Coping with Chronic Illness
Notes from a Lecture
by Dr. Michael Vallis
NSAEHA Newsletter, December
According to Dr. Michael Vallis, people
who come down with a chronic illness have suffered a loss. In many
cases, they can no longer trust or rely on their bodies to do the things
which they always expected to be able to do. It is not uncommon for
people to take a long time to accept their situation and begin to regain
a positive perspective and lifestyle once again. The psychological
challenges that the chronically ill encounter during this transitional
time and the healthy coping strategies that help people to deal with these
challenges were the topics discussed by Dr. Vallis during a lecture sponsored
by the AEHA on October 8, 1991.
During the lecture I kept saying to
myself- “I wish I had heard this lecture a long time ago because it might
have saved me a lot of grief.” There was so much that Dr. Vallis
said that I could identify with and many of this suggestions on how to
cope were ones which I had learned the hard way without much help.
Nevertheless, it was still really nice to hear an expert tell me about
my reactions and struggles with my illness. It was also good to be
reminded of the types of strategies which can be used to get through the
rough times that I still experience.
The lecture was almost 2 hours in duration.
It was full of interesting insights with which most people in the audience
seemed to be able to identify. Hopefully, a tape recording of the
seminar will soon become available to other members through the AEHA library.
The following are my interpretations of some of the points made during
1. It is the unfortunate burden of
the victims of chronic illness to educate the non-victims.
People in general want to believe that
illnesses are short term and acute. In other words, they expect people
who get ill to also bounce back and get better within a reasonably short
time period. If the ill don’t get better then they are often seen
as being hypochondriacs or as having other psychological problems.
This is especially true if the disease is controversial, the cause is unclear,
or the symptoms are vague and difficult to see.
These societal beliefs are very widespread.
The victims of chronic illness are therefore forced to try to educate friends,
family, co-workers, and physicians of their experience of the illness and
its long-term reality.
2. The focus should be on illness
rather than disease.
Disease is what has gone wrong at the
biological level. Illness on the other hand concerns the impact that
the disease has on a person. Suffering and disability cannot be predicted
on the basis of a disease. Two people with the same amount of disease,
may have different amounts of illness. It is once again up to the
victims to educate others about their illness.
3. It is important to express emotions
and it is OK to feel bad.
It is important for family and friends
to realize that it is quite normal for a chronically ill person to experience
sadness and depression over their situation. By expressing such emotions,
we can feel better. It often takes more energy to keep emotions inside
than to release them. Family and friends should be told not to be
frightened by such emotions. However, feelings of hopelessness (ie.
“there is no future”, “there is no sense in going on”) should be taken
more seriously. Hopelessness is not normal and requires intervention.
4. To overcome depression:
Build a sense of the future by setting
short term goals and plans. The plans should include things that
give you pleasure and the goals should be achievable ones designed to give
a sense of mastery. Feelings of pleasure and mastery often bring
people out of depression.
5. A healthy coping style:
If we become chronically ill, we must
view it as another life transition to which we must adapt. We must
first accept that we are not the same person that we previously were.
This means that we must recognize that we have different limits and abilities
and our expectations of ourselves must change accordingly. A healthy
coping style involves setting different expectations; focusing on mastery
of activities that we can still partake in; incorporating pleasure in our
lives; and trying to find meaning for ourselves.
6. Be an active rather than passive
As a patient you are in charge.
Involve yourself with your treatment. Ask for an explanation of the
treatment options and become involved in selecting the treatment best for
you. View your physician as your coach who works with you.