Chronic Illness as systemic
Chronic illness is, as many of us know, very tough on systems. At some level most of us understand:
The term chronic means that some illnesses or situations go on and on and on and on.
Systems are chronically interactional. A affects B which affects C and D. B, C and D affect A which changes A which changes B, C and D, all of which affect and change each other which ….
Chronic diseases or situations are not anyone’s fault.
Sounds pretty simple and axiomatic. Yet, even knowing these “facts,” we humans engage in blaming, punishing responses to chronic illness or situations. We humans would often like to believe that there is a simple solution. If A would just change his or her behavior then B, C and D would function better which would help A continue to change which would...
Let’s discuss these three points one at a time. Point number 1 is about the nature of chronic.
Oxford dictionary. Com defines chronic (in English) as:
(of an illness) persisting for a long time or constantly recurring.
(of a person) having a chronic illness.
(of a problem) long- lasting.
(of a person) having a bad habit.
(British informal) Of a very poor quality.
Whether the chronic condition is an illness such as diabetes, addiction, dementia, or some other condition which adversely affects the health of the person, it is:
Frustrating because we cannot make the other person not have the behavior or the illness.
Exhausting – the person may need constant care.
Feels personal – it may often appear that the person does not care how their behavior or lack of taking care of themselves affects the rest of the family.
Imprisoning – often there is no one to watch or take care of the person or situation long enough to allow the rest of the family to go on vacation or just take regular breaks.
Shameful – may feel or even believe that others do not want to publicly expose the person or condition to people outside the family.
Expensive – the illness or condition may use up a lot of resources of the family.
Point number 2 is that systems are chronically interactional. This adversely affects the family in the following ways:
The illness or the condition may affect the ability of the person with the illness or the condition to make what seem to be simple, logical decisions. For example, the diabetic needs to restrict their diet, possibly take medication, and exercise. The alcoholic has to refrain from drinking, stay away from triggers (people, places or things which remind his brain of a stored habit/thought) as much as possible. The alcoholic also needs to use therapy, a 12-step program or some other system to change his or her thinking. The obvious problem is that the he or she needs a well-functioning mind to make healthy/logical decisions to take these actions.
The exhaustion and residual effects of exhaustion of the family members who do not have the diagnosed illness or condition will affect their ability to take care of themselves and eventually their ability to make logical/loving decisions.
The person with the chronic illness or condition may already feel bad or shameful about themselves. When the other family members react with blame and anger this increases their stress which may increase the craving for alcohol, other drugs, unhealthy foods, nicotine, or behavior such as anxiety, obsessive/compulsive behavior, or other dysfunction which, of course, makes the person feel worse about themselves which makes the rest of the family feel bad which triggers dysfunctional behavior which …
We also now know that, “… the brain’s executive command center does not completely relinquish control of habitual behavior. A new study from MIT neuroscientists has found that a small region of the brain’s prefrontal cortex, where most thought and planning occurs, is responsible for moment-by-moment control of which habits are switched on at a given time. (news.mit.edu).” Habits are very resistant to change. This is good for positive habits which help us function. It is great that I do not have to relearn how to type very time I sit down at the computer (multiples times a day). In other words, habits/addictions are tough to change.
Point number 3 is that the chronic illness or condition is not anyone’s fault. Really! It certainly seems as if the person with the chronic illness or condition:
Does not care if their decision to not eat the right food, stop their compulsive or obsessive behavior, resume smoking, quit taking their medication or quit going to 12-step meetings, stop therapy, stop seeing the doctor, stop acting on sexual impulses or other “feelings” affects other family members.
Is a person who decides to “sin,” be self-centered, or otherwise act the same as a self-centered, spoiled, 13-year-old.
We humans seem to be especially fond of assigning blame or fault to an individual, a group, or even an country. When we are able to convince ourselves that A is to blame thus making him or her a bad person, it follows that we need to make A see the error of his or her way. If we punish or even kill A then the problem will no longer be present. At some level, most of us know that diagnosing the cause of the problem is not that simple. If it was then the solution would be simple and effective. We would punish, lock up, or even kill A and we will no longer have the problem. What is wrong with this? The problem with this is that the diagnosis is wrong. If we have an inaccurate diagnosis it does not matter what we do, the system will not get healthy. Let us, for a moment, consider the family who has a family member who is an alcoholic. It is true that the problem is partly the addiction. Often when the alcoholic comes home from treatment, he or she is their “old, charming, loving, helpful, healthy self.” The other family members will typically respond by:
Relating to the person as healthy and be very grateful.
Relating to the person as one who needs to make amends and make amends and make amends and make amends for their past behavior. The rest of the family either does not trust the alcoholic to stay healthy or wants to make sure that the alcoholic knows that he or she has ruined the life of the family for years or even forever.
Some combination of these two.
Disowning the family member.
Much of the time the alcoholic will relapse by drinking or more likely by dropping pieces of recovery and reverting to old ways of behavior which will eventually result in a return to drinking or engaging in other negative addictive behavior – i.e. exchanging drinking for compulsive gambling, sexual behavior, eating or other drugs.
If or when the alcoholic relapses the family members will also revert to their former way of responding to him or her. They are also in relapse mode.
If the alcoholic does not relapse the family system will face the challenge of other chronic conditions – physical aging, dementia, death, accident resulting in physical injuries which are chronic and require long-term care, financial hardships because of recession, changes which make family business obsolete, etc. If the family system does not have healthy tools for dealing with chronic conditions or situations, it will again be chronically ill as a system.
With any system life is going to show up. If we fail to diagnose systematic problems or conditions no matter what the chronic illness or condition is, the system will not heal. Individuals may heal by moving away or somehow limiting contact but they system will stay chronic unhealthy.
Systems can be treated and can heal, but only if everyone in the system can agree that the problem is systemic. To be sure there are still going to be challenges. Life will show up, but healthy systems do what they need to do to deal with the new challenges. Sometimes, outside help in the form of long-term care or treatment is needed. The person with acute dementia may need to live in a different setting which has 24-hour care. The alcoholic may need to live in a half-way or quarter-way house when they complete residential care. The diabetic may need a regular support group. The person with advanced Parkinson’s, ALS, or some other physically and/or mentally deteriorating disease may need to live in a different setting. There are no one size fits all solutions. One fact is clear. If the system does not accept the diagnosis as systemic, no solution will work for long. When the diagnosis is systemic there is:
No blaming.
Focus on problem solving.
Willingness to make tough decisions
Openness to loving support which is willing to support and help the system.
Lots of room for laughter, grief, and other small ways of taking care of each other and themselves individually.
Much courage and faith in a power greater than oneself – God of one’s understand, friendship, life process, or system.
Acceptance that when life if tough it does not mean that something or someone is at fault. It is just tough.
Written February 11, 2016
Chronic illness is, as many of us know, very tough on systems. At some level most of us understand:
The term chronic means that some illnesses or situations go on and on and on and on.
Systems are chronically interactional. A affects B which affects C and D. B, C and D affect A which changes A which changes B, C and D, all of which affect and change each other which ….
Chronic diseases or situations are not anyone’s fault.
Sounds pretty simple and axiomatic. Yet, even knowing these “facts,” we humans engage in blaming, punishing responses to chronic illness or situations. We humans would often like to believe that there is a simple solution. If A would just change his or her behavior then B, C and D would function better which would help A continue to change which would...
Let’s discuss these three points one at a time. Point number 1 is about the nature of chronic.
Oxford dictionary. Com defines chronic (in English) as:
(of an illness) persisting for a long time or constantly recurring.
(of a person) having a chronic illness.
(of a problem) long- lasting.
(of a person) having a bad habit.
(British informal) Of a very poor quality.
Whether the chronic condition is an illness such as diabetes, addiction, dementia, or some other condition which adversely affects the health of the person, it is:
Frustrating because we cannot make the other person not have the behavior or the illness.
Exhausting – the person may need constant care.
Feels personal – it may often appear that the person does not care how their behavior or lack of taking care of themselves affects the rest of the family.
Imprisoning – often there is no one to watch or take care of the person or situation long enough to allow the rest of the family to go on vacation or just take regular breaks.
Shameful – may feel or even believe that others do not want to publicly expose the person or condition to people outside the family.
Expensive – the illness or condition may use up a lot of resources of the family.
Point number 2 is that systems are chronically interactional. This adversely affects the family in the following ways:
The illness or the condition may affect the ability of the person with the illness or the condition to make what seem to be simple, logical decisions. For example, the diabetic needs to restrict their diet, possibly take medication, and exercise. The alcoholic has to refrain from drinking, stay away from triggers (people, places or things which remind his brain of a stored habit/thought) as much as possible. The alcoholic also needs to use therapy, a 12-step program or some other system to change his or her thinking. The obvious problem is that the he or she needs a well-functioning mind to make healthy/logical decisions to take these actions.
The exhaustion and residual effects of exhaustion of the family members who do not have the diagnosed illness or condition will affect their ability to take care of themselves and eventually their ability to make logical/loving decisions.
The person with the chronic illness or condition may already feel bad or shameful about themselves. When the other family members react with blame and anger this increases their stress which may increase the craving for alcohol, other drugs, unhealthy foods, nicotine, or behavior such as anxiety, obsessive/compulsive behavior, or other dysfunction which, of course, makes the person feel worse about themselves which makes the rest of the family feel bad which triggers dysfunctional behavior which …
We also now know that, “… the brain’s executive command center does not completely relinquish control of habitual behavior. A new study from MIT neuroscientists has found that a small region of the brain’s prefrontal cortex, where most thought and planning occurs, is responsible for moment-by-moment control of which habits are switched on at a given time. (news.mit.edu).” Habits are very resistant to change. This is good for positive habits which help us function. It is great that I do not have to relearn how to type very time I sit down at the computer (multiples times a day). In other words, habits/addictions are tough to change.
Point number 3 is that the chronic illness or condition is not anyone’s fault. Really! It certainly seems as if the person with the chronic illness or condition:
Does not care if their decision to not eat the right food, stop their compulsive or obsessive behavior, resume smoking, quit taking their medication or quit going to 12-step meetings, stop therapy, stop seeing the doctor, stop acting on sexual impulses or other “feelings” affects other family members.
Is a person who decides to “sin,” be self-centered, or otherwise act the same as a self-centered, spoiled, 13-year-old.
We humans seem to be especially fond of assigning blame or fault to an individual, a group, or even an country. When we are able to convince ourselves that A is to blame thus making him or her a bad person, it follows that we need to make A see the error of his or her way. If we punish or even kill A then the problem will no longer be present. At some level, most of us know that diagnosing the cause of the problem is not that simple. If it was then the solution would be simple and effective. We would punish, lock up, or even kill A and we will no longer have the problem. What is wrong with this? The problem with this is that the diagnosis is wrong. If we have an inaccurate diagnosis it does not matter what we do, the system will not get healthy. Let us, for a moment, consider the family who has a family member who is an alcoholic. It is true that the problem is partly the addiction. Often when the alcoholic comes home from treatment, he or she is their “old, charming, loving, helpful, healthy self.” The other family members will typically respond by:
Relating to the person as healthy and be very grateful.
Relating to the person as one who needs to make amends and make amends and make amends and make amends for their past behavior. The rest of the family either does not trust the alcoholic to stay healthy or wants to make sure that the alcoholic knows that he or she has ruined the life of the family for years or even forever.
Some combination of these two.
Disowning the family member.
Much of the time the alcoholic will relapse by drinking or more likely by dropping pieces of recovery and reverting to old ways of behavior which will eventually result in a return to drinking or engaging in other negative addictive behavior – i.e. exchanging drinking for compulsive gambling, sexual behavior, eating or other drugs.
If or when the alcoholic relapses the family members will also revert to their former way of responding to him or her. They are also in relapse mode.
If the alcoholic does not relapse the family system will face the challenge of other chronic conditions – physical aging, dementia, death, accident resulting in physical injuries which are chronic and require long-term care, financial hardships because of recession, changes which make family business obsolete, etc. If the family system does not have healthy tools for dealing with chronic conditions or situations, it will again be chronically ill as a system.
With any system life is going to show up. If we fail to diagnose systematic problems or conditions no matter what the chronic illness or condition is, the system will not heal. Individuals may heal by moving away or somehow limiting contact but they system will stay chronic unhealthy.
Systems can be treated and can heal, but only if everyone in the system can agree that the problem is systemic. To be sure there are still going to be challenges. Life will show up, but healthy systems do what they need to do to deal with the new challenges. Sometimes, outside help in the form of long-term care or treatment is needed. The person with acute dementia may need to live in a different setting which has 24-hour care. The alcoholic may need to live in a half-way or quarter-way house when they complete residential care. The diabetic may need a regular support group. The person with advanced Parkinson’s, ALS, or some other physically and/or mentally deteriorating disease may need to live in a different setting. There are no one size fits all solutions. One fact is clear. If the system does not accept the diagnosis as systemic, no solution will work for long. When the diagnosis is systemic there is:
No blaming.
Focus on problem solving.
Willingness to make tough decisions
Openness to loving support which is willing to support and help the system.
Lots of room for laughter, grief, and other small ways of taking care of each other and themselves individually.
Much courage and faith in a power greater than oneself – God of one’s understand, friendship, life process, or system.
Acceptance that when life if tough it does not mean that something or someone is at fault. It is just tough.
Written February 11, 2016
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