When denial is not the enemy

I once watched a recorded interview with Stephen Levine, the Buddhist teacher, author and extraordinary man who dedicated much of his life to serving the dying, particularly through the AIDS epidemic. He left a marvel-worthy legacy, not only through his books and teachings, but through the way he invited people to be more deeply human in the presence of suffering, fear, end of life and love.

In the interview, a woman spoke of her exhaustion as a support worker. She was caring for someone who was seriously ill and, in her words, deeply in denial about his diagnosis and impending death. You could hear her battle-weary worry and frustration. She was trying to help him understand, trying to support him to see what seemed obvious, trying to bring him into the truth of what was happening.

Stephen listened deeply. He did not rush to answer. He did not correct her. He simply received what she was saying, paused, tilted his head slightly and quietly asked, “Why would you want to take away his denial? It might be the only hope he has.”

There are some sentences that stop the room. For me, that was one of them.

Because surely denial is bad, isn’t it? Surely denial is what we are meant to break through, gently challenge, educate away or bring into the light?

In end of life care, we often speak about truth telling, planning, choice and open conversations, and all those things matter deeply. People deserve information. They deserve to understand their options. They deserve the opportunity to prepare, to make decisions, to say what needs to be said and to live and love well in the time that remains.

And yet Stephen’s question points to something more subtle, and perhaps more compassionate. What if denial is not always the enemy? What if sometimes it is not ignorance, but protection? What if it is not resistance, but mercy? What if, for a time, it is the only bridge a person has between the life they love and the end of life they cannot yet bear to face?

In our raw world of exposure, we can become very quick to divide things into black and white. One side is feared, avoided or judged, while the other is sought, praised and promoted. Acceptance is good. Denial is bad. Truth is good. Avoidance is bad. Hope is good. Fear is bad. But human beings are rarely that simple, and end of life rarely fits neatly into any moral category we try to place around it.

There is the seed of life in death and the seed of death in life. There is the seed of white in black and black in white. These are not comfortable truths, but they are deep and fundamental ones. They ask us to stop rushing toward certainty and instead learn how to stand in the centre, where both realities can be held, equal in value and importance.

This is one of the great invitations in end of life care. Not to force a person into our version of readiness, and not to abandon truth either, but to develop the capacity to listen for what is happening.

Sometimes a person who appears to be in denial may still be preparing in ways that are quiet, symbolic or indirect. They may talk about future plans while also wanting family close. They may reject the word dying while giving away treasured possessions. They may say, “When I get better,” while their body, their choices or their silences are telling another story.

People may know more than they can say. They may be touching the truth, then moving away from it, looking at it from the corner of their eye, or allowing it to arrive in small pieces rather than all at once. If we are too determined to make them say the words we think they should say, we may miss the sacredness of their timing.

This does not mean we collude with lies or withhold information they have the right to know. It does not mean we pretend everything is fine when it is not. It means we learn the difference between offering truth and imposing it. We learn the difference between invitation and intrusion. We learn to ask ourselves whether the truth we are trying so hard to deliver is truly for the person in front of us, or whether it is partly for us because their denial makes us anxious, helpless or uncomfortable.

That is a tender and confronting question.

When someone we love, or someone we are supporting, does not appear to be facing reality, it can stir up so much in us.

We may worry that time will be wasted, conversations will be missed, practical matters will be left undone, or family members will be unprepared. These concerns can be real and important, particularly when decisions need to be made. Yet even then, our work is not to wrestle someone into awareness. Our work is to accompany them with honesty, patience and respect for the pace at which their heart can open to what is happening.

Perhaps this is where the image of the scales of justice becomes helpful. We have two hands for a reason. One hand may hold truth, planning and the practical realities of illness and end of life. The other may hold tenderness, hope and the psychologically safe shelter a person may need to get through the day. If we place all the weight on truth without compassion, we can become harsh. If we place all the weight on comfort without honesty, we can become avoidant. The centre is not always easy to find, but it is where wisdom lives.

So, we breathe. We listen. We look within. We notice where we are leaning. Are we leaning toward control? Are we leaning toward our own discomfort? Are we leaning toward needing the person to approach end of life in a way that makes sense to us? Or can we come back to presence, allowing, and the quiet humility of not knowing exactly what another person needs in any given moment?

This, to me, is where the marvelling begins. Not in pretending that end of life is easy or beautiful in any simplistic way, but in recognising the astonishing ways human beings protect themselves, love each other, reach for meaning and keep finding warmth even when life is changing beyond their control.

Sometimes hope looks like a treatment plan or a final family gathering. Sometimes hope looks like acceptance, clear conversations and beautiful preparation. Sometimes it looks like silence, distraction, humour, future plans or the simple refusal to say the word dying before the person is ready.

And sometimes, as Stephen Levine so gently reminded us, hope may look like denial.

Not because the person has failed. Not because they are foolish. Not because we have done something wrong if we cannot shift it. But because, in that moment, denial may be serving something sacred. It may be holding the person together. It may be giving them just enough room to breathe.

Before we take it away, we might pause and ask: What is this protecting? What hope is living inside it? What is being held here that I need to honour, rather than fix?

In the end, this is not about doing nothing. It is about doing something much harder than fixing. It is about being present with enough steadiness to hold both truth and tenderness, life and death, fear and hope, knowing and not knowing.

It is about accompanying the person in front of us, not the version of them we think they should be.

And perhaps, when we can breathe, allow, and marvel at the whole messy human truth of it all, we may find the centre again. And there, quietly, is peace.