Diabetes Burnout: What To Do When You Can't Take It Anymore

by William H. Polonsky, PhD, CDE

Copyright © 1999 by The American Diabetes Association. 

Excerpted with permission of the publisher, The American Diabetes Association.

For more information or to order this book, please call the American Diabetes Association at 1-800-232-6733, or visit http://shopdiabetes.org/.

NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.

Making Peace With The Police

How can you recognize the diabetes police and convince them to turn in their badges? Consider the following six strategies:

1. Start a conversation. In as friendly a manner as possible, talk honestly to your diabetes police about your frustrations. Tell them that you understand and appreciate their concern, but that their policing makes you feel awful and that isn't helping you to manage your diabetes more effectively. If you are having trouble with your eating, exercise, or some other aspect of your diabetes care, you should acknowledge this to your loved ones. But be assertive about letting them know that you must be in charge of any and all plans for change. Remember that the point is not to blame them (there is already enough blame going around), but to make peace with them.

For example, Matthew was a 68-year-old attorney who had been battling with his wife for years about his weight problems and his diabetes. In desperation, he sat down one day and wrote her as long, heartfelt letter. In the letter, he explained how painful all of her critical, insulting comments about his weight had been. In addition, he spelled out his own frustrations about his weight and diabetes. To his delight, his wife came to him and apologized. She explained that she had meant her comments to be helpful and had never realized how much he was bothered by her words. Thanks to Matthew's action, a warm and genuine conversation between loving partners, rather than police versus criminal, was begun.

2. Advertise your own self-care efforts. Even though you might prefer to keep things private, find public ways to show your diabetes police that you are acting responsibly and thoughtfully about your diabetes self-care. For example, you might let your spouse watch you check your blood glucose, then show him or her how to treat high and low results. Also, you might explain to your loved ones about all of the many diabetes self-care tasks that you do, including those you do well and those you are still working to improve. By speaking out in this manner, you will begin to convince the diabetes police what you already know: that you are a trustworthy, responsible adult.

3. Help the diabetes police to be helpful (in a different way). Because they are people who care about you, it may be almost impossible to stop the diabetes police from being helpful. The trick is to redirect their efforts away from actions that are driving you crazy and toward actions that may actually be of some value. Thus it will be valuable to explain to your diabetes police, in a tactful manner, about the concrete types of support that might be of real help to you.

How do you do this? Thank your loved ones for their concern about your health, explain that their actions are not helping you to manage your diabetes better, and let them know that there is a much more effective way to help you. For example, rather than yelling at you for overeating again, perhaps your spouse will be willing to stock the cabinets with some less fattening snacks or agree to attend a diabetes education class with you. Following this strategy, Robert explained to Sarah that it was not helpful when she argued with him about hypoglycemia. Instead, he proposed a new deal: if she thought he was hypoglycemic and in need of assistance, she should just bring him a glass of juice, without any comment. In exchange, he promised he would drink it – without any argument.

Making use of your own experiences with diabetes, think of creative ways in which your loved ones could actually be of help. Remember that the diabetes police are eager to be of assistance, at least in most cases. By giving them constructive tasks to do, you are taking an important step toward weaning them from their roles as police officers.

4. Clarify areas of responsibility. Arguments about diabetes can often result from confusion over who should be responsible for which activities. Consider the case of George, a 69-year-old retired engineer with type 2 diabetes, and his wife, Betsy. George and Betsy would argue every evening about whether or not George was eating enough vegetables at dinner. The more Betsy pushed George to eat more vegetables, the angrier and less cooperative George would become. The solution is to work together and to reach an agreement that clarifies the different areas of responsibility – in other words, to decide who will be responsible for what.

When Betsy and George tried this, they were able to agree that Betsy would be wholly responsible for getting tasty vegetable prepared and onto George's dinner plate and George would be entirely responsible for getting his vegetable from his plate into his mouth. This may sound silly, but it works! When both parties can come to agreement, there is an unmistakable sense of relief. In Betsy's case, she felt free from her aggravation and guilt that she wasn't pushing George hard enough. In George's case, he felt release from his anger and resentment at Betsy for constantly nagging him. In the end, more vegetables got eaten and the diabetes police went into retirement.

5. Take a good look in the mirror. Consider how your own biases and behavior may be contributing to the problem. First, give careful thought to whether the diabetes police in your life are real or imagined. Are you actually being observed, blamed, or hassled about your diabetes? Perhaps, like Roger, you fear that others are blaming you (or about to be blaming you), even though it is not really so.

If the diabetes police are really at work in your life, think about how your own actions may be contributing to this. For example, Robert's "I'm fine" responses (which he would say even if he wasn't fine) only made Sarah more anxious, leading to more policing. Similarly, Patricia kept bringing candy bars to church every Sunday, even though her sisters would search through her handbag each time. Why would she continue to do so week after week? When her sisters became enraged at her, was this a sign to Patricia that they really cared about her? Perhaps she, like Robert, was merely affirming her independence, reminding her sisters each Sunday that no one was going to control her life. Regardless, there can be no doubt that Patricia's actions were contributing to her sister's policing behaviors.

So consider whether you may have something in common with Patricia and Robert. Might you be taking such poor care of yourself that your loved ones feel that they must join the diabetes police? Of course, the diabetes police are certainly not blameless, but it is important to remember that both sides – police and criminal – contribute to the problem.

6. If nothing else works, get professional assistance. When police and criminal have been locked in battle for years, it can be a difficult habit to break. The diabetes police may fear that if they step policing, your criminal actions will only intensify. You, the diabetes criminal, may fear that if you give in to demands of the diabetes police, you may lose y our freedom. When no change seems possible, ask your health care provider about referral to a mental health professional who is knowledgeable about diabetes. A little help can make a big difference.

Patricia's sisters, for example, could not stop hassling their sister, and Patricia could not stop binging on chocolate. In fact, as they explained their story to me, they could not even stop screaming at each other. At the support group that evening, I felt I was on a low-budget daytime talk show, just waiting for the violence to begin. Once they quieted down, I convinced them to try the following intervention. Over the next week, Patricia and her sisters would meet together each night. For 30 minute, they would have a "Peanut M&M party," doing nothing else but enjoying Peanut M&M's. There would be no comments by anyone. Though they were certain I was crazy, they agreed to this experiment.

By the end of the week, with permission now to eat and enjoy what she previously could only sneak, Patricia soon noticed – to her great surprise – that she no longer liked the taste of chocolate. After years and years of Peanut M&M's, she realized that she had had enough. In addition, with her sisters no longer screaming and trying to control her, she found it much easier to really listen to them. She finally recognized how worried they were about her health and, for the first time, began to understand how important it was to manage her diabetes properly. Patricia's diabetes care soon began to improve dramatically.

This particular type of intervention is certainly not appropriate for everyone, but it may give you a sense of how a little outside assistance can help to resolve the struggle between police and criminal. A variety of different counseling techniques are available, all designed to transform your loved ones from diabetes police back to caring friends.

Police No More

By using these six strategies, you can disarm the diabetes police. But before taking any action, always remember that the intentions of your loved ones are good. While they may be driving you crazy, your friends and family are actually trying to be of help to you. Your task will be to educate, letting your loved ones know that you must be treated respectfully, like any other responsible adult, and helping them to understand how they can more effectively support you and your self-care efforts. No police and no criminals, wouldn't that be nice? With tact, kindness, and assertiveness, you can succeed.

For more information or to order this book, please call the American Diabetes Association at 1-800-232-6733, or visit http://shopdiabetes.org/.

Last Modified Date: January 17, 2014

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