Thursday, December 20, 2018

The Power of Words

"Words are, in my not-so-humble opinion, our most inexhaustible source of magic." - Albus Dumbledore. 
Sticker from Pimp My Diabetes
There has always been conversation in the chronic illness community about language - whether to say "diabetic/asthmatic/etc." versus "person with diabetes/asthma/etc." Some people don't like being on the receiving end of a label, while others strongly identify with one, and others still have no preference. I don't believe there is one simple answer as to which is best. I believe it's best to explore with the individual how they wish to be identified when referring to their diabetes (or any other chronic illness). It's also important to remember that that person is a person, whether they are comfortable with being called by their illness or not. They may be comfortable with you calling them a diabetic, but don't forget - that's not all they are.

So many nuances exist in communication. If someone casually asks "you're diabetic?" versus a brash "you're a diabetic?", I'm likely to have different reaction. There's so many nonverbal cues - body language, tone, facial expression. No one wants to feel that someone is accusing them of something, and most people don't like to be the recipient of sad puppy eyes. The words themselves aren't the whole picture. But they're a big part of it.


Compliance vs. Adherence


I've talked before about the word compliance in the medical field and the negative connotation it can have. The word "comply" is so similar to "obey." People living with chronic illness are already stuck with a disease they didn't ask for. Admonishing them for not "obeying" to this illness will convey that you're on the illness' side, not theirs. Because of how long and how heavily the word has been used, it's gained a derogatory nature . Hearing "non-compliant" being used to describe someone feels like hearing a dirty word. It stains a person's medical record, strikes trepidation into most providers, and causes bias when assessing a person, whether you realize it or not. There have been recommendations to switch to the word "adherent," which to me makes more sense and is kinder. Asking if someone is adhering to their regimen acknowledges the patient's role in their illness, while creating a comfortable space for them to have a conversation about what their barriers are to self-care.


Control vs. Manage


Recently I was listening to Rob Howe's podcast, Diabetics Doing Things, and came across his interview with Erin Aker, founder of the Diabulimia Helpline. In her interview she talked about the word "control," and how detrimental it can be for mental health. While control is important for diabetes management, intense desire for control can manifest into different forms of anxiety. Especially when it comes to managing a chronic illness that is so difficult to control. 

While I've had my own struggles with control and fear of losing it, I've never given much consideration to the power the word itself holds and how we can shake that power. Aker talked about using the word "management" versus "control." I felt like a light bulb went off in my head. Such a simple shift - swapping out one word for another - could make such a difference. If we keep thinking about our diabetes in terms of control, we're more prone to become obsessive. Re-training our brain to use the word "manage" eases some of the pressure. It is a more benign word, from a mental health perspective. I encourage everyone in the chronic illness community to consider what Aker talked about.

What language do you prefer when it comes to your diabetes? Do you have a preference? Many people say words don't matter to them as much as the content of the conversation. Comment below and let me know your thoughts.