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  • Katie Willard Virant MSW, JD, LCSW

Chronic Illness: Coping With Dependence and Self-Acceptance

With support, it is possible to grow after loss.

Chronic Illness: Coping With Dependence and Self-Acceptance
  • Painful feelings about chronic illness dependence can adversely affect mental health.

  • Acknowledging the guilt and shame of chronic illness dependence can help soften painful emotions.

  • Communicating with caregivers about painful feelings surrounding dependence is essential.

Pain and fatigue can affect energy levels, cognitive sharpness, and physical mobility.

Living with chronic illness involves grieving for the life one is expected to lead. This grief encompasses the experience of relying on others for care that, if one were not ill, one would be able to provide for oneself.

Our culture prizes independence. It feels good to do things for ourselves. But it’s important to recognize that there are many areas in which we also normalize and approve of dependence.

Dependence and Self-Acceptance In Person Appointment

As a society, for example, we depend upon public entities. When our house is on fire, we call the fire department, rather than fight the fire by ourselves. When we have to drive in a snowstorm, we don’t grab a shovel; rather, we rely on city plows to keep the roads we share safe.

Similarly, in family units, we share resources and labor. Grocery shopping and meal preparation typically are done for the family as a whole. Financial planning involves shared decision-making and pooling of money. There are many ways that we are not independent, and we look upon this as a positive.

Chronic illness dependence differs from the examples cited above because it goes against what we believe to be “normal.” So, it’s not dependence per se that is frowned upon, its dependence that we believe to be socially unacceptable.

Chronic illness dependence is correlated with depression, anxiety, withdrawal, and hopelessness (Williams, et al., 2016). Guilt about requiring assistance and shame of feeling like a burden to others are common emotional experiences cited by people living with chronic illness (Williams, et al., 2016).

How can we work with the difficult feelings associated with chronic illness dependence? Acknowledgement of difficult feelings, strong communication with caregivers, and improving self-worth are three important ways to make dependence less fraught.

Dependence and Self-Acceptance In Person Appointment

Dependence and Self-Acceptance Virtual Appointment

Acknowledgement of painful feelings

Guilt and shame are difficult to acknowledge, even to oneself. Anger, depression, and anxiety often mask guilt, shame, and loss. If you’re feeling angry, depressed, or anxious about dependence issues, see if you can dig underneath these emotional reactions and find the roots of guilt and shame.

  • “I hate the needy, dependent person I have become due to my illness.”

  • “I am a burden to my family; I ruined their lives when I became ill.”

These are painful—and common—beliefs. It’s important to bring them into the light so that you can work with them. Ask yourself:

  • Am I holding myself to a different standard than I hold others to?

  • If my spouse, friend, sibling, child, etc., were in my shoes, what would I feel toward them?

  • Am I blaming myself for a situation that I didn’t choose and that is beyond my control?

Communication with caregivers

Sharing your vulnerability with caregivers and being open to hearing their vulnerabilities can increase feelings of agency and power. Sharing how dependence makes you feel allows you to be seen and understood as a person, rather than as an object of care.

Being curious about how your illness dependence affects your caregiver allows you to give them the gift of understanding as well (Catchpole & Garip, 2019). Illness dependence becomes a “we” issue to be faced together. Both the ill person and the caregiver are viewed as having needs, and the goal becomes how to meet those needs as generously as possible using problem-solving coping (Bigda-Peyton, 2019).

Dependence and Self-Acceptance Appointment

If one person is meeting your caregiving needs, process with them how it would feel for both of you to spread out caregiving responsibilities. Are there other family members, friends, or social services that can step in? Decreasing dependence on one person can provide much-needed space for both the primary carer and the recipient of care.

Improving self-worth

When dependence increases, life changes. The roles once played are altered, shattering one’s sense of self-worth.

Who am I if I can’t work, cook for my family, dress myself, go out, and socialize? Who am I with this illness?

This painful question is necessary, but the hurt it calls up often causes people to turn away, rather than toward it.

  • Who can you be with these new limitations?

  • What can you do?

  • How can you contribute?

  • What can you offer?

Stay tuned to these questions, looking for new ways to feel valuable. Grieving your old roles is important; so is finding a way to grow into new roles.

Dependence and Self-Acceptance Appointment


Chronic illness dependence is challenging, provoking feelings of loss and grief. Meeting this challenge with acknowledgment of painful feelings, communication with caregivers, and attention to self-worth can allow growth after loss.

Katie Willard Virant, MSW, JD, LCSW, - Website -


Bigda-Peyton, F. (2019). Can't live with you, can't live without you: Working with a primitive, hostile, dependent couple. Modern Psychoanalysis, 43(2): 33-48.

Catchpole, S. & Garip, G. (2019). Acceptance and identity change: An interpretive phenomenological analysis of carers' experiences in myalgic encephalopathy/chronic fatigue syndrome. Journal of Health Psychology, 26(5).

Williams, A.M., Christopher, G. & Jenkinson, E. (2016). The psychological impact of dependency in adults with chronic fatigue syndrome/myalgic encephalomyelitis: A qualitative exploration. Journal of Health Psychology, 24(2): 1-12.


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