Chronic Illness & Self Esteem
“An illness is like a journey into a far country.
It sifts all one’s experience and removes it to a point so remote that it appears like a vision.”
– Sholem Asch, Polish-born American Jewish novelist
“I’d feel better if I felt better.”
I had to think about that one for a minute. I had been speaking with an elderly friend who had been suffering from some chronic breathing and heart issues.
She had also mentioned that old Art — arthritis — had been visiting all the joints. I had to admire her sense of humour.
Chronic disease and pain conditions often contribute to low self-esteem. Here, chronic is defined as a disorder that persists over time and has been deemed incurable. Unlike acute diseases that offer hope of a cure, chronic ailments require a dramatic shift in thinking. The individual must learn to live with the affliction and that can prove challenging.
Other factors can arise as a result of chronic illness and contribute to low self-esteem: an inability to meet goals and objectives, additional stress on relationships, an inability to be financially self-supporting, an inability to take part in previously enjoyed social activities, along with physical and cognitive difficulties.
“Some days it seems like I can’t do anything worthwhile,” my friend noted.
Despite her generally positive attitude, I could tell that the constant pain and discomfort was having its impact on her. I worried that her comment might lead to feelings of worthlessness which, in turn, would most certainly lead to depression, apathy and a lack of motivation.
There is an old adage that says as long as you’ve got your health, you’ve got your wealth.
There is, of course, a presupposition built into that statement that suggests without your health, you have nothing.
Worse yet, without your health, you are nothing.
The truth is unexpected health changes can strike any of us. Even without the level of health once enjoyed, many people still live a rich and full life, albeit a different life than previously lived.
It would seem that the biggest challenge is not the pain but the negative beliefs that arise out of it.
The antidote is a strong sense of self-worth, but that can be easier said than done. The first step is to have a little sit-down meeting with yourself.
Ask yourself, “What can I control and what is beyond my sphere of influence?
Is it time to draft a new job/life description?”
As challenging as it can be, there must be a transition away from resistance and a victim mentality toward a place of acceptance, compassion and understanding.
There are four accepted stages of transition: Crisis, Stabilization, Reconstruction and Integration. These stages represent an ongoing journey of adjustment and require ownership of the process.
The crisis stage is just that: a time of crisis and chaos.
A common response to news of an illness is shock and disbelief. Learning that an issue will continue in a chronic mode often adds fear, stress and anxiety to the situation.
We may feel victimized and demand answers to questions such as, “Why me?”
The goal of this phase is to bring the situation under physical and emotional control. We’re still who we are inside, despite the decline of the body.
This can be challenging as we must deal with our own fears and feelings plus those of family members.
The stabilization stage is a time to focus on reconstructing our life. Routines will change and new approaches will need to be devised.
Typically, this is a time when depression may set in, but it’s important to note that depression is often the result of resignation. The goal here is not resignation – a “What’s the use?” mentality – but rather acceptance of a new reality. It’s a time to reflect on our life and determine what we need to do in order to remain productive.
The reconstruction stage is where we finally acknowledge the permanence of our illness. We begin to acknowledge our abilities and limitations.
We come to terms with the knowledge that we will no longer be able to live the way you did before the illness. It’s a time to shift awareness away from what we can’t do and toward what we can accomplish.
It is a time of forgiveness. Forgiving ourselves and others who may not have been there in the capacity we expected or required. The goal of this stage is to build a new sense of meaning in life and a greater sense of self-awareness. It will likely mean helping others close to us come to a place of acceptance.
The integration stage is where we ask the all-important question, “What can I take from this experience that will help me to become a more loving, positive, heart-centred person?”
We realize that we are wiser, more capable and certainly more self-aware as a result of the illness. We understand the process and though may backslide, especially when symptoms flare up, we now have the tools to get ourselves back on course.
We have integrated our pre-crisis self with our current self so that life becomes whole again and we at last have a sense of peace.
Morrie Schwartz, the 78-year-old sociology professor in Mitch Albom’s non-fiction best seller Tuesday’s with Morrie, shares this piece of advice with Albom as the time of his passing draws near.
“If you hold back on the emotions – if you don’t allow yourself to go all the way through them ‚ you can never get to being detached, you’re too busy being afraid. You’re afraid of the pain, you’re afraid of the grief. You’re afraid of the vulnerability that loving entails. But by throwing yourself into these emotions, by allowing yourself to dive in, all the way, over your heard even, you experience them fully and completely.”
I might add one piece of advice as imparted me by my dear friend: never lose your sense of humour. It will keep you grounded and real.
Humour brings together hope and healing.
Murray Fuhrer is a self-esteem expert and facilitator. His new book is entitled Extreme Esteem: The Four Factors. For more information on self-esteem, check the Extreme Esteem website at www.extremeesteem.ca