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Reframing Shame with a Diagnosis of Diabetes

This post was contributed by WN4DC Symposium intern, Hannah Frazee.

Between the judgments from others on how the patient should be managing their diabetes, to the constant feedback about blood sugars from meters and pumps – diabetes has a lot of holes for shame to hide. The diagnosis of diabetes can bring an onslaught of shame for patients. Julie Sweeney, RSSW and master therapeutic counselor, provides some ideas for how professionals can work through the shame from the diagnosis of diabetes (whether a new diagnosis or existing), allowing clients to heal, and move forward.

Dispelling myths can give the client another perspective about their diagnosis, and change the way they view their diabetes management.

When a diabetes diagnosis is new, there are many areas where practitioners can begin to work through the shame that could be coming with any new diagnosis. Julie recommends normalizing the shock that can come with a new diagnosis of diabetes. Clients may feel a variety of emotions as a result of the shock, such as, guilt, anger, or shame. Giving the client space and time to process these emotions is extremely beneficial. Another point Julie mentions is the importance of discussing what other practitioners, family, or friends have said about diabetes, and dispelling myths that might not be true. Dispelling these myths can give the client another perspective about their diagnosis, and change the way they view their diabetes management.

If you have clients who have had diabetes for a longer time Julie suggests taking a different approach in working through the shame. As Julie points out, those with a previous diagnosis of diabetes could have years of shame built up. Julie recommends simply asking what the client believes to be true about having diabetes. Asking this particular open-ended question allows the client to lead the conversation, and can give the practitioner insight as to where the shame could have started. In addition, simply listening to the client’s story and what they have been through can give the client a space to bring up the shame they may be feeling about their diagnosis.

One of the most significant areas that can cause shame for clients with diabetes is constant feedback from numbers, such as A1C, weight, waist circumference and blood sugar checks.

Julie suggests using the Health at Every Size® (HAES) paradigm to reframe the shame that can come from all of these numbers. One way practitioners can empower the client to reduce the shame of diabetes is to ask what the client wants to do for their treatment, this gives the client the autonomy to pursue health in ways they feel is best. To reduce the shame that can come from all the numbers is to reframe these numbers as “data” or information, not something that defines the client’s self-worth.

Shame is something practitioners should be aware of when it comes to the diagnosis of diabetes. By providing clients space to work through the shame, they are allowing clients the possibility to have more mental space for better diabetes management, if that is something their client wishes to pursue.

If you are interested in learning more about how practitioners can work through the shame complex with their clients, sign up for the WN4DC symposium to hear Julie’s webinar. In addition, you will have the opportunity to learn from 17 other speakers about the intersections of weight-neutral care, and diabetes.

Hannah Frazee is a sophomore student studying Dietetics at Iowa State University. She believes in the Health at Every Size paradigm and is especially interested in how systemic oppression impacts health outcomes. In the future, Hannah hopes to work as an eating disorder practitioner and is especially interested in working within the intersection of diabetes and eating disorders.

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