You made your first therapy appointment and although you know it’s a positive step, you may still feel hesitant. To ease your pre-appointment nerves, we asked our friend and Diabetes Late Nite podcast guest, Dr. Wendy Satin Rapaport, Psy.D. LCSW aka The Diabetes Psyche, to share three questions she asks during the first therapy session to help clients living with diabetes feel more comfortable with the process.
Photo by Priscilla Du Preez on Unsplash
1. What prompted you to seek therapy now?
Wendy Satin Rapaport Psy D (WSR): This is an important question because we, as therapists, want to understand whose idea it is (parent? spouse?) and what is bringing you, so that we have YOUR agenda. You can always ask us questions too because this is all about you and my goal as a therapist is to make you comfortable in this situation.
2. Up until now, how have you been coping with your diabetes?
WSR: This question allows you to begin to see the original response you had to your diabetes diagnosis and if and how you have changed. The question implies that people change over time. It also asks you to determine your opinion with your assessment – not the family or medical team’s response.
3. Have you ever done therapy before? If so, what parts were helpful and what parts were not? Do you think you will have the courage to let me know when I am helpful or not?
WSR: This series of questions gives the therapist an idea of your acceptance and/or resistance of getting the help and then honors your control over this experience. A therapist is for a resting place, education, and prevention of bad habits and the startup of good habits.
Getting to Know You …
WSR: Before your first session, your therapist will likely request intake paperwork and maybe a questionnaire that asks for your medical history, medications, mental health services, current issues or stressors, an assessment of depression or anxiety, and what you hope to get out of therapy. They may want you to elaborate on them during your initial session. Any of the papers the therapist asked you to fill out so that you begin to think about how you feel as well besides letting your therapist know what’s going on for youAnd if you are not comfortable filling out papers your therapist will understand that as well but remember everything is confidential.
The beauty of a therapist in your life is a chance for it to be all about you in the most loving way. It is like a friendship in part with the promise of complete confidentiality. You do not have to please your therapist. What freedom.
Friendship Matters: memoir, life lessons, laughter
Dr. Wendy Satin Rapaport Psy.D. LCSW, Patricia Addie-Gentle RN, CDE, Alexis Gray, Author of the Noodle Shop Mysteries: Vivien Chien, Lorraine and Brooks, Sara (Mandy) Reece, PharmD, CDE guest on Divabetic’s Diabetes Late Nite podcast with music from Maren Morris.
Share your thoughts and opinions with us. Take our Listener Survey.
We’re excited to announce our special line-up for Divabetic’s World Diabetes Day edition of Diabetes Late Nite. Diabetes Strong founder, Christel Oerum will stop by the studio to share her experience thriving with type 1 diabetes and the Queen of Soul, Aretha Franklin will provide musical inspiration. Join us here on Wednesday, November 14 from 6 – 7:30 PM.
Christel is a certified personal trainer, diabetes writer and advocate. She has been living with type 1 diabetes since 1997, and lives by the motto “there’s nothing you can’t do with diabetes.” With a wonderful life motto like that, we had to ask Christel to share some advice and guidance on staying strong with diabetes prior to our podcast interview.
Q: You posted on Diabetes Strong that when you first started to work out that you didn’t understand the difference between being ‘skinny’ and being ‘fit’. Can you explain how this impacted your fitness goals?
Christel Oerum: It shifted my whole approach to health and the way I structure my workouts and nutrition. While “skinny” can easily become an endless chase to “lose weight”, being fit and strong is more tangible. My focus is now more on increasing strength and eating to ensure my body can perform. I find strength incredibly empowering and I never go to the gym for “punishment” or to lose anything. I go because I like it and when I leave, I feel accomplished.
Q: Most women don’t want to lift weights because they’re afraid of looking ‘too bulky’ – what’s your opinion?
Christel Oerum: Building muscle is surprisingly hard, especially for women, so I don’t think women have to fear that. To “bulk up”, you have to consistently (we’re talking years) lift heavy and eat enough to support muscle gain. I’ve done that, and I don’t think I look “bulky” but that I look strong.
Q: What does your saying ‘forget about “toning” and focus on “building” mean?
Christel Oerum: “Toning” is such a weird term. Toning indicates that you lean out (aka reduce your body fat) to reveal your muscle tone. Well, you need to build muscle first in order to show it off. I think a lot of people (especially women) become frustrated when they lose weight and still don’t have the “toned” body they want.
Obviously, we all carry muscle even if we never lifted a dumbbell, but if you really want to “tone”, you’re probably also interested in having a little more muscle tone to show off.
Q: How do you deal with blood sugar fluctuations before, after and during your workout?
Christel Oerum: I limit the fluctuations by having a good understanding of how different workouts most likely will affect my blood sugar and by knowing which blood sugar management strategies are optimal to implement. I’ve written several articles on that on Diabetes Strong because it’s something many struggle with, and it takes time and effort to figure out what works for the individual.
But gaining that knowledge is golden. By knowing which types of exercise most likely will increase blood sugar and which won’t, we can adjust our medication and food accordingly and just enjoy exercise more.
Q: How do you feel that knowing how many calories you’re eating and what kind of calories you’re eating is important?
Christel Oerum: I don’t think it’s always important to know your calorie intake. I definitely don’t track what I eat all the time. However, if you do want to gain or lose weight, it’s important to know how much you’re consuming compared to how much you should be consuming. And the most efficient way to determine that is by tracking your food for a while. There are different methods for that and I always recommend people choose the right method for them. If tracking calories result in unwanted eating pattern and eating disorder behavior, I highly recommend a different method.
Q: How can others living with diabetes learn how to make peace with their obstacles and find ways to turn them into something positive?
Christel Oerum: I truly believe in finding your way through joy and support. We all have obstacles we need to tackle, and if they’re not approached with some level of positive outlook, they will become practically impossible to work your way out of. Diabetes is an obstacle, but it’s also an opportunity to become extremely aware of how your body works and responds to pretty much anything you do. And you’re not alone in this journey. There is a vast diabetes community online that you can tap into. We’re in group chats, Facebook, Twitter, Instagram and in person at meet-ups around the world, you just need to reach out.
Q: We’ve read that you often advise people living with diabetes who are interested in starting a fitness routine to do ‘what gives them energy’ what does that mean? Can you explain?
Christel Oerum: I find that when we enjoy something, when we have fun, it makes us happy and gives us energy. If you love to dance, you might be smiling all the way through that favorite song of yours, and you’ll probably have a smile on your face or in your heart even after the song is over, even if you are out of breath and covered in sweat. That’s how I feel about resistance training. I might not always want to go, but I pretty much always feel amazing afterward. I feel energized and happy.
Do what you like and what makes you happy – not what someone else says is the “best” way to exercise.
There are many reasons that Aretha Franklin is the legend of legends, a groundbreaking singer with the fortitude to transcend race and genre, using that tremulous voice as the bulldozer to break down every barrier set up in her way.
Aretha’s own health journey is sparking a discussion about the uncertain connection between pancreatic cancer and diabetes. Long-standing diabetes can be considered a risk factor for pancreatic cancer. It causes a modest increase in risk of 1.5- to two-fold. Some of the other risk factors for pancreatic cancer include smoking, chronic pancreatitis (inflammation of the pancreas), family history of pancreatic cancer, obesity and certain genetic syndromes.
Diabetes Late Nite is a fast-paced, full-filled hour of diabetes education and wellness advice that encourages listeners to “laugh a little, learn a lot.
