Coming down with an illness is part of our human condition. We will all be tested at one time or another. Learning effective coping strategies becomes an integral part of recovery. I find it helpful to differentiate “illness” from what I call “sickness.”  The term illness refers to the physical nature of a disease process while the term sickness refers specifically to how one reacts to being ill.  In my experience as a practicing physician for more than 40 years, the response to illness becomes as important as the treatment you are receiving from your doctor. Oftentimes sickness behavior can become more problematic than the biological signs and symptoms of the illness process.

I know that this sounds like a very simple concept. But it is far from being straightforward. How one responds to and learns about coping with illness becomes a critical component of what I call the “recovery equation.” Listed below are some of the most important parts of the recovery equation:

Your attending physician and the level of trust present

• Trust must be based upon time and experience. Do you feel like your physician knows you and has your best interests in mind?  When meeting with your physician, do you believe that you are the primary focus of his (hers) attention? How effectively does your physician communicate in helping you to understand the nature of your illness and treatment options available? Does your physician reach out to consultants in complicated medical situations? Will your physician admit to being wrong or making a mistake when the situation warrants it?

The context in which the illness develops:

• If life is reasonably stable when you come down with an illness it is often easier to put effective coping strategies in place than when one is dealing with life stress (e.g., problematic marriage/kids, financial difficulties, drug abuse, romantic breakup).
• The role of secondary gain. This concept refers to the importance of being “sick.” This is similar to the first grader with a “tummy ache” who is avoiding having to read a book report in school. This child may have a minor upset stomach but its magnification serves a purpose, a secondary gain. Secondary gain can serve to enlist sympathy or help someone deal with a problematic life situation. Unlike malingering, which is a volitional process, secondary gain is usually an unconscious psychological process. A severe and chronic form of secondary gain is seen in the development of “sick role identity”, where illness is maintained as a way of life and existence.

The individual’s personal history:

• A 40-year-old male with chest pain may have more difficulty coping with illness regarding this problem if his father died at a young age from a heart attack. Our expectations of illness often influence the sickness behavior that results.
• The president of a large successful corporation who is used to solving all problems and being in total control of business matters emotionally decompensates in the presence of an episode of cancer.  This individual is not used to being dependent. Coping with cancer requires depending on doctors, nurses, chemotherapy staff and a whole host of support personnel; a treatment course that entails that one surrender control to others.

As can be seen from the above examples, one’s psychological reaction to illness is part of the recovery process. Half of the recovery battles entail recognizing that illness can breed sickness. Once one is aware of their reaction to illness it becomes possible to work on improved ways and mechanisms of coping with illness. Do not be shy in seeking help from mental health providers. We are all human beings, none of us are perfect and being human entails imperfection when it comes to medical illness.

If you or someone you love is having trouble coping with illness, contact psychiatrist David A. Gross, MD at 561-496-1281 today.