By Nicola J. Davies, PhD
The fact that you are reading Diabetes Self-Management suggests that you are eager to learn new ways of dealing with this demanding condition. It is likely that you’ve heard a great deal of advice on improving your diet, controlling your blood glucose levels, and starting or maintaining an exercise routine. However, it is also important to consider how you care for your mental and psychological health. Many people pay too little attention to these aspects of healing, yet such activities as guided imagery, meditation, and mindful eating can be excellent additions to anyone’s self-management routine. Each of these techniques – and others, as well – can help you learn to accept and feel compassion for yourself, and that, in turn, can lead to rewards both measurable (in the form of improved blood glucose control, for example) and immeasurable.
While most people understand the concept of compassion as it applies to other people, fewer recognize the importance of extending compassion to themselves. Many people neglect to provide themselves with the same love and support that they offer to family members and close friends.
Many people are also overly self-critical, doubtful of their capabilities and desires, and too ready to negatively compare themselves to others. They see mistakes as permanent failings and temporary setbacks as insurmountable obstacles. When it comes to their own shortcomings, they see mountains where only molehills exist. But allowing greater self-compassion into one’s life can change all that.
Self-compassion presents an alternative way of thinking about yourself and your perceived faults. It allows you to bestow upon yourself the same love and support you give to those close to you. It also helps build your emotional resilience so that it’s easier to weather future blunders without spiraling into guilt and recrimination.
Dr. Kristin Neff, Associate Professor in Human Development and Culture at the University of Texas, has proposed three major components of self-compassion:
Self-kindness. This means avoiding harsh judgment of yourself and instead treating yourself with care and understanding. Self-kindness is a gentle and accepting approach in which you use kind and caring language with yourself, as a good parent might use with a child. You learn to actively soothe and comfort yourself when something goes wrong, rather than turning to harsh and judgmental criticism. Exercising self-kindness means avoiding negative language; just as you wouldn’t call your best friend fat, lazy, or stupid, you shouldn’t use such language with yourself either.
Embracing common humanity. This means recognizing that imperfection is a shared aspect of the human experience and not a personal failing. When experiencing problems in life, it is common to feel as if you are the only person in the world who has that problem – even when this is obviously not the case. You may have experienced such feelings when you were first diagnosed with diabetes. This mind-set can leave you feeling isolated and powerless. But when you commit to embracing a sense of common humanity, you develop an understanding that everyone is in the same boat together. All of humanity deals with failure, disappointment, and shame. Once you internalize this reality, you will begin to feel more connected with the world and less alone in moments of trouble.
Mindfulness. This means seeing the big picture by keeping your present experiences in perspective. It means seeing life – with all of its nuisances, obstacles, and disappointments – as it is, no more and no less. By having a balanced perspective, you can avoid getting carried away with thoughts and feelings and letting them control you. You begin to realize that reality consists of only the present moment, not anxieties about the future or regrets about the past.
When living with a chronic condition such as diabetes, self-compassion can be helpful in a number of ways. Embracing self-compassion is not about gaining more control over your life, but rather about controlling how you perceive your life and the struggles you encounter. It is about having the resilience to deal with day-to-day conflicts in a more positive and empowering way.
Diabetes is a complex disease, requiring constant evaluation of your behavior – which is why feeling compassion for yourself is essential to successful self-management. With self-compassion, you can develop a new relationship with your diabetes, in which you pay attention to it without judging yourself. You do this in part by applying mindfulness to your daily self-care activities, such as food preparation, eating, exercise, and blood glucose monitoring. Dealing with the ups and downs of diabetes can be difficult, but being compassionate toward yourself can help you make peace with your diabetes. This has both mental and physical benefits.
Mental benefits. Research has shown that people who treat themselves with compassion have greater psychological health than those who do not take this approach. Self-compassion correlates positively with overall life satisfaction, feelings of happiness and optimism, social connectedness, and emotional resilience. Self-compassionate people also tend to have less extreme reactions to problems than people who are excessively critical of themselves. It follows, then, that lacking self-compassion can lead to self-loathing, depression, anxiety, and perfectionism – all of which will ultimately have a negative impact on your diabetes management. Taking a compassionate approach will lead to greater awareness of your health, more resilience to deal with health-related setbacks, and more nurturing mental responses to distressing thoughts and events.
Physical benefits. A lack of self-compassion has been shown to be related to a variety of eating problems and disorders, including emotional eating. Research has shown that when dealing with a restrictive diet, people who are self-critical tend to feel “eating guilt” when they stray from the diet – which often leads to overindulgence as a method of coping with this feeling. People who practice self-compassion, on the other hand, are more likely to forgive themselves for eating something that’s not on their meal plan and move on.
Furthermore, if you treat yourself with compassion, you will feel more motivated to opt for healthy rather than harmful choices. Self-compassion strengthens humans’ innate yet often neglected awareness of how their bodies are feeling, thus increasing their ability to self-regulate, heal, and maintain good health.
There are a number of ways to cultivate self-compassion, including the following four:
1. Consider your reaction to having diabetes. Ask yourself: Do you accept your diabetes and work with it, or do you resent your diabetes and try to fight or ignore it? What kind of language do you use with yourself when thinking about or discussing your diabetes? Do you often insult yourself, or do you usually take a kind and understanding tone? By evaluating your initial level of self-compassion, you can identify areas where you need more work and attention.
2. Consider your feelings about having diabetes. Take some time to write about a diabetes-related issue that tends to make you feel inadequate or bad about yourself. Write down how this issue makes you feel inside: Does it make you scared, sad, depressed, insecure, or angry? Focus on whatever emotions arise when you think about this issue. Try to be as honest as possible, examining your feelings without exaggerating them or pushing them away.
Once you have your honest feelings down on paper, think about a real or imaginary friend who loves you unconditionally and is accepting, kind, and compassionate toward you. This friend knows you intimately and can see all of your true strengths and weaknesses, including any negative aspects of yourself that you’ve been writing about. Reflect for a few moments on the feelings this friend has toward you. Now pick up a new piece of paper and write a letter to yourself from the perspective of the friend, focusing on whatever negative emotions you’ve been probing within yourself. What would this friend say to you about your perceived flaws, from the perspective of unqualified compassion and support? How would this friend convey such compassion to you, particularly in response to whatever pain you inflict upon yourself through harsh self-criticism? What would this friend say to remind you that you are only human, and that all humans have their strengths and weaknesses?
After you finish writing it, set the letter aside for a while – maybe a few days. Then read it as if you were seeing it for the first time, letting the words truly sink in. Reflect on how soothing it is to hear these compassionate words and to realize that they came from inside of you – which means they can come from you again anytime you feel a need for them.
3. Keep a self-compassion journal. Journaling has been found to enhance both mental and physical well-being, and it is an effective way to get in touch with your emotions. Journaling has been found to be particularly useful for people with chronic conditions such as diabetes. Every evening, find a few quiet moments to reflect on the day’s events. Write in your journal about any negative feelings, anything you judged yourself for, or any other difficult experience that caused you pain or sadness – no matter how trivial it may seem. For each event, make a point of using the three components of self-compassion to help frame the way you think about the events:
• Self-kindness. Write yourself some kind and understanding words of comfort. Adopt a gentle, reassuring tone and let yourself know that you care about yourself. For example: “It is all right; you strayed from your diet, but it wasn’t the end of the world. Maybe you can keep some healthy snacks at your desk to avoid cravings at work.”
• Common humanity. Write down some ways in which your experience was connected to the larger human experience. This might include acknowledging that being human entails being imperfect. (“It is normal to slip up every once in a while.” Or, “I am not the only one facing these challenges; many people have diabetes.”) You may also want to reflect on the underlying causes and conditions behind the negative event. (“I was already stressed out about my afternoon meeting, which made me less resistant to food cravings.”)
• Mindfulness. Explore any painful emotions that arose from your self-judgment or difficult circumstances. Write down how you felt, including whether you were sad, ashamed, frightened, or stressed. As you write, try to be accepting and nonjudgmental of your experience, capturing your emotions as they were rather than minimizing or exaggerating your experience. (“I was stressed about my meeting, so I indulged and felt guilty afterward.”)
Using the three components of self-compassion as part of your journaling will help you organize your thoughts and emotions, as well as help you incorporate these attitudes into your everyday life. If you keep this journal regularly, the practices of using kind language and keeping your experiences in perspective will become easier and will help you treat yourself in a caring way.
4. Take care of yourself. Managing your diabetes effectively might mean that you need to recharge your inner battery occasionally to have enough energy to give to others. Grant yourself permission to satisfy your own needs first – recognizing that this will not only enhance your quality of life, but also enhance your ability to contribute to the lives of others. By showing yourself the same love and care you show to the people you care about, you are cultivating a more balanced and capable self. Whether you pamper yourself with a relaxing bubble bath or organize a night out with friends, relaxing and recharging your mind and body will improve your mood, ability to concentrate, and general outlook on life. Taking the time to respect your personal needs – and making a habit of it – will also help you manage your diabetes more effectively.
Living with diabetes can be difficult mentally, physically, socially, and emotionally. If dealt with negatively, it can hurt relationships and interfere with life goals. The stress of living with diabetes can lead to anxiety, depression, and poor eating habits. Self-compassion will improve your emotional resilience in the face of these difficulties. It can give you the support you need to cope with guilt, anxiety, and depression. By treating yourself with compassion, you surround yourself with a blanket of acceptance rather than a cloud of judgment. As a result, you are more likely to make healthy decisions about your diet, exercise, blood glucose management, and other factors associated with diabetes. And that is just the beginning; self-compassion will help you cope with anything life throws your way.
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