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Acceptance of a Life-Impacting Illness

Posted by Stephen Lemire on October 25, 2011 at 9:30 AM

How one comes to accept the diagnosis of a life-altering illness is not something a person typically thinks about unless they're faced with its impact head-on and, usually, when they least expect it. Reflecting on time spent with clients in the Greater Lowell Behavioral Health Association and with friends and loved ones that have been diagnosed with major illnesses such as cancer, I realized that their acceptance did not come at once, but rather in phases, as they learned to understand it and to live with it over time.

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My experience in counseling and supporting these individuals taught me to recognize four stages of acceptance prior to recovery: intellectual understanding, ego recovery, spiritual development, and release of regret and lost opportunity.

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Moving through these steps is an ongoing process. Many people have to retrace their steps at times, and not until they understand most of the stages are they ready to begin recovery. Some individuals may not experience these phases in any set sequence; others may experience only some of them. However, it can be valuable to look at the acceptance of a major illness through this framework, even if it only prompts the patient to create their own objective, structured point of view.

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The first level, intellectual understanding provides the foundation for the levels to follow. Here the issue to be addressed is confusion. By reading, researching, and asking questions of others (both professionals and those experiencing the illness), are they able to understand the diagnosis objectively. They realize that they are going down a road that they never knew existed before, and that they need a new map to guide them. They have to design an appropriate treatment plan, including clinicians, medication, family and friends, and other built-in supports.

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The second level, ego recovery, involves a more personal level where feelings of worthlessness and inadequacy must be faced. Many are challenged to ask themselves questions such as: What did I do wrong? Did I not take care of myself? Am I defective? Did I miss obvious warning signs? It is not until they accept the illness on a subjective level that they realized that they were biologically predisposed to get it.

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On the next level, spiritual development, new avenues of growth continue to be opened. Most people initially experience feelings of abandonment and victimization, constantly returning to the question of Why me? However, their comfort level increases as they begin to believe that there are lessons to learn as they go through this painful experience. Ultimately, they feel that they can use this experience to help others. Working on this level is an ongoing process. On one hand, it helps to re-create the individual’s value system concerning moral beliefs and appreciate the importance of participating in family and community groups. On the other, it motivates many to volunteer to help, to educate, and, at times, to serve as a role model for others who are not as far along in their own recovery.

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The final and most difficult level continues to be the release of regret and lost opportunity. Frustration arises from taking an inventory of personal and material losses, mourning those losses, and identifying new limitations resulting from the illness. Yet, starting over in many ways provides a clean slate to identify opportunities based on insights that they had never expected to learn about themselves or others. They are both forced and allowed to live with a heightened sense of the here-and-now. They realize that if they take care of themselves day-to-day, the short-term future will take care of itself. Daily priorities in this phase include attending to physical and mental well-being, working productively, and building relationships. The hope, as one proceeds in this phase, is to develop the momentum that is needed to avoid ever having to start over.

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I recognized that individuals could not rush the process as they passed through these levels of acceptance. Doing so only created self-imposed pressure and additional aggravation. Rather, as they moved at a more gradual pace, they could focus much more on what they were learning about themselves, the illness, and living with the illness. This acceptance can open the door for a more enduring recovery.

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(Earlier version published in Polar Express, Spring 1997.)

Categories: Real Life Wisdom, Behavioral Health, Odds & Ends

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