The Mind and Chronic Medical Conditions
By Larry M. Berkelhammer, PhD
For millions of people living with chronic medical conditions their lives look like this:
• Life consists of going to invasive medical tests & treatments.
• Their entire life revolves around being sick.
• They begin to view themselves as a disease with a person attached to it.
• They very commonly fall into a passive, victim stance due to unremitting physical disability, dysfunction, pain, fatigue, medical appointments, and a broken medical system (in the U.S.).
• That is not a life that is conducive to health.
New biomarkers and especially genetic markers are allowing physicians to become increasingly effective in diagnosing chronic medical conditions, yet treatment for chronic conditions is still quite ineffective. There are literally thousands of chronic and life-threatening medical conditions (some common and some rare) for which there are now clear diagnoses but no cures, and few effective treatments. It can be incredibly exasperating to receive such a diagnosis and learn that modern medicine offers no good options other than drugs that control the symptoms but do not stop the disease process. Sometimes, there are treatments that do in fact slow the disease progression but many of those medications create other problems when the drugs are taken long-term.
Even the process of finding the diagnosis is not assured. Many people still spend up to twenty years going from one specialist to another in the hope of connecting their symptoms with a diagnosis. Quite often, different specialists give different diagnoses, prognoses, and treatments and the treatments often don’t work due to having an incorrect diagnosis.
I spent years wondering how to best treat people for whom medicine seemed to have no answers or has poor answers. In reviewing hundreds of studies, I came to the conclusion that for those of us living with chronic health challenges, mental training can make an enormous difference is health and wellbeing.
An advanced metastatic cancer patient once asked psychooncologist Lawrence LeShan if he thought the chemotherapy would work; LeShan answered: Only if you’re in there too.
Quality of health and wellbeing are very positively influenced by a sense of mastery, which is about living with intentionality and direction rather than being dependent on others to get well, or to stay well.
There are many ways to cultivate mastery. Here are the ones most substantiated by research:
• Identify personal life values and find ways to live by those values.
• Practice authenticity, which includes authentic self-expression.
• Cultivate empathy, compassion, and connection with others—all others—not just those close to us. This is enormously challenging, yet is profoundly life-altering.
• Engage in activities that provide meaning and purpose both at work and play.
• Pursue activities where you have a sense of community and social support.
• Practice “loving self-care,” which is the application of mindfulness to self-care.
• Develop a mindfulness practice and integrate it into every aspect of life. This allows us to identify cognitive fusion and to defuse from private events.
• Get involved in an organization that serves the needs of an underserved population.
• Find an experienced psychotherapist (ideally group therapy) whose orientation is skill-building rather than psychodynamic or psychoanalytic.
Acceptance and Commitment Therapy (ACT) is tailor-made for the development of mastery because of its focus on identification of and guidance in pursuing personal life values. Mindfulness-Based Cognitive Therapy (MBCT) is another skill-building-based psychotherapy.
Larry Berkelhammer, PhD, is a researcher and psychophysiologist who uses his blog, www.LarryBerkelhammer.com, to show how learning to live with conscious intention can maximize health and well-being.