April 5, 2019
Where does a psychologist fit in diabetes healthcare?
There is so much more to managing diabetes than simply doing diabetes. And there is more to diabetes distress than just acknowledging that it is there.
By Renza Scibilia
Where does a psychologist fit in the diabetes healthcare professional equation?
For me, it must be as part of any multidisciplinary team.
I’m not sure that the day I was diagnosed would have been the right time for me to have an appointment with a psychologist (but let’s be honest, it would have been no less helpful that the dietitian and her rubber food moulds). I certainly do wish that I’d known having someone to talk about my mental health was a sensible thing for when I needed it. Helpful too to learn about how to go about getting an appointment. I was told about the eye specialists and podiatrists that would be part of my future team, but no one thought to mention a mental health professional.
It shouldn’t have taken almost four years – four very difficult years in a lot of ways.
I have an endocrinologist who asks the right questions. She doesn’t fill those silences where I am looking for the right words. She is encouraging and supportive and never judgemental and understands that diabetes-related distress can be paralysing. She also understood she was not the person I needed to get through those times. I love that she knew that.
She also knew that no matter how many SMART goals we set together (even if I said that I would be able to do them because they were achievable and completely not unrealistic) until I had a mental health professional work with me there was no way I was going to do them.
One of the first things she did when I started seeing her 17.5 years ago was refer me to a psychologist. The guilt that I was feeling about the imperfect numbers or the lack of imperfect numbers because I was barely checking them was steeped in a complex and convoluted mess. I needed a mental health professional whose expertise was to help guide me through it all and show me how to get things sorted.
Over the years, seeing a psychologist has helped me with my diabetes management enormously. Those times when diabetes has terrified me to the point of paralysis and inactivity, the times where I wanted to blame diabetes for other things going on (because it is there and I generally don’t like it so it’s convenient to point my finger at it!). The times when the uncertainty of diabetes and the fear of what lies ahead, or the times when life overall has felt just too big and scary. I have benefited from having a mental health professional work with me. In fact, I doubt that I would see diabetes the way I do now without that support.
There is so much more to managing diabetes than simply doing diabetes. And there is more to diabetes distress than just acknowledging that it is there. Having diabetes specialists who understand about distress is valuable. But I really do think that understanding it ourselves, being able to identify warning signs, and developing sustainable strategies to deal with it any time it comes back needs the expertise of a psychologist.
Reprinted in part from Renza Scibilia’s blog, Diabetogenic.
Renza Scibilia has lived with type 1 diabetes since April 1998. She is a well-known diabetes patient advocate and activist, promoting a person-centred approach to healthcare, and the development of diabetes information, services and technologies.