This diagnosis is now a part of you — but don’t lose sight of the fact that life always has some hardships. “Recognizing that pain and illness are inevitable features of life, people productively adapt to and accept that they have RA and no longer experience the distress associated with ‘fighting’ the diagnosis,” says Ashwini Nadkarni, MD, an assistant professor of psychiatry at Harvard Medical School in Boston.
That can be especially helpful as your RA — just like your relationship with the diagnosis — evolves over time. “If one is living with a chronic condition, it means it’s not going to go away. It may get better. It may even go into remission,” says Joan Westreich, LCSW, the social work coordinator of the Early Arthritis Initiative at the Hospital for Special Surgery in New York City. “However, you still have to deal with the reality of coping with some physical, psychological, and social changes in your life. Rather than fighting against what you cannot control, try to control what you can.”
Here are some tips to help you do that.
1. Give Yourself Space to Grieve
2. Then, Keep Moving Forward
There is room for frustration, despair, self-pity, anger, and all sorts of other wide-ranging emotions after an RA diagnosis. All feelings are valid, and you should give them their appropriate space. But hone your mindfulness: Think about when these feelings are actually helpful and when they’re simply bringing you down, Dr. Bourdeau says. “Anybody can find anything in their life to be upset about, and we know that when they do that, they tend to be more depressed.”
3. Change Your Language
You get to decide how you talk to yourself and to others about your RA, and that can involve overhauling your vocabulary to be more empowering.
Maybe you decide you won’t refer to your RA as an illness or a disease but instead as a condition, which can feel easier to manage mentally for some people, Bourdeau says. Maybe you focus on person-first language, rather than identity-first language: Instead of calling yourself arthritic, for example, you call yourself a person with rheumatoid arthritis or a person who sometimes experiences challenges due to an arthritis-related diagnosis, says Jessica Auslander, PhD, a clinical mental health counselor who has worked with the Arthritis Foundation’s patient education team.
This might help you remember RA is just one part of your identity, not your entire identity, Bourdeau says.
4. Cultivate Self-Compassion
Deciding how you’re going to talk about RA is part of treating yourself kindly in regard to your condition. And this is essentially self-compassion, or showing yourself the kindness, understanding, and acceptance that you would offer a friend, Dr. Nadkarni says. Tune in with your thoughts, feelings, and self-talk about your RA: Is it different from how you would talk to a friend with your same diagnosis?
To improve that relationship with your RA and your whole self, it might help to try some self-compassion exercises like writing yourself a supportive letter, she says, or even using self-compassionate touch. For example, place your hand over your heart and appreciate its warmth, she says.
If you need to remind yourself to be self-compassionate, think about the inverse of the Golden Rule. “Instead of doing unto others as you would have them do unto you, do unto you as you would do unto others,” Westreich says. “I think if one can work from that perspective, it’s meaningful and productive,” she says.
5. Praise Adaptation, Not Productivity
American culture emphasizes productivity, and it can be tempting to shame and blame yourself for not being able to keep up when you have RA. If you find yourself saying things like “I shouldn’t get so tired” or “I shouldn’t need so many breaks,” you may need to repair your relationship with productivity as part of building a good relationship with your diagnosis, Dr. Auslander says.
“It’s not easy for anyone to accept a decline in their ability to perform valued activities or participate as they once did,” Westreich says. “So, one needs to be able to recognize the realities of living with chronic illness. But at the same time, we work together to develop an understanding that RA needn’t define who they are as a person. All of their unique qualities remain, as does the possibility of living a full life.”
Auslander recommends focusing on and praising your ability to adapt, not to produce, by instead saying things like “Look how well I adapted” or “Look how I faced that challenge.”
6. Reconnect With Your Body Through Movement
One way to take an active role in building a healthier relationship with RA is to focus on the activities and experiences that help you feel better. For example, Bourdeau says, is there a form of gentle movement that helps you still feel active while also helping to manage your RA pain? “If you focus on what you can do and how you can manage some of your limitations, it’s less distressing than focusing every day on your limitations,” she says.
Finding a form of physical activity that works for you can be especially helpful if you feel any resentment toward your body and the pain it’s causing you, Auslander says, because “exercise reconnects you with your body in a positive way.”
And remember, your ability to participate in certain activities may change over time, too. To honor that, if a client says something like “I can’t do that because of my RA,” Auslander says she always adds “for now.”
7. Find Ways to Make Meaning
Research suggests that those who find a deeper meaning in challenging experiences that aligns with their goals and values may have an easier time coping with their circumstances, including chronic pain.
“The idea is to integrate having RA into one’s identity in meaningful ways,” Dr. Nadkarni says. For example, maybe before your symptoms began, you saw your job as your purpose. After your diagnosis, maybe you “find a newfound meaning in your RA, perhaps by … becoming a coach for individuals with chronic pain,” she says. Consider looking for volunteer opportunities, mentorships, or chances to lead support groups for people with RA.
“For many people, as they adapt to new realities, there is an ongoing process at different stages of their illness where they navigate shifts in their identity and in their roles in life,” Westreich adds. “This process provides an opportunity to reassess one’s values, as well as the meaning of various activities or relationships in their lives.”
8. Find Gratitude Where You Can
Gratitude may feel far from your mind when you’re working toward acceptance of your RA. And while it can undoubtedly be difficult to feel grateful in challenging moments, research shows that people with chronic illnesses who are more grateful tend to have lower rates of depression than those who are less grateful.
You don’t have to be grateful for your diagnosis to build a healthier relationship with it, though. “It’s necessary to acknowledge the reality of the experience of living with RA, but at the same time, one has an opportunity to also acknowledge the positive aspects of one’s life,” Westreich says. Instead, try focusing your gratitude on “close relationships, good work, access to leisure and cultural activities, meaningful practices such as meditation and spiritual practices, not to mention daily opportunities for joy,” she says.
9. Consider Professional Support
It’s not always easy to implement any of these changes on your own. And you don’t have to. “I’m of the mind that everyone can benefit from some kind of counseling or support,” Auslander says. That can look different for different people, and include one-on-one counseling sessions using various schools of therapy, group therapy, support groups, or even online forums.
Many people who join the support group Westreich runs tell her they’ve never met anyone else with rheumatoid arthritis. The opportunity to speak with and learn from other group members helps combat some of the isolation that can prevent you from forming a healthy relationship with your diagnosis. “The group members who live with RA support one another in a profound way,” she says.
A particular form of therapy called acceptance and commitment therapy or ACT has been shown to help improve physical and emotional functioning, pain, and quality of life in people with rheumatic conditions.
“People learn to detach from their thoughts and feelings, recognizing their thoughts as just thoughts rather than facts, and enhancing their psychological flexibility,” Nadkarni says. Consider searching for a therapist who offers ACT in your area or virtually.
It takes time, effort, and self-awareness to achieve a healthier relationship with your RA, and everyone’s experience is different. But with consistency, compassion, and these tried-and-true steps, you can make progress.
The Takeaway
- A diagnosis of rheumatoid arthritis can be challenging to face, but learning to accept it can help you manage more effectively.
- Give yourself time to grieve and be kind to yourself. Reframe certain ideas about yourself and reconnect physically with your body.
- Consider seeking professional help, particularly a support group or a form of therapy called acceptance and commitment therapy, which has been shown to help people with chronic conditions.
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