Stress and Chronic Illness

 

by Rick Rader, Morton J Kent Habilitation Center

Definition of a Life Crisis

A crisis may be defined as an acute stress situation that is a threat to our sense of self. Typical situations or events that may trigger a crisis reaction include:

  • A major disaster involving an entire community, such as a flood, tornado, earthquake or air crash
  • Sudden death of a family member, especially a child
  • The loss of one’s home, e.g., through fire, earthquake, storm
  • An acute traumatic injury or illness resulting in a chronic physical disability
  • Sudden loss of a job or a job-threatening situation, including business takeover, layoffs, malpractice lawsuits, work injury

A crisis can, and usually does, strike suddenly. We may be a casual bystander, not directly involved with the specific incident (such as witnessing a traumatic auto accident), but still suffer a crisis reaction. When we are in the middle of a crisis, we don’t generally understand what is happening or what might happen in the immediate future. Distorted perceptions are common. Other typical responses include depression, confusion, anxiety, foreboding, feelings of panic, fear of impending loss and shock. In helping a loved one or a peer (or even ourselves) through a crisis, it is important to recognize the following psychological and emotional reactions to a crisis:

  • A loss of sense of reality and ability to adequately differentiate between our emotional state and the realities of the external world.
  • Feelings of helplessness that serve to increase tension even further: “Why can’t I relieve this horrible feeling?”
  • Refusal to acknowledge emotions such as anxiety or physical symptoms inability to predict or anticipate future events.
  • No clear understanding of the cause of an event, inability to address the question, “What will happen to me next?”
  • Loss of psychological and emotional equilibrium, often followed by renewed efforts to cope.

Most of us will experience several crises during our lives, and it is important to be prepared. While reactions to crisis often involve anxiety and depression, the negative effects of these emotions can be relieved by understanding their causes.

Overcoming a Life Crisis

In most cases, the passage of time alone is sufficient to restore healthy psychological and emotional functioning after a crisis. However, it may also be necessary to consult a doctor or therapist to obtain objective insight and emotional support during such periods. This assistance is typically of a short-term (crisis intervention) nature. Often, all that is needed is to learn a new set of coping techniques for dealing with the stress presented by the extraordinary life event creating the crisis.

After a divorce or a breakup of a relationship, for example, we may feel completely alone in the world. Emotional support from others is needed to fill the void and reduce the isolation, loneliness, despair and need for validation. Family and friends are often the first line of support in such situations.

Events tend to occur so quickly during a life crisis that we don’t have time to develop new behaviors to cope with the related stressors. For this reason, role-playing and other techniques designed to teach new coping skills can be useful in helping the victims of crisis. This kind of help can even be obtained before a crisis occurs, and can be thought of as a psychological inoculation against disaster!

If it is likely that, at some point, a crisis situation will occur in our lives, we can prepare by learning problem-solving methods that allow us to respond appropriately when the time comes. Those with dangerous occupations can be taught methods for assessing their options in the event of an injury or psychological trauma. This involves the use of rational, non-emotional problem solving to handle the problem and make decisions regarding recovery.

Other stressful events, such as the loss of our home or personal belongings through fire or theft, can be dealt with by assessing the situation from a different perspective. This can take the form of cognitive restructuring, a method of modifying thoughts, perceptions and emotions related to a situation. The result: We learn to re-frame the loss so that grief and despair are not immobilizing. A sense of thankfulness to be alive and hope for rebuilding can foster a more positive attitude about our acute life situation.

Another important aspect of crisis intervention is to counteract the expected psychological and emotional withdrawal by helping the victim reach out and share the sense of grief, loss and despair. A major step in restoring psychological and emotional balance is to link our personal loss to losses suffered by others.

Deriving a sense of meaning and purpose from suffering, as well as understanding the nature of our own grief, can provide the strength needed for survival.

Believe it or not, life crises can have a long-term positive impact. For example, a recent sturdy of high school students who had suffered life crises such as gang violence or the death of friends indicated that 87 percent of those studied later developed a more positive view of life. The researchers stressed that many people have the ability to transcend pain and adversity, a position previously under-emphasized in other studies. In other words, cognitive changes were brought about by these individuals’ own painful experiences, changes that provided a means by which their understanding of life’s meaning could grow.

During a crisis, the courage to continue with life even while suffering personal grief is nurtured by providing compassion and help to others. A prime example is the founding of the group Mothers Against Drunk Drivers (MADD). MADD was founded by a Texas woman whose daughter was fatally injured by a drunk driver; instead of withdrawing into her own loss, despair and self-pity, she discovered that there were hundreds of other families who shared her grief and decided to do something about it. MADD now sponsors support groups for families who have been victims of drunk drivers, as well as funds national campaigns against drinking and driving. Essentially, she utilized a personal act of compassion to focus on the needs of others who had suffered similar losses, thus accelerating her own process of self-healing.

It is interesting to note that Chinese ideogram for “crisis” and “dangerous opportunity” are the same. A crisis can be seen as testing our attitudes, resources and creativity. Just as maintaining our physical, emotional and mental health helps us to take full advantage of positive opportunities, it will also facilitate our coping with a life crisis. It allows not only for more effective short-term coping-but also aids us in turning adversity into personal growth.

Reality Check

Learn to put stressful situations in perspective by asking these questions:

  • Does this situation reflect a threat signaling harm, or a challenge signaling opportunity?
  • Are there other ways to look at this situation?
  • What exactly is at stake?
  • What is the worst that can happen?
  • What are you afraid will occur?
  • What evidence do you have that this will happen?
  • Is there evidence that contradicts this conclusion?
  • What coping resources are available?

Your illness may bring out some of the best aspects of your personality, such as determination and patience, but it will also bring out some of the worst. It has the same effect on relationships. The problems you and your partner were having before the diagnosis will persist until you correct them. If the two of you had a difficult time making decisions about priorities, or talking about money, or relating to each other physically, you are probably still going to have to keep working to improve these aspects of your relationship.

Just like other people, sick or not sick, your problems do not go away by themselves. It is tempting to throw up your hands and say, “I’m not well. How can I deal with that?” or “I don’t think that’s important anymore. Why don’t we talk about real problems-like mine?” It’s not fair to use the illness as an excuse to quit on your partner, or yourself, or your relationship. You still have a responsibility to care and share and participate in your relationship like an adult.

Your perspective may change, however. Your illness, or the illness of your partner, may change the way you think about your problems and the way you approach them. You both may decide that some of the old issues are not issues any longer. Or, you both may decide that your time together is too precious to spend it discussing trivial differences. If a chronic illness has one beneficial effect, it is to hasten the process of change. These changes can be very positive if you know what you are trying are improve.

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