Your 'Relationship to Help'

Working with a diabetes counselor for your mental health.

By Jen Nash, DClinPsych

How can someone who only sees you once or twice a year for roughly 15 minutes at a time really ‘get' what your experience of diabetes is like?

The diabetes doctor, nurse, or dietician can't. But here's something you may not have thought of - they're not really there to.

Let me explain. Of course your healthcare team want you to be in control of your diabetes and in good health. They are passionate about helping you to manage the delicate balance between food, insulin, and activity so that your blood glucose control is just right. This is fantastic – it's where their skills and expertise lie, and they can advise you based on their expert knowledge of the inner workings of the human body.

But as committed and as dedicated as they are, they are not your psychologist, your diabetes counselor or any other counselor, or your friend. They aren't there to help you work on the other ‘inner workings' of your body – your emotions.

That's why Clinical Psychologists are the newest members of the Diabetes Team. It's thankfully becoming more and more recognised that managing diabetes takes an emotional toil as well as a physical one. Government health guidance is calling for greater access to psychological therapies – yet a recent survey in the UK showed that less than one third of Diabetes Centres have access to specialist psychological services. There are just not enough of us! That's why I'm passionate about offering you education and advice through this blog and the other work that I do.

Two Sides of the Story

So, today I'd like to share some ideas about how you can feel more connected with your healthcare team, which should include a diabetes counselor. Common experiences of relating to healthcare professionals that I hear from people with diabetes I work with are:

  • Feeling rushed
  • Not being ‘heard'
  • Feeling misunderstood
  • Not feeling free to talk about what is really of concern, e.g. that diabetes is getting you down
  • Feeling scolded or made to feel like a ‘bad' patient
  • Being patronised, unintentionally or otherwise
  • A pressure to lie about your blood glucose results or other health behaviour
  • Feeling that the healthcare professional is an "expert" and can't be disagreed with
  • Not attending health appointments at all and avoiding healthcare professionals entirely.

However, some common challenges from the healthcare professional's point of view are:

  •  Not having as much time to spend with patients as they'd like
  • Feeling pressure to be the ‘expert'
  • Feeling at a loss to know how to help
  • Working within an environment with stretched resources
  • Team conflict amongst their colleagues
  • Working to meet government targets which prioritise ‘hard' data such as blood glucose control achieved over ‘soft' data such as psychological well-being or quality of life
  • Not being able to fully appreciate the lived experience of diabetes (being an ‘expert' rather than an ‘expert by experience')
  • Having to maintain the caring role at work when experiencing personal challenges in their life outside of work

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Last Modified Date: February 16, 2013

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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