Suffering with a smile, how do you do that?

Medical psychologist Mark Cruisen of the Diakonessenhuis in Utrecht has no such qualifications. He is not a happy-smiling guru who claims that positive thinking makes ills go away. “Yet it is undeniable that people deal with illness differently,” he says. “Just like with other problems.” Psychologists call it coping.

Cruisen: “How a disease affects the quality of your life depends not only on the symptoms of the disease, but also on your coping strategy, in other words: how you deal with it.” A floating thought? “Not at all,” Cruisen says. “In people with the same physical symptoms, there is a demonstrable connection between their coping strategy and the inconvenience they experience from their complaints.” He gives an example. “Patients who keep a pain diary and learn to analyze which patterns can be recognized in it, get a better grip on their complaints. They can adjust their behavior so that they can better cope with the pain. But the feeling that they can do something about the pain themselves also increases their quality of life.”

happy type

Being ill is in fact an extreme situation, which magnifies how you deal with yourself and with problems. One always thinks: why me? The other knows how to put a positive spin on what happens to him or her. For example, he writes, like Frederike Pol, a book about the cancer that hit her. Like Marlies van Wijngaarden, she uses her burnout to finally change course. Or, like Carli Varga, moves to a place where she is less bothered by her illness. Crouzen: “Not everyone is able to do that.”

The glass can be half full or half empty. What you see and experience when you become ill strongly depends on your attitude to life. And that is not a jacket that you can exchange for another at will. Your attitude to life is largely determined by innate temperament, by the environment in which you grew up and what you have experienced: things that you can do little about. Still, people who aren’t blessed with an optimistic outlook on life can learn to change their coping strategy, Cruisen says.

At his office hours he sees many people who feel angry, sad or anxious because of their illness. For example, they say, “I’m in pain all day and no one understands me.” Or: “I’m so scared I’m going to have another heart attack. I want to get rid of that fear.” But changing your feelings doesn’t just happen. Crouzen: “Don’t practice thinking positively if you’re not such a cheerful person by nature. That just makes you insecure.” Fear and anger also do not disappear by letting out positive cries. The suppression of thoughts or feelings actually has the opposite effect in our brains. Cruisen: “That’s because our brains don’t understand the word ‘not’. When someone says to themselves, “Don’t think about that scary man,” your brain reads, “Think about that scary man.” The more you try to suppress such a thought, the stronger it becomes.”

Vicious circle

Therefore, according to Cruisen, the first thing you should do is recognize the negative feelings that an illness causes. It’s completely understandable to feel angry or sad when you have a nasty illness, he tells his patients. But, he tells them afterwards, don’t dwell too long on those feelings. “Otherwise you end up in a vicious circle. You then choose too much for your short-term feelings. If you feel gloomy in the morning and stay in your bed, you will continue to feel gloomy. Still, just going to work – changing your behavior – is often better.”

Try not to dwell on negative feelings: the same goes for anger, says Crouzen. “It may seem healthy to throw out anger about your illness. But if you keep expressing your anger, you will become angrier in the long run. That leads to more and more stress and anger.” And that is not only unpleasant for yourself and your environment, it is also bad for your health. “Anger creates stress. The more stress, the slower the physical recovery, research shows.”

In small steps

Okay, so change your behavior. But how do you do that: exercise, if you wake up every day with pain? Looking for new activities, while you prefer to smash a window? Crouzen: “Ask yourself what needs to be done so that your life becomes worthwhile again.” Not an easy task, because when you are ill, you tend to think about what you can no longer do. You have to flip a button to think of what you would like. Crouzen tells about a lady who was angry and sad that she could no longer work because she had developed a chronic intestinal ailment. “She didn’t sleep a wink anymore. “If only I could sleep again, I’d get through the days better,” she said. We worked on her sleeping problems first.

Then she decided she wanted to garden. Her intestinal complaints did not go away, but she did not let it affect her whole life.”
Don’t think too big, he just wants to say. “If you have too much of yourself, it causes unhealthy stress.” If you try to change your behavior in small steps, you will notice that thoughts and feelings will eventually ‘participate’. Cruisen: “What makes it difficult is that it usually takes quite a long time before that happens. There is a period of about five weeks between your behavior and your thoughts. That means that sometimes against your gut feeling you have to keep practicing for a few weeks with behavior that feels strange.”

Other strategy

And if you still fail to feel better? Cruisen: “Then you have to try something else. When something doesn’t work out, we tend to try harder. However, more of the same does not help as a strategy. It’s best to try something a certain way up to three times. If you don’t notice any results, it’s smart to choose a different strategy.”
In the end you will find a way that suits you. What matters is that you get the feeling that you are not only a victim of your illness, but that you can do something yourself to improve your situation. Although you cannot heal yourself, you can often get a little more control over your illness and thus improve the quality of your life.