If you're living with a chronic illness, you're in the right place.

Friday, August 9, 2013

Acceptance: Part 2

In my last post, I wrote about Acceptance as it relates to life with a chronic illness.  I apologize for the delayed follow-up, Steph and I moved our Oak Park office at the end of July and, well, you all know how moving goes.

I talk a lot about acceptance with my clients, and it can be a tricky topic to broach.  Think about it.  Here I am, captain psychology, suggesting to people with sometimes horrible illnesses to accept their situation rather than try to fix it.  I should clarify that acceptance doesn't mean not seeking the best care and treatments, but being able to determine when you've done all that you can to regain as much health as possible versus continuing to fight.

Fight.  We hear that word a lot in the chronic illness world.  It's a pretty strong theme in our culture in the United States, and when we're diagnosed with something like cancer, lupus, or rheumatoid arthritis we're automatically transformed into Rocky Balboa.

Yo, medicaaaatttioooon!

We do know that acceptance can be helpful, but there are some caveats.  Acceptance of your illness can lead to better and more informed decisions about treatments, greater adherence to those treatments, and improved outcomes like symptom control and quality of life.  People who accept their condition tend to be more open about it with others, even educating others or advocating for themselves and their peers.  

Acceptance isn't always a good thing, and can actually have some pretty negative experiences in the wrong context.  It can lead to depression, demoralization, and even suicidal thinking.  We obviously don't want that to happen, which is why when I talk to people about acceptance I tread lightly.

For acceptance to be a positive experience, we need adequate resources and support to assist us with all the problems that come with having an illness.  If we feel like we have family members who understand, friends we can vent to, and a good doctor-patient relationship acceptance is much more likely to be a good thing.  Our experience with stigma, or negative attitudes of others about our illness, also plays a role.  What really matters here isn't if we hear people say crappy things about us or our illness, but rather how much we internalize or believe these statements to be true.  People who internalize stigmatizing attitudes toward their own illness generally don't do well with acceptance.  If you feel like you don't have adequate support or think pretty negatively about your illness, you'll want to make changes here before trying the exercise below.

Ok, enough talking Dr. Taft - how do I work on accepting my illness?  Grab a pen and some paper to write these things down and get started:

Evaluate your  thoughts about your illness.  What memories, worries, fears, self-criticisms, or other unhelpful thoughts do you dwell on, or get “caught up” in? What thoughts do you allow to hold you back, push you around or bring you down?

Evaluate your behaviors related to being sick.  What are you currently doing that keeps you stuck; wastes your time or money; drains your energy; restricts your life; impacts negatively on your health, work or relationships; or worsens your problems?

Evaluate your feelings about your condition.  What emotions, feelings, urges, impulses, or sensations do you fight with, avoid, suppress, try to get rid of, get overwhelmed or pushed around by, or otherwise struggle with?

Evaluate your challenges.   What important situations, activities, people or places are you avoiding or staying away from? What have you quit, withdrawn from, dropped out of? What do you keep “putting off” until later?

The key word in each of those points above is Evaluate.  This isn't simply the act of writing these things down, but thinking about each one critically.  I like to call this playing scientist, or lawyer - whichever you prefer.

  • Are there alternative explanations or viewpoints for your thoughts?  
  • Would your argument hold up in court?  Or to peer review?
  • Are there other behaviors that you can be doing that will help you get un-stuck?  These don't have to be pie-in-the-sky, but rather should be small, attainable things you can do every day.
  • Instead of fighting off negative emotions, let them happen for a little while then try to change them by evaluating your thoughts and behaviors and making changes.
  • Stay present.  Thinking too much about the past and the "should haves" can lead to sadness and depression.  Thinking too much about the future and the "what ifs" makes us anxious.  Focus on today.
  • Go easy on yourself.  On paper, these things may seem like common sense, but they're really pretty hard to implement.  
I'll leave you with some words from Marty McFly, I mean Michael J. Fox

“My happiness grows in direct proportion to my acceptance,
and in inverse proportion to my expectations.” 

Dr. T