A Nod of Acceptance

Giving someone a nod when we see them is often a means of recognizing their presence. It’s not like stopping full-out and saying “How are you?” which can lead to a longer conversation, but it is a recognition of another person and an acceptance of their presence.

When I started working with people who had diabetes, the catchphrases seemed to be “They haven’t accepted their diabetes” or “I guess I haven’t accepted my diabetes.” Sometimes this meant that a person’s diabetes was out of control due to some poor choices, and sometimes it meant that he simply wasn’t paying attention to it. But everyone was looking for a simple explanation for why they were having trouble with diabetes control, and it was chalked up to acceptance.


My impression of acceptance used to be that it was some type of “open-arms” gesture, with a sense of welcoming whatever we were accepting. Since I didn’t believe that this happened for most people who have diabetes, I strongly disagreed with the notion that a person had to accept his diabetes in order to live with it. In fact, I saw many people who hated the condition, like my dad, but managed it fairly well. It seemed clear that it wasn’t acceptance but another term, “adaptation,” that was really important in terms of living with diabetes. I still believe this.

Adaptation is recognizing the reality of a situation, identifying options for how to deal with it, and then acting on the best perceived alternative. If we learn how to adapt, it is a strength we will have forever.

When it comes to dealing with diabetes, a person is certainly encountering change all the time. Change will come with stages of life, physiological changes, stressors, and lifestyle changes. In all of these situations, we must adapt.

I have to admit that I have also adapted my two concepts of acceptance and adaptation. I am now recognizing that acceptance doesn’t have to imply such an “open-arms” invitation to diabetes, but it does mean a willingness to give diabetes a nod of recognition. It’s not always necessary to stop and give it the attention we would give to a good friend, but it is necessary to give it its due: a nod of acceptance that it exists and that, unless we are willing to give it enough attention, it will demand more that we want it to get.

So do you give diabetes a nod of acceptance, or do you try to avoid the reality of its presence?

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Joe Nelson: Joe is a psychotherapist in private practice in Minnesota, where he specializes in the psychology of chronic disease and sexual problems and works with couples, families, children, and teens. He has been a Licensed Psychologist since 1985 and has earned a master’s degree from St. Mary’s College Winona, a bachelor’s degree in social work from the University of Minnesota, and an associate’s degree in human services from the College of DuPage in Glen Ellyn, Illinois.

Joe has worked with troubled youth in Chicago and Minnesota and on a special project on Turtle Mountain Reservation in North Dakota. He was the first social worker hired by an affiliate of the American Diabetes Association. He worked at the International Diabetes Center for 20 years, directing psychological services there for 12 years. A Certified Sex Therapist, Joe co-developed the Sexual Health Center at Park Nicollet Clinic.

Having practiced meditation for over 30 years, Joe offers instruction in mindfulness-based meditation to patients in groups and as individuals. Joe is married, has a 23-year-old daughter, and enjoys scuba diving, motorcycling, golf, and being outdoors doing almost anything.

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