Diabetes is all about balance — balancing activity and baseline insulin, balancing food and bolus insulin, always striving for that balance point between too high and too low. Twenty-four hours a day, 7 days a week, 52 weeks a year, we aim for balance. And as we all know, that balance can be elusive sometimes. Even for people with tight control, that balance isn’t always guaranteed. I wrote last week about the surging blood sugars I experienced after a horsefly bite; they were unlike any blood sugar surge I had ever had!
In the midst of the physical balancing act, it’s very easy to lose our emotional balance. When we’re dealing with something as intimate, as serious, and as hard to escape as our own minute-to-minute health status, detaching our emotional state from that physical rollercoaster is really tough. But it’s not impossible. A few ideas and practices can really help us live better with the ups and downs of diabetes.
Emotional responses are triggered from within
When I worked as a therapist, one of the key goals with almost every client was to help him understand the following: Our emotional responses are not triggered by events, but rather by the cognitions that we form in response to those events. Sound a little complicated? Let me break that down with an example.
Let’s say your blood sugars have been generally stable lately. You check before dinner, and you’re 114. You calculate your food, and take the right amount of insulin. You don’t “cheat” and have a few more carbs than you accounted for. You follow the routine just as you should. Two hours later, you are 287. You have no idea WHY you are 287 — it just seems to strike out of nowhere. How do you feel?
For most of us, the immediate feeling is anger or frustration. Understandable; nobody likes a high blood sugar reading. But there’s a step in between the reading and the feeling. It happens in a split second, and on a level most of us aren’t even really aware of. In between the reading and the feeling, there’s a thought. It’s not even a fully formed thought; it may not even be a verbal thought, and it’s barely conscious. But it’s there. And it’s that thought that truly gives rise to how we feel and, perhaps more importantly, has the power to lock us into a negative emotional state far longer than we need.
For many, it is the thought of permanence that throws us — we read that high number, and instantly worry that all of our previous balance is now “lost,” that we are now out of balance, and we will stay that way…forever. Remember, the kind of thought we’re talking about is the very subtle, subconscious kind of thought. It’s often the kind of thought that we know isn’t true objectively, but on a deeper level we find ourselves buying into it.
Another thought that can plague us is the thought of self-blame. We read that high number and instantly sink into the idea that “I failed; I can’t control my blood sugar; I’m not good enough.” Again, it’s a thought that on a rational level you might be able to dismiss out of hand. But it’s not a rational, conscious thought. It is a subconscious thought, an idea bubbling up from the recesses of the mind like a shadow. And there are hundreds, thousands, even millions of other subconscious thoughts that can bubble up in situations like this. What they all have in common is the ability to lock us into an emotional stress response from which it is very hard to detach.
Tag and release
I meditate on a regular basis, and one of the most common instructions given for meditators is to “tag and release” thoughts as they arise. The idea is very simple. As we meditate, we simply notice when a thought arises. When it does, we “tag” it (so we recognize it and label it), and then we “release” it (we drop it; we practice letting it go).
This little exercise is a wonderful tool for us Diabetians. The first step is to recognize the thought that arises. This isn’t easy. These are scarcely conscious thoughts — sometimes they’re completely unconscious at first. “Tagging” them takes practice. But the more we practice, the easier it becomes. Each time you feel anger or frustration arise, stop. Take a deep breath. Close your eyes and notice all of your thoughts. Search for that little thought that’s locking you into a feeling of panic. Identify it; name it; tag it.
Once you have tagged your thought, take another deep breath. Relax your muscles (this is important — we hold onto our emotions physiologically, almost literally “in our muscles and bones”). Soften your gaze; relax all of the muscles in your arms, your hands, your face, and your chest. Breath deeply, slowly, and smoothly. With each out-breath, let go of the thought and return to the present moment.
The steps above won’t take away frustration or anger — we all get mad when our blood sugar spikes. But the more we become aware of the cognitions underlying our feelings, the more power we have to move past them. In a remarkable study, researcher studied a group of meditating Zen monks, and compared their responses to a control group of everyday people. They wired each group to machines analyzing heart rate, perspiration, brain wave activity, and other physiological indicators. They then flashed provocative images on a screen in front of them. Some of the images were of naked women, some of the images were scary, and some were violent.
What they found was the following: Each group showed a spike immediately after the image was flashed. So the monks had a thought just like everyone else did; the thought of “Ooh, attraction, I want” to the naked women, a thought of “I’m in danger” to the scary image, and so on. But the monks returned to a balanced baseline almost immediately. The spike happened, the thought was immediately “tagged and completely released,” and the cognitive-emotional state returned to neutral. For the control group, the spike took minutes, or even hours to come back down.
The difference, of course, is that the monks knew how to immediately root out that shadowy thought, let it go, and move forward. It’s a wonderful skill, and one that all of us should strive to build for ourselves. We may not match the lightning-fast response of those Zen monks, but the more we practice, the closer we can get. And the closer we get, the happier we’ll be, whatever our meter says.