Psychological Control 
of a Chronic Illness 
has 3 Components

Vijai P. Sharma, Ph.D

Psychological control of a chronic illness has three components: Management of Symptoms,

Management of Daily Activities, and Management of Emotions. The management of symptoms was discussed in a previous article. In most chronic diseases, symptoms wax and wane and don't stay the same. When symptoms are more troublesome than usual, continuously remind yourself, "this too shall pass." 

Management of Daily Activities when you have a chronic illness is nothing less than an art. To do what you want to do, when you want to do it, at your pace, and on your terms is a skillful art indeed. You need skills in management of daily activities when "your feet are tired and you have miles to go." A chronic illness may be accompanied with low energy, occasional drops in energy, shortness of breath at times, and occasional flare up of pain. 

You may be someone who has trouble falling asleep. You wake up several times in the night, finally getting up early, and even feel sleepy and lethargic during the daytime. You may get upset with yourself, your spouse and children, or with the rest of the world because you are not able to do what you could do before. Anger and other negative emotions can drain your energy out. Stop all such  "leaks" in your energy, be they from anger, fear, or from feeling sorry for yourself.  

After stopping the energy leaks, develop the art of doing things at your pace and keeping in tune with the rhythm of your body. For example, you may have more "oomph" for performing certain tasks in the afternoon than you do in the morning. Make daily, weekly, and even monthly schedules to suit your specific needs. The art is to plan meticulously and yet be very flexible to accommodate flares and low- energy days. Schedule adequate breaks and rest pauses. "Pacing" means exerting yourself just right, not too little and not too much. Also schedule events that would provide you entertainment and laughter, opportunity for moderate exercise, social interaction, and spiritual development, such as meditation, prayer, and congregations pertaining to your faith. 

The art of pacing and scheduling involves focusing on what you can do and are going to do rather than on what you can't do, don't want to do and won't be able to do. Don't overexert. Define your safe limits. When you respect those limits you may be able to do far more than you ever thought you could. Don't try to do the whole project in one round if it exceeds your safe limits. Many people make this mistake and "pay later." Break a big task into small steps and schedule them in. Check them when you have completed each step. Each successful step raises self confidence and satisfaction, and improves the mood. 

Management of emotions really boils down to monitoring and modifying the negative thoughts that can play havoc with your mood. Why control thoughts? Because we feel what we think. Thoughts cause our moods. Most common negative thoughts that accompany a chronic illness are anger-, anxiety-, depression-, and isolation thoughts. 

Anger thoughts are about the unfairness of it all. Examples: "Why me?" "It's not fair." I can't do what I used to do." "Nobody cares about what's happening to me." "I was stupid for not seeing it coming." Anxious thoughts are about underestimating your own abilities to cope with the circumstances and ' overestimating the negative outcomes of the chronic illness. Examples: "It's going to be even worse in future." "I won't be able to handle the pain." I won't even have a clue about what to do if it got worse." 

Depressive thoughts are about loss of control, hopelessness regarding future and helplessness about the present. Examples: "I can't do anything anymore." "What is the use of trying." "It's only going to get worse in the future." "I can't help myself and nobody else can help me either." Isolation thoughts are due to lack of faith in others, even cynicism, and lack of understanding that there are many others who are in the same boat. Examples: "No one can understand my illness." No one wants to be around someone who is sick." "I have let everyone down, how can I face them now?" 

Don't let your illness change the perception of who you are, who you were, and who you will become. You are more than your illness and your physical body. You are not a "heart patent," or a "lung patient," you are a person who has a heart disease or a lung disease. You can become a bigger hero by learning to manage your illness than you were as an "able bodied" person. Anybody can ride a regular horse but one who learns to ride a tiger is an object of our wonder and admiration. Anyone can run empty-handed but one who walks with two hundred pounds on his or her shoulders, even though experiencing excruciating pain and huffing and putting all during the act, is to us performing an extraordinary feat.

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Copyright 1996, Mind Publications 



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