Know When to Hold’em: Playing the Diabetes Blame Game

It is the eighth annual Diabetes Blog Week, started by Karen from Bittersweet Diabetes and today is day 3 –  The day one topic is here about expecting the unexpected and day two is here about the costs of diabetes.

Today’s prompt is one I am very passionate about and have written, spoken and shouted about – the blame game.

Having diabetes often makes a visit to the doctor a dreaded experience, as there is invariably bad news of one kind or another.  And sometimes the way the doctor talks to you can leave you feeling like you’re at fault.  Or maybe you have a fantastic healthcare team, but have experienced blame and judgement from someone else in your life – friend, loved one, complete stranger.  Think about a particularly bad instance, how that person talked to you, the words they used and the conversation you had.  Now, the game part.  Let’s turn this around.  If you could turn that person into a puppet, what would you have them say that would leave you feeling empowered and good about yourself?   Let’s help teach people how to support us, rather than blame us!  

The day you are diagnosed with diabetes is the day that blame takes a seat in your house, and your car, your bed, the supermarket, your relationships, your head, and that party you went to last week. And it most definitely takes a big hulking ginormous seat at the doctor’s table.

Blame and self blame are two pretty similar but entirely different concepts. Blame is something others impose upon you due to their own experiences, thoughts, intelligence (or lack of), personal role in the situation at hand, and often, prejudice. Self blame is something you do to yourself due to shame, guilt, lack of self esteem, bad experiences, misinformation, worry, anxiety, depression and burn out. Of course sometimes, you really need to stand up and accept that something was indeed your fault and cop it on the chin – in self blame or blame from someone else. Part of this is to know that it is ok to make mistakes. It is ok to have to apologise and accept the blame for something and you do not have to keep on and on about it, or drop dead from the horribleness of it all. We all make mistakes. We all say things we wish we didn’t, we all make dodgy choices, we all stuff up. So whatever, if it was your fault and it really did matter, then deal with it and move on, let it go.

We have been going through an inordinate amount of “sorrys” at our place in the past few months. Our wonderful 8 year old Maxwell, lives with high functioning autism and one of his most recent compulsions, is to apologise, like ALL the time…..over and over. Apparently it is quite a common OCD behaviour, related to a fear of something going wrong. He seeks constant reassurance that everything is ok, that HE is ok and that he can let go of an insidious sense of doom and guilt, by us accepting these constant apologies. At first we did. Then it got stretched out to “apology accepted” and on an on it went until all of us were tearing our hair out, and he was sobbing on my lap about how he could not handle it any longer.

The psychologist told us that by responding at all, we were enabling this behaviour and that we needed to either ignore it, walk away; or distract him. It has been working to a degree in that we feel slightly better about just being able to let it wash over us like waves while we roll with it, rather than taking responsibility for his feelings, and so, he is also dealing better, despite “the sorry thing” still bringing a strong A game.

Life with diabetes is similar. When you get diagnosed, particularly with type 2 diabetes, there is a strong message of blame – it is YOUR fault you got it. I can not count the number of people who have told me this over my years of diabetes counselling and education….and for many with type 1 diabetes, parents in particular, blame is a constant – was it something I did wrong, could I have done anything differently?

NOTE OF IMPORTANCE NUMBER 1: IT IS NOBODY’S FAULT THEY GOT DIABETES OF ANY TYPE

There are endless opportunities to let blame in – every time you check your blood glucose and see a number you don’t want to see. Every time you eat…anything…every time you have a drink or three. Every time you have a crashing low after an over correction gone overboard. Every time you wake up and every time you go to sleep, and especially every time you stand up in a doctor’s waiting room to be taken inside.

Blame is a funny thing. It tends to grow stronger if you acknowledge it and let it in – a lot like the sorry thing. I have had many experiences of this, as a person with type 1 diabetes and as a mum. Usually these experiences are disempowering and demotivating and do nothing to help you want to make changes. I think one of the worst things you can do to someone else, is to presume you know more about them and their situation than they do. Telling them they should or should not have done a particular thing, or that they could have gone about it in another way and then nothing would have gone amiss, is unhelpful. Better to ask them how they are feeling, how things are going for them and would they appreciate any support.

NOTE OF IMPORTANCE NUMBER 2: Trust me, people with diabetes do enough self blaming to cover you, so if you don’t have something nice to say, don’t say it.

Case in point.

A while back I called my Gastroenterologist about blood test results, after having had a rough trot with my control, my gut and needing iron infusions. He said to me “well all of my department is great, but Dr Robert’s (my Endo) department is not so great”. Oh? I said…and what pray tell did he mean by that? “Your HbA1c is 7.5% he said, so Dr Roberts has a lot of work to do!”. I was LIVID!! It is NOT his department I shouted…it is MY department!! AND in fact given what I have been GOING through, that is a pretty fine result!!!!!!!!!!!

oh but the blame!! It got in my head and then it went around and around and around.

So here is another way he could have done that.

“Well Helen, all of your blood results are within target ranges. Your iron has come up from the infusion and your general blood chemistry is all in normal ranges. Your HbA1c is 7.5%”.

THAT IS ALL HE NEEDED TO SAY.

Your HbA1c is 7.5%…..

No judgement needed. No assignment of responsibility. No implying this was something bad, terrible, about to turn the world into a disaster area. That is all he needed to say.

NOTE OF IMPORTANCE NUMBER 3: The best way to understand someone else is to ask them rather than telling them. Make genuine enquiries about how they are, and how you can help. Never presume you know what it is like for them, even if you have had similar experiences. Always be kind. Never blame them for their chronic conditions like diabetes, stick to the facts, and never presume it is simple.

You really gotta know when to hold’em, know when to fold’em and know when to walk away. And I sure as hell am walking away from blame.

Helen