Abstract

“This patient doesn’t realize she’s dying.” “Dad keeps forgetting more and more things, but he insists it’s just age.” “I always say you can be overweight and healthy, but I panic every time I visit my cardiologist.”

Such statements may seem entirely reasonable and well-intentioned. Yet invoking denial in relation to a medical situation—implying a refusal or inability to understand, whether on the part of patients or their loved ones—is never neutral. The mere suggestion of illusion, irrationality, or cognitive distortion carries consequences: it can subtly transform the dynamics of care.

Indeed, when we assume that someone is improperly “attached” to reality, do we not risk undermining their standing as a free, autonomous, and fully competent subject? In this talk, I examine the effects of accusations of denial and the pervasive imperative to “accept” as an unquestionable norm. I argue that so-called denial may be less a psychopathological state than an instrument of power relations—and I explore possible forms of resistance to its coercive force.