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Updating Your Coping Skills

by Reji Mathew, PhD

As you explore new coping strategies, you’ll find that different strategies match different needs. For example, you may find that doing yoga or meditating is particularly helpful when you need to relax. Or you may find that using humor, playing with a pet, or socializing with friends helps to energize you. Exercise may do the trick when you need to release pent-up stress. The important thing is to stay open to trying various strategies to find what works for you.

In many cases, you will call upon a mix of skills to deal with the specific stressors in your life. Lisa, 76, coped with a source of stress that she faced both by asking for help and also by learning some new computer skills. She says, “My husband and I are on a fixed income. I am diabetic and he is in a wheelchair. Maintaining a healthy diet is expensive. I was feeling worried and overwhelmed. I told my niece, who was helping us plan our meals. She orders bulk items from the Internet to reduce costs, and I go to the grocery for the fresh foods. I am doing better with managing my diabetes. I felt ashamed to talk about this. Exercise is for free, but not food. I did not know how to use the computer and would not think of it as a coping skill. My niece is now teaching me how to use the Internet.”

Chronic illness management can easily feel like a second job. Keeping up with doctors’ appointments and medicine regimes can be emotionally consuming, and it is natural for frustration or boredom to set in. One coping strategy that may help with frustration or boredom is to reward yourself for carrying out necessary tasks. For example, you might reward yourself for keeping a doctor appointment by scheduling time with a friend or taking an afternoon off to watch a good movie.

Peter, a 32-year-old with Type 1 diabetes, tells how he evaluated his coping strategies during a time of change in his life and later rewarded himself for his efforts: “During my first week of graduate school, I suffered a hypoglycemic attack during my commute to school. It was very scary. I talked with my psychotherapist. Before grad school, I was a pro in managing my condition. Once I started school, my routines to check my blood sugar would waver dramatically on a daily basis. I could not pinpoint why. I kept a coping skills journal for three weeks, in which I recorded my class schedule and planned breaks, as well as unplanned interruptions such as traffic delays. What my therapist and I learned was that my new goal of getting a graduate degree took up much of my mental energy, which made me easily forgetful and overwhelmed. I had to change the way I planned my days and took breaks. I now keep extra food with me on my commute to school, because I never know if I could be delayed. I also let my professors know of my needs in case I need extra support. I rewarded myself with an iPod for getting through this period.”

Working on relationship skills

In addition to exploring new coping and stress-reduction skills, successful management of a chronic illness often requires building interpersonal relationship skills. Many people find it hard to accept that illness and disability often require depending on others. Developing your “people skills” can make it easier to ask questions, initiate communication, and ask for help, but it takes practice.

Exercises that may help in this area include role-playing, in which you “rehearse” a potentially anxiety-provoking conversation with a trusted friend, who plays the role of the person you need to talk to (such as a doctor or an insurance company representative, for example). It may also help to write down requests before you make them orally. And it can help to problem-solve with a psychotherapist before taking on a feared situation.

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