"I Am Not a Slave to My Illness"

Around 40 percent of people in Germany are affected by chronic disease – an increasing trend that includes conditions such as asthma, rheumatism, diabetes, and mental illnesses. In most cases, those affected simply cannot carry on as before; they have to make changes in their life. They can find out how to make these changes successful as part of the INSEA self-management program.

Alexandra Wolters | May 2017
Photos: Lennart Helal

"There’s no way I’m just going to drop everything. I might as well just kick the bucket a few years earlier." When Thorolf Heber was diagnosed with a serious case of diabetes in 2014, the pensioner reacted stubbornly at first. When the doctor explained to him that if left untreated, diabetes could lead to kidney failure, a stroke, or blindness, he sat back down. Heber listened closely and ultimately realized that he had to change something: lose weight, get more exercise, check his blood sugar levels regularly, and inject himself with insulin. So that’s what the former chef did. Today, the 75-year-old weighs 20 kilograms less, eats and enjoys his meals mindfully, cycles a lot, and takes regular brisk walks through his hometown of Hannover.


Self-Management to Combat Despondency

His strong will, his family and friends, and the INSEA program for chronic diseases supported by the Robert Bosch Stiftung all helped Heber. Heber and his wife were invited to take part in an INSEA course by their health insurance provider in 2016. In the first hour, the two course instructors and the ten participants spoke a great deal about what problems their various conditions cause them – and about the vicious circle that many of them had found themselves in: they are in pain, sleep badly, are therefore always worn out, and can’t be active and cope with their day-to-day lives. That makes them despondent, leads to depressive moods, and often causes isolation.

"In many cases, it’s not necessarily the chronic disease itself that is the problem, but all these symptoms that it triggers and intensifies," explains Gabriele Seidel, who leads the coordination of INSEA at the Hannover Medical School. Most people find it very difficult to get out of this vicious circle on their own.

And that’s where the INSEA program comes in, offering these chronically ill people the self-management tools they need to deal with as many everyday situations as possible. The participants learn about, for example, the power of positive thinking, which can be used to alleviate pain. They also find out how important it is to look after themselves and to formulate clear I-messages to communicate to others. They get tips about healthy eating and learn simple movement and relaxation exercises.


A Course That Appeals

"It’s not for me, I don’t need it," summed up Thorolf Heber after his first session. "I’m active, I’ve successfully changed my diet, and I don’t feel like I’m in a vicious circle," said the amateur dancer, who enjoys twirling around the dance floor to rock ’n’ roll. He only went to the second session to cancel his registration for the course, but ended up staying for the whole six weeks.

"I asked myself what would happen if my life was thrown out of balance again. I figured it wouldn’t hurt to know a few self-help tips." Furthermore, the goals that all the participants and instructors set each week appealed to him. This central component of the INSEA courses should teach the patients to assess themselves, set realistic goals, and achieve these in small steps.

Clear, Self-Set Goals

Fifteen minutes of exercise each day, only three cigarettes per day, walking four kilometers twice a week, going to bed before midnight three times a week, drinking at least one and a half liters of water every day. The goals can be very different. Thorolf Heber set himself the target of working on his model ship for at least one hour each day, and failed in the first week. "That was too ambitious." So the amateur model maker reduced his task to three days per week – with success. In the last session, the pensioner was able to proudly show off photos of his finished barque. "It’s a great feeling to be able to do that. It’s shown me once again that I’m not a slave to my illness."