For World Diabetes Day on 14 November, we also have a blog from Dr Rob Whittaker, Consultant Clinical Psychologist, Bradford Teaching Hospitals NHS Trust

Rob Whittaker'Wellbeing’ – it’s everywhere these days, isn’t it?

But what does it mean? And how might psychology be able to guide us in how to experience more of it in our lives?

Wellbeing is a relatively new term – almost unheard of 25 years ago when I first started working in diabetes psychology. Some say it is too vague a term to be useful. Others see it as marking a welcome shift from the negative to the positive, from focusing on what’s wrong with people to what promotes contentment and what helps people feel happy. It also usefully widens the territory from those with mental health problems to all of us – we can all strive for a greater sense of emotional wellbeing, regardless of our starting point.

The NHS defines wellbeing as: ‘a positive state of mind and body, underpinned by social and psychological wellbeing. It enables and supports good relationships, improved resilience, improved health, meaning, purpose and control’.

Sounds pretty good! But how to experience more of it?

Before I get on to that, I want to guard against being too rose-tinted about this. Over the years of doing therapy with people living with diabetes, it has been vital to give people space to speak of what is difficult in their lives, the relentless demands of the condition, how it can wear people down, how it can be so hard to balance with all their other priorities and concerns. It’s really important to acknowledge this.

It has also been equally important to explore stories of how people respond to these difficulties – their stories of success, however small these may seem to outsiders. How they managed to balance feeding a toddler with remembering to take their insulin 20 minutes before eating themselves. How they managed to pause for a moment at the biscuit cupboard and consciously ask themselves how they want to proceed, rather than find themselves halfway through a pack of digestives before they’ve even noticed.

My conversations in therapy with people living with diabetes almost always include stories of what brings them positive emotion. What skills people are bringing to bear on the challenges of living their lives in line with what’s really important to them and how they are connecting with others in ways that sustain them and bring them joy. These connect to the work of the so-called ‘Father of Positive Psychology’, Professor Martin Seligman from the University of Pennsylvania.

Seligman is a world expert on the science of happiness and his PERMA model gives some useful insights into what contributes to a sense of wellbeing:

  • Positive emotion – engaging in activities that bring us hope, interest, joy, love, compassion, pride, amusement or gratitude – whatever these might be for you.
  • Engagement – getting absorbed in something that both challenges us and allows us to use our skills – to the extent that we experience ‘flow’ where we lose track of time and any sense of self-consciousness.
  • Relationships – working out which people have a positive impact on you and doing what you can to develop and deepen these relationships – getting in touch with friends, finding new opportunities to make friends such as joining groups with shared interests, really investing in these relationships.
  • Meaning – engaging in activities that connect to what you really give value to in life. This will again be highly individual but might include doing something that fits with your political or ethical or spiritual commitments – often something that makes a valuable contribution to the lives of others.
  • Accomplishments – finding ways to reflect on and celebrate your achievements, especially those ‘small wins’ that can so often go unnoticed.

If you are or if you care about someone with diabetes, take some time to think how you might put PERMA into practice – sometimes the smallest change can make a big difference.

One thing COVID taught us is that wellbeing is a collective achievement, determined by multiple influences at every level. From decisions made in Whitehall, to the ways health services (including but not solely the NHS) are organised, to how physical health problems are spoken about, to the material circumstances of people’s lives and the relationships they have with those around them.

Living well with diabetes is a collective effort too.

On this World Diabetes Day, whatever your connection to diabetes, I invite you to consider what contribution you might be able to make to the wellbeing of people living with this condition.

Further reading:

If you are interested in further reading and insights as to the importance of psychologically informed diabetes care, please read ‘Why should we have diabetes psychologists in the multidisciplinary team?’. The article was published in the Journal of Diabetes Nursing, by Dorothy Frizelle Consultant Clinical Psychologist and Head of Service, Mid Yorkshire Hospitals NHS Teaching Trust, and Executive Director, UK Association of Clinical Psychologist. There’s also a presentation on the Partnership website.