Chronic Illness: Part 2

Chronic Illness: Part 2

Managing an emotional or physical illness requires resilience. Unfortunately, the very nature of these disorders sometimes makes it very hard for the patient to exercise the skills and the attitudes of resilience.

Coping with a brain injury is difficult no matter what level of support one has. The very nature of a head injury usually involves a loss of control, not just over physical functions, but over emotional ones as well. Dyscontrol is one of the hallmarks of a brain injury, meaning that people have difficulty regulating their thought and their feelings and emotions. If recovering from a brain injury, often the patient will engage in perseverative behavior. Perseveration is again one of the factors that make management of a head injury difficult. People get stuck. They have difficulty letting go of a particular thought or idea. They may behave in a repetitive fashion, may continue to attempt to do something in the same way over and over again, even though their behavior is not being effective. This results usually in increased rigidity and more frustration and anger. 

Learning to control perseveration and to be “flexible” is a difficult process for most people with a head injury.  But with time and patience, new coping skills can be learned and people can learn with a brain injury to be more flexible, to try in new and different ways to solve a problem and to gain control over their emotions and their world.

Other chronic illnesses such as cancer can make it very hard to exercise the skills and the attitudes of resilience. In the face of a devastating illness, optimism can be hard to come by. Inadequate insurance coverage and medical debt, which is the number one cause of bankruptcy in this country, can be overwhelming and people can sink into feelings of helplessness and hopelessness. These are times when finding a sense of purpose and direction is crucial.

I have learned from many of my patients that with time, patience and support can change things for the better. A chronic illness doesn’t have to change every aspect of your life, and the changes that occur may not be permanent. There is much wisdom in the saying, “This, too, will pass,” and blaming yourself or others for your troubles never makes things any better.

Many of the patients that I have seen with chronic illnesses over the years tell me that the one thing that was essential for them to continue moving forward, to continue battling the cancer, or learning new coping strategies was a sense of purpose, a reason for doing it. They may have found that sense of purpose through their religious beliefs or through their family, their work or their friends. But they found it. And through that they found resilience and the ability to bounce back from adversity.