The “Terrorism” of Diabetes

Since the fall of the twin towers on 9/11, we who live in the United States have collectively experienced a new way of life—one that is affected by the possibility of something horrible happening.

Before this tragedy, most of us were relatively innocent, not intending to harm anyone else in the world and somewhat naive about the potential for bad things to happen. We found out on 9/11 that that some things cannot be controlled, and we are finding out now through our fear about more bad things happening that the cost is high, emotionally and energy-wise, when trying to prevent future events. It would be great if we could ignore and deny this reality, but if you’ve been to the airport recently or watched the news, it’s hard to stay unaffected.

Diabetes has its own parallels to terrorism. It would be unusual if you were unaware of possible complications of diabetes, such as heart disease, retinopathy (eye disease), nephropathy (kidney disease), and neuropathy (nerve disease). Almost everyone hears about these “terrors” from health-care professionals, and even if you don’t, you are at least likely to have heard about Uncle Bill’s amputation or Aunt Betty going blind from “well-meaning” family or friends. No matter how you get the message, you do get the message that if you don’t take care of yourself, bad things may happen to you.


This threat of bad things is likely to get your attention and, for a time, motivate you to really get on track. However, the effect of constantly being on guard is not likely to help your motivation—it is actually more likely to be draining on your resources. As with going through security at the airport, if you are subjected to the same thing every day, it no longer gets your attention; you may find that your energy to stay on top of things begins to wane and you get lazy. The problem is that the threat doesn’t go away, and if you are not dealing with it the anxiety about it gets bigger. It’s the same with diabetes: The threat of complications doesn’t go away, and if you are not doing what you need to do to care for yourself you are more likely to have anxiety about it.

This situation of being fear-driven is familiar to many of us. We often think that this is the stuff that helps us change, and for some it really works, but as I pointed out earlier it can backfire and cause us to quit paying attention. Change is really a combination of (1) fear getting our attention, but then (2) us redefining our situations in positive terms so we feel drawn to keep up positive changes. This is where a support group can be useful, to help you keep up hope. It is also where seeing a therapist to work on changing your belief system can help in the battle against being discouraged. When you find positive support, it will help you have the energy to persist with your self-care in spite of the psychic shadow of complications.

The threat of diabetes complications can be scary. It can act as a motivator to make you begin to pay attention, but it is important to focus on the positive when trying to effect behavior change. This strategy can help you remain diligent as any lurking terrorist waits for you to look the other way.

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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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