Lately a few discussions with certain individuals have arisen regarding this whole debate around ‘accepting’ diabetes. These individuals I might as well tell you are health care professionals. None of us have diabetes, and I would never claim to know what it must be like to have diabetes. This idea of acceptance is based on the theory by Elizabeth Kubler Ross that when a person is diagnosed with a chronic condition/disease they go through the five stages of grieving: Denial, Anger, Depression, Bargaining and Acceptance. They are grieving for a loss of their health, and when it comes to parents of children with type 1 diabetes, they also go through the process, as well as other family members and even close friends.
They come in no particular order, and usually it takes 18 months according to research for a person to come to terms with even having diabetes, regardless of type. When I meet someone with diabetes in my practice for the first time, I usually assess, without them really knowing, what stage they are in and tailor the session to suit that stage. It is very rare you will find any health care professional who will do this, but I feel it is vital. Helping and supporting someone with diabetes who is in denial, will require a very different approach to helping someone who is angry or even depressed. This requires training, skill, empathy, compassion and most important of all years of experience. Not doing this in my belief, can and has seriously damage a persons self-management of diabetes. I see this all the time in my practice and it makes me sad to see people with diabetes who have been affected by not recognizing this approach.
I learnt a very valuable lesson recently. Acceptance is not about ‘giving up’ it is about moving on, moving forward. I personally would have looked upon acceptance as giving up, accepting a certain negative situation or person I was not happy with. I reflected that back on me as having somehow failed. But once I realised that acceptance is much more bigger than that. It is about freeing yourself from a certain thoughts, feelings and emotions you have around a certain circumstance which has been holding you back. It is about freedom and gaining back some control of a situation. Being in a constant state of denial, anger or bargaining regarding an issue etc, can be draining of energy, and you slightly begin to lose your grip on reality and perspective. It can eventually become all consuming and envelope you in a depressive emotional state.
It can become even more difficult when working with a child or teenager with diabetes and their parents. You may have a child who has ‘accepted’ the fact they have diabetes (children are surprisingly mature when it comes to this issue) but the parents may not have or even be ready to allow diabetes into their lives. And the situation can be vice versa, where you have a teenager rebelling and not accepting diabetes, whereas the parents have and are eager to move on. The family are at an impasse, which can be a very trying time for all involved.
These stages of grief can occur at anytime when you have diabetes and can be triggered by any life circumstance. If you need to increase insulin doses, moving from injections to pump (or vice versa), increasing or starting certain types of medication, a new school, classmates, college etc. Your mind sees all these as something new, something different and somewhere deep down inside of you it seeks an acknowledgement that you are living with a chronic condition. These situations bring about a certain ‘reality’ to diabetes, which depending on what stage you are in, can be very difficult for people to deal with. For many they may not know, understand or recognize what they are feeling as being in a stage of grief.
To understand and recognise these stages are vital, because when you understand, it gives you a certain level of control back over a situation. No one loves having diabetes, nobody asked for it, and no one wants it. It is there 365 days a year, it is the job without weekends off or holidays. But it is there, and it is not going away. You can’t change the diabetes, but you can try to change you.
We are here to help at Diabetes Insight. With Founder of Diabetes Insight, Helena Farrell, RGN, MSc Diabetes trained in life coaching, psychotherapy, nursing and diabetes, we are one of the only practices in the country that can amalgamate and incorporate aspects of all these therapies into our consultations with people with diabetes.
So to answer the original question, does anyone ever accept diabetes? I don’t think so, but ultimately I hold my hands up. I will never know, I don’t have diabetes. I am not expert enough to answer that, and no two people with diabetes are the same.
I have no expectation on any of my clients to accept their diabetes, but I do help support them to reach a better understanding of how to live with it by putting strategies and plans in place.
I will end this blog with a saying that sits on my office desk and I feel is quite relevant to this blog…