Adapting to Limitations: When Illness Messes with Your Promises

March 24, 2016

by Joan Friedlander

Correctly, or not, our trust in and our reliance on others – and ourselves – is built on promises. It’s deemed “good” to do what you said you would when you said you would do it, and bad when you don’t. This training starts early on in life, long before you’re fully developed, and it goes in deep. So what happens when illness – yours or the others you care for – makes it difficult to promise or commit to anything, especially things you really care about? In my experience, this is one of the more socially stressful aspects of living with active disease.

Natalia, who suffered for years with severe endometriosis, and continues to deal with immune sensitivities, summarized the dilemma perfectly:

“To plan activities or not? I feel so awful when I have to cancel. I planned, then had to cancel a family movie night because I felt ill. Now I’d like to play music for a Hay House conference, but I’m afraid to sign up for it and then have to cancel.”

She went on to say, “My problems are stress sensitive, so anticipation of a performance can be aggravating to my symptoms, but my doctor said after talking to me, that my biggest stress seems to be not making music! It’s hard to balance, very hard.”

When Anxiety Attacks

What if you’re like Natalia, you really want to do something but are afraid that you won’t be able to? First, you have to deal with your own feelings about being at the affect of something that is basically out of your control. After all, your body is just doing its thing. You don’t like it, others might not like it, but it is a fact of your life.

Who Are You Really Worried About?

Who are you most worried about disappointing, or being criticized by? Is it your boss, your teacher, your parents, friends, who? Regarding your list, whether just one person or an entire group, can you pinpoint the exact nature of your fear? Is it financial, the fear of rejection, of being judged, or something else?

Why Are You Worried?

Do you feel ashamed? Has anyone in your life expressed a lack of trust in you? Have you been told that you are making it all up, that you’re just being a whiny baby, something like that? Do you carry a false sense of pride that you are Mr. or Ms. Reliable?

What about body shame? We live in a world that prizes health and applauds accomplishment. I remember when a friend implied that I could control what was happening to me. I was so ashamed of what was actually going on in my body, that it was easier to just keep quiet and say nothing.

Brainstorming Options

Once you have identified the nature of the fear underlying the “promise dilemma,” you’ve got something tangible to work with, making it possible to brainstorm options. Natalia identified 3 concerns:

1) anxiety associated with pre-performance stress

2) applying to be a part of something she really cared about, being accepted and then not being able to make it

3) her own disappointment should she not be able to make it.

My questions for her included the following.

  • Is it important enough to you to apply, knowing they might actually accept you?
  • Can you ask someone to help you out that day so that the physical burden is shared?
  • Are there ways to make yourself more comfortable before and during the event so that your body is more relaxed?
  • Who needs to know about contingencies, if anyone?



Let’s say you’ve gotten yourself sorted out. You have identified your concerns and come up with some options in case something goes awry. But, what do you actually say, either before committing or on the day of the event if you find yourself in a flare and unable to make it?

I suggest starting with the truth, as much or as little as you feel needs to be shared. Other than having to face down your fear of what other people will think, sharing the truth about your situation can go a long way towards reducing your own stress! Furthermore, when you are forthcoming, the person on the other end usually appreciates it. It allows them to make an informed decision as well. And, if they give you grief, it might be a strong indicator that would be healthier for you to opt out.

When all is said and done, you are your body’s best ally, or you will be as soon as you figure out how all of this is going to work for you. Through trial and error, and over time, you can learn how to deal with uncertainty, when it’s OK to promise and when it’s not, and how best to talk about it. Trust yourself.

I’d love to hear from you. What questions, solutions or concerns do you have about making and keeping promises in the face of uncertainty around your condition? You can write to me privately (joan at businessfrombed dot come) or post something for discussion.



joan-grey4-headshot-smlJoan Friedlander is the author of “Business from Bed” and co-author of “Women, Work, and Autoimmune Illness.” She is an expert in working and living with chronic or serious illness. Through her books, workbooks and coaching, she helps people restructure their career or business in the wake of a serious health setback. For more tips from Joan, visit

I remember getting in trouble for arriving home 10 minutes later than my parents wanted me to. I carried the fear of being late with me well into adulthood, always giving myself more than enough time to get somewhere, often arriving early. I can still hear my mind babbling in my head if I think I’ll be late, but now I see if for what it is, and I am far less compulsive about it.

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