Acceptance is Not Submission
It’s been said that RA patients, along with others receiving a chronic illness diagnosis, often go through the five stages of grief. These stages were first described by psychiatrist Elisabeth Kübler-Ross in 1969 and include denial/isolation, anger, bargaining, depression and, finally, acceptance. While these stages of grief were originally meant to apply to death or dying they’ve certainly been applied to other serious situations, including long-term illness.
Acceptance is the very foundation of living your fullest with RA
I follow a number of blogs, forums, and support sites where patients have loudly (in all caps) proclaimed, “I WILL NOT ACCEPT THIS DISEASE!” I politely beg to differ because I believe that acceptance is the very foundation of living your fullest with RA.
Acceptance doesn’t mean that you’re submitting to RA – that you’re just going to let it control your life. (Although, let’s face it, sometimes it will.) Rather, acceptance is planting a flag. It’s where you start your battle plan. It’s gaining a clear understanding of what the situation is so you can start exerting control – through treatment, through lifestyle, through building your support team.
Beyond that, acceptance takes you out of the other four stages of grief. Denial, anger, bargaining, and depression are all pretty negative situations. Acceptance is the mechanism we use to propel ourselves past that negativity and move forward to positive action. It’s literally impossible, for example, to be in a state of denial and acceptance at the same time.
That doesn’t mean that new developments won’t send us for a tailspin backward on occasion. There’s no question that RA is unpredictable and changes will cause us to revisit some of the other grief stages.
The RA rollercoaster
I’ve been on a number of different biologic treatments and every time I “fail” a treatment I definitely go through the process again. First I deny that the treatment’s failing. Then I tend to bargain to just give the current treatment a bit more time. Then I get really angry that I have to deal with yet another change and more insurance questions and not knowing whether the new treatment will even work. I seldom go through the depressive stage, but I eventually get on with accepting the new situation and moving forward. Sometimes you go through this process in an hour. Depending on the situation, it may take days or weeks to process.
I have to tell you that, even being the realist that I am, accepting RA has been hard. I am RF negative. My labs always come back perfectly normal – even if my joints are swollen and tender. Lots of treatments haven’t worked. I know something is going on, but fully accepting that it’s RA (and not something else) has been difficult. And every time I have those doubts, I go through those stages all over again.
But back to my original premise, that acceptance does not mean that you’re submitting to RA. Acceptance is gaining clarity and power and purpose. You can’t fight RA if you deny you have it, or you’re bargaining with the Universe for something else. You can only fight RA if you accept that it’s your foe.
On a scale of 1(low) to 5(high), how difficult is it for you to talk about having RA?