From the author: In this article I tried to outline my vision of the process of accepting an incurable disease, using different concepts and my own clinical experience. In the 50s - 60s of the 20th century, medical science took a big step forward in terms of the development of medical technology. As a result, cancer patients doomed to death received a certain “respite”, despite the fact that their disease remained fatal and incurable. Swiss psychiatrist Elisabeth Kübler-Ross, who worked with such patients, saw her task as supporting them on such a difficult path. However, in the process of her work, she began to note that the experiences of terminally ill people develop into certain patterns, types of reactions, which also replace each other in a certain pattern. In her book “On Death and Dying,” she describes these five stages: Denial, Anger, Magical Thinking, Depression and Acceptance. It was later found that such a reaction is typical for people not only in the case of a fatal and incurable disease, but also in any traumatic a situation strong enough not to be accepted and lived at once... And since our entire growing up is a series of traumas of varying degrees of strength, it is not surprising that such a process is one of the foundations of our mental life. In this case, one often gets “stuck” at any of the stages, and at each moment of time a person is at different stages of acceptance in relation to different traumatic situations, as a result of which in everyday psychotherapeutic practice a mosaic picture appears before the specialist. Understanding the causes and mechanisms of this process their patients is an important tool for helping, so I would like to dwell in more detail on how I see the process of acceptance and what pitfalls it is fraught with. However, I could not help but note that the domestic school of clinical psychology also has its own interesting developments. In particular, developed at NIPNI named after. Bekhterev's theory of types of attitude towards illness describes 12 forms of response, without building them, however, into any stages. So, in the scheme that I keep in my head, working with a seriously ill patient, or a person who has experienced (or is experiencing ) severe stress, there are six stages: 1. Anosognosia (from ancient Greek ἀ - not + νόσος - disease + γνῶσις - knowledge) is a form of psychological defense in which the patient avoids awareness of the fact of his illness, “not noticing” it. The patient may consider himself healthy, not in need of examination and treatment, or admit that he has another, less dangerous disease. There is no outward emotional reaction to current events; patients return to their previous lifestyle, not being interested in either the consequences of what is happening or the possibility of changing anything (including the possibility of treatment). At this stage, patients strive to live their old lives, especially in the absence of symptoms of the disease, which is very typical for certain diseases, for example, blood diseases or HIV infection, some even more actively begin to implement old plans. As a rule, neuropsychiatric disorders do not develop in patients in this group due to the use of coping strategies such as repression and dissociation. Typical phrases at this stage: “So what next?”, “I’m not interested in this,” “The way things were, so they will be.” 2. Denial as a reaction differs from anosognosia by a more active and more conscious avoidance of the fact of what happened. People actively convince themselves and everyone around them that there has been an error, confusion, or something similar, devaluing the information coming to them. However, the transition to this stage is characterized by a distinct affect of fear, which is externally manifested by growing anxiety, up to panic attacks, and internal dialogues, which invariably lead to the conclusion that there is no veracity of what happened. Typical statements at this stage: “But no one knows this for sure”, “You are mistaken.”3. After the breakdown of primary psychological defense.