How can someone who only sees you once or twice a year for about 15 minutes at a time really ‘get’ what your experience of diabetes is like? The diabetes doctor, nurse or dietitian 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 counsellor 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.
So, today I’d like to share some ideas about how you can feel more connected with your healthcare team. Common experiences of relating to healthcare professionals that I hear from people with diabetes I work with are:
- Feeling rushed
- Feeling scolded or made to feel like a ‘bad’ patient
- Not being ‘heard’
- Feeling misunderstood
- Not feeling free to talk about what is really of concern e.g. that diabetes is getting you down
- 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.
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 wellbeing 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
How does it feel to read these two lists? Do any of them resonate with your experience or surprise you? Just viewing the relationship from the other person’s perspective can be helpful.
But there are practical steps you can take today to feel more in control of this relationship. Here are the 3 P’sof improving your relationship with the individuals in your healthcare team:
The first step is to plan for your appointment. Think back over the last month – what has confused you, or surprised you, or encouraged you, or frightened you about your diabetes? What are the three things you like to know or say?
The second step is to be an active participant in your appointment. William Polonsky, a US writer suggests using the ‘ABC’ of effective communication:
- Assertiveness– express yourself with confidence
- Brevity – speak as briefly as you can, staying to the point at all times
- Clarity – express yourself clearly, using short sentences and simple words
The third step is to understand and keep in mind that you and the healthcare professional are equals. Rather than feeling like a passive recipient of expertise, remember that you are two adults with an immense wealth of expertise. The healthcare professional has expertise of diabetes and how the body works and you have immense expertise gathered through your lived experience of daily life with diabetes. Together, you can share that expertise with one another to work towards the benefit of your health.
However, while some people reading this will implement these steps and begin to make changes right away, for others, it can feel harder to make changes. This is when it’s worth thinking about what’s going on inside you that’s causing this resistance. To help you with this, you might like to try this exercise:
- Think about your diabetes healthcare professional now.
- Take notice of the feelings you are experiencing. Are they positive or negative?
- Put a label on the feelings you are experiencing – hopeless, contented, angry, joyful, embarrassed, tense, supported, sad, uncertain, frightened, secure, shameful…?
- Now try to associate the feelings you have about the healthcare professional with the feelings you have about someone else in your life. Who from your past do you also have those kinds of feelings about?
- What figure from your early life comes to mind? Your strict headteacher at school? A kindly babysitter? Your controlling parent? A supportive uncle?
This may seem like an odd exercise, and in some ways it really is! But psychodynamic models of therapy offer the idea that the way we relate to people in our life today, particularly ‘authority’ figures such as healthcare professionals – are modelled on these early relationships.
So perhaps you relate to your diabetes doctor as if they are your controlling headteacher from school, who you always wanted to secretly rebel against. Or your supportive uncle, who if you smiled sweetly for long enough would always ‘let you off the hook’ if you did something wrong. You might think this is complete nonsense and if it’s not a helpful idea for you, then don’t make use of it.
But if this way of thinking does resonate with you, then you may be interested to know that in psychology-speak, this inner model of relating is called your ”Relationship-to-Help’. Becoming more mindful if your personal relationship-to-help can really assist you to relate to your healthcare team in a more balanced, adult way, improving your ability to take their advice on board and increase your health and wellbeing
If you’d like help to think about your own ‘relationship-to-help, or any other aspect of your diabetes wellbeing, I’d love to hear from you. I offer free 20-minute ‘Get Aquainted’ calls to help you think about your diabetes in a different way – email email@example.com for further details!