.

    May the Blessings Be!



  5. Thank you for this. I’ve never seen anything on this topic, and what you’ve said so eloquently in a few words is so helpful.


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