Diabetes as a "hero journey"

Share thoughts and ideas regarding what can be done to meet contemporary humanity's need for rites of initiation and passage.

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cosmolew
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Diabetes as a "hero journey"

Post by cosmolew »

:idea: As a psychotherapist, I'm developing an approach for psychosocial support for persons with diabetes. I've mapped out the experiences that persons frequently have with diabetes with Campbell's "Hero Journey," as an engaging, hopeful and motivating theraputic framework. My experience both as a therapist and as a person with diabetes teaches me that the "inner world" of the person facing a chronic disease must be grasped from the perspectives of the person. The "hero journey" provides a universal map that the client and therapist can use to explore the deeply personal "landscape" of this interior world.

I would enjoy sharing more about this topic with others who work in this arena.

Clemsy
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Post by Clemsy »

cosmolew, welcome to the JCF Forums.

Fascinating project. Please feel free to share your work here as I'm sure others share my own interest in your application of the hero's journey.

Cheers,
Clemsy
Give me stories before I go mad! ~Andreas

cosmolew
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Post by cosmolew »

The Centers for Disease Control estimate is that about 20.8 million Americans are living with diabetes. Depression and diabetes are powerfully linked, although the relationship is not completely understood. Significantly, a person with diabetes who is depressed is more likely to engage in poor self-management of the disease, in particular, medication non-compliance, physical inactivity, poor nutrition, and smoking.

Mythological motifs and their underlying psychological narratives might be fashioned into a therapeutic framework for persons facing this complex disease, particularly for those facing psychological difficulties that interfere with managing the disease. The "Hero Journey" provides a universal map that a person and her or his therapist could use to explore deeply personal features of this "inner world."

I have developed a short paper on this approach, and plan to pilot its use with a group of persons who have diabetes in the near future.

If you have an interest in learning more, please reply. :D

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Post by Hernando »

cosmolew wrote:The Centers for Disease Control estimate is that about 20.8 million Americans are living with diabetes. Depression and diabetes are powerfully linked, although the relationship is not completely understood. Significantly, a person with diabetes who is depressed is more likely to engage in poor self-management of the disease, in particular, medication non-compliance, physical inactivity, poor nutrition, and smoking.

Mythological motifs and their underlying psychological narratives might be fashioned into a therapeutic framework for persons facing this complex disease, particularly for those facing psychological difficulties that interfere with managing the disease. The "Hero Journey" provides a universal map that a person and her or his therapist could use to explore deeply personal features of this "inner world."

I have developed a short paper on this approach, and plan to pilot its use with a group of persons who have diabetes in the near future.

If you have an interest in learning more, please reply. :D
The symptoms of diabetes are:
-Feeling thirsty
-Frequent Urination
-Feeling Tired, irritable
-Losing weight fast.
There isn't a cure for diabetes. It doesn't mean you can have the chocolate bar every once in a while, but you should definately watch what you put in your mouth (even if you aren't a diabetic) Try water when you're thirsty (only 1 glass of soda a day) Don't eat sweets when you're hungry and exercise for 3-5 hours a week. This will prevent diabetes. I also recommend seeing a doctor to make sure that you do not have diabetes.
also notes :idea:

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Last edited by Hernando on Mon Sep 17, 2007 8:55 am, edited 1 time in total.

cosmolew
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Post by cosmolew »

The Call to Adventure

From this perspective, the first communication of a person’s diagnosis of diabetes would be the mythic “Call to Adventure,” marking the first stage of the Hero’s Journey. Campbell describes this auspicious stage as one “…that signifies that destiny has summoned the hero and transferred his spiritual center of gravity from within the pale of his society into an unknown zone…represented: as a distant land, a forest, a kingdom underground, beneath the waves, or above the sky, a secret island, lofty mountaintop, or profound dream state” At the moment of hearing the diagnosis of diabetes for the first time, a person may accept “the call” either willingly or reluctantly. The diagnosis may come as a complete surprise or even shock to the person, or, perhaps, it was somewhat anticipated from prior medical history. Either way, the person likely will mark this event in time as a pivotal milestone in his or her life. Inviting the person who is diabetic to describe in detail the event of their diagnosis as “A Call to Adventure,” sets the stage for framing the disease itself as a mythic challenge to be overcome.

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Post by Martin_Weyers »

One of my artist friends is suffering diabetes since about two years. I'm wondering if maybe the indispensable readjustment of his habits has helped him to focus on important activities; On the other hand tiredness seems to have limited productivity to a degree that makes it impossible to maintain efficency in working, jobbing, family etc. So there's the call, maybe, but the call to what?

Probably every disease, failure, accident etc. can be regarded as a call ... if you are able to quit your past, do not loose hope, and keep eyes open to see the mythic patterns. Easy to talk about - difficult to practize! The hero's journey certainly can help, but everybody has to find out on his own. Probably one has to be careful not to teach the diseased person: Don't let yourself go ... that's the refusal of the call!
Works of art are indeed always products of having been in danger, of having gone to the very end in an experience, to where man can go no further. -- Rainer Maria Rilke

cosmolew
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Refusal of the Call

Post by cosmolew »

Refusal of the Call

But there is another possible response to the diagnosis of diabetes in the “Call to Adventure” that resonates with mythological and psychological significance: The person who is diabetic may refuse, deny, or ignore or otherwise diminish the diagnosis. Initial failure to heed the “Call to Adventure” is not uncommon for mythological heroes. Campbell categories this possibility as the “Refusal of the Call,” and explains “…the subject [hero] loses the power of significant affirmative action and becomes a victim to be saved.” Similarly, for persons who are diabetic, a failure to heed the medical diagnosis is not uncommon, despite the obvious risks. With diabetes, an initial reluctance or refusal to accept the diagnosis can delay, slow down or defer proper treatment of the disease and interfere with one’s self care. Yet, sooner or later, a person who is diagnosed responds in some manner to the mythic “Call to Adventure,” when denial at last gives way to acceptance. At this stage of the journey, timely emotional support from individuals and groups can help the “reluctant hero” with diabetes frame the diagnosis as a hopeful opportunity to become healthy, rather than an insurmountable contest to dread.

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Post by creekmary »

Here is is common. Everybody I know has diabetes or a close relative with diabetes. It's no shock and almost expected. My dad joked about "the land of the one-legged Indians." Amputations of varying and increasing degrees, kidney failure, blindness. I can name at least a dozen people off the top of my right now head missing legs or feet or toes. My mom was depressed and shocked twenty years or so ago when she was diagnosed, but she's just part of a community now. Like living on Molokai.

I expect to have it. I am not that concerned, no more than the possibility of heart attack or other health related death. I see it all around me, I know what to expect, it is nothing uncommon. Doctors think we are health professional when we discuss our mother, we have that much knowledge of the disease.

I think it might be dealing with the unknown in isolation that causes problems.

Susan

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Refusal of the Call

Post by cosmolew »

When faced with the diagnosis of diabetes, a person typically has two fundamental choices: 1) Retreat into fear, ambivalence, hopelessness, anger, depression, denial and/or attraction to existing problem behaviors (e.g., smoking, over-eating, physical inactivity); or 2) Take control of one’s life (and blood sugar levels), and frame the disease as a magnificent learning opportunity to be a healthy and hopeful person. Obviously, from a health and medical perspective, the second option is the preferred choice. But there are complicating factors. Type I or insulin dependent diabetes is commonly diagnosed in childhood. Young children frequently depend upon parents to take full responsibility for their medical care. Type II diabetes is chiefly characterized by insulin resistance, and typically onsets in adulthood. A person who is diagnosed with diabetes of any form may be mentally impaired (temporarily or permanently) to the point of not being competent or able to take control of managing the disease.

For several reasons, the allure of retreat still attracts many fully competent adults who have diabetes. The challenge for patients of managing the disease has become more complex in recent years, with nearly one-third of diabetes patients listing five or more medications in 2000. Yet, rarely do medical visits for diabetic patients last more than 20 minutes. Self-care for the person who has diabetes involves closely tracking multiple elements, including diet, medications, feet inspections, blood glucose levels, blood pressure, kidney function, eye examinations, blood lipids and physical exercise. Over time, managing the disease can overwhelm even the most conscientious patients. Defeatist attitudes are common with patients with diabetes; especially as the disease progresses and treatment plans change in response. Such changes can frequently trigger feelings of personal failure.
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Post by creekmary »

Isn't that the way it is with most health diseases, though? If someone has heart disease for example, they can either deny or ignore it and go right along with their T-bones and baked potatoes with butter and sour cream followed by a smoke and coffee and cake (which sounds pretty good to me right now) or get gung-ho about organic tofu and running 5 miles a day.

It is a pain in the butt to deal with and you still end up dead. My aunt has to deal with insulin shots, mom is only on the pills and diet (but she has a lot of self control and likes to be organized about things). Grandma - only had a touch now and then and they let her do as she pleased. She lived to be 96.

My cousin's mother took care of herself but died from kidney failure, their aunt (the mother's sister) is in the hospital now getting a toe from her remaining leg removed. Her husband died blind and legless. The old man who lived by our church died the same way. One of our deacons lost his teenaged daughter to diabetic coma because she was undiagnosed. My sister-in-law's mother has lost one leg to the knee and is working on losing another. The foot's half gone now.

I can't say what goes on inside others, but for me, when my time comes, if it does, I won't be particularly afraid, because it is familiar. It will just be one more pain in the butt to deal with. If you live your whole life as 'a call", this is just another bump on a journey, not a whole call unto itself. But maybe it will cause people to realize there is "a call" for them to answer. But isn't it the same for people with cancer, close calls from a car wreck? Anything that makes you stop and examine the mystery of life?

Why don't you come up here and research? There's plenty of ground to work with. You sure won't have to hunt for one-legged Indians to talk to, they'll be all around.

Susan
"Indian Health Service - whaddya expect fer nuthin'?"

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The Crossing of the First Threshold

Post by cosmolew »

Creekmary speaks from her experience and it is heart-rendering. There are genetic predispositions for diabetes. Some groups of humans are impacted with this disease more than others. Sounds like you are in a group that has a definite tendency to develop diabetes.

What helps you? What programs help your group of people (you are related to gentically) prevent or delay the diagnosis of diabetes? What symbols serve to protect you. You are not alone. My heart goes out to you.

I have had diabetes for over 17 years and have gone through various stages of denial and depression and anger about the disease. I have not developed and serious complications thus far, but I know the risks are ever-present. In the last three months I have reduced the amount of daily insulin my body requires by 60%, and have eliminated two medications completely. A new diet, resulting weight loss and strength training have made me healthier. I have more hope now.


Once the diagnosis is accepted, the person with diabetes crosses a “Mythic Threshold,” full of challenges, fears, unknowns, but also fervent hopes for a healthy life, free of diabetic complications. Campbell describes this mythic passage as “…moving out of the known sphere altogether into the great beyond…it may be a plunge in the ocean…a passage into the desert…getting lost in a great forest.” Typically, crossing the mythic threshold in the diabetic hero’s journey occurs in a doctor’s office or hospital emergency department. It is a passageway interspersed with blood tests, educational classes, nutrition lessons, possible medications (including insulin); and, possibly, needles, weight loss régimes and physical exercise.

Campbell aptly foreshadows a common occurrence at or near the mythic threshold: “For those who have not refused the call, the first encounter of the hero journey is with a protective figure…who provides the adventurer with amulets against the dragon forces he is about to pass.” Hopefully, the person on a Diabetic Hero’s Journey encounters “guardians” at this early stage. Guardians might take the form of doctors, nurses, dieticians, counselors, trainers, friends and family members. Guardians can provide valuable instruction, emotional support, and hope, while pointing the way toward health. As for amulets, these might take on one of several forms for the diabetic patient, ranging from a glucometer for testing one’s blood, religious symbols of protection, books on understanding the disease, to a vial of insulin itself.

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Post by creekmary »

For me it's my family and the community. I've seen that it's not that big a deal. Life goes on. Watching others around me and growing up with it.

So Ralph Henneha lost his legs and was blind, he'd go to church 5 miles in his Hoverround if he had to. Didn't stop him. His wife and her sister, didn't stop them. Their children live with it. Some of them have it too. Life goes on.

I am not exaggerating when I say everybody around here is either diabetic or has a family member who is.

Just one more pain in the butt to deal with. Everybody here knows to watch your diet, don't get fat, better work out, or you'll end up diabetic. If you do, everybody knows what the outcome is likely to be, but you die anyway, eventually, from something. You take care of yourself or you don't. Everybody helps you too. Somebody sees somebody reach for that extra piece of cake at a birthday, there's joking "have to take an extra shot for that tonight, annit?" Everybody knows and is aware.

There's knowledge, there's education, there's support and experience. Lots of girls go into health care because of experience and necessity of dealing with family members. Experience, knowledge and example. Lots of community and family support. It's just a part of every day life around here.

Susan

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Refusal of the Call

Post by cosmolew »

Creekmary says: "You take care of yourself or you don't." With diabetes, it's a struggle either way. In periods when I did not take care of myself, I was refusing the call to adventure on the hero journey. I retreated into my old habits of overeating and inactivity and smoking. I did not answer the call. I refused it. I was angry and depressed and scared. I looked the other way. :cry:

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Post by creekmary »

You probably just got tired of it. So much discipline! Even mom falls off the wagon, off and on. You just get tired of it.

But that's part of it too. You can be slack and lazy and blind to what you should do, that happens. It's all about whether or not you get back up on that pony and ride or not.

And who have you got to help you with it? To let you know it's normal? To support you in that effort? Like I said, everybody here watches "their" diabetics. "Now aunt mary! You know you'll be sleeping through afternoon services you eat that piece of cake! Be fallin' off the seat....then we'll just have to pick you back up, and you KNOW we don't have any men, probably have to just leave you down there..."

Susan

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[b]Initiation[/b]

Post by cosmolew »

Right, so much discipline, and I got tired--physically and psychologically. It was a test of character, to be sure. Sooner or later on the mythic journey, the person who is diabetic faces various forms of initiation and tests of character. In a mythological and psychological context, the tests that the hero encounters on the journey “…symbolize self-realization, a process of initiation into the mysteries of life.” As the journey of diabetes intensifies, it frequently brings forth considerable physical and psychological tests. Some of the tests can be relatively easy, thus instilling confidence. A person who is diabetic learns for the first time how to test his or her blood sugar with a glucometer. A diabetic injects insulin for the first time. A person who is diabetic orders a healthy choice off a restaurant menu that is loaded with unhealthy ones. A guest who is diabetic politely refuses her host to take an appetizer that would precipitously raise her blood sugar, and explains why.

Yet, other tests or trials can be tougher, and exact quite a toll on a person’s psyche. A common scenario involves the tendency of the diabetes to progress. For example, a Type II diabetic person who once controlled blood sugar levels with only modifications in diet
and exercise finds out that medications must be taken now to keep blood sugar at safe levels. Diet and exercise will no longer do the trick. This can be a psychological test, as the person strives to fend off feelings of personal failure or inadequacy, however misplaced or irrational these expressions may be. Timely emotional support and cognitive therapy may help the person who is diabetic to put feelings in proper perspective, and to reframe the challenge as a biological condition of the disease and not a personal failing. I was easily confused. These feelings, however predictable they may be, can be tricky to sort through, without competent, timely and supportive therapeutic interventions. There is a danger in being too isolated in this stage of the journey. I know I was.

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