Understanding each other to better accept each other

By Marie-Ève Major, social worker
CHUM Cystic Fibrosis Clinic
Montreal (Quebec)

Cystic fibrosis is undoubtedly a chronic disease with significant impacts on the psychosocial functioning of individuals affected by it. Indeed, it affects the personal as well as the family and social sphere. It also has consequences on professional and academic life, as well as on daily and domestic activities.

According to the American psychologist Julian Rotter (1916-2014), each human person has a tendency to attribute the elements that affect them to causes that will mainly be Interiors, or rather exteriors. Obviously, individuals with cystic fibrosis are no exception to this reality. In fact, in their speeches, we can identify elements associated with one or the other of these two opposing beliefs.

Still according to Rotter, people who think they have full control over their lives will be said to have a Internal locus of control, and people who attribute what happens to them to external causes, a external locus of control. In literature, we sometimes also talk about places of internal and external control. For the psychologist, these two notions should be understood as a spectrum of possibilities, and not as absolute values. So most individuals' loci of control fall somewhere in between.

The primary objective of this text is therefore to help you better position yourself on the scale of the various locuses of control by examining your beliefs and questioning your beliefs. Second, it will allow you to become aware of the strengths that belonging to one or the other of the two groups has allowed you to develop, through your process of accepting the disease. Finally, it will lead you to identify the limits inherent in each of these two schools of thought, in order to know how to recognize the various challenges that you may have to face in the future.

The internal locus of control

People who have a mostly internal locus of control generally believe that nothing happens for nothing. They establish a very clear causal link between their actions and the consequences of these actions on their lives. If they failed an important exam at school, it was because they had not studied enough. If they did not get the promotion they had hoped for at work, it is because their performance at the interview was suboptimal. If they arrived at their medical appointment late, it is because they did not get up earlier than usual in preparation for the traffic caused by the snowfall. In relation to the disease, these people will also expect their clinical condition to reflect the assiduity and determination they show in carrying out their treatments.

When their medical condition is stable or even better, improved, there are no words to describe the sense of pride that comes from behind their smile. The spirometry result is consistent with the efforts made and all is well in the best of all worlds. However, when the clinical condition worsens, these people will have the reflex to blame and blame themselves. They will then recall all the occasions when they did not give their best, and then establish a direct link between these punctual digressions and the state in which they are now.

Thus, when things are going well, having an internal locus of control allows the individual to maintain a positive and confident attitude about the future. It also promotes his commitment to school or work, as well as his adherence to therapy, as he is convinced that his condition is the product of his perseverance. In addition, by thoroughly analyzing each of his successes and failures, the individual with an internal locus of control develops a capacity for introspection as well as extraordinary coping strategies.

However, there are some disadvantages to having an internal locus of control. The individual belonging to this group can in fact sometimes be extremely perfectionist and feel a strong sense of guilt or shame when confronted with a failure. Moreover, because his self-esteem is closely linked to his success and achievements, he can easily become anxious or depressed when his efforts are not rewarded by the expected results. Finally, this individual is usually more vulnerable to criticism and emotional blackmail, because in addition to considering himself fully responsible for his condition, he will also tend to feel responsible for the happiness or unhappiness of others.

In order to counterbalance the disadvantages of the internal locus of control, the individual can learn to distinguish between the feeling of Guilt and the feeling of Responsibility. For example, instead of unnecessarily blaming yourself by saying to yourself:”If my lung function is reduced this month, it is because I did not do my respiratory physiotherapy exercises every day. I was cowardly and now I am getting what I deserve.”, a person can instead take responsibility by saying:”It is possible that not having done my respiratory physiotherapy exercises contributed to the decrease in my lung function this month. My health is important to me and my actions should better reflect this reality. My goal is to do better next month.”.

In this example, the individual with a mostly internal locus of control exploits the strengths that flow from belonging to this group while refusing to be violent by allowing himself to be overcome by feelings of guilt or shame. In this way, he considerably increases his chances of making a positive change in his life.

The external locus of control

For their part, people who have a locus of control that is mostly external will explain the phenomena that affect them by environmental factors over which they have no control, such as luck, chance, others or institutions. If they failed an important exam at school, it was because the subject was too difficult. If they didn't get the promotion they were looking for at work, it's because the managers who were interviewing made the wrong choice. If they arrived at their medical appointment late, it was because there was traffic due to the snow. In relation to the disease, these people will maintain the belief that it is futile to offer impeccable therapeutic adherence, since a medical emergency that could lead to an irreversible deterioration of their condition can occur at any time, regardless of how hard they try to take care of their health.

Having a locus of control that is mostly external has few advantages. You might think that these people are less prone to anxiety because they seem to get carried away by life without any hassles or worries, but that's not the case. Indeed, although these people tend to feel less guilty about what is happening to them, they are nonetheless anxious about the prospect of having no power over their future, no influence on the course of their history. The challenge for these people will be to develop their spirit of initiative and their power to act in order to regain some control over their lives.

The good news is that no one has a 100% internal or external locus of control. Most of the time, the effects of the external locus of control are counterbalanced by elements of the internal locus of control, and vice versa. It is also important to keep in mind that there is no right or wrong way to interpret events that affect our lives. Indeed, each human experience is unique, complex, and valid.

Conclusion

In view of all these elements, it can be said that knowing where our locus of control is mainly located in relation to what we are experiencing is a good way to identify our strengths, as well as the challenges we face in our journey of accepting our reality. This quest is certainly not an easy one. It requires a great deal of courage. Indeed, it calls on our ability to question ourselves, a skill that is not available to everyone and that can sometimes cause us discomfort.

If you want to start a personal growth process in order to better understand the reasons behind your thoughts, decisions and behaviors, surround yourself with people with whom you can discuss and share your thoughts without fear of being judged. Do not hesitate to ask for professional help from a psychotherapist who will listen to you and guide you, especially if your family and social network is not willing to do so. In addition, some people feel less need to talk to when they are introspective and prefer to read books or write their thoughts in a journal. Finally, practicing an artistic or sporting activity can also allow you to refocus and discover yourself.

To know each other better is to understand each other better. To understand each other better is to accept each other better. And it is by working on self-acceptance that we can finally develop more love and respect for the human person that we are.

Source
Rotter, J.B. (1966). Generalizedexpectancies for internal versus external control of reinforcement. PsychologicalMonographs, 80 (Whole No. 609).

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