Self-Efficacy and RA

Living with rheumatoid arthritis can make completing basic tasks very difficult, if not impossible. In my case, I know that my physical limitations mean it takes me longer to do things and also more effort. However, I have an enduring belief that where there is a will, there is a way to get things done.

While I was growing up with RA, my parents taught me to take care of myself, to always find a way because they knew I would need this skill to cope as an independent adult.

If I couldn’t do something, it was up to me to find a way, find a tool, or ask for help.

Self-efficacy is the belief in one’s ability to complete tasks and reach goals. It is a concept defined and explored by psychologists to understand how people cope with challenges throughout life. It’s related to how we think about ourselves, self-esteem, motivation, habits, and behaviors.

If I have learned anything from living with RA, it is that the disease is a problem to be solved. Can’t open a jar? Find a gadget that will help. Can’t walk long distances? Get a wheelchair. Can’t do the laundry? Get help with this task.

While I am naturally stubborn and will struggle (and struggle) to do something myself, I also was trained in self-efficacy. This means that I don’t give up, even when faced with a daunting problem. Instead, I will work to figure out a solution or a workaround.

For me, self-efficacy has been crucial for living with RA.

It is something that I practice, that I tell myself over and over: “I can do it. It’s just a matter of figuring out how.” I think, if we sent a man to the moon, then I can get this task done.

My go-to example of self-efficacy is when I learned how to walk again after my total hip and knee replacements as a teenager more than 20 years ago. My recovery was complex and took a long time. It took me weeks of physical therapy to gain the strength to practice standing, then more time to practice standing unassisted (no walker).

The first time I stood up by myself, my arms were shaking from pushing myself up and my legs were quaking with the effort of standing. As I looked down five feet to my feet and the vast expanse that loomed from the chair I had just launched from, I honestly did not know how I would sit back down. I feared falling, tilting and missing the chair. I feared that my legs were shaking so much, I would sit with a crash and break my weakened bones.

I was frozen. I could not sit, yet time was running out because I did not have the strength to stand for long. I cried for help and the physical therapist guided me down with an arm. I had failed this time, but would not do so in the future. My mother coached me, telling me to say to myself: “I can sit down by myself.” Over and over. She wanted me to practice believing it, then practice the act until it was true.

To me, this is self-efficacy: believing that I can accomplish what I put my mind and effort to, especially when it is very important to me.

No, I’m not going to convince myself that I can climb Mt. Everest. But if I put my sights on a goal (even one that seems extremely difficult), I will find a way to make it happen.

Without a strong sense of self-efficacy, I would not have recovered successfully from my first hip and knee replacements, or the knee revision surgery three years ago. I would not have gone to college, lived by myself, worked and grew a career that I’m proud of, or enjoyed the travel I have experienced.

Perhaps the best way to put it is that while I have RA and live with physical disabilities, it does not define me. Instead, I choose to define myself and create a life that I enjoy.

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