Rewards and Punishment

My fight is all mental.

If I can be in a good place psychologically, I can manage my diabetes.

PhysicianWithin-FesteI have been slowly working my way through “The Physician Within” by Catherine Feste. Cathy Feste is a type 1 diabetic who happens to live in my area. She is a magnificent motivational speaker, and has a true gift for making you feel good through whatever struggles you are dealing with. I attend events where she will be anytime I get the chance, and always come away with something positive.

Partway through the book I stumbled onto something that struck a chord. In chapter 3 she talks about how we have a “natural feeling that efforts should be rewarded”. Please note that I have not finished the chapter yet, so I’m commenting on this only partway through.

A natural feeling that efforts should be rewarded.

Maybe that is what gets my head all screwed up most of the time. It is a lot of work for me to manage my diabetes. I can be very diligent, and do it for a while, but eventually I get tired of it, and start to feel worn down. The little obstacles that life presents will mushroom into impenetrable blockades. It’s ridiculous.

Am I subconsciously expecting some reward for my hard work? Should I feel some difference during the periods that I’m managing better than when I’m not? Fighting a condition who’s only reward is lack of punishment. Even sometimes being “punished” in spite of all the hard work?

And if I am managing only to avoid potential punishment, is that a good reason? Is the fear of long term complications enough to motivate me to do all the hard work every day?


This potential punishment sometimes seems like it’s so far in the future, that the motivational strength is not very strong! It’s as if I sometimes feel that it’s so far off that I have the time to turn myself around and “get right” in time to keep the complications at bay, even if I “relax” my willpower for a little while right now. A dangerous game to play.

I just really resent the idea of being diligent in my management out of fear of complications. It makes me angry. How many times have you been told “you’d better control your blood sugars or you’ll lose a foot”? We are surrounded by horror stories of people someone knows who has experienced some terrible complication. Why doesn’t that “scare me straight”? Because it makes me angry, and that never works for long. Anger is not a healthy long-term emotion.

In me it breeds rebellion, which causes wild swings in my management efforts.

Along with that though is this build up of potential guilt. What happens if I start seeing complications? Will I be dealing with a bunch of undeserved guilt? Will it really be undeserved? I mean I can manage my diabetes right? Why is it so hard sometimes? I feel like I have to dedicate every waking second of my day & night to making smart decisions and anticipating events, calculating everything (did I mention I hate math?), dealing with unexpected highs & lows (aren’t they all unexpected & inconvenient?), and trying to ward off the potential complications and accompanying guilt.

Now these thoughts and feelings might seem very negative. But I don’t see it that way. The way I feel is that I need to work through these feelings and find some positive way to deal with this lifelong struggle, and in a way that helps build me up and not tear me apart.

How do you do it? Is it out of fear of complications? Is that Ok with you? Do you just incorporate it into your life and not bat an eye about it? What is/was your acceptance like? Was it a one time thing, or do you continue to sway back and forth? Is it possible to maintain your sanity with managing diabetes and all else that life throws your way?

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Scott K. Johnson

Patient voice, speaker, writer, advocate, and Senior Community Manager at Blue Circle Health. Living life with diabetes and telling my story. All opinions expressed are my own and do not necessarily represent my employer’s position. Read more…

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