Prevention | Support Strategies
Talking Back to Diabetes: What Are You Saying to Yourself?
Talking back lets you replace negative thoughts with ones that support positive change
Alice decided to turn over a new leaf. Her last hemoglobin A1c check three months ago told her she had to, because at 10.1 percent, it was way higher than it should have been! So she started eating better, walking a couple of times a week, monitoring her blood glucose regularly and taking her medication on time every day. Now it was time for her next A1c check, and Alice was actually looking forward to the result, instead of dreading it as she usually did.
“Only 9.3 percent!” she exclaimed when she got the result. “All that work and my level didn't drop even 1 percent. And I know 9.3 percent is still much too high.” Over the next few weeks Alice felt herself giving up. She stopped walking, almost never checked her blood glucose, started having a big bowl of ice cream as a regular evening snack and skipped her medication whenever she told herself she was “too tired” to take it.
What's up with Alice? She is clearly disappointed, and that's understandable. She worked really hard and didn't get the payoff she was expecting. But does that explain her giving up? I don't think so.
The stories we tell ourselves
Alice gave up, but not because her A1c didn't come down as much as she was hoping. Alice gave up because of what she told herself when her A1c didn't come down as much as she was hoping.
It's true. We are always talking to ourselves, all the time, engaged in mental chatter, telling ourselves the stories that give meaning to our experience. That's what Alice was doing. And the stories she was telling herself were not pretty. They all boiled down to the message that she would never be able to control her diabetes, no matter what she did.
There are a couple things you have to keep in mind about Alice's story and all the stories we tell ourselves. First, we are largely unconscious of these stories. Often we are completely unaware of what we're saying to ourselves, or even that we're talking to ourselves at all.
Second, the stories we tell ourselves are almost always exaggerated, most often in a negative direction. These stories are “awfulized,” reflecting the most negative possible perspective on a situation. Think about what Alice was saying to herself: “I'll never . . . no matter what . . . .” That's pretty extreme, isn't it?
Third and most important, the stories we tell ourselves, including those awfulized ones, can create a self-fulfilling prophecy. If trying to manage your diabetes were really a hopeless cause, as Alice told herself, then giving up would be the sensible thing to do.
But there's good news: awfulizing is not inevitable. You can manage your stories, just as you do your diabetes, by monitoring and making adjustments.
What are you saying to yourself?
To start, you have to figure out what you are saying to yourself. What is the story your diabetes is telling you? If the answer doesn't come to you right away, think about some aspect of your life with diabetes that isn't going as well as you want it to. Pick any issue, big or small, from coping with the news you have diabetes in the first place, to getting yourself to check your blood glucose as often as you should.
For example, let's take the issue I just mentioned: getting yourself to check your blood glucose as often as you should. If you struggle with this, what is the story you tell yourself? Is it something like, “It's too much trouble to check when I'm away from home” or “I hate sticking myself” or maybe, “Why bother? It's high every time I check.”
Talking back to diabetes
Whatever story you tell yourself about monitoring your blood glucose, once you recognize it, you know what you're dealing with. These are the thoughts that keep you from checking more often. Now that they are out in the open, you can talk back to them if you want to. Talking back lets you replace the old story with a new one that supports the changes you are seeking.
Let's go back to Alice's situation. She was telling herself that she could never control her diabetes no matter what she did, so she gave up. Then she decided to talk back to her diabetes, saying, “No, that's not true. The truth is that what I was doing improved my control, but not enough.”
The new story Alice used to talk back to her diabetes was only a little different from her old one, but that little difference was critically important. Her new story reminded her that even though she wasn't satisfied, she had already accomplished something by improving her A1c almost 1 percent. Her new story also reminded her that other things she could do might improve her control even more. Alice's original, awfulized story led to an unfortunate ending: Alice gave up trying to control her diabetes.
Alice's new story has a happier ending. Recognizing she had already taken a step toward her goal, Alice decided to call her doctor and talk about things she could do to continue lowering her A1c level. They discussed adjusting Alice's medication, and she made an appointment to see a nutritionist for additional meal planning advice. Talking back to her diabetes, coming up with a new story to replace her old one, was the key to rekindling Alice's motivation.
Talking back to your diabetes can pay off for you, too. Give it a try. Figure out what you are saying to yourself, think about how you would like to modify that story to help you get (or stay) on track. Then talk back!
