When the demands of life require capabilities that seem to exceed our resources, when we feel the threat of loss and exposure, we experience anxiety. In an effort to avoid the pain of anxiety, we practice the deceptive art of denial.

     Denial is an unrealistic hope that a problem is not really happening, and will go away of itself. It is an attempt to put distance between ourselves and our experience, and protect ourselves from the threat of danger. In its many forms, denial acts like a pain reliever. The practice of denial is an attempt to ease the discomfort of anxiety by a subtle and ingenious twist of attention. 

Denial can become your worst enemy. It diverts your attention, and decreases your mental efficiency by way of trade off. As long as you refuse to accept the truth of your situation, you must of necessity, refuse to give it your attention. Instead you will pay attention to every possible manner of distraction you can employ to support your denial.

    Denial is a major thread in the fabric of adult traumatic brain injury. You may be unstrung by your bizarre experiences, as well as your inability to re-arrange them in a way that fits with your self concept, and at the same time, refuse to admit to yourself that they are happening. 

     In an attempt to relieve yourself of the anxiety you feel, you may enter into a conspiracy with yourself, the conspiracy of denial. You may blame incidents of distortion on being "tired, irritated, ill, distracted, forgetful, etc." When this does not relieve the anxiety, you may focus on your neurological symptoms, or the aches and pains of your body. Or, you may blame other people, or other things for you problems. Family, friends, job, traffic, or the weather may become convenient targets for your anger and frustration. You may even resort to desperate measures to reassure yourself that you are real, and that your responses are reasonable and rational. Other such measures attempt to keep others from discovering the "truth" about you. 

     Denial is a natural, human, self defense mechanism. Denial allows us to buy time to adjust to the shock of injury or loss. However, the practice of denial beyond a reasonable period of adjustment increases the risk of greater injury and losses. Brain injury impairments do not go away by themselves just because you do not want to face them in your self. They take their toll on your life whether or not you have a clue as to what caused them. 

     You may reach a point when you can no longer ignore, rationalize or justify your experiences, and your behavior does not make sense. In the face of mounting evidence that something is very wrong, you may turn to others for reassurance. You will hope that they can define what is real for you, and help you recover your old reality. At this point, the sane world of family, friends, doctors and society, for reasons of their own, may join you in a mad dance of denial. If you do not understand what is going on, it can make you feel very "crazy." 

     Interpersonal relationships are complicated. Sometimes, family and friends fail to be truly supportive because they are in denial. We have pointed out that there are many types of denial, and many circumstances in which denial occurs. We have cautioned that denial is deadly and can sabotage your program of self-management. Regardless of the reason, denial follows the same pattern. It draws attention away from the problem, and focuses it on some diversion, a red herring. 

    Your family members or friends may sense that you are substantially different than you were before your brain injury. They may feel anxiety about your ability to have the same meaning for them in a relationship, and may not quite understand your condition, or your needs. 

     They may even deny that you have a real problem, and tell you your symptoms are imaginary, the result of emotional, or psychiatric problems. Additionally, they might hold the belief that your odd behavior is volitional or willful, designed to elicit sympathy. They may be as confused, uncertain and frightened as you are about the changes in you, and the way in which you behave. 

     It is terribly difficult to accept change in the people we love. If your mental capabilities, behavior, or general attitude have altered substantially, your family and friends might be afraid that you will always be that way. They might even go so far as to blame themselves for the injury itself. They might feel responsible for the changes they see in your behavior, feelings, attitude and overall personality. 

     They might blame themselves for not being able to make things right for you. They might fear that you will be a burden because of the cost, or inconvenience your condition imposes, and then feel badly for feeling that way. They might harbor doubts and reservations about the effectiveness of the treatments you are following.

      If you are in denial yourself, and seeking relief from your anxiety, you may unwittingly perpetuate the deception. That way you do not have to focus on taking responsibility for yourself. Denial around you can cause you to lose track of your goals, and may encourage you to be careless or inattentive about adhering to your self-management program. When you sense denial in family members or friends, you must make an effort to find out what it is about, and how your can ease their fears. 

     Sometimes what feels like denial is in fact symptomatic of inadequate communication skills. Serious misunderstandings can be overcome by straightforward talk. Explain how you feel, what you want and need from them, and what they can expect from you in return. Avoid the trap of expecting people to automatically know and anticipate your needs. When that little voice in your head tells you, "they are dumb," for not knowing what you need, ask yourself whether you have told them clearly, logically, and unemotionally, the things you want them to consider and/or do.

    Denial is an unrealistic hope that a problem is not really happening and will go away by itself.  Measure your denial quotient below.