For the past few years I've been creating a platform for ‘Thriving with Diabetes,’ the most worthy goal I can think of for living with diabetes.
My research with behavioral scientists, reading about how the brain works, gathering peoples' "stories" and my own personal experiences, have supported and further emboldened my view. For me, 'Thriving with Diabetes' is about creating your best life, not despite having diabetes, but because of having it. I believe thriving with diabetes requires three things:
1) A thorough understanding of how to medically manage your diabetes
2) A high level of emotional resiliency and
3) Meaningfulness, in other words, deciding that it is worth the effort.
My current work involves writing articles and books and giving presentations that help people with diabetes develop this insight, and these skills. I am also continuing to gather evidence that supports and expands my thinking.
Three key theories related to managing improvement are also applicable to diabetes management. Systems theory, Complexity theory and sociologist Aaron Antonovsky’s theory of health and illness, Salutogenesis.
Systems theory suggests that if you want to help people it’s of paramount importance that you first-and-foremost understand them in their context (i.e. how they live: What food is available to them? Is their neighborhood safe enough to walk in? etc.). Complexity theory suggests that experts can only help with sustainable behavior change through probing and crafting a response with the patient that is owned by the patient. Salutogenesis suggests that people can succeed if they: 1) can make sense of their situation (comprehensibility), 2) perceive that they can influence it (manageability) and 3) decide that it is worth it (meaningfulness).
I witnessed some of this when I interviewed people. When I asked people to tell me their story (context) about living with diabetes, I would learn their values and influences and they would begin to make better sense of their actions and see what further steps toward improvement they might make. They would also access whether or not they wanted to take those steps. Surprisingly, I learned that just in sharing their story, they found it a healing experience.
My books support my philosophy
My forthcoming book, (Publication August 1, 2009) 50 Diabetes Myths That Can Ruin Your Life: And the 50 Diabetes Truths That Can Save It helps people manage the medical aspects of diabetes. It debunks the myths that are keeping people from living their best lives. Myths such as “You have to be fat to get diabetes,” “Eating too many sweets causes diabetes,” “Insulin shots are painful,” "If my foot hurt I would know it," and “Type 2 diabetes is not as serious as type 1.” It also provides tips from top diabetes experts and patient stories, which share teachable moments.
My first diabetes book, The ABCs Of Loving Yourself With Diabetes,helps readers develop greater emotional resiliency. The ABCs provides wellness principles, emotional nurturing and practical "how to's," coaching readers to focus more on their capabilities than their fears, and live from a place of courage, confidence, gratitude and pride. Such positive emotions energize more positive actions in managing diabetes. Barbara Fredrickson,distinguished professor of psychology and principal investigator of the positive emotions and psychophysiology lab at the University of North Carolina has documented that positive emotions actually change our physiology and open our hearts and our minds to greater health, creativity and happiness. While patients need to be aware of the consequences of poor management, focusing on what we want (health and happiness), rather than on what we don't want (complications), moves us toward our desires. In popular literature only negative emotions are associated with diabetes like anger, depression, fear, guilt and shame, and then coping strategies are offered. The power of positive emotions go entirely untapped. The ABCs is a truly innovative approach to help support better management and it is supported by the Behavioral Diabetes Institute in San Diego.
Further Work
I continue to interview people with diabetes and loved ones to capture their unique, intimate story of what it’s like to live with diabetes. I have already interviewed more than 135 people.
From this work two coaching models are emerging to help support patients with their management. One model helps patients reflect on, and pinpoint, where they are currently in their diabetes management from poor to excellent on both the medical and emotional spectrum. The second model helps people move toward improvement in both the medical and emotional fields fueled by their own resources and capabilities. More information will come about both these models as I continue to develop and test them.