Chronic Illness, Disability & Pain

“People often are angry in the setting of a terrible loss. They often feel envious of other people, and this is a starting place. But over time things evolve and change. And at the very least, people who have lost a great deal can recognize that they are not victims, they are survivors. They are people who have found the strength to move through something unimaginable to them…”

– Dr. Rachel Naomi Remen

Are you struggling with chronic illness, pain or disability? Perhaps you are facing difficult physical symptoms and still trying to figure out what’s going on. Or maybe the devastating medical diagnosis is clear, but you aren’t sure how to face adjustments and losses associated with your diagnosis. If so, counseling can be a great resource to help you adjust to these changes.

The Centers for Disease Control states that 6 in 10 Americans are coping with some kind of chronic disease. In spite of this, many find the American healthcare system lacking in terms of managing chronic illness, as the American medical model is based on acute problems (i.e., problems that are easily identifiable and follow a predictable trajectory of full recovery), rather than management of chronic disease (i.e., health problems that can be difficult to define, recurrent, and ambiguous in their trajectory). This can often result in frustration, a sense of isolation and alienation, and even despair related to knowing how to adjust to illness and pain, and where to turn for trusted guidance and support.

Chronic illness and pain can be incredibly pervasive in the ways they negatively impact life. Indeed, the body is the foundation for all aspects of living, thus when there is disturbance in the body’s functioning, it’s not uncommon for many, if not all, of life’s areas to be impacted.

Common ways that chronic disease can affect one’s need for supportive counseling include difficulties with the following:

IDENTITY ISSUES

Perhaps you were able-bodied and are now unable to do activities you love, or have needed to change careers, or even stop working altogether. Or maybe you’ve been dealing with your illness/disability your entire life but have struggled to build a positive self-image as a chronically ill/disabled person. Chronic illness can disturb every aspect of living from recreation to: hobbies, employment, sexuality and relationships. These are the things we use to clearly define our identity. As a result, difficulty in adjusting to changes and limitations can negatively interact with individuals’ self-concept and result in a lack of a consistent, cohesive and positive sense of self.

DEPRESSION

The body is a system. Therefore, when one imbalance occurs (i.e., chronic disease) it can affect the full system and lead to chemical changes in brain and hormonal functioning which can result in a disturbed mood. In addition, chronic illness is unpredictable and taxing, and may provide consistent losses which may contribute to an overriding sense of grief and sadness. Those facing severe symptoms may also find an increased need to be house or bedbound, which may result in inadequate connection to nature, social interaction and activity. This can all lead to the manifestation of clinical depression and research has shown that depression is a common co-occurring disorder with numerous chronic diseases.

ANXIETY/MEDICAL TRAUMA

Repetitive losses and physical malfunctioning can contribute to an overall sense of helplessness and powerlessness. This may create chronic worry, obsessiveness and a “keyed up” nervous system that is consistently preparing your body to face the next impending threat related to decline. This can result in polarized behavioral responses such as shutting down and disengagement to hyper-awareness and overly-controlling behaviors. Moreover, post-traumatic stress disorder (PTSD) may develop from acute episodes in which illness has led to abrupt sudden losses or changes, which can be overlaid with ambiguity and crisis. In addition, while your physical capacity declines, stressors and demands can increase as your illness may require more attention, and more money and time. Paradoxically, illness may necessitate even more of these than even the healthy you had, or healthy others have. All of this can work together to create chronic stress which may spiral downward into a full manifestation of an anxiety, depressive or post-traumatic stress disorder.

PARTNER & FAMILY STRESS/CONFLICTS

Chronic illness can disrupt long-standing and agreed-upon family and partner roles and boundaries. Furthermore, community, family and individual knowledge about chronic health problems varies, and often partners and family members lack appropriate education about the chronic illness experience and how to effectively respond to these changes. Ill individuals often begin adjusting to illness with a sense of misunderstanding in terms of who they are becoming, and loved ones can experience a parallel process in terms of not understanding how to relate to the new ill/disabled you. This can create disorganized relationships which are prone to: miscommunication, unmet expectations and needs, fear, resentments, and general strain.

EMPLOYMENT ISSUES AND FINANCIAL STRESS

Sometimes chronic disease can result in functional disability, necessitating a reduction in working, a complete career change, or cessation of work altogether. In addition, healthcare costs are exorbitant and medical problems are the number one reason for bankruptcy in the United States. Furthermore, private disability insurance is based on a profit-driven model which maximizes profits by increasing the number of healthy participants, while simultaneously decreasing the number of paid claims and purging unhealthy members from membership rosters. This incentivizes disability insurance companies to unjustly deny benefits and care. In addition, the governmental Social Security Disability fund, and its administration, is grossly underfunded. Accessing governmental Social Security Disability benefits is an arduous process, often accompanied with multiple denials, wait times that drag out for years and administrators who are insensitive to, and misinformed about, chronic illness and disability. All of this can work together to create significant financial burdens for the chronically ill/disabled and their families. This is particularly problematic, since financial stress is also a risk factor for: increased physical decline; depression; anxiety; hopelessness; and, if left unaddressed, even suicide.

PREJUDICE, DISCRIMINATION, ISOLATION AND ALIENATION

American society is still struggling to integrate chronic illness and disability into mainstream culture. We are bombarded with popular cultural portrayals that either ignore illness and disability, or misinform the public about the lived experiences of the ill and disabled. Many laws, rules and norms are crafted from an able-bodied perspective and either exclude the chronically ill/disabled, or serve as barriers to access and opportunity. Furthermore, negative attitudes towards illness and disability are internalized by individual members of the society (e.g., the self, friends, family, coworkers) and perpetuated in regular social interactions. All of these factors can work together to reinforce a sense of exclusion, isolation, and general alienation for the chronically ill/disabled person. This can result in internalized shame and a consequently negative self-concept which contributes to depression, passivity, low self-esteem, anxiety, helplessness and hopelessness.

Are you experiencing any of the above symptoms?

Chronic illness and pain are significantly misunderstood and under-addressed human experiences. You deserve extra support to face these difficult challenges! Contact me today, for a free 15 minute consultation regarding your symptoms, goals and how we can work together to address these issues.