A few times recently I’ve been asked how it is that an illness diagnosis becomes a mental health (in addition to a physical health) issue. It’s a good question, and because I’m certain it’s been asked out of genuine interest (as opposed to an attempt to make idle small talk), I thought I’d blog about it!
For a long time, Western medicine has been grounded in an acute illness model, i.e., mainly geared toward reducing (or ‘treating’) the signs and symptoms of physical complaints that are short-lived. As a consequence, physical illness has largely been viewed as the domain for medical doctors and medical specialists, who are able to ‘fix’ their patients, and send them on their way. I’m not surprised, therefore, that people wonder about the relevance of psychology for physical illness.
In reality, however, many people have illnesses that cannot be fixed. For example, there’s currently no cure for diabetes (a disease affecting about 1 in 20 Australian’s), HIV, Lupus, some forms of cancer, cardiovascular disease, chronic obstructive pulmonary disease, and rheumatoid arthritis, to name just a few. Instead, these conditions are ‘managed’; a process that involves life-style adjustments (e.g., diet and exercise), dealing with persistent (often unpleasant and unpredictable) symptoms, and sticking to medication regimens that may be complex and intrusive into normal life.
It’s the ongoing complexity and demandingness of chronic illness, and the physical, behavioural and emotional challenges that this poses for a person, that makes living with a chronic illness more than simply a physical or ‘medical’ issue. It’s also very much a psychological one.
Over the years, I have worked with many people with diabetes to help them deal with a range of problems, including the emotional reaction to diagnosis, fear of hypoglycaemia, planning and implementing lifestyle change, problem solving, goal setting, low mood and anxiety-related issues, family relationship problems and, more recently, diabetes-related distress. The relevance of ACT for coping with each of these challenges cannot be underestimated. I’ll never tire of the glimmer of hope (or maybe it’s relief) that I see in people’s eyes when we direct our attention toward creating for them a rich and meaningful life, while at the same time supporting them to handle the stress, frustration and various other ‘curve balls’ that living with a chronic illness inevitably brings.
Written by Janine Clarke, psychologist