Originally Posted by EndGameNYC

The triggering of denial is so universal in the face of a potentially lethal medical diagnosis as to be startling only when it is not present. By definition, denial and the other defenses come into play whenever we're confronted with trauma. The "reflection of denial," as you put it, is not a simple concept. When unwanted conscious content is successfully repressed, it then "creates" or becomes a part of an intrapsychic conflict. This conflict, in addition to the psychic energy required to keep the content unconscious and to sustain the conflict, will eventaully reveal itself in another form (e.g., anxiety) of which we are largely conscious, though we are generally unable to link this "newer event" with that which was made unconscious. Sometimes these newer events "make sense" to us, and they sometimes carry what seems to be an obvious purpose, and sometimes they don't.

In my sister's case, the "reasons" for her not wanting to burden me or anyone else with her struggles, though they "make sense," do not mean that they are not a "reflection of denial." Bear in mind that unconscious defenses need to be efficient in order for them to "work," and this drive for efficiency often includes a compelling or at least a plausible "cover story." Again, the primary purpose of defenses is to protect the person from trauma, and they are neither "good" nor "bad." My framing her behavior in terms of denial was not a criticism, but an observation based on my experience. Mary Ann also said that she did not want to "tell this" to anyone, even to herself. If nothing else, this is a signal that revealing her fears around her diagnosis would only create further anxiety and essentially make both the reality of her diagnosis and her related fears "more real." Denial seeks to avoid this as the revelation of disturbing content to other people would therefore create additional sources of anxiety.