Support is hard to find even misleading at times. The family is supposed to be supportive but, what some people think is supportive, may feel just the opposite. Here is the dilemma at hand: Friends, family, and loved ones may believe that they’re supportive but, instead, they may be overly protective or punitive towards the person living with diabetes. The very person that they’re trying to help!
How does this happen?
The ones who were supposed to support you may be hurting you instead. Several things may be happening, your loved ones may be scared, in denial, feel irrationally guilty, have control issues, or there is a possibility that they were not supportive before the diabetes diagnosis.
When a loved one is afraid you’ll get hurt whether the fear is real or imagined, it may cause them to micromanage your diabetes or your behavior. Fear can show up as over-involvement and may make the person living with diabetes to withdrawal from the relationship, act out towards their loved ones or even act out against them self. I’ve seen this multiple times while working with clients in my private practice. The person living with diabetes knows what eating a lot of sugary sweets will do, but due to a lack of support and anger, they continue to mismanage their diabetes.
The negative impact of over involvement happens when the person living with diabetes feels that their loved one is always on their back about how to take care of their diabetes and what they are eating. The person with diabetes may think something like this, “If you think that’s bad, wait till you see my next A1c!!!” The behavior that follows can’t present itself in multiple ways, letting one’s blood sugar careen out of control. A common example of this is when the person who is living with diabetes, starts eating what they want to eat instead of what they need to eat. The pitfall is that the person living with diabetes believes that the loved one is a support and becomes reactionary when they get disappointed. “You shouldn’t eat that. You can’t tell me what to do!”
When a family member or spouse becomes codependent with the person who has diabetes, they desire to control the person living with diabetes to protect them. They make efforts to change the person living with diabetes for the better. Which usually happens without acquiring accurate knowledge of the emotional or physical needs of the person they are taking care of. They tend to be the individual who does tons of research for the individual who is living diabetes, instead of letting them do it for themselves. They have a tendency to be the know it all of diabetes. Although they have the best intentions and feel they are supportive, they inadvertently put the person living with diabetes in a catch 22.
For the person living with diabetes, the “catch 22” pitfall forces them to make a choice between their loved one and doing what’s best for them. The dilemma is if you don’t go along with what your significant other is telling you to do, you risk getting into an argument, disappointing them or even losing them. If you go against your better judgment to avoid this, you may risk having an unnecessary high or low blood sugar.
In some cases, the pitfall is denial, the person who has always been the greatest supporter cannot face or accept their loved one’s diagnosis. Depending on the person with diabetes age, this can be more devastating than the previous pitfalls. For a child, this can mean taking on more responsibilities than they need to or are capable of doing. A parent’s irrational guilt and denial can leave the child isolated and with the parent no longer available, the child may make up the rules on how to manage their diabetes causing great physical or emotional issues.
For a spouse who goes into denial, it will be difficult and may even cause a stable marriage to break apart. Luckily, as adults, we can make other choices for support and seek out help from a Certified Diabetes Educator, a marriage counselor or a psychotherapist who specializes in diabetes or chronic illnesses.
Anyone can be supportive if they want to help and are open to creating healthy dialogue around what the person living with diabetes needs are. The biggest pitfall that causes all the problems is that the individual who is providing support assumes to know what their loved one or friends needs are around support.
Every person living with diabetes needs support specifically designed for their needs and the only way to know how to best support your loved one is to ask. Once you know, you can adjust how you provide support and your loved one living with diabetes will hopefully be receptive.
It is also important to keep asking as support needs can change over time. “How can I best support your needs and help you manage your diabetes?” If you are the one living with diabetes, try having a conversation where you express what you need from them. So they can give you support that helps you instead of frustrates you. Make sure they are open to having a serious discussion, if they are not ready, schedule a time with them, in the future when they will be ready. Don’t have it after a fight or after a long day of work. Make sure you have plenty of time to talk and are both in an emotionally stable place to listen and to be open to compromise.
Support can come from anyone but make sure they are capable of giving it, and you can openly talk about your needs. Hopefully, you can avoid some of the pitfalls and feel supported in your diabetes management, because doing it alone is tough.
Whether you are a significant other, struggling to be supportive, a parent struggling to deal with your child’s diabetes or a person living with diabetes, psychotherapy or counseling can help. Psychotherapy is a method of support for individuals living with diabetes and their families. It can resolve issues with a significant other as well as issues the significant other is having around not being able to protect their loved one. Couples and family counseling can help you, and your loved one develop open and healthy communication, so good support can occur.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.