Often, those with chronic pain or illness will be told to not “wallow in denial” about their illness, sometimes misleadingly insinuating that a simple clear-eyed acceptance of their diagnosis or prognosis is all that is required to not be “in denial”. Acceptance of the medical reality is only part of the equation. Understanding the ways in which I indulge in denial of my lived reality is a more difficult endeavour, and - as I have been learning - one of critical importance.
Denial is not inherently evil - in many ways it has had a protective purpose; such as preventing me from plunging into existential ennui. On the other hand, it stings especially deeply when it allows me to judge my self and my functionality based on my non-pain days. Through denial, I also relieve myself of my duties to lay in place structures and foundations for my life that I can rely upon to maintain my life and progress even on days that hurt. My denial is wishful thinking that can never derail the pain but it can derail a life.
My diagnosis is literally a structural thing that seems to respond well to structural treatments; as a result of this medical reality two distinct thought processes seem to have developed: I know and cognitively understand beyond doubt that mine is a condition I will need to at least monitor, if not actively manage, for my entire life. Simultaneously, I do not automatically consider the long-term implications of this in terms of health care access, opportunities and options for employment, geography, hobbies, etc., whenever I contemplate the future or, really, even the present.
Because of the ongoing aspects of my treatment and the general success of those treatments (to varying degrees) it is simple for me to buy into the belief that it will “just be completely better someday”. That belief is even easier to swallow when I have a few days with diminished or (like last week) almost *zero* pain. Deep-seated, self-preserving denial asks “If the pain is going to keep getting better and eventually vanish altogether for forever, there’s no need to learn the subtleties between ‘normal’ and ‘something’s not right’ pain, is there?” I rob myself of understanding where my true limits are, and my life is poorer as a result.
On low-pain days, it’s often hard to convince myself to push through minimal pain in order to do something fun or enjoyable. Denial makes it easy to believe limiting my activity to preserve my body’s current state of non-pain is a viable strategy. The behavior is the same regardless of the actual level of pain I'm feeling - even on good pain days there are times I end up doing the exact things I would be doing if I were actually experiencing more pain, because I think I can avoid a future flare up. I ignore the fact that the pain WILL return regardless, and so limit my life needlessly.
Medical reality encroaches on my lived reality in ways that I can’t afford to not think about. But my magical thinking brain occasionally says “Yes, you can not think about this for awhile! You’ve been feeling so good lately this will surely last forever.” No amount of optimistic denial can change the core truth that I still do need to pay attention to things like how I sit in a dining room chair for hours at a time during a tabletop game. Yet I am usually, inexplicably, surprised at my own surprise that because I wasn’t sitting correctly, a different-than-usual tendon has decided to be, for awhile, as elastic and strong as the 5 year old rubber band that’s lurking in your kitchen junk drawer. It is an entirely predictable thing - unless I’m busy pretending it's not.
The most destructive aspect of this wishful thinking enables the less disciplined parts of me to indulge in laziness or hedonism on days when I’m not in physical pain. It’s hard for me to tap into the motivation to use those days to their potential; not just because the startling sensation of liberty from pain takes me by surprise and I sometimes don’t know what to DO with a good day, but also because the denial which pushes away the truth of my own body’s structure allows me to indulge in the illusion that such painless days are the "new normal", and can be taken for granted.
Continuing to deny the plain fact the pain will return also challenges my ability to lay in place the coping mechanisms (habits, resources, techniques) I need to function with some modicum of confidence and competence when it does. When the familiar pain comes back to rest in its familiar places, I feel *doubly* useless for not fully functioning when I had the chance. And because I had not taken the opportunity to mitigate as much as possible the common backslide - even just a little - it is not a stretch to say that this denial is actively harmful. It feeds an unhealthy cycle which layers shame onto expectation onto varying degrees of worthiness and my beliefs of my value as a human and bakes it into a shitty croissant of self-loathing.
I’m in the process of training myself to recognize and then scrupulously ignore the subtle impulses to retreat into denial. I’m also learning how to ignore or at least shush the chorus of shame surrounding my medical reality. I’m learning how to harness the discomfort I DO feel at those ’wasted’ days and use that propel my full participation in my own life at every opportunity. Every success adds another brick to the bulwark of my self-worth. It’s not an easy process, but lately I find this quote by Richard Morgan’s Quellcrist Falconer helps:
Face the facts. Then act on them. It's the only mantra I know, the only doctrine I have to offer you, and it's harder than you'd think, because I swear humans seem hardwired to do anything but. Face the facts. Don't pray, don't wish, don't buy into centuries-old dogma and dead rhetoric. Don't give in to your conditioning or your visions or your fucked-up sense of... whatever. FACE THE FACTS. THEN act.
“View on the Nile near Cairo” by Thomas Seddon (British, London 1821–1856 Cairo) via The Metropolitan Museum of Art is licensed under CC0 1.0