The conclusion of The DX series Mindfulness and Diabetes takes a look at the eight-week mindfulness-based diabetes management course held through emindful.com. Led by Steve Alper, L.C.S.W. and diabetes coach and counselor Heather Nielsen, M.A., with primary care physician Jeff Horacek, M.D. as advisor, this pilot diabetes program was based on the Mindfulness-Based Stress Reduction (MBSR) classes developed by Jon Kabat-Zinn, PhD. This week, Catherine describes the conclusion of the course and what she learned from it. To read more about the program and Catherine’s journey, see the first two stories: Using Mindfulness to Help Manage Diabetes and Mindfulness & Diabetes: A Personal Story.
As the course progressed, we experimented with many different mindfulness exercises. In one, we spent several minutes fully experiencing a piece of food – smelling it, visually examining it, and feeling its texture on our fingers and tongues before finally tasting it. We used our usual diabetes routines like testing our blood glucose or giving ourselves shots as “mindfulness breaks” – recurring cues to pause and take a few deep, mindful breaths. We even tried “mindful yoga,” a series of gentle stretches geared toward helping us feel a connection between our bodies and our minds.
As is often true with diabetes, the lessons I learned from mindfulness-based diabetes management also proved useful elsewhere in my life. Whether I was stuck in traffic or struggling with a frustrating assignment, I found myself using mindfulness to avoid reacting in a way that might build stress upon stress.
At the end of the eight-week session, Steve had us put together what he called an “MBDM Relapse Prevention Tool Kit”: an 8.5” x 11” envelope that we were to fill with copies of our guided meditation prompts and a letter to ourselves that he insisted we begin with “To my sweetheart.” (“Using ’Darling’ or ‘Dearest’ is okay, too,” he said, “but you’ve got to use one of them.”)
The letter was to consist of two lists: one of situations that often cause us personal “diabetes distress” (e.g., waking up with exceptionally high blood sugar or having a low at the gym) and one of compassionate and nurturing activities – that we knew would have the power to emotionally soothe us, such as taking a bath or spending time with friends. Whenever we experienced our own individual “diabetes distress,” Steve suggested we follow a simple series of steps. First, take a few deep, mindful breaths and try to be present with whatever we were experiencing. If that didn’t alleviate our stress, we should try one of the mini-meditations we practiced in class. And if that didn’t help, try one of the nurturing activities on our list. We were to keep cycling through these steps until we felt better.
At the very end of class, Steve asked what at first sounded like a really weird question: what had this experience cost us? I didn’t know how to answer. My experience in the class had been entirely positive. I was calmer and less angry about diabetes, and felt better-equipped to accept diabetes’ daily challenges with self-compassion and grace. What could these benefits possibly have cost me? And then one word jumped into my mind: perfection. Truly practicing mindfulness-based diabetes management would require me to accept that perfection is an impossible goal – in diabetes and in life.
This is not a concept that comes easily to me. I believe strongly in the importance of personal responsibility and in holding myself and my diabetes care to the highest possible standard. My goal is to have more stable blood sugar, regardless of the state of my pancreas. Some of this pressure leads to good results, but it often adds considerably to the distress I already feel, and it rarely provides any sense of accomplishment. As James Baraz, meditation teacher and author of Awakening Joy once said, “If you’re a perfectionist, the best you can do is break even.”
What I learned from the MBDM class is that it doesn’t have to be this way. It’s possible for me to be gentler to myself without letting my diabetes care slip. It’s possible for me to accept that it’s counterproductive for me to beat myself up about something not entirely in my control. It’s possible for me to take care of my diabetes and take care of myself. Yes, that means I will have to give up my goal of perfection. But given all I’ll be gaining, it’s a price I’m willing to pay.
For more information about MBDM, visit emindful.com.
Catherine Price is a freelance journalist and type 1 diabetic who has written for The New York Times, Slate, Popular Science, and O Magazine, among others. She blogs about diabetes at asweetlife.org. Catherine is currently working on a book about the history and science of vitamins, to be published by the Penguin Press. Price is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies or affiliates.
© 2012 The DX: The Diabetes Experience