Living With Type 2 Diabetes Is Family Affair
Family involvement is crucial to diabetes control.
Spouse Affected Most continued...
"Many, many couples in which one partner has diabetes have
never sat down and talked about what this is like for them," Fisher says.
"They don't know what their spouses are thinking and their spouses don't
know what they are thinking."
Very often spouses represent an unrecognized health
"The data is very clear that rates of depression,
depressive affect, and bad mood is high among spouses of people with
diabetes," Fisher notes. "This isn't often attended to. Often the
spouse feels no role in the disease. They are very concerned. This often gets
them into the role of being the diabetes police. The patient takes a piece of
cake and the spousal eyebrows rise."
Once these issues are out in the air, many people find that
they can come to terms with what they've been avoiding.
"These are normal couples struggling with abnormal
situations," Fisher says. "It is not that they are crazy or sick: It is
a new situation. It is a husband, a wife, and diabetes -- a threesome -- and
diabetes is often the elephant in the living room that never gets
Resolving Family Roles
In every family, different family members tend to take on
different family roles.
"One person wants to focus the family on moving on, and
another wants to make sure the illness gets taken care of. A family needs both
types," McDaniel says. "Some family members get so scared they don't
want to go near any mention of the illness. Some get too involved, to the point
where the patient gets angry and says, 'Quit telling me what to do.' That
happens even in the most well-adjusted of families."
This is where a family therapist can help.
"I think with a little bit of tweaking, people move from
polarized positions over time," McDaniel says. "The overbearing person
may say, 'Well, probably I was overdoing it a bit,' and the avoiding
kind of person may say, 'Well, maybe we do need to pay a little more
attention.' Sometimes meeting with someone like me helps them see that every
family has a continuum of response."
Unless the illness is overlaid on intense, unresolved
conflicts, this doesn't mean weeks or months of family therapy.
"Sometimes just normalizing the emotional response to
illness and giving people a space to talk with each other channels things in a
constructive direction, rather than all that anxiety getting discharged as
anger," McDaniel says. "Emotional reactions to illnesses like diabetes
are totally normal. Being scared and angry and wondering what is to blame
happens to everybody. It happens to family members as well as to patients. That
is really important for people to expect. But they should know that it will get
better. They will find a place for their feelings and for the
Two basic things have to happen. Everybody in the family needs
to feel that they matter -- that what they are doing is helping. And everybody
in the family needs to feel that the meaning they make of the experience
connects them to one another.