Posted by Summer Katz, MA, LMHC, Patient Advocate
About one year ago (in March 2019) the movie Five Feet Apart was released. At the time, I noticed that the cystic fibrosis community was standing very strongly on both sides of the fence about this newest CF blockbuster. Personally, I decided to go see it because I was hopeful that the movie would represent at least a piece of living life with CF, whilst spreading awareness to a wider audience with movie-going audiences.
For those who have not yet heard about it, or are undecided about seeing it, this blog will analyze a piece of the movie’s plot and a metaphor it appears to present of our own self-esteem, self-image, and any fears creating insecurities or confidence conflicts.
The story is about a few teenagers and young adults with cystic fibrosis who are in the hospital at the same time. The characters attempt to navigate relationships and connections around the parameters of our CF guidelines. One of the characters is clearly on top of her regimen of following the rules about keeping six feet apart at all times from other CF patients, while another character seems rebellious and angry now that his treatment options are limited, recently being diagnosed with B. cepacia.
Attempting to avoid any other spoilers here, I will simply highlight a scene in which two of the characters keep a distance between each other, but essentially disrobe down to their underwear. I found this particular scene to offer pretty good authenticity and acknowledgment of some of the physical and emotional experiences of life with CF. With no words being spoken and music playing during the scene, it seemed to allow the varying audience members to interpret their own relevance behind the interaction.
I took from it a very real fear that many of us with cystic fibrosis, who have numerous scars and even medical devices on our bodies, can easily be deterred by our own perception of how physically attractive or desirable we can be. Granted, these scars and devices are completely out of our control, and our genuine partners ideally will be completely accepting of that. But, there is something to be said for what goes on in our own minds, comparing our physical appearance with that of our healthy counterparts.
How does this internal comparison impact our ability to be completely open and vulnerable, intimately or even sexually with our physically scar-free/device-free partner? There are many scenarios in which the concept of perceived physical attraction could be explored, but for the sake of this blog, let’s discuss (1) dating and (2) being in a committed relationship.
You can find a number of resources on how to disclose your diagnosis to your partner (including in one of my previous blogs). However, let’s assume that you have already shared your CF diagnosis and treatment regimen openly, and you have been taking steps to hide this scarred piece of your body from your partner.
Now for some psychology-based education… We tend to navigate relationships based on our attachment styles (Bowlby, Ainsworth). Sometimes our insecurities are triggered or even become escalated based on these attachment styles; secure, anxious/ambivalent and avoidant (there are a number of links in the resources section that offer further exploration on attachment concepts and topics).
As a licensed mental health counselor, I encourage my clients to step to the side of over-focusing on blame of what their partner is doing or not doing and shift their focus inward – We truly can only control (to a degree) ourselves; our thoughts, our behaviors, our responses to those fear-based triggers. I also understand that, with CF, not having control over much of what happens in or to our bodies, we often experience and even express fear that the undesirable or unwanted outcome will only get worse and prevent us from living our best lives.
The below list includes tips on reducing the impact of the triggers to anxiety or fear-based response to these insecurities:
- Determine the source of your anxiety. Understand that anxiety comes from the fight-or-flight mechanism in the brain, and it provides a normal protective survival instinct. The primary difference is that the body does not know the difference whether we are in physical danger or if the anxiety comes from cognitive and emotional distress.
- Stop catastrophizing (thinking worst-case scenario). Engaging in paranoia rarely offers you benefit when the distress you are experiencing is primarily coming from what you are thinking and how you are feeling (emotionally). Alternately, consider the opposite: thinking better, if not best-case scenario just may help your desire to feel better about yourself and your dating interactions or intimate relationship.
- Highlight your strengths. Recognize your qualities, emphasize them and revel in all that you define as good about you!
- Stop comparing yourself. You have value. Practice ‘affirmative thinking’ (Beckwith).
- Participate in trust with self compassion and kindness. Consider the opposite of fear, which is actually trust; trust of yourself, your partner, and the overall commitment of your dating intentions OR trust in your relationship. Allow yourself to be open and vulnerable, alongside the important consideration that when people show you who they really are – believe them.
- Reach out to a trusted friend or professional for support. You don’t have to harbor your thoughts and feelings alone. Take advantage of others in your life for the purposes of venting, processing, and exploring healthy ways to navigate your life experiences.
Lastly, I want to reference below two amazing media campaigns that encourage ‘embracing our beauty’ no matter what we look like! We are human beings, and therefore we are allowed the space to be aware of our flaws and imperfections. I believe that the goal is simply to not over-focus or stay stuck on describing our flaws as undesirable or unwanted. I would like to remind you of the benefits of incorporating giving yourself permission, just as much as you are giving yourself credit.
With that, let’s make an effort to acknowledge the fact that, as human beings, we are relationship-oriented creatures. We are going to pursue, develop, and certainly work to maintain our relationships. So, let’s be careful getting too caught up in the fears inside of our own minds and consider the possibility that our partner can be that external support, approval and acceptance that we are hoping for in the first place.
These two campaigns are great reminders of the concept that we need to work on improving our own positive internal dialogue, which may in-turn also benefit our self-esteem and confidence.
The Salty Life: The Salty Life is an awareness campaign and magazine that features raw and inspirational stories of CF in real life.
The Dove Campaign: The Dove Self-Esteem Project centers on a vision of a world where beauty is a source of confidence, not anxiety. Dove’s mission is to ensure the next generations grow up enjoying a positive relationship with the way they look.
Summer Katz, M.A., LMHC
Licensed Mental Health Counselor
Cystic Fibrosis Pharmacy Patient Advocate
*Disclaimer: This blog is provided for informational purposes only (including brief topic exploration or reflection) and should not be used as a substitute for professional mental health or medical treatment. **All listed resources have been identified for supplemental reading only, and the Cystic Fibrosis Pharmacy nor Summer Katz, M.A., LMHC is neither affiliated nor endorsing the aforementioned published material.