Prevention | Support Strategies
Reframing: A Great Way to Banish "Diabetes Overwhelmus"
How to look at something you’re struggling with from a different perspective
Here is my favorite technique for banishing diabetes overwhelmus, the feeling of being dragged down by the day-to-day demands of diabetes. I call it reframing. Reframing means taking something you’re struggling with, and looking at it from a different perspective, one that helps make the situation less overwhelming and more manageable. Reframing is based on the fact that we are always thinking, and that our thoughts powerfully influence how we feel and what we do. I call these thoughts automatic thoughts. They’re automatic because they just seem to pop into our heads. We’re often not even aware of what we are thinking when we have these automatic thoughts, but they still have tremendous power. Let me give you an example from my own experience, so you’ll get a clearer idea of what I’m talking about.
For many years I’ve shared professional offices with a dear friend and colleague, Joseph Napora. Our offices are wonderful, with a big waiting room between the separate offices where Joseph and I see our patients. I usually get to the office earlier than Joseph does, and if I don’t have a patient when I first arrive, I leave my office door open and Joseph comes in for a friendly morning chat when he arrives. Every once in a while, though, Joseph goes straight into his office without coming in to say hello. That’s when my automatic thinking kicks in big time! Like most people, my automatic thinking is based on the messages I heard as a child. So, when Joseph doesn’t come in to say hello, I’m off to the races with thoughts like “I must have done something wrong. What could it be?”
I can work myself into a state with these thoughts, and spend a lot of energy desperately trying to make it up to Joseph. Or, as is sometimes the case, I can flip the other way, to thoughts like, “Boy, is he impolite! I’d never ignore him that way. Just wait until next time he tries to be friendly to me!” Naturally, this can also get me worked up, and could lead to me to act weird with Joseph next time I see him. All because of my automatic thinking about what it meant that Joseph had not come in to my office to say hello. The fact he didn’t come in was actually no big deal. No, the big deal was the thoughts I had about why he didn’t come in, how I framed his behavior. That was a really big deal, because it so powerfully affected how I felt, and often how I acted as well.
My automatic thought, or frame, was, “He’s mad at me. What have I done wrong?” But if I stopped for a moment, I’d realize that it was probably not true. In fact, if I was looking for reasons he didn’t say hello, there were several more likely explanations. Maybe he had to go to the toilet. Or he might have had an emergency with one of his patients or a fight with his wife. If any of these reasons (or any of a thousand other possibilities) applied, the fact he didn’t say hello wouldn’t bother me at all. I’d just be sure to check in with him as soon as I could.
Reframing can really help to relieve stress and make life a lot easier. To make reframing work for you, you need to recognize that you (and everyone else in the world) do think automatically, often applying your own personal negative frames, and making life harder than it needs to be. You also need to build skill in stopping yourself when you are thinking automatically and framing negatively. You need to recognize what negative messages you are sending yourself, and you need to find some positive frames that help you manage those situations you find most stressful.
Now, you’re probably wondering how this applies to diabetes. I’ll try to show you with an example of one great positive frame – sharing information. There are a lot of people with whom you should share at least some information about your diabetes: your health care providers, your family, your close friends. But the person with whom you need to share information most clearly and openly is yourself.
That’s right. If you want to reduce some of the stress that often leads to diabetes overwhelmus, you need to do a better job talking to yourself. I know that might sound strange, but it’s true. You’re already talking to yourself all the time about your diabetes. But if you’re like most people I know, what you are saying -- your automatic thoughts -- are pretty harsh and negative. And that only makes things harder to manage.
For example, if you test your blood and get a really high reading, let’s say 340 mg/dl, what do you say to yourself? If you think about it, I bet that at least from time to time you say things like, “What did I do this time? I can’t do anything right! It’s impossible to control this damn disease.” Thoughts like these, natural as they are, hurt in two ways. First, they make you feel bad: guilty, helpless or hopeless, for example. Second, when you feel bad, it’s much more difficult to maintain your motivation for the hard work of managing your diabetes. And that can trigger a negative cycle of feeling bad, taking less good care of yourself, feeling worse, and taking even less good care of yourself.
I’ve been trying to get the blood glucose meter companies to put positive framing voice chips in their meters. Then if you got a 340 reading, your meter could help by offering a brief consultation with the Best Friend voice chip. If you chose this option, the Best Friend (who really has your well-being at heart and knows lots about diabetes) is activated:
“Hmm, sorry to see that 340, and it looks as if your numbers have been on the high side for the last couple of days. That’s a shame. But I see that you were much closer to normal earlier this week. So this looks like a short-term problem. You’ve been doing well, so let’s see if we can figure out what’s going on and help you get back on track.”
“Any changes in your eating?” You answer, “No.”
“Any changes in your medications?” You answer, “No.”
“Exercising less?” You answer, “No.”
“Do you have an infection, or are you under lots of extra stress?” You answer, “No infection, but things have been especially tough at work the past few days with that big report due, and I’ve been pretty constantly stressed out as a result. Thank goodness I’ll be finishing things up today.”
“Well,” the Best Friend says, "It sounds as if you might have figured out what’s going on. Let’s see if we can come up with some ways to relieve your work stress when we have more time to talk. For now, just remember that you’re doing a good job managing your diabetes and the rest of your life. Now, get yourself off to work or you’ll be late, and that will only add to your stress.”
Those of us who are looking for the fastest possible blood test would probably skip this option every time, even if it were available. On the other hand, many people have told me that a Best Friend voice chip would be a welcome addition to their meter, because it would offer some much needed support for the never-ending work of diabetes management. For these folks, the Best Friend voice chip would help reframe some of the many occasions when diabetes triggers negative thinking.
Until the Best Friend voice chip is a reality, try to be your own chip. Reframe situations you find stressful, talking to yourself as you imagine a best friend who also knows a lot about diabetes would. I think you’ll like the results.
