Core Assumptions About Illness

When a person is diagnosed or is struggling with an ongoing illness, how the family adapts, manages and copes with that family member and the illness, arises from core beliefs based on generational perceptions, values and explanations for illness.  Within the family culture, any illness and healing process represents two sets of core beliefs: 1) beliefs of the family members; 2) beliefs of the ill patient.

Most people have rather firm convictions and beliefs as to why disease occurs as well as why one person is afflicted and another is not.  Even though science may provide the intellectual explanation of the disease process, core beliefs including values and spiritual matters typically arise to provide another level of explanation, justification or rationale regarding the disease.

Within the family, explanations for the illness may include spiritual beliefs such as judgment (God is punishing), hope (prayers for healing) and acceptance (it’s God’s will, meditation and mindfulness).  In some families, there is a core belief that illness is shameful. For the ill family member, this may results in feelings of guilt, resentment and despair.  Another approach in some families is that of denial, in which members of the family willingly deny (frequently out of fear) the diagnosed member expression of his experience, his fears or procedures undertaken.   Family beliefs may also be based on scientific studies and understanding (he should have taken better care of himself) or psychological reasoning (she gets so stressed out it’s no wonder she got the disease).

In addition to one’s family influenced beliefs, individual core beliefs also come to the fore when illness enters a family member’s life. Individual core beliefs may be based on ethnic and cultural belief systems as well as familial systems.  We tend to turn to personal core beliefs in times of crisis, struggle, difficulty, uncertainty. For example, an adult daughter may think:  “My father is very ill;” “good daughters care for their ill parents”

Researchers have found that core beliefs about the meaning of one’s own diagnosis of illness vary a great deal across diseases and even within one disease.  For example, the person diagnosed with diabetes may think that it is simply a disease that is caused by too much sugar in one’s diet and as an opportunity to make some positive changes; another person, diagnosed with diabetes, may immediately catastrophize and think of the worst possible outcome (I’m going to die; God is punishing me). Researchers are beginning to realize that these individual core beliefs about one’s illness may more accurately predict adherence and long term self care surrounding the diagnosis.