Diabetes Self-Management Blog

I always heard that feeling sorry for yourself was a bad thing. But now I know that compassion for ourselves is often necessary for healing.

This week I’m in Alaska speaking on “Empowerment as Medicine” at the Alaska Native Diabetes Conference in Anchorage. Like other Native populations in America, Alaska Natives have high rates of diabetes and complications. They are usually blamed for it — told they have weak genes, bad behavior, or some mix of the two.

Most people with Type 2 are told the same thing. But the Native Alaskans also have high rates of heart disease, cancer, lung disease, alcoholism, and other health problems, and they’re blamed for those, too. In fact, they have higher than average rates for many chronic conditions. So are their genes responsible for all of that? Does that even make sense? How could they have lasted 10,000 years with such “bad genes”?

And how bad could their behavior be? Yeah, they might eat more carbs and exercise less, but enough to double their rate of diabetes? Research at the University of Michigan shows that all health behaviors (weight, exercise, smoking, drinking) combined, accounted for no more than 40% of the health differences between healthy and unhealthy people. Other studies find the contribution of behaviors to illness closer to 20%.

The rest of the excess illness may be caused by stress. Stress caused by hard lives; especially by trauma. The Native Alaskans have been occupied and abused for at least the last 100 years, when the Klondike gold rush started. That is a lot of trauma — being pushed off your land, put under the legal control of people who despise you, seeing your culture attacked, suffering murders and rapes. Out of stress and despair, you may start doing it to each other.

Trauma can be defined as “stress that never goes away.” Once you have been traumatized — think Iraq veterans with PTSD — the world never seems a safe place again. You will be constantly fearful, constantly stressed. Your insulin resistance, abdominal fat, and blood pressure will be constantly increasing, because that is what stress does to you.

Unfortunately, trauma can be passed down from generation to generation. Stressed parents raise stressed children. The abuse those kids suffer and the painful lives they lead put new layers of trauma on their own children. This is called “historical trauma” or “intergenerational trauma.” The cycle can get worse with time, unless people do the hard, painful work to gain more control of their environment and get the necessary support to overcome their trauma.

This is where self-compassion comes in. When people are being blamed for everything that is wrong with them, it’s hard not to believe it. (Do you ever feel that way?) If you’re no good, why bother trying to get better? To heal, traumatized people need to tell their stories and recognize that it’s not their fault.

In my opinion, some twinges of feeling sorry for one’s self are helpful. Occasional crying about the pain of one’s life is also good for you. You don’t want to get stuck in grief, but many people have never expressed grief for the losses and injuries they have suffered. Gabor Maté, MD, author of When the Body Says No, says that to suppress a powerful emotion like grief, one also has to suppress all emotions, so that life becomes joyless and empty. This can’t be good for you.

Most of our readers are probably not Native Alaskans, but many people with diabetes have stories of hard lives. Many studies link diabetes with history of trauma, poverty, or loss. Military veterans have twice the rate of Type 2 diabetes as the general population, and many of them are traumatized. Many lesser traumas contribute to diabetes, too.

Does it help to face these stories? Does it help to talk about them with others? Many trauma experts think it does. Maybe one doesn’t have to tell the world, but there should be a support net of people who can listen and share. The idea isn’t to take a “poor me” attitude to life, but to acknowledge our true feelings and give them some attention, as we would a suffering child.

Maybe it’s easier for some people to suppress their memories and move on. But I wonder how much that hidden pain is costing their bodies. How much diabetes; how much hypertension and heart disease comes from unacknowledged pain, and the harmful behaviors we adopt to self-medicate? I don’t know, but treating ourselves, and each other, with compassion seems like a necessary starting point. What do you think?

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Emotional Health
Fear and Diabetes… (11/20/14)
Diabetes: The Good and Bad Go Hand in Hand (11/10/14)
What Has Diabetes Taught You? (10/29/14)
People Treat You Differently With Diabetes (10/24/14)

 

 

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