An example of denial in action is the teen with diabetes who wolfs down two pieces of birthday cake at a party, knowing full well that she’s going to regret it later; or the young person with hemophilia who insists on performing daredevil stunts on his dirt bike. But suppressing the reality of a health condition is also an effective coping strategy that allows people to go on living productively. Denial becomes a problem only when it leads to dangerous outcomes.
This defense mechanism, seen mainly with younger adolescents, consists of partial denial. The teenager accepts her condition and often exhibits a firstyear medical student’s knowledge about it, but chooses to block out how she feels about it. Intellectualization can be useful when employed as a delay tactic; it gives the young patient time to sort out and deal with her emotions. But if it persists, the adolescent never truly comes to grips with her situation. She may also fall into a pattern of shutting out all uncomfortable feelings, at which point intervention from a health-care professional is certainly warranted.
When the going gets tough, even the most outwardly stoic youth may revert to childish behavior. Regression provides temporary escape from stressful situations. The proper parental response? Be firm about what you will and will not tolerate, but show plenty of caring and patience. In time, the young person will learn to cope with his circumstances in a more mature fashion.
This is another short-term survival tool, frequently wielded like a battering ram. Defiance, combativeness and testing limits at home and at school are all expressions of a teenager’s anger and depression over his predicament: I’m furious that I have this stupid disease! And even though I know it’s irrational, Mom and Dad, sometimes I can’t help venting my rage in your direction. Acting-out behavior can be hurtful to anyone who stumbles into its path. It may also manifest in self-destructive ways, such as poor performance in school, experimenting with substances and/or sex and run-ins with the law. Involving a mental-health expert from the beginning can help to prevent things from spinning out of control.