The 'Guilt Monster' of Chronic Illness


“You really need to reschedule?”

Reading that text from my client killed me. It was a Saturday morning, the day after one of my infusions for my chronic uveitis. I had been having weekly six hour infusions for the last nine weeks, and even though I tolerated it with minimal side effects and was use to the process, I still woke up the day after with a monster headache and feeling purely exhausted.

I work two jobs, full-time as a clinical director at an adolescent mental health program, and part-time as an individual therapist for adults. I’ve been working six days per week for the last two and a half years, something which most of my colleagues have a hard time fathoming.

When I had to start the infusions, my full-time job had to get squeezed into four days. I began meeting with most of my existing clients on Saturday mornings while I seriously considered leaving the outpatient clinic – yet not actually following through with it.

I’ve made it work, mostly because of an amazing team at work that has been wildly supportive and understanding.

Yet the amount of guilt I have been feeling has been enormous. Because of my schedule and my poor health, my mind has been bogged down so much that I’ve been overly forgetful and falling behind on paperwork.

It grows every time I have to reschedule a meeting or tell my kids and their families that I will be out yet another Friday. Add on top of that canceling outings with friends or a date night with my fiancé, and it’s enough to make me want to cry.

A trick I use with my clients sometimes is to challenge them to picture their emotion or symptom as a character in order to depersonalize it. I like to picture the guilt I feel as a monster that lingers behind me. He has gross teeth that show when he cackles at me each time I make a mistake or give him too much attention. He looms behind me at my desk, and when I realize I forgot yet another deadline or meeting, he taps me on my shoulder with his long talons and waves.

So when I received that text from a client, asking if I truly needed to change his appointment, I almost cried. I try so hard every day not to let my disease run my life, yet some days it feels unavoidable.

When my guilt takes over, when that monster is laughing so loud I can barely focus, I try to remind myself that I will not be able to show up for my clients if I don’t show up for myself. Sometimes that means I must prioritize my own health and needs. When I tell myself this, I like to believe that the monster shrinks a little bit, or that his laugh becomes temporarily silenced.

Thankfully my client was understanding, and I was able to do some phone coaching to give him some support until our session on Monday. My monster shrunk a little bit, yet still loomed behind me that day as I focused on recuperating. Sometimes he just can’t be conquered. I’d like to believe, though, that over time and through self-care and reflection, my power will eventually be stronger than his.

What do you do to manage the guilt you might feel because of your illness? What might your guilt monster look like? And, most importantly, how do you engage in self-care to strengthen your power of your monster?

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Thinkstock Image By: Olga Miltsova

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