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I have multiple sclerosis (MS). I have probably had MS since the mid 1950s, when I was in high school. I was diagnosed definitively in 1971, when I was 29 years old. Thirteen years later, two years after becoming a psychotherapist, I was informed of my diagnosis. Because MS is a chronic, deteriorating disease that becomes more visible with time, it forcibly intrudes itself into the therapeutic situation. For almost ten years I thought about writing an article exploring the impact of this phenomenon but did nothing. I finally overcame my resistance when, in 1994. Ruth Cohen and I made dual presentations to the Washington Psychologists for the Study of Psychoanalysis and then to the Greater Washington Society for Clinical Social Work. I was excessively anxious about both those presentations. What was going on?
Allowing myself to write this paper required I give up the protection of some of my defenses, most notably denial. The literature indicates that denial, on some level, tends to be the initial reaction of psychotherapists to their own illness, at least for those who write about their experience (Schwartz and Silver, 1990). Denial as a defense has been described as either adaptive or pathological. If it is pathological, one refuses to acknowledge or recognize something, such as illness, to the degree that one behaves as if it, the illness, does not exist. For example, such pathological behaviors include refusing to go to the doctor, refusing to take medication when necessary, or otherwise behaving in a self-threatening manner. On the other hand, adaptive denial, or what has been referred to as healthy denial, would entail, for example, my being able to take care of my illness while, at the same time, effectively saying, “My MS is a part of me, but I am not my MS.”
There is a sense of empowerment when acknowledging one's illness while not defining oneself by that illness. “I may not control my MS, but at least it does not control me.” Adaptive denial enables one to g