Assessment of Denial in Cancer Patients

Denial as a reflection of underlying psychopathology in cancer patients has been the subject of controversy in the literature. It is alternatively viewed as exerting either a positive or negative influence on adaptation to illness. This article offers a conceptual approach that can refine the clinician's understanding of the varied and complex manifestations of actual denial and describe defenses that can be mistaken for denial. Fifteen cases of extreme denial are analyzed, and principles are extracted concerning major aspects of denial, central areas for assessment, and strategies for intervention.