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Permalink Reply by Sarah on June 2, 2008 at 8:01pm

to get myself through school, I'd go to the gym to try to "burn" the anxiety or stress, it really helps! as for going low during a session, I would recommend testing your blood sugar before the session starts and if its lower than what you would like, eat something quick, lke a few crackers or glucose tabs.

hope that helps

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Permalink Reply by Andy Stanton on July 6, 2008 at 12:59pm

Kim:

I survived Grad School (1995 to 1997) with Type I. Yes, the stress of working on a graduate degree can be very hard on your condition.

One suggestion is to get a pump. This will help you regulate your blood sugars more easily. As a college student with diabetes, you need to make sure you have some type of health insurance. A short stay in the hospital with DKA, can cost thousands of dollars.

Good luck in your phd program!

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Permalink Reply by Kim on July 6, 2008 at 3:35pm

Thanks Andy.

I plan to push for the pump in October. My endo said it is a lot to learn and he was worried I didn't have the time to learn it. I never understood that, but didn't argue.

Good point about health insurance. Most of my friends in school go without. I have been on COBRA off of my mom's family plan for a while now. It's expensive, but luckily my parents are helping me pay the rate until I finish school and get on my feet.

Only one more year of school though = )

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Permalink Reply by Lee Ann on July 6, 2008 at 4:17pm

It's difficult to manage the stress during grad school and take care of your health. I can't say that I managed my diabetes very well during grad school, but that's another story for another day.

I'm a therapist, and the suggestion to check before sessions is about the best you can do. The other suggestion to look into a pump is good also because it will enable you to more accurately control your basal insulin. I don't know what theorists to which you subscribe, but I think the blank slate is over-rated. Obviously, self-disclosure has to be done very judiciously and with therapeutic intent, and as you practice you'll find a balance that works for you. I have a pump and a CGM, so I'm one step short of walking into sessions wearing a t-shirt that says 'I'm diabetic'. I set my CGM to vibrate, but it still goes off, and I have to attend to it regardless. My pump has alarmed for various reasons too mid-session, and while that's less frequent, I have to attend to that too. For me it's akin to being a pregnant therapist because it's there, people might know or wonder, sometimes they ask, and sometimes it gets talked about. I've had to eat a couple of pieces of candy mid-session too on many occasions. If it's already come up that I'm diabetic, I tell them my BG feels a little low so I'm just going to eat something while we talk. So how, when and if it comes up varies, but I don't think it's necessary to keep it a big secret. I actually think keeping it a big secret creates barriers because you're compromising your true self, and you're preoccupied with your own immediate needs so you aren't in the moment. I think it's poor role-modeling for how to cope with an uncomfortable situation. They can see it almost as obviously as they can see I'm a white, married, female in my 30's. It's all fuel for countertransference, and you deal with it accordingly. That's why I don't think very highly of the Freudian, psychoanalytic blank slate approach. So much can be accomplished by use of self as long as you are aware of boundaries, you use purposeful self-disclosure as a means to a therapeutic end, and you work with the countertransference to enhance the therapeutic relationship and promote change.

This is how I've come to manage this particular issue, and it has informed my overall approach in some ways. You should definitely have a good chat about it in supervision though. I hope you find a way to approach it that works for you without compromising your work.

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Permalink Reply by Kim on July 8, 2008 at 11:01am

Thanks for the advice.

I actually practice interpersonal/psychodynamic therapy. I agree that some self-disclosure to some extent is warranted depending on the relationship and the situation. As far as diabetes I agree that it needs to be addressed. It has taken me out of the moment many times. It's a new diagnosis for me, and it came when I was very busy. I never really took the time to think it all through. I did talk to a supervisor and even through her psychodynamic perspective, she said I need to tell them. The main thing she made me think about was "what if I pass out". No need to cause a client more trauma in life.

Luckily, I am done classes for the doctorate and will have a year to work at the master's level and finish my dissertation. That will free up a lot of time and I'm sure I'll find a way to balance my life a lot better.

Thanks again for the advice. It's great to hear from someone in the field!

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Permalink Reply by Lee Ann on July 8, 2008 at 11:08am

Good luck writing the dissertation. I keep feeling tempted to get my doctorate, but writing my masters thesis was so painful, I'm not sure how I would ever complete a dissertation. Plus, I'm ear-deep in student loan debt already. :(

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Permalink Reply by Kim on July 11, 2008 at 11:08am

Thanks, I'll need the luck. I decided to do a pretty ambitious study for some reason. Wish I had stuck with just doing a survey....

Also, I would not go back for the doctorate if I were you. Everyone who's graduated said they would stop at the Master's if they could do it again. There are so many hoops to jump through for the doctorate that you don't know about until it's in your face. After all that you're in crazy debt, and don't even make much more money than a Master's level. The only real difference is testing. That offers good money, but it takes years to get consistent referrals.

Just my opinion = )

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