The Fear Monster and RA, Part 1
I was just talking to a friend who lives with rheumatoid arthritis and she mentioned how much fear she has to conquer every day. Fear is a natural response to intense challenges, and RA offers up challenges on a daily basis, so I wasn’t surprised to hear this. Although I wasn’t surprised, it did make me sad. Especially when she told me that her fear was being compounded by the people who were supposed to help her- her doctors, and some of her friends. Rheumatoid arthritis is a disease that has so many challenging aspects to it, uncertainty, pain, living with side effects to the medications that help the disease, fatigue; these things are only the tip of an iceberg filled with challenge. It’s only natural when trying to juggle so much uncertainty and fit all of it into an actual life, that fear would follow. After all, who wouldn’t be afraid when presented with so much hardship?
The fear that comes with RA impacts decision-making
The problem is, when you’re fearful you make horrible decisions. When you feel fear, your higher cognitive function (called executive function,) the part of the brain that helps with decision-making and problem-solving, shuts down. You are also damaging your health. Fear is an emotion that triggers the fight/flight/freeze response in the body, and when fear floods your body, it responds by shutting down unnecessary functions like digestion, while sharpening senses related to danger, like heart rate, which increases. How many times have you felt fear and your heart started going crazy? Imagine this happening 24/7 and you will understand that cardiovascular health will suffer when you live with fear. Fear interrupts memory storage, and over time fear impairs the part of the brain that consolidates memory so that it gets harder and harder to store long-term memories.
Getting to the bottom of the fear
This is a conundrum, and as such there are no easy answers to fix this vexing issue. But there are things to do that will help. For me, the first thing I do when I feel fear flooding my body is to find out what I’m afraid of. Am I having to cancel plans with a friend for the fourth time and feeling afraid that she will be upset with me? Is it that I’m having hives and afraid this means that I’m developing a drug allergy? Both of these things will cause a similar physiological response in my body but require very different reactions from me in order to get out of fear.
Facing RA-related fear head-on
Facing fear head on and challenging the thoughts that have created the fear, can help when you feel fear taking hold. Once you figure out what you are afraid of, then you will be able to figure out what action steps to take. Sometimes, like the example I gave above about canceling plans with a friend, it helps to challenge that fear. Is your friend really going to be upset or is the fact that your body keeps acting up making you upset? If your friend is actually going to be upset, then he/she may not be the type of friend you need. Maybe you stop making plans with that person for a while, and reassess who you hold close in general. RA is stressful enough, and it is extremely important for all of us living with RA to limit stress in our lives as much as possible.
When family doesn't understand RA fear
This gets harder when the people that are being hard on you are members of your family. Unfortunately, it’s also very common. RA is a family disease and each of us cope differently. In my life, I’ve found that members of my family can compound my fear at times because of the worries they are carrying, or because they have strong opinions about what will help me that differ from mine. Because these fears are coming from people I love very much, this can be the most insidious type of fear to extinguish. Because I value my families’ opinion a lot, I’ve found that their fears can influence my own self-talk if I’m not careful. So, when I talk to a member of my family and I feel myself tense up, I’ve learned to pay attention. I’ve learned that before I get angry I feel frustrated, irritated, and can’t express myself well, so I shut down. That’s when fear creeps in. This happened recently, and since I’ve been determined not to let fear get the best of me, I’ve incorporated a few tips from the field of cognitive behavioral therapy, to combat my fear.
Some tips for combatting RA-related fear: CBT
Before I tell you about what I do, here is a good description of cognitive behavioral therapy, or CBT:
Cognitive behavioral therapy (CBT) is a short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel. It is used to help treat a wide range of issues in a person’s life, from sleeping difficulties or relationship problems, to drug and alcohol abuse or anxiety and depression.”1
When I’m feeling fear that just won’t go away, especially if it’s being fed by the people around me, I’ve found that a simple CBT exercise helps. I examine the situation, look at the self-talk I use in that situation, how am I feeling, and what do I do when this happens. Then I counter all of this by again looking at the situation, find new ways to think about it, then feel how I feel with this new thought, (am I still feeling fear?), then try out new ways to respond. It takes practice, and I can’t say I’ve mastered this technique but I can say that it works when I do.
In Part 2 of The Fear Monster I’ll be talking more about using CBT and give some great resources that will make it easier for you to kick your fear to the curb.
Right now, what RA tips would most be helpful for you?