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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5 thoughts on “Rewards and Punishment

  1. I agree with Kerri. I’m hoping to have a baby in the next couple years, so the health of my little one is great motivation.

    But right now, in the day to day, my motivation is the way I feel. I feel SO GOOD when my blood sugars are managed/controlled. I didn’t realize what a fog I was living in when my sugars were “okay” until I started having better control. I even quit caffine a few months ago, which also made me feel better.

    I agree Scott, the distanct threat of “complications” is not motivating for me. I just don’t want diabetes to control me and my life completely, and I find when I proactively deal with it, I feel better and can go live my life with less interference.

    Good luck to you and I really enjoy your blog, it never fails to make me think!

  2. For me, it’s the mere promise of the potential of a child that keeps me motivated. I don’t have children yet, but my hope is to have a child in the future and thinking of their yet-to-be conceived life is motivation enough.

  3. Keith – Thank you for taking the time to comment. I appreciate your concern, and your comment was very meaningful for me.

    I think I tend to over analyze, and make things harder than they have to be. One day at a time is probably the best way to look at it.

    Very very powerful thing about Mr. Cleveland. It is very encouraging to think of how well he has done with such limited tools. I especially liked the remark about “…before he got the pleasure of beating himself up daily over BG readings” – that put a big grin on my face! And it is very encouraging to think that the body has such an incredible ability to heal & recover.

    I do have a lot to live for, and as Wil says I also have a lot of motivation to be a good father to my kids. This dialogue, and blogging in general is very therapeutic for me and helps a great deal. Your comment, especially regarding Mr. Cleveland has been rolling around in my head since I read the comment yesterday.

    Thank you!

    Wil – as always, thanks for the feedback. As I mentioned above, my kids are a huge motivation factor, and probably a main reason I’m working my way through these struggles and feelings.

  4. I’m 42. My little one turns four in a couple of months. I gotta last a long time to raise him into a proper man. That’s all the motivation I need.

    By the way, as author of “The Art of Control” I disagree with you on the control/vrs management issue! But that’s probably just symantics….

  5. Scott–
    I hate it that you are so torn over this issue, although I’m not… maybe I should be.

    I just try to take each day as it comes. As you know some days are great, others not so hot. If I blow it one day on something, I try not to do it again.

    One thing that gives me ALOT of hope is the brothers, Robert and Gerald Cleveland who have both had T1D for >70 years. If I’m correct Robert will have had it for 80 years this year. Blood glucose testing for the general population came along in the early 80’s. For the sake of argument, lets say he started bG testing in 1980. That means he was on urine testing for 50-55 years before he got the pleasure of beating himself up daily over bG readings. Obviously urine testing is pretty darn inacurate–little more than a shot in the dark and yet through careful diet and exercise he’s done very well.

    That gives me alot of hope. Diabetes is difficult to manage in the best of circumstances, yet here is someone who did well with very crude technology. It also tells me the body has a vast ability to recover.

    Yes, I know alot of people don’t do well. As I write, I have a sister-in-law with a venous port self-administering antibiotics in order to save her toes. It’s not working. She and her husband, both on insulin, spend most of the time >300 and if the truth be known probably have many 400s as well. It’s a rare day when I (and probably you too) pop a 300 and then I/we drive it back down as quick as possible.

    One final thing, I really enjoy life. I have alot to live for and I can tell by your posts you do too. I have a good family and I enjoy doing many things and I’ve got several things that I want to do but just haven’t yet.

    This is too long but I hope it helps.