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Handbook of Communication in Oncology and Palliative
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David Kissane, Barry Bultz, Phyllis Butow, and Ilora Finlay

Print publication date: 2010

Print ISBN-13: 9780199238361

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780199238361.001.0001

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Denial and communication

Denial and communication

Chapter:
(p.147) Chapter 13 Denial and communication
Source:
Handbook of Communication in Oncology and Palliative Care
Author(s):

Linda Sheahan

Simon Wein

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199238361.003.0013

Patients who appear not to acknowledge the diagnosis of an illness, or its gravity, are said to be ‘in denial’. Denial is a common reaction, especially when an illness is life-threatening. The expression of denial depends on personality, coping styles, degree of self-awareness, and the extent to which the patient can manoeuvre their illness-pathway through the healthcare system. It ranges on a spectrum from beneficial coping to maladaptive self-harm. The best approach is to develop a ‘feel’ for the patient's coping style, support the patien,t and note the balance between fear and adaptation. Generally, a trusting relationship and good communication will be all that is required to allow the patient to open up and ‘let go’ of denial. This chapter establishes a pragmatic view of denial, explores how it functions within the clinicianȓpatient relationship, and then demonstrates when intervention is appropriate and how that intervention is best undertaken. Specific attention is given to the communication skills required for an effective clinical response to denial.

Keywords:   denial, clinicianȓpatient relationship, communication skills, intervention, cancer, personality, coping styles, self-awareness, fear, adaptation

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