On April 11, I posted a piece titled “When to Call It Quits.” On April 14, the San Francisco Chronicle printed an exposé about 88-year-old Senator Diane Feinstein. In this front-page story, Feinstein was described by a few colleagues as losing her edge. Some worried that she was experiencing dementia.

Since over 40% of the elderly experience cognitive impairment, Feinstein’s alleged failings are not shocking. What’s more, rumors of her memory lapses have been swirling around for years. Many news outlets picked up this recent story. In response, Feinstein called the editorial board of the SF Chronicle to refute the story, claiming she is still at the top of her game.

Shortly after Feinstein’s call, another piece appeared on the SF Chronicle’s editorial page, justifying their original story. The editors did acknowledge that Feinstein was quite lucid during their phone call.

Although I don’t doubt that Feinstein has both good and bad days and the time to call it quits could be now (or two years ago), I objected to the line that read “denial is a hallmark of dementia.” Presumably, this meant to convey that Feinstein was in denial about her dementia. This may be true, but they got something very wrong. Denial is not a hallmark of dementia; denial is a hallmark of being human.

Not Just a River in Egypt

Denial is a coping mechanism used to varying degrees by most of us. When faced with bad news or potential bad news, we have a tendency to stick our heads in the sand. This is why we ignore symptoms of distress (both physical and emotional), why we don’t see indicators that our jobs or relationships are in jeopardy, why we don’t keep track of our finances.

Denial is a strategy that gives us time to calm ourselves and unconsciously adjust to a distressing reality. The danger in staying in denial is that we don’t effectively treat or manage our challenges. Staying in denial can exacerbate the situation. We all have loads of examples of how detrimental this can be to one’s health and well-being from simply ignoring a bill until late fees have accrued to denying a pain or physical symptom until the condition worsens, perhaps beyond treatment.

In part I of “When to Call It Quits,” I wrote that some people stay in their jobs longer than is wise because they need the income or because of inertia. At 88, these two reasons don’t apply to Feinstein’s situation. Ego attachment or clinging to the past might be more applicable to her circumstance. Feinstein has a stellar record—what a pity that she may be tarnishing her reputation by refusing to call it quits.

Lack of Insight

Unlike denial, lack of insight is due to physiological changes in the brain. When a person has lack of insight, they can’t recognize that their behaviors or emotions have changed. This is largely because of deterioration in the frontal lobes, and is more common and pronounced in certain types of dementia than in others.

Denial tends to get better over time (meaning that the reality of situation demands we remove our heads from the sand), whereas lack of insight worsens in those with dementia. I have known several folks with dementia who would recognize their inability to retain information in the early stage of their cognitive decline but as the dementia progressed, they were no longer aware of their condition. This is not denial; it’s neurological lack of insight.

Hopefully, if you’re reading this post, lack of insight is not your problem. But if you’re part of the human race, you might be suffering from denial. What physical or emotional conditions are too painful for you to face? How might facing these situations better equip you with strategies to improve or overcome these problems?

“Denial is a save now, pay later scheme.”

—Author Gavin de Becker