Hung Worry

Posted by fxckfeelings on June 4, 2012

When people argue about medical self-care, be it with family or just with themselves, their feelings are often masquerading as reason. After all, emotions make decisions fraught and complicated, while reason tells you that you can never control your health, just make choices that have costs and probabilities. If you face those costs and probabilities with courage, you need never defend your decisions, regardless of their outcome. It’s natural to worry, but it’s useless to let worrying dictate what you do and don’t do with your health.
–Dr. Lastname

My husband and I have a great marriage, but there’s one issue we seldom agree on, and it’s irritating as well as worrisome. Whenever I decide to get medical advice about a problem, like back pain or anxiety, he suggests I’d do better by sucking it up and staying away from doctors and medicine, which is the way things were done in his family. I, on the other hand, believe you owe it to yourself to get good medical advice and that getting treatment is the way you take good care of yourself. I don’t like his disrespect for my opinion or his lack of sympathy when I’m clearly suffering. My goal is to get him to at least respect my point of view.

It’s natural to emotionalize health care decisions in terms of fear because that’s how we often make them: when we’re worried enough, we see a doctor.

Trouble is, worry can as easily drive you to avoid as to overuse medical care and can also embroil you in endless debates with family members whose worry style is a little different from your own. And there are many styles to choose from.

There are those who worry most about not catching an illness until it’s too late, those who worry more about being dependent on doctors and medications, those who worry about worrying and those who don’t worry at all.

If you counter your husband’s concerns with your own and enter the great medical worrying debate, you’ll get nowhere; he thinks he’s protecting your from self-centered hypochondriasis, you feel he’s not respecting your pain or judgment. The debate will feel personal when, of course, it isn’t, while the feeling that it’s endless will be close to accurate.

Instead of arguing your right to worry or what to worry about, think through your criteria for seeing a doctor. On a rational level, they don’t depend on worry but rather on fairly concrete conditions that people usually agree on, e.g., a fever that doesn’t go away, a lump that gets larger, or anything that prevents you from working or gets friends and close relatives thinking of ways to avoid you.

Instead of responding to your husband’s emotions with your own, define the issue in terms of principles and procedures. For instance, don’t ask for sympathy for your back pain, though you deserve it. State your understanding that there’s probably no point in investigating the cause of your back pain unless it’s particularly severe and hasn’t been investigated before. It’s worth seeking relief, however, when it gets so bad you might not be able to get to work. You understand that treatment might not help—you don’t have faith that it will—you simply think the alternative is worse.

If your husband insists on discussing his feelings about treatment, cut him short and ask him to look up the literature and help you figure the odds. You’re not interested in faith, because that’s not what drives your decisions. You’re just trying to play your cards right and you want to know how likely a treatment is to help and/or harm.

You don’t have faith in either seeing doctors or staying away from them, but you do have faith in your own ability to make good risk management decisions. That’s the only kind of topic you wish to discuss, and you need not worry about his response.

STATEMENT:
“My husband’s stiff-upper-lip attitude to medical treatment often makes me feel like he doesn’t care if I’m hurting or need help, but I know it’s just an emotional style. If I want his help in dealing with a medical decision, I will ignore his attitude and instead challenge him to gather information and use objective methods for deciding whether treatment is necessary. He’ll probably rise to the challenge but, if he can’t, I don’t need or want his input.”

I’d like to know why I’m so good at sabotaging myself, and am particularly good at destroying my greatest achievements. When my weight got out of control at 250 lbs, I got surgery and since then I’ve dieted and exercised and got my weight down to what it was 30 years ago. It took 2 years of hard work and I was proud of myself. The day after I hit my target weight, I went on an eating binge for 24 hours. Tell me why I did that to myself. I’d like to know why I hate myself.

Hating yourself is a good trigger for compulsive eating, so don’t ask me, or yourself, self-hateful questions; you might think you’re trying to solve your problem, but you’re really making the problem that much worse. That’s what a good 12-step program is all about; declaring that you have no right to hate yourself for losing control because you never had control in the first place.

Emotionally (see above), we all tend to hate ourselves for losing whatever control we hold ourselves responsible for having, forgetting the ton of scientific evidence showing that weight is very, very hard to control, nevermind all the money spent and pounds regained in the process. We know we’d give anything to lose weight (and have), and that our control wavers from day to day. Still, we persist in believing that, since we technically control our jaw muscles, we therefore have total control, so the fault is ours.

Instead of pushing yourself down the endless spiral of self-blame, sulking and snacking, get yourself into a rational/non-self-hating frame of mind by admitted that you actually don’t have control. This is, of course, the first of the 12 steps, but it’s also a rational statement of fact that allows you to take credit for making the brave and well-researched decision to put yourself through surgery because you cared about your health and couldn’t find a simpler or safer way of restoring it, then finding the strength to build habits of self-restraint and maintained them for two whole years.

Then remind yourself that dyscontrol is always possible—surgery can’t remove whatever part of your personality/brain it comes from—and that a time of celebration is a natural trigger for many people. Instead of being shamed by your slip, learn from it and recognize it for the blip that it is.

So retract your letter to me. Rewrite it properly, with self-respect, recounting your accomplishment with pride. Then investigate the circumstances around your slip so you can avoid repeating those circumstances. Your goal is continued self-improvement, and that doesn’t come through self-castigation, but through self-respect.

STATEMENT:
“I feel defeated and humiliated by my eating binge, but I know better than to express those feelings and thus give them strength. I have procedures for dealing with slips and people who will help me without blame. I’ll do my best to regain control tomorrow. “