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October 18, 2018
by Ruth Gordon, MA, MSW, LCSW

Resisting Give-up-itis

October 18, 2018 10:55 by Ruth Gordon, MA, MSW, LCSW  [About the Author]

October is breast cancer awareness month. Most women (and some men) live in fear of receiving this diagnosis. Visit the office of a radiologist who specializes in breast cancer, and you will find a room full of women in various states of fear and denial.

The world has come a long way since this treatment has been open for discussion. There was a time when it was considered tempting fate to even say the word “cancer” aloud. Nonetheless, it is frightening to know that every woman, if she lives long enough (depending on her genetic makeup, general health and lifestyle), will be told that she has breast cancer. What she does with this discovery will make a huge difference in the quality of her life from that point forward.

There is a new term that is being used by physicians and mental health providers that is called give-up-itis, or GUI. This occurs when there is a loss of activity in the portion of the brain that provides motivation for self-care.

Actually, the term was established after the Korean war to describe the deterioration and death of certain prisoners-of-war.

It has been recognized that individuals who develop give-up-itis can die within three days. Usually it’s three weeks. They are described as withdrawing from human contact and refusing to eat. They, literally, turn their face to the wall and give up.

John Leach, Ph.D. has recently published some research he piloted on the subject. It would appear that the part of the brain that stimulates the motivation for self-care ceases to function properly.

This part is called the anterior cingulate circuit. When an individual is stressed the brain releases the neurotransmitter dopamine. After this burst, and if the stress continues, the frontal cortex causes the dopamine to recede to below-normal levels.

The importance of this knowledge and it’s relationship to breast cancer is what doctors have told their patients over the years. A positive attitude can make all the difference in the process of recovery.

Similar in impact is the diagnosis of prostate cancer in men. One of the greatest fears and cause of ongoing depression and anxiety is the blow that is delivered to sexual functioning. Ironically, some of the hormonal treatment that may be indicated provokes symptoms close to what women experience during menopause.

Loss of libido, hot flashes and fatigue are common manifestations. Additional misgivings include a fear of sexual intimacy and feelings of emasculation. Patients whose emotional needs are met experience a more vigorous recovery.

In cases of breast and prostate cancer important sexual body parts are affected. Being surrounded by ads and attitudes regarding the “perfect” body, both men and women are vulnerable to feeling “less than”.

If give-up-itis sets in an individual is more likely to experience a return of the cancer. Furthermore, such individuals are likely to withdraw from emotional intimacy as they recognize their feelings of shame.

Another term for give-up-itis is psychogenic death. It has also been called Voodoo death. This is caused by fear. If an individual believes the consequence of breaking certain rituals or taboos results in a curse, their health may begin to deteriorate.

As a rule the casting of a harmful spell is accomplished by a recognized practitioner. Although it is possible to look up “spell casting” on google or to hire someone to do that for you, the spells that are most powerful are believed to come from an individual with real supernatural powers.
It is believed that Voodoo was based in the religious beliefs of slaves captured out of West Africa.

The stronghold for this practice has been identified as Haiti. As Roman Catholic priests attempted to convert the West Africans, certain groups held on to their original beliefs. A man or a woman could become a Voodoo priest. It was believed that priestly power was passed on from dead ancestors.

A curse cast by a Voodoo practitioner was a serious matter. The practitioner holds the power to cause a psychogenic death as well as the power to remove the curse. As a result of give-up-itis, the subject loses the will to live and withdraws from normal life. The result of this behavior is death.

Using contemporary findings, “freeze” has been added to “fight or flight”. When an individual is overwhelmed by fear to the point that he/she can neither fight or flee, the freeze response may set it. This occurrence will allow emotions to be numbed and can, at times, protect an individual’s sanity. The other side of this manifestation may be death.

Give-up-itis, can be turned around at some of the stages of deterioration. Physical activity and/or the belief that there is hope can restore the will to live. The reason for this is that in either case dopamine is released, which will cause the individual to feel more in control.

All the above demonstrates the need for teaching ways to add dimension to an individual’s way of interpreting the world. Extreme black and white thinking can be harmful to mind and body. It also is not, necessarily, valid. Inability to access imagination and flexibility can leave one feeling overwhelmed and trapped.

Cognitive/behavioral and similar modalities are essential in instructing individuals to successfully pass through the inevitable hardships that accompany life.

Using Mindfulness or positive thinking are helpful in this exploration. Hope loosens the shackles that keep one stagnant. Latching on to even an unlikely source of optimism is powerful when combating fear.

Truth be told, one cannot, as a rule, with certainty, predict an outcome. After all resources have been utilized counting on a miracle, fate, or just plain luck can be the key to what turns things around.

Bowing to GUI is, literally, the end. People die before their time as a result. The very act of resistance can give a feeling of strength to those who formerly believed all was lost.

One can always count on change. The direction and result of that change remain a mystery.


Betuel, E. (2018, September 28). People Who Give Up on Life can Die From psychogenic death, say Scientists. Retrieved October 08, 2018, from

Bonar, S. (2017, March 9). Men and Prostate Cancer:the emotional impact. Retrieved October 08, 2018, from

Goodman, A. (2017, September 25). Emotional and Psychological Distress Associated with Prostate Cancer. Retrieved October 08, 2018, from

Ratner, P. (2018, October 2). 5 Stages of Psychogenic Death or Give-Up-Itis. Retrieved October 08, 2018, from

Seltzer, L. F., PhD. (2015, July 8). Trauma & the Freeze Response:Good, Bad, or Both? Retrieved October 08, 2018, from

Survival Psychology: The Won't to Live. (n.d.). Retrieved October 08, 2018, from the

About the Author

Ruth Gordon Ruth Gordon, MA/MSW/LCSW

I bring with me +30 years of experience as a clinician. My Masters degrees are from: Assumption College, Worcester, MA, Master of Arts in Psychology & Counseling/ and Boston University School of Social Work, Boston, MA, an MSW in Clinical Social Work. This is the 11th year I have written a monthly newsletter that is sent to approximately 500 individuals. The archive can be found on my website,

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