Lloyd Austin's Hidden Diagnosis: Why Some People Keep Serious Illnesses Private

Defense Secretary Lloyd J. Austin III is under scrutiny for concealing his diagnosis and treatment for prostate cancer. But experts say it may be a common coping mechanism.

US Defense Secretary faces scrutiny after failing to immediately disclose his recent prostate cancer diagnosis and diagnosis to the White House. related hospitalization, a violation of protocol for which he apologized.

But while the secretary, Lloyd J. Austin III, as a member of the cabinet, made facing certain expectations about whether and when he should publicly disclose his health status, mental health experts who work with patients with serious illnesses, such as cancer, say the reluctance is common - even in the age of oversharing online.

“I see it all the time with my patients,” said Dr. Andrew Esch, senior advisor in education at the Center to Advance Palliative Care, a national health care advocacy organization based in New York. "It's very human not to want to get skinned for the whole world to see."

There are many reasons why people might choose to keep their illness for them in some contexts, experts said, but some are more common than others. Privacy can be a coping strategy, said Dr. Itai Danovitch, chair of the department of psychiatry and behavioral neuroscience at Cedars-Sinai in Los Angeles, particularly in the first days after a diagnosis, when patients are inundated new information.

“There are different strategies that we use to try to control things that are out of control,” he explained. “One of the common mechanisms we use is to compartmentalize. » Although compartmentalization, or separating certain thoughts and emotions, is often maligned, it is adaptive, Dr. Danovitch said. For example, it can help people stay professionally focused even when illness causes significant stress.

Dr. Danovitch warned, however, that if the compartments become too “deep and separate,” they could prevent people from receiving necessary treatment. He gave the example of a patient who does not have follow-up tests for a suspicious lump because it is too stressful.

Others may have struggling to feel how vulnerable it is to reveal it. an illness, said Steven Meyers, professor and chair of the psychology department at Roosevelt University in Chicago. They may discover that their diagnosis is associated with a stigma that will leave them open to pity.

“Some people view being healthy and physically capable as a essential to their lives. their role or their identity,” he said. “These people will have a much more difficult time admitting publicly that they feel diminished in their self-esteem. These people will also be much more concerned about being a burden to others. »

Cultural and generational norms can also influence the decision to disclose, said Dr. Jesse Fann, medical director of psychiatry and psychology at the Fred Hutchinson Cancer Center in Seattle . He said he's seen a general trend where young people who grew up in a social media environment are more likely to talk about their diagnosis.

Mr. Austin, on the other hand, who is 70, is "fiercely private."

Even if experts were reluctant to prescribe circumstances under which anyone "should" share, they said certain factors could help influence the decision. Some powerful arguments in favor of disclosing a health problem relate to protecting your own health.

"I always validate a person's desire for privacy. a person, whatever their reasons," Dr. Fann said. . "But I also explain that keeping their diagnosis completely secret, or not being able to talk about it, can actually make it more difficult for them to seek help when it's needed - very concretely, getting a ride to get treatment or get a listening ear when needed. you're stressed."

Keeping a low profile can also lead to social isolation.

“Loneliness has a profound impact on the way a patient can live...