If conscious normal men and women could be placed so much at the mercy of their own inner chaos, surely one abject leper in a coma could have a dream that was worse than chaos—a dream specifically self-designed to drive him mad.
Covenant holds to his false dilemma that engagement with the reality of the Land would drive him mad.
This is one of the key stupidities of this story. A vivid reality must always be dealt with as real. I.e. Dealt with in it's own terms.
Memory remains the life line reaching back across any transition between realms.
While you have memory, you are safe to engage - hence not a dilemma.
This 'false dilemma,' is just a device by the author to encourage sympathy with a rapist.