The Guilt of Diabetes
How to put your old pal guilt into perspective and use it to move forward with your diabetes management.
with Amy Tenderich
Editor's Note: While this columnist is no longer writing for dLife.com and we have ceased to update the information contained herein, there is much to be read here that is still applicable to the lives of people with diabetes. If you wish to act on anything you learn here, be sure to consult your doctor first. Please enjoy the column!
July 2005 —Chomp! Another cookie goes in... Mmm, mmm! Dee-lish! But suddenly, the gut wrenches. It's not indigestion per se, but your old pal: guilt. That's your fifth cookie today, and you haven't walked all week. You haven't been checking your blood sugar too often, either. Goodness knows, if you're diabetic, what's not to feel guilty about?
First, there's the sense that it's your fault you got this disease in the first place. Then on a day-to-day basis, you get to beat yourself up for all the diet-and-exercise rules you've broken, as well as for every off-target glucose reading. And this ain't just cheating on Weight Watchers; this is your core health and potential life span you're playing with. Guilt can be absolutely paralyzing. We've got to stop the madness!
I, for one, used to think that a healthy dose of guilt was just what the doctor ordered: that extra kick in the pants required to get me to "be good." But research, talks with experts, and my own struggles have taught me that guilt is truly useless in dealing with the 24/7 responsibility and attention that diabetes demands. Out with it, I say!
Know Thy Enemy
What the heck is guilt good for anyway? It's one of those emotions whose evolutionary purpose is a riddle. The Espire Guide to Emotions states that its function is to "stop behavior that violates a self, family, or societal standard." But they also note that it's become twisted into a syndrome of flogging oneself for an accumulation of many ordinary "sins," i.e. simply not doing what you think you should — making it something of a plague for diabetics, with our incredibly long list of "should's."
Other definitions claim that guilt is a natural "cover-up" for other emotions being denied or suppressed. Makes sense: we are angry and frustrated about the diabetes, and take it out on ourselves.
The biggest problem is what it does to us: guilt shuts us down. It stops us from learning what we need to know for our own care, and from giving our best to take care of ourselves every day.
Naturally, there is an excess of self-help books on coping with guilt, and probably an equal surplus of guidebooks and fact sheets telling us how to manage our diabetes. What about combining the two? Why not make your first goal for improving your diabetes care to STOP FEELING GUILTY? Of course, this requires a major attitude adjustment – on which there is also a plethora of how-to books.
"Best of" the Tips
In order to cut to the chase (in my usual fashion), I have merged and fine-tuned some of the best tips out there on eradicating guilt from your life:
Re-examine Your Goals and Priorities
No more impossible rules like "I will never eat junk food again!" We can never be perfect, so rules like these just set us up to fail and can promote depression. As Dr. Richard Jackson of the Joslin Diabetes Center told me recently, it's best to narrow down ONE or TWO health goals that you will work on in the coming months. Then you can compare your results (e.g.,blood pressure or A1C) side-by-side and see that you have made a difference.
Put Yourself in Charge
Sounds trite, but the idea is not to let yourself be run or controlled by the diabetes or the self-criticism that it can invoke. Make a conscious decision to reward yourself for what you've done right, and not dwell on mistakes. Also important is not allowing well-meaning family and friends to play what Dr. William Polonsky calls the "Diabetes Police" (i.e. "should you be eating that?") Take a kind but assertive stance in clarifying who's in charge of your diabetes.
Learn from Your Mistakes
Think adjustment, not acceptance. Think "high" and "low," rather than "good" and "bad" blood glucose. Think "checks" not "tests." And view your off-days and your BG results not as signs of failure, but as information to help you decide what to do next.
Change Guilt to Regret
Again, no dwelling on mistakes here, but a simple change in semantics can make a big difference: regret puts transgressions into the past, and requires no penitence. It allows you to accept that you did the best you could in a particular situation at the time, but that you can and will improve.
So enjoy the cookie! It's not the end of the world. But do it consciously, because you are allowing yourself to eat this cookie now – and knowing you'll be doing something a little more "diabetes-friendly" very soon.
Read more about Amy Tenderich.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Yogurt Parfait Savory Carrot Soup Sesame Chicken Fingers Cheddar Cheese and Rice Roll Raspberry-Cranberry Granita Apricot Barbecued Chicken Strawberry Angel Cookies Apple Butter Pudding Pan Seared Beef with Green Peppercorn Sauce Steamed Oysters with Chile, Ginger, and Coriander
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...