Diabetes Self-Management Blog

You know how doctors always try to motivate you with fear? They tell you all the terrible things that will happen to you if you don’t take their medicines and follow their diets. You’ll lose your kidneys, your eyes, your legs, maybe your life. So shut up and do what we tell you!

When I talk to doctors, I usually tell them that the fear approach doesn’t work for most people. But I thought I would ask you if it motivates you. I do find that fear can sometimes help us make productive changes. But there has to be hope for avoiding or coping with the threat! Otherwise, fear is paralyzing.

Fear as a Weapon
We’re seeing fear used as a weapon now, in the massive “bailouts” (read: robbery) being taken from taxpayers and given to the richest people in the world. The big bankers and government leaders warn that the whole economy will crumble; the whole world will sink, if we don’t give them all the money in the world right now. We can’t afford to wait! The danger is too great.

This is an example of fear that is paralyzing. We’ve gone through eight years of fear-pushing like this from the Bush Administration about terror. We have to give up all of our rights and start a series of wars now and forever, or the terrorists will get us in our sleep. Now Obama is doing exactly the same thing. (Naomi Klein explained the political use of fear in her book The Shock Doctrine.)

So it’s easy to see the lethal effects of fear. I’ve been learning about it for myself lately, as my multiple sclerosis (MS)-related disability continues to get worse. I find myself spending too much time and stressing far too much about the unknowable future.

A Positive Response to Fear
And yet, ignoring my fears or pretending I don’t have them doesn’t help, either. Fear actually can be a positive thing if we handle it right. Sometimes, it helps me to write down my specific fears. What, exactly, am I worried about? What’s the worst that could happen? If it happened, how would I deal with it? And how can I prepare for those possibilities now? Is there anything I can do to prevent them that I’m not doing already?

Another thing that helps is to ask myself, how realistic are these fears? How likely are they? Do I perhaps have some wrong information that adds to my fears? I had a patient with Type 2 diabetes whose father had died of complications of diabetes, and he was convinced he was going to die young also. He thought self-management was a waste of time, because he was doomed anyway. He just didn’t know that the complications were avoidable.

With diabetes, there are obviously some things you can do to prevent complications. But we also know that there are no guarantees. So what do you do to deal with fears of complications? Do you just try not to think about them, or what? It often depends on your earlier experiences with diabetes. How did you first learn of the dangers of complications? How did you feel about that? Was it motivating or paralyzing?

William Polonsky, PhD, CDE, director of the Behavioral Diabetes Institute, says that if you’re tied to a railroad track and can’t move, it doesn’t help to worry about the train. Diabetes is the track and the train is complications. But the difference is, you can get off the track! You can self-manage your way clear of the train, in most cases.

I guess I’m talking about moving from fear to confidence. Do you know what I mean? Does fear help you or paralyze you? How do you move to confidence, or at least serenity?

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Emotional Health
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