The medical definition of denial: “a psychological defense mechanism in which confrontation with a personal problem or with reality is avoided by denying the existence of the problem or reality” (Merriam Webster emphasis added). Personally, I think denial kills more people than almost anything else. I have no stats on this and I don’t even know if anyone has ever studied it, but think about it: “I don’t have heart disease.” “I’m not a diabetic.” “I’m not addicted to XYZ.” Saying it isn’t true does not make it true, no matter how often you say it or how loudly you say it. You may not want it to be true, but no matter what you want or what you believe, if it is true, sooner or later, you will have to deal with it. The only issue is going to be if you are dealing with it voluntarily or if you are forced to deal with it by being admitted to the hospital for a medical emergency.
Most people who are obese have a variety of medical issues, especially when you get to be about my weight. Type 2 diabetes, heart disease, hypertension, joint pain & deterioration and fatty liver disease are just a few of them. Frankly, a lot of them can be remedied or at least mitigated, by losing weight. Of course, many of these patients only grudgingly admit that they even have a weight problem: “I’m big boned!” (A few extra pounds is “big-boned;” weighing 250 lbs is a “weight problem!”) Denial is insidious and it works against you constantly. You refuse to believe you have a weight problem so you don’t take any steps to make positive changes. The weight problem compounds other health conditions but even if you deal with those (i.e. taking diabetes medication), by not dealing with the weight, you are hampering any help the medication is giving you.
“There are none so blind as those who will not see.” We have all kinds of similar sayings but the meaning is all the same: “I refuse to believe this.” Legally the term is “willful blindness” and depending on the charges, you can get into some serious trouble over it, because you should have seen or known X was occurring. (In other words, it was obvious to everyone but you!)
It takes a lot strength to come face to face with your problems. It often means admitting something painful, embarrassing, awkward. It feels like you’ve failed and let people down. It’s one of the hardest things many people ever do in their lives. It means dealing with the weaknesses in yourself and whatever mistakes you made. It means that other people might learn about your flaws and errors. In all honesty, there are mistakes and weaknesses that I have admitted to myself, but not to others, because frankly, it’s just way too embarrassing. Yep, I SCREWED UP BIG TIME!! Thanks for listening- please leave me alone in my shame now! While I may not have shared my flaws, errors and shame with everyone, I did admit to myself that I had/ have a problem and I cannot handle it on my own. I got help for my problem or I took steps to remedy it (most of them, anyway…)
Denial, i.e. not dealing with it, often just makes it worse. In the case of disease, it takes a greater toll on your health and in some cases, can cause irreparable harm. In my case, not dealing with my type 2 diabetes has left with me some minor neuropathy in my right calf. Part of this problem was plain old denial (I don’t have diabetes) and part of it was not knowing how to manage it. By learning to manage it, my blood sugar and my weight, I no longer have this problem, but the neuropathy remains.
Other issues might mean that you are making things harder for yourself and could be sabotaging yourself. Two of the issues I see a lot on MFP and also My 600 lb Life are emotional eating and toxic relationships. Emotional eating comes up so often, it’s a wonder if there is anyone who isn’t an emotional eater! Most of us know it and admit it: it’s just a fact of life! I get stressed, I eat; I get angry, I eat; I get sad/ depressed/ happy/ worried- whatever, I EAT! Once you realize and admit this fact, you can take steps to resolve this problem, but until you admit there is an actual problem, you cannot and will not be able to resolve it.
A recent example of this was on My 600 lb Life this season: one of the patients refuses to admit she is an emotional eater and when she met with the therapist, she denied she had any issues with emotional eating and walked out of therapy stating it was a waste of her time. When I watched her episode, she described a childhood and adolescence full of feelings of loneliness, rejection, inadequacy, sadness and even a suicide attempt, after which she flatly stated that her weight gain spiraled out of control, but nope, she is NOT an emotional eater! Her episode ended with her struggling with cravings, afraid of going back to old habits and feeling that she would have to go on alone because no one else knew how to help her. The truth of the matter (in my opinion anyway) is that her therapist and Dr. Nowzaradan were trying to help her, but until she admits that her emotions affect her eating, she is making this process much harder than it has to be. I believe she is having cravings and struggling to control her eating because her sense of isolation and the stress of daily life are triggering her old coping mechanism: eating her emotions. Until she learns to deal with her emotions with something other than food, she will continue to struggle. It’s something I have had to face myself. I had long realized that I ate out of boredom, and I took steps to make sure I always had something to do in the evenings when I usually ate in front of the tv (for months I had the most elegantly manicured nails!) When I had a fight with my mom one evening and found myself staring into the fridge, I realized “oh crap! I’m eating because I’m stressed!” It was a tough transition to find a way to deal with my emotions that didn’t involve food (it’s still a bit hairy at times) but I know that when I feel anger, stress, fear, anxiety, I am most likely to eat something just to calm myself down and I can cut that off before it happens. I can choose to do something else, but this particular patient, by denying even the existence of the problem, cannot take those steps. She is hamstringing herself with the only option left: toughing it out the hard way.
The other issue I see a lot is toxic relationships. There is someone in your life whose sole function seems to be to denigrate you, sabotage you or just make life as difficult as possible for you. These can be people you work with or family members and sometimes even your spouse. One of Dr. Nowzaradan’s patients had a husband who preferred his wife be super morbidly obese. One on hand, he was concerned her weight might lead to her death, leaving their young daughter without a mother, but on the other hand, he wanted a wife who was super obese. He was inconsiderate, unsupportive and went out of his way to make things harder for her. On one occasion, he was going out to pick up dinner for the family and she asked for a salad, to which he retorted :”I’m not getting you a salad. If you want to eat grass, you can go out in the yard and graze!” Predictably, they ended up getting a divorce, but first she had to come to terms with the fact that her husband was not only unwilling to change his own habits, but was going out of his way to sabotage her own efforts to improve her health.
It would be great if everyone in your life was really helpful and supportive, but that is extremely rare. Most of us have people in our lives who run the gamut from helpful to not helpful and/ or indifferent. The ones we really need to watch for are the ones who are downright toxic. If this person (and hopefully there is only one) is a coworker or someone not related, it’s easier to deal with. If they are someone you work with, depending on just how toxic they are, you can complain to your supervisor about their obnoxious and inappropriate behavior. When that person is someone in your family, it’s a lot harder to deal with. It hurts to think of someone you love or loved or who is supposed to love you going out of their way to be hurtful. We deny there is a problem: he’s having a bad day; she doesn’t mean that; she’s just scared of change; he’s doesn’t want to be inconvenienced. Sometimes those excuses are true, but when you find yourself making excuse after excuse for the hurtful, disparaging comments and behavior, it’s time for a reality check. Denying that this person really is toxic can be hurting you. You may have to decide if this is a person you want to keep in your life, and that can be a hard decision for some of us to make. It may be that you have to sever your relationship with that person or at the very least accept that they do not have your best interests at heart. Depending on who this person might be, whether a sibling, parent, child or spouse, this can cause major upheaval in your life and coming to terms with not only severing the relationship but also having to deal with the resulting fallout can be a factor in continuing to deny that there is a problem! If your brother, for example, is the toxic individual you want to avoid, severing the relationship can lead to fallout with your parents and other siblings. Yes, it can be complicated and hurtful, but until you admit there is a problem, you are stuck in the hurtful situation.
Sometimes we are simply too close to the problem. Our emotions get in our way and blind us to what’s really happening. When I was in college I had some friends who used to tell me I should have been a therapist (oh hell no!) because they would complain about whatever or whoever was causing problems in their life and usually what I would do is ‘clarify the situation’ by restating what they had just told me, and sometimes offering my advice on how to resolve the issue. Generally, what they found most helpful was that I restated their problem and since they could analyze my statement objectively, it helped them get clarity on their situation. Once you can look at a situation objectively- stepping back from the emotions- it’s easier to see how to help yourself. I wasn’t offering any kind of therapy to my friends: I was just their sounding board, and we can do something similar in keeping a journal. I don’t mean a food journal; I mean the old fashioned “dear diary” kind of journal. If you write down what you are thinking and feeling, it’s a lot easier to see what is really going on inside you. You have to think to write out your emotions; you have to put your feelings into words, and once you do that, in my experience anyway, you can get a better handle on what you are feeling and then you can begin to take steps to help yourself. Sometimes, you need to vent your feelings, take a couple of days to get over the feelings and then go back and get a good look at your situation. This isn’t just about emotional eating either; this is how we see destructive patterns in ourselves. X happens and we react by doing Y which leads to more of Z. The boss is a jerk to me, I eat an entire bag of chips or a pie or just way too much and then I feel physically ill, feel more shame and become more depressed, which leads to more emotional eating. Substitute ‘alcohol’ or ‘pills’ or any other destructive behavior for ‘food,’ and yes, there is a real problem there! This is how most of these destructive patterns start, and then they continue to escalate unless steps are taken to change the behavior.
Most of us are aware if we have a problem: “I keep running out of money at the end of the month but I don’t know where my money goes!” Obviously you are overspending somewhere or need a better budget. “I keep gaining weight no matter what I do!” Are you eating too much or eating the wrong things? Journals and budgets can help, but sometimes we need another pair of eyes. Sometimes, we are so deeply buried in our own problems that we can’t see something is going on with us. If anything, we are only aware that we are hurting or that things never seem to go our way. This is where you can either seek help from a professional or a trusted friend. Ask them to speak frankly with you and when you promise that you won’t get offended or angry, you do have to mean that! There is a saying: real friends say the hard things to your face and good things behind your back. That’s what a real friend does: you are eating way too much and I’m worried about your health! When they do speak plainly and frankly to you, you have to listen with an open mind. You have to be ready to change and that may involve asking your friends and family to help you do that.
Living in denial is not a good place to be. It often keeps you in pain and keeps you from improving your life. Obviously, there is a whole lot more to denial than just emotional eating and toxic relationships. Denial is flat out dangerous in my opinion. It’s hard, it’s ugly, and it hurts. It’s a lot like lancing an infected wound. Although the infection may be slowly killing us, we are afraid of causing more hurt to an already sensitive and painful area, but it’s the only way to let the infection out and once cleaned, the wound can heal quickly. Once you come face to face with whatever your problems or issues are, just taking action to help yourself ease the hurt and pain. It takes strength and courage to face your demons, but once you do, they lose their power over you.