Greetings to all here.
I'm sorry this post is rather long (I can hear you all saying 'as usual'!) but it might help some here with the tricky topic of how to deal with the emotional implications of PMR/GCA: or, for that matter, any other life-changing illness or situation.
First, the usual Disclaimer! Although I am not a qualified Psychologist, I was fortunate to study Change, Personality Theory and Counselling Psychology many years ago whilst at Uni, and in my professional work I’m invariably dealing with people in some kind of Change process. So, I hope this post brings some personal insights into the Human side of, as well as some practical strategies for dealing with the emotional side of Change in the context of chronic illness especially. As always, I am very open to dialogue about, and alternative perspectives around this complex and, for many, very personal topic.
Change, and the Human Condition..
As we all know, like night and day, Change is inevitable in Life! But a sudden and unwelcome change in our physical health, daily capabilities, self-concept and future expectations can be as psychologically and emotionally demanding as nearly anything else that we are likely to encounter along the way. And, as many of you say, dealing with Uncertainty around these things can be the most emotionally challenging and stressful experience of all. PMR/GCA places Uncertainty directly at our feet and says to us: 'Go on then, try me out!'
Does our Personality Type affect how we cope with major Illness?
In my books, of course it does! Without going into Psychobabble (!), it is generally acknowledged by Behavioural Psychologists that our inherent, unique Personality Type (if you like, our personality ‘profile’) can influence many aspects of how we perceive and approach life, work, relationships, and Change itself.
Here, I’ll just set out a very rough ‘sketch’ of a model of Personality Types that has its foundations in early 20th Century (Jungian) Psychology, and is widely used in various forms in helping People and Organisations to understand one of the greatest questions for humanity: what makes people ‘tick’ differently, what motivates us, and how we deal with life’s challenges.
This comes with the rider that even the most modern forms of ‘Typology’ are still far from an exact or predictable science, and there are many other (e.g.) environmental, social and cultural factors that can influence our Personality or Behavioural ‘Style’ in context. Also, we are all a mixture of ‘Styles’ in differing proportions: some of us ‘stronger’ in one / less pronounced in others, some of us ‘all rounders’. That’s what makes life and people so interesting - if, at times, also frustrating!
So, nothing here is meant in an 'absolute' sense, nor necessarily scientifically / empirically provable. It is only my interpretation based on many years of working with people in Change in many contexts - and of course, learning about myself along the way, also!
The 4 broadly defined ‘Types’ and Coping Challenges / Strategies - a brief Introduction:
(n.b. beware stereotyping - think about whether you are 'more / less' of any Type, or evenly distributed across all 4!)
‘DOERS’ tend to be more ‘Action’ oriented / motivated. Typical Strengths: Task focused, Planning and Achieving, Setting Targets, Being ‘in Control’. Typical Coping Challenges: Loss of Sense of Purpose / Control, Feelings of Inadequacy. Suggested Strategies: Make ‘Flexible’ plans, Delegate, Share the Load, Involve others in the Process, Practice Relaxation techniques, Decide: ‘What really matters most today?’, Plan and Pace Mental and Physical Activities strictly. Learn to 'Be', as much as 'Do'.
‘SUPPORTERS’ tend to be more ‘Relationship’ oriented / motivated. Typical Strengths: Empathic to others, Caring, Emotionally Giving. Typical Coping Challenges: Emotional exhaustion / overload, Guilt around not being ‘available’ for others, Resentment of demands of / requests from others, Being unable to say ‘No’. Suggested Strategies: Focus on Self more, Negotiate time / energy spent in supporting others, Give yourself ‘Treats’, Study / Develop (true) Assertiveness, and how to say ‘No’ kindly but clearly! Learn to Give - to Yourself.
‘ANALYSTS’ tend to be more ‘Data / Logic’ oriented / motivated. Typical Strengths: Problem Solving using Facts and Figures, Structure and Routine, Evidence-based decisions. Typical Coping Challenges: Accepting Ambiguity / Uncertainty, Unable to find clear, predictable ‘Answers’. Suggested Strategies: Explore Creative Side and Pursuits, Play with Abstract concepts, Let-go of Routine and Structure a little, Avoid ‘second-guessing’ outcomes or faulty logic / rationalisation, Listen to your emotions, share and trust them. Learn to Feel as well as Think.
‘EXPRESSIVES’ tend to be more ‘Emotionally’ oriented / motivated. Typical Strengths: Charismatic Communicators, Socially Competitive and Persuasive, High Emotional Energy. Typical Coping Challenges: Anger, Frustration, Loss of Social Self Esteem, Sense of Injustice, Despair. Suggested Strategies: Research reliable facts and data about your health condition, Introduce and follow Pacing Strategies, Be aware of your emotional ‘temperature’, Take a more structured approach to coping, Think before Acting / Reacting. Learn to balance Heart with Head.
Of course, ALL of the above ‘Types’ can experience ALL of the above Coping Challenges: no single Challenge is exclusive to a particular Personality Type! However, to my logic (and based on experience), it’s likely that different Types are likely to experience differing reactions (challenges) to Change, and also respond better to differing Coping Strategies. Therefore, it can help to know which strategy is more likely to be successful, given the combination of your Personality Type and the type of Emotional Challenge you are experiencing in the Change Process. 'Knowing Yourself.. and all that?!
Moving on to The Emotional Journey in Change..
Whichever of the 4 Personality Types you most closely identify with (or even if you don’t identify with any of them!) this leads me on to the Kubler-Ross model in managing and coping with Change - which I’m sure some of you will already know, and many will relate in one context or another.
Dr. Elisabeth Kubler-Ross (rip) was a ground-breaking Swiss Psychiatrist who studied and documented her experiences in dealing with the emotional journey of patients with terminal illness (she did her first work of this kind in the 1970's, I think). She went on to publish several internationally acclaimed books about the emotional journey / process that, almost universally, her patients went through in coming to terms with Change and Grief in the most profound circumstances of all. Her stories are incredibly poignant, and her concept of the emotional stages in the journey (very basically, 'Shock, Anger, Denial, Negotiation, Acceptance') is almost universally transferable into any Change situation, from the mundane to the major.
I'm laughing as I write this: today, I discovered a flat tyre on my car and the Kubler-Ross reaction kicked-in without my realising it. First reaction was to say 'B****r! (shock). Then, 'The garage sold me a bad tyre' (displaced anger). Then, kick the tyre. 'No, it's ok really, the pressure is just a bit low' (denial). Then, 'Maybe I don't check my tyres often enough?' (honest negotiation with self). Then, 'Ok, so the tyre is as flat as a pancake. Either way, I need to call the Rescue Service and get mobile again' (acceptance / asking for help / moving forwards).
On a serious note: the most interesting (and possibly important?) thing about the Kubler-Ross model is that it suggests that we often find our most productive emotional and practical resources at the (later) 'Acceptance' stage in the Change process. This is when we are more likely to think more clearly, rationally (and possibly, also, creatively ?) about solutions to the way forwards in Change (for ourselves / others), and to let-go of some of the naturally powerful but potentially self-restricting emotions in the process. In my experience, this is also the stage where we can truly 'let others-in' (e.g. our nearest and dearest) to our emotions, hopes (and fears..) so that they can help and support us as much emotionally as practically - as they usually want to do but might have been afraid to before, due to (for some of us, at least) the need to always be 'in control' (!).
Give in, Give up.. or Roll With It?
'Giving-in' and 'Giving-up' are two different things, as I'm sure we will all have said to others in our lives when supporting them through a crisis? Yes, Despair, Depression, and a feeling of wanting to 'Give-up' can be Hell :-(. I have been on this journey too, in a past, difficult chapter in my life. Along the way, I learned and still try to use the Survival Philosophy of 'Rolling with it' as a more gentle interpretation of 'Giving-in (or up)' and it helped me immensely in getting through a few tough years of massive Change and Challenge at all levels.
Coping - A Battle, or a Game?
Many people mention the idea of 'battling / fighting' with PMR - I can well-relate. How about thinking of 'PMR vs. You' as a game, more than a fight, where (a bit like the boxer Mohammed Ali (again, sadly, rip) you develop a strategy of holding-back, laying low, and waiting until PMR eases back on its ferocious punches and you regain some feeling of control once again? Yes, it's a day-by-day process: but 'Baby Steps' are often best in making big Behavioural Changes: and, as many here say, Patience is Key. Easier for some Personality Types than others?!...
Coping - Have Faith in Yourself?
Confidence in our abilities, mental and physical resources, and our self concept (Who I Am) can be one of the greatest casualties of a life changing illness or injury: and this bit of our identity is invariably challenged by the Change Process itself.
Finally, the simple words 'Don't worry, things will be ok' can, for many of us, be a powerful part of the coping process. I'm not a particularly religious or spiritual person, but Faith in Yourself can also be a big factor in coping with major Change: or at least the process of accepting it. And there's another up-side: the process of major External Change can often force us to find Internal emotional, practical and creative / intellectual resources / talents that we had overlooked in ourselves before.
All of reminds me of the old saying: 'what doesn't kill you makes you stronger'. Work in Progress for some of us?!
Now, after all of this serious intellectual stuff, my mind is already turning back to more, mischievous John Wayne stories. In terms of coping strategies, Laughter is one of the best for me 
With best thoughts and hopes
MB 
PMR/GCA ‘STRESS’ AND ‘SOCIAL’ MODELS OF HEALTH AND WELL BEING
