At first glance, Jack’s case may seem similar to the guest posting from October 8. In each case the principal figure is afflicted with cancer. A close look at these cases, however, reveals that when it comes to coping strategies, cases could not be more dissimilar. Our guest contributor chose a direct confrontational strategy that, while not one everyone would choose, nevertheless illustrates appropriate and effective coping. Jack’s case, however, shows the dire consequences that come from a lifetime of poor coping strategies involving chronic avoidance and denial.

THE CASE OF JACK THE AVOIDER

From childhood into adulthood, Jack consistently avoided openly expressing any negative emotions and actions (such as anger, jealousy, aggression, etc.), and from accepting responsibility. The older of two children, Jack came from a working-class family. He was always a physically large, overweight boy, and the other kids typically made fun of him. Consequently, he never developed much self-confidence and had pretty low self-esteem. He protected his fragile ego by “hibernating” and went through the motions of life below the radar screen as much as possible.

Jack’s family never had much money and his early family and home life was short on warmth and love. In fact, the primary source of acceptance, praise, and “love” in Jack’s family seemed to be food. There was always lots to eat, and the parents rewarded their kids for “eating well,” which really meant overeating. Whenever the kids came home from school, Mom was in the kitchen cooking, ready to welcome them with all sorts of treats.

Jack’s father, on the other hand, was a domineering, cold, and harsh parent. In fact, other kids and their parents who knew him called him, “Khrushchev” (Prime Minister of the Soviet Union, considered by many to be quite ruthless). His wife suspected he physically abused Jack when she was not around, but she had no direct evidence. In any event, dad was an intimidating figure and Jack decided very early in life that the best strategy was to stay out of his way as much as possible. Thus were planted the seeds of his avoidance forest.

In high school and college Jack was not popular, but he usually had a small group of peers to hang out with, although not as close buddies. For the most part, these were quiet years; Jack got acceptable grades, stayed out of trouble, kept mostly to himself, and stayed below the radar screen, just as he had done with Dad. He plugged along, but always avoided challenge and confrontation. He quietly did his work and stayed out of trouble.

After graduation from college Jack got a job, met a girl, got married, and began a family. Unfortunately, he continued to avoid facing the increasing challenges of his life. His wife, Brenda, ran the household and made most of the decisions, both domestic and financial. When children came along, Brenda became the disciplinarian and primary caretaker. Jack pretty much stayed in the background when it came to guiding and raising his kids. He seemed to love the kids, but getting too close was psychologically threatening to his fragile self-esteem.  His relationship with his kids mirrored his relationship with his father (not at all unusual): He could not get too close because he feared rejection and abandonment.

In his early work years Jack’s employment record was spotty. He was unsuccessful in a couple of jobs and had a failed business venture, but he eventually found a job that gave him some success and financial security. In spite of this success, however, he began turning to alcohol more and more. He spent long hours away from home socializing and drinking while Brenda was home managing the kids and the home. When she confronted him about his need to take on more responsibility and be more involved, he refused to discuss the situation. Many friends and work colleagues saw these same patterns of behavior. As Brenda recalls it, Jack worked very hard to avoid stress or confrontation with her or with anyone else; he would simply “bottle up” his feelings and retreat into silence or even leave the house and go to the local bar. The seeds of his childhood had sprouted into what psychologists call an “avoidant personality.”

Jack developed some health problems in his early forties, but he kept his symptoms to himself. He chose not to tell Brenda about his pains and not to get checked out by his physician. Once again, he avoided taking action, even though such avoidance could potentially threaten his very survival. Eventually, however, the cause of his pain, cancer, became obvious: He developed open, bleeding sores on his skin, and he needed Brenda’s help in caring for them. Brenda pleaded with him to go to the doctor but he stubbornly refused, even as his condition worsened. His denial and avoidant tendencies had reached irrational and life-threatening levels. Brenda took extreme action and had him involuntarily committed to a medical facility for diagnosis and treatment. Her actions, unfortunately, came too late. The physicians said his cancer was too advanced and he had only months to live, a prediction fulfilled in a few weeks.

Following Jack’s death, Brenda struggled both financially and psychologically. Looking back at Jack’s last years, Brenda said he showed very little compassion for himself or his family. He had become self-preoccupied, disconnected from other people, and basically had no sense of purpose or life goals. He did not care about his own life and took no steps to help himself in spite of pleas from Brenda, friends, and colleagues. Nothing seemed to matter to him except avoiding stress at all costs. He avoided basic responsibilities and negative emotions, especially ones that could produce confrontation with others. Jack’s lifetime of avoidance had led him into a black hole. And to top it all off, he didn’t give a damn!

Jack’s behavior had dire effects on others, especially his family. Brenda was left with little money and a mountain of bills. After Jack’s death, she struggled to support her kids and to come to grips with her own psychological issues. For the most part she was successful in both areas, although the personal area became more complicated because one of her boys developed Jack’s avoidant patterns, which only served to awaken lots of unresolved conflicts in Brenda. Eventually she voluntarily sought psychiatric hospitalization. Both inpatient and outpatient counseling helped her greatly, and she began to take effective control of her life.

Jack’s case illustrates a primary element inherent in ineffective coping: His life was devoted to avoidance of any sort of conflict. Such a strategy is doomed to fail because life involves conflict and pain, and continuous efforts to avoid cannot work in the long run if we are to thrive. Confronting and dealing with emotions and psychological pain are necessary steps if we are to become psychologically strong and healthy. Jack, however, refused to confront the demons that began to control him when he was very young. He was overly sensitive to rejection, criticism, embarrassment, and disapproval. Consequently, he chose to avoid conflict that put him at great psychological risk. Unfortunately, when we avoid conflict, problems grow stronger and become more complex, eventually taking us in a downward spiral from which it becomes difficult to escape. Jack never did escape.