Leann Harris has lived with type 1 diabetes for 14 years. As a Positive Psychology Coach, working with people with diabetes across the globe, at Delphi Diabetes Coaching, she focuses on the mental fears and emotional challenges of thriving with diabetes. She is passionate about helping others learn resilience skills, counteract shame and blame, and overcome diabetes burnout. Her motto is ”Know Yourself, Know Your Diabetes.”
As both a patient living with diabetes and a Positive Psychology Coach, what aspects of daily diabetes management do you feel spark the most anxiety and stress?
I feel it’s all the daily mental choices I make. I want to make the best choices for my health, but I want to avoid lows, avoid going high, avoid feeling hungry, avoid being disrupted during a work day to check my blood sugar, avoid complications, and avoid feeling as if all I do is act like a pancreas. I have competing avoidance desires and sometimes that’s what makes me stressed out. Anxiety is fueled by being trapped in this avoidance loop. We work ourselves up trying to be in control or trying to be perfect. We become frustrated in a day filled with: “Oh, look at that 326 mg/dL,! Arugh! I forgot to give insulin for lunch,” It’s a wonder we don’t ask for crystal balls alongside our meters.
If we feel out of control and the need to DO SOMETHING, we shame ourselves when the right answer isn’t apparent. Our actions follow our beliefs. If we believe we are incompetent, dumb, or lazy, we behave like someone who is incompetent, dumb, and lazy. Alone, it’s hard to see where this pattern begins and ends, which is why it’s so difficult to change our beliefs and our behavior and stop blaming ourselves. It’s my job as a Coach to help people see that their judgments aren’t facts and that life can be better.
What could help a patient go from a place of anxiety and stress around their diabetes to a more confident, empowered place?
The Positive Psychology approach is to step back and try and see our lives for what they really are. The main goal is to cultivate the conditions, processes, and beliefs that allow for someone to embrace their unique approach to life and to thrive. As a Coach, I help people understand the negativity bias we’re born with and how take steps to see the reality of life, which has both positive and negative pieces. It’s actually when someone takes in all of reality — the good, bad, and neutral — that people make progress. We are more than our blood sugars and more than what we ate today. We are even more than just people with diabetes. We don’t usually allow ourselves the freedom to maximize the skills we were born with and, with this broader perspective, to savor the pleasures, strengths and values that have nothing to do with a disease. Every person has a unique set of talents that, when revealed and put to work, make not only diabetes self-care easier but give a new meaning to our lives as a whole.
In what ways could a caregiver or physician help to not only support a person struggling with anxiety around diabetes but also be sure not to add to it or trigger it through their interactions with that patient?
For starters, remember that knowledge does not equal change. Patients need your expertise, but when only facts and fears are discussed in a visit, most people can’t change their beliefs and behaviors. Think about how many people smoke with full knowledge and the desire to quit. Instead of a cigarette, many people use food to self soothe. Unless you replace that food with a different form of comfort, they don’t have a viable path to change. Help your patients find alternative behaviors. Clinicians are human too, so it’s easy to become frustrated with people’s lack of response to the facts. Believing in someone’s capability, even if it’s hidden by circumstance at the moment, will do more to motivate than fear ever does. Compassion wins in the long run, every time.
I truly believe that the more self-aware of a clinician you are, the better care you give because you have examined what things actually helped you. Unless you start treating aliens, what helps you will certainly help another human being. You have more knowledge than what’s just in your head, and patients need your knowledge tempered with understanding and wisdom.
Focus on what does work for each person. I realize in an 8 minute visit this might be hard to do. But just as it’s easy to point out the 456 blood sugar, look for patterns that went well. Say things like “I see for 5 days that week your pre-lunch blood sugar was under 130 mg/dL. How do you think you accomplished that?”
In what ways do you think the newer developments in diabetes technology both relieve and/or trigger those stressful emotions in day-to-day diabetes management?
Being a geek long before I was a diabetic, I welcome our new electronic overlords. I have mostly Christmas-morning-type feelings when I think of new technology, and the only time I’m stressed is if the battery is dead. My hope for technology is to take over some of this churn from task switching inside my head. That’s why I’m really looking forward to any version of the artificial pancreas: I haven’t forgotten what it’s like to have something act like a proper pancreas and let my brain be normal and not a brain/pancreas hybrid. In the meantime, anything that is small, lightweight, and works with my existing devices is a complete win.
I also want my technology to mine my data for me. I want software to alert me to trends and tell me the statistical significance of a proposed change to my care plan so I can discuss the idea with my doctor. I want to harness the power of the data to lessen the mental stress of how to make the best choice with the information available.
Remember, knowledge is empowering – that’s why we developed the Dario glucose meter. Dario combines a glucose meter that plugs directly into any smart mobile device with personalized information and support to make life easier for people with diabetes.