Our acceptance of chronic disease – “Is our healthcare broken or is it just me?”

The Greek letter "Psi" is the symbol of the field of Psychology. Here it overlays Leonardo's Vitruvian Man; a symbol of perfect proportionality.

The Greek letter “Psi” is the symbol of the field of Psychology. Here it overlays Leonardo’s Vitruvian Man; a symbol of perfect proportionality.

My motivation for seeking proficiency in the healing arts has always been the amount of gratuitous suffering in the world. I don’t know if it was my Catholic upbringing or the ubiquity of that great existential bumper sticker in the early 90’s, but I was able to handle the fact that s#!% happens in life. I knew there were some hardships in life that were unpreventable or unavoidable. Poor health was not one of these things.

Shit happens

As far back as I can remember, I’ve been focused not on sickness, but on our human potential to perform at our optimal capacity. This definition of health has left me acutely sensitive to the amount of avoidable disease and dysfunction some of us are so willing to accept as we age. I’ve been told countless times that getting old isn’t easy and that I should expect immense deficits in performance in the years to come. Now, I know enough about the endocrine system to know that there are cycles in life that make us more resilient in our younger years, but to accept a second act full of aches, pains, indigestion, and incontinence? Is that really “normal” or just typical in our society? Is sickness or health our default setting? I think many of us have answered these questions for ourselves without even knowing it. It is time they come to the forefront of our consciousness in order to more effectively leverage the proliferating onslaught of public health and anti-obesity campaigns to come.

Lasting behavior modification must first start with personal introspection. In other words, the message has to mean something to the person before it can be trumpeted from the mountain tops.

Allow me to explore how my ideas of health were developed:

I never really got sick as child. I was told I had good genes. I also had a nurse for a mother so I grew up priding myself on my health. While my peers never left home without a jacket and remained skeptical of the 5-second rule, I threw caution to the wind when it came to doing things that might make me sick. I grew up just before the “Purellization” of America, but if the stuff had been around during my childhood, I’d like to think I’d be the only one in my class to proudly NOT have the travel bottle ever affixed to my backpack.

My view of sickness at this point in my development was that some people were “blessed” and others were not. We were just all at the mercy of our genes.

As I learned more about pathology both in the classroom and in real life, I began to realize that we have more control over our health beyond our genetics, socioeconomics, race, etc.

Even ignoring the emerging evidence in Epigenetics (the idea that we can turn certain genes on or off through our behaviors/environment), there is a great potential for controlling our outwardly expressed health through mindset.

Starting off with the idea that the human body is born broken and in constant need of healthcare intervention in order to function properly sets one up for failure. This ethos is firmly implanted in to the minds of some of our most difficult patients. It fosters a learned helplessness and low self-efficacy that is nearly impossible to overcome…unless we acknowledge it.

We in the healthcare community are dumfounded by some of the reactions we get from our “problem patients”. We simply can not understand how somebody can be so objectively ill and not be willing to do anything about it. What we fail to realize is that often times, a deep sense of security is at the heart of their unwillingness to change. Safety and security are major contributors to the inertia of our “problem patient’s” mindset.

But how can anybody feel safe and secure when they are being informed of their dangerously abnormal lab results?

We can share all the scary numbers and statistics in the world but if we fail to offer an equal amount of security to offset that provided by the sickness, readiness to change will remain low. For many chronically ill patients, they have found ways to deal with their diagnosis. Sometimes it is denial and other times it is full acceptance. Such acceptance demands that they find a way in which they can justify being sick. In other words, they find a use for their sickness. The only way to live with the harsh reality that you are somehow flawed or broken is to normalize your situation. Their sickness becomes their crutch.

The manner in which the sickness serves the individual is highly subjective. For some, being Diabetic allows them to snack more often. Perhaps having chronic migraines or GI upset means you can have a pre-made excuse to decline social invitations. These are a couple of examples of some of the more superficial “crutches” I’ve observed over the years. Sometimes the normalization is rooted deeper in the psyche. Incorporating a diagnosis in to ones sense of identity offers them an explanation for short-comings in other aspects of life. If they are not as successful as they think they should be, they can blame it on the disease. If they are unable to find a companion in life, the disease helps fill that void in that it is a way of relating to others dealing with similar circumstances.

The award-winning Sundance hit documentary ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system?

The award-winning Sundance hit documentary ESCAPE FIRE: THE FIGHT TO RESCUE AMERICAN HEALTHCARE tackles one of the most pressing issues of our time: how can we save our badly broken healthcare system?

The first step to furthering change is to explore the subjective manner in which the sickness is serving the patient. This isn’t an easy process and it may take some time. Sadly, time is not a commodity afforded to healthcare providers because it is not valued as a worthy intervention unto itself. My wish for the evolving model of care delivery is that we maintain venues for “change talk” to occur.

The award-winning documentary, Escape Fire, peels back the healthcare debate beyond who should and shouldn’t pay for their own health insurance. This bold film questions whether or not the system that we are currently offering is one where health is even the emphasis. We see fewer numbers of primary care physicians and more specialists. Productivity is becoming the magic word in healthcare. Physicians are evaluated not on the health of their patients but on the number of patients they see.

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10 thoughts on “Our acceptance of chronic disease – “Is our healthcare broken or is it just me?”

  1. Very well written and truthful. In my opinion, many people that have a chronic illness seem to always use it as their crutch. It makes sense too. For example, I have a heart condition that doesn’t allow it to function at its full capacity like a “normal” person. Now on one hand I could live a very nice life with this condition. I don’t have to exert myself, I have a great excuse not to go to the gym, I could watch what I eat, but you know, I already have a bad heart so it doesn’t really matter does it? If this were the definition of my life, the universe surely has stopped spinning! I refuse to be a captive of my “illness”. I probably challenge my body to do things that healthy young adults would never think of doing. My doctor tells me to slow down, my family and friend think I’m a fool at times, but for me, I’m living life on my terms. Quite literally, unless you have some sort of severely life threatening illness such as polio, cancer, MS, or any other “heavy hitter” as you might say, your body is capable of such miraculous things. I hear too many excuses from people all the time. “Oh, I want to go running but my knees are just killing me lately” “I would go to the gym but my back has been hurting” “I broke my ankle back in the first grade, maybe it hasn’t healed yet…”. In an attempt not to sound overly facetious, I hope my point has been made. You can always work around chronic conditions, and a reasonable diet combined with a humble fitness routine will do wonders for your body. If you’re already healthy, don’t take this for granted; keep striving to be better and maintain a high level of health. If you are disabled by a disease, DO NOT let it control you. When it comes down to it, you are in charge, YOU are the foreman for your incredible body.
    Thanks for reading,
    -$ean

  2. Thanks for this well-written article! As I was reading, I was connecting with my experience of alternative healthcare systems… where experts do value time as a “worthy intervention unto itself”. However, those that I’ve encountered are offered at a price that is prohibitive to many.

    I appreciate your exploration of the mind/body connection through your discussion of sickness as crutch. I’m interested in further exploration of this connection re sickness as manifestation of trauma stored in the body. Perhaps you can guide me to resources that explore this further, or alert me when you publish another expertly written article about it;)? The reason that I think this is so critical to explore is… those who are suffering from sickness due to trauma that their body may have stored (for decades in many cases), may feel crushed/confused/abandoned by an inference of sickness as crutch.

    I look forward to your thoughts!

    Annie at Biocadence

    • Hi Annie,

      Thanks so much for your input. It does seem that time is a commodity we are quick to neglect in many areas of human interaction. I’m thinking of the business world in particular. We are well aware of the power of relationships and person-to-person interaction but it seems every hi-tech innovation is focused on creating short-cuts around this key element. The same can be said of the healthcare industry. I actually was guilty of this thinking last night at a lecture with legendary Sport Psychology consultant Dr. Ken Ravizza. I asked him if he has found any time-saving techniques for establishing rapport in his 30+ years of working with elite performers. He responded that he hadn’t and he’s long since stopped looking because there is no substitute or short-cut in getting to know another person at the level necessary to influence their thinking/behavior.

      I’m glad you brought up the trauma issue. It is something I have thought about but have yet to write about in depth. There is a great article from Time magazine on childhood trauma and obesity: http://www.time.com/time/health/article/0,8599,1951240,00.html

      The website for the study is: http://acestudy.org/

      Thanks for reading and sharing your wisdom.

      Bobby

  3. Hi! I’m so glad you shared your experience at the lecture by Dr. Ravizza!

    Thank you for the links re trauma/illness. I’m considering writing about it also… using a different filter than you may, as I don’t have your healthcare education and experience. I hope that we will both explore it, as it’s certainly a topic that needs more attention;)!

    I appreciate your writing, and will be back for more!

    Annie

  4. i agree – extremely well-written and a much needed message. many of us hold on to stories as our ‘identity’, providing a sense of grounding and meaning. while i appreciate that there are those who are in truly ill health and compassion is needed for all, perhaps focusing on ‘sickness’ allows us to avoid our inherent wellness and potential for greatness (which can be even more frightening than illness). just my take on this. thank you and namaste.

    • Thank you for your take on this very sensitive issue. Because compassion and care should be the very first consideration when healing the sick, it is difficult to know when it is appropriate to discuss the degree to which we are in control of our own health outcomes. There are cases of affliction but it pains me to see people relinquish their sovereignty over their own bodies and buy in to the idea that sickness is just an inevitability. Namaste.

  5. Pingback: How the Ego informs our Motivation | Daily Dosha

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