When Support Isn’t Enough

By Joe Nelson | October 25, 2006 9:40 am

To Cathy W, who commented about her friend with diabetes on last week’s blog,

It certainly sounds like you’re feeling frustrated about your friend’s lack of self-care and a bit powerless to help her. The interactions you have reported with your friend make it sound like her health is more important to you than it is to her. This type of relationship keeps you on edge about something you cannot control and lets her off the hook about something she needs to address.


In some ways, this relationship is a bit like a parent taking care of a child who is being irresponsible. The parent means well and may feel sorry for the child, so he or she is inclined to continue to pick up after the child or fix things for him. A better technique would involve holding the child accountable and actively involving him in the process. With your friend, it sounds like you feel a combination of anger toward her lack of responsibility and empathy for her for the discomfort she has. It’s really this ambivalence that prevents you from being firm with her and laying out your expectations for her self-care. After all, you obviously care for her and want her to be well, just not at your expense.

I’d also like to point out that I liked the response Coco gave you last week. She suggested that your friend probably needs some professional help, and I agree. The higher incidence of depression in people who have diabetes and the further increased risk of depression when someone has diabetic complications would suggest that some of your friend’s behavior may be due to this issue. What we know about diabetes is that it can be tough enough to control when the person who has it is emotionally healthy.

If there is anything else in her history that is affecting her mental health, she might want to talk about that, too. She may have grown up with some confusion about what supportive relationships look like. This history could be affecting your relationship with her as well. If your friend is open to it, the two of you could meet with a counselor together and you might find out how you can be most helpful as a friend.

Finally, I would suggest that you have an honest discussion with your friend about your feelings about her self-care. Talks like this can at times be difficult and a bit confrontational, but if your relationship is as close as it sounds, then she may also be open to a frank discussion. Obviously, you need to be the judge of what your relationship can tolerate.

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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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