The doctor raised her head from my 5 page, 10 point, double-sided health history. It was sitting atop 44 pages of dated, labeled, and highlighted lab results from the last seven years. She raised an eyebrow. "You must be an older sibling," she said, a sardonic smile tugging at her mouth.
"Oh, um no." I said, embarrassed despite myself. Embarrassed for so obviously being one of those patients. A googler. A but-what-about-bartonella, I'm-going-to-have-to-get-that-compounded, big old pain in the ass.
Her eyes narrowed. "Huh, an oldest girl then."
"Well, I've got an older sister actually." Apologetic smile while wanting to shout, excuse me for being organized and proactive about my own damn health! But also needing this doctor to want to help me. So.
She gave a little snort of exasperation, shuffling the lab results on her desk. Which is about when it began to dawn on me that I just might be an overfunctioner.
If you haven't come across this concept of over and under-functioning, I've found it a really helpful way for understanding relationship dynamics and my own reaction to stress. I first heard about the idea in the work of Brene Brown and Harriet Learner. The basics are that optimal functioning means taking on 100% of responsibility for one's own life and obligations. When we face stress however, most of us either habitually grab for control of more than our allotted 100% (over-function) or habitually pull back and take on less than our 100% (under-function).
Those of us who over-function often try to "fix" other people's problems (I'll be taking my 100% and your 20%, thank you). For me, this "fixing" impulse is most intense when my own problems are too overwhelming, and when I'm not dealing with my fear and sadness in healthy ways. In families, older siblings and eldest girls tend to be over-functioners while younger siblings are more typically under-functioners. In our culture, more women are over-functioners than men (nagging wife cliche, anybody?). Over-functioning can look bossy and controling. Under-functioning can look irresponsible and unambitious. Unchecked over-functioners and under-functioners in relationship essentially enable each other's stress response, often drive each other nuts, and commonly (if subconsciously) seek each other out. Here's a great overview of under and over-functioning if you want more details: http://www.willmeekphd.com/overfunctioning-underfunctioning/
After the appointment, I mulled this over-functioning insight over on my long drive home. Since reading about the concept a few years back, I've always assumed I was an under-functioner because I'm the younger sister, and I even fit some of the typical characteristics - I've been underemployed often, I frequently need financial help, and I'm the kid my family worries about. So, (I mulled) am I an under-functioner who just over-functions regarding my health because, well, what other choice do I have? Roll over and let modern medicine shuffle me off to hypochondriac corner? Sit tight and watch my life grind to a halt while they forget to run my labs, again?
On the other hand, over-functioning is a response to stress, and navigating the medical system with chronic illness is a pretty blatant stressor. My natural instinct is to stay up half the night googling, then call the clinic once an hour until they prescribe me this medication without added fructose (I don't, because every 2 hours is more polite). My impulse is to try the weird diet, and the biofeedback, and all seven of the supplements I just read about online, starting right now (I don't, primarily because I'm way too tired). If it walks like an over-functioner, swims like an over-functioner, and quacks like an over-functioner...
It slowly dawned on me that over-functioning is a pretty foundational characteristic in all departments of my life. Relationship patterns - wow hello. That 22 page agenda I wrote last week for the community meeting? Huh. My exercise regimen back when I could exercise - phew. I've always used over-achieving and white-knuckled control as armor against my stressful emotions. Seeing my behavior patterns in the light of this common stress response helped me feel less unfathomable and ornery, more forgivable and human.
Of course, I'm not the only one around here breaking the sibling-order guidelines. Every person - and at least 2/3rds of the dogs - in my immediate family is a die hard over-functioner. And I have a feeling you just may be too.
Chronic fatigue, fibro, autoimmune, and other related illnesses affect millions of people around the world, and they affect people across pretty much every demographic. I have no doubt there are under-functioners out there who are ill with these conditions, but there's no ignoring a pattern here. Most of us with one of these chronic, misunderstood illnesses had an over-achieving, perfectionist, type-a personality before we were taken ill. And a large percentage of us were competitive athletes.
I haven't tracked down any data to back these statements up (what, no good data on patients with chronic illness?), but I have talked to a lot of people with chronic illness and a lot of professionals who work with the chronically ill every day. There's a glaringly obvious trend: those of us over-achieving, over-working, over-functioners? We're predisposed.
Because our systems were made vulnerable by a higher baseline of stress? Because when we first got ill we didn't listen to our bodies and rest appropriately? Might there be a genetic link between personality and immunity? Someday science might tell us why. In the meantime, how do we transform this default stress response so we’re not slowing down our own recovery by draining already exhausted resources?
Challenges like chronic illness are not only stressful, they also take away our sense of control over our own lives. They knock our coping strategies (exercise, overwork, perfectionism) right out from under us, leaving us face to face with the shadows and emotions and traumas we were much more comfortable burying under constant activity. Life took away our protective shell right at the moment it handed us a whole lot more pain to protect ourselves from. In my case, and maybe yours too, that painful paradox amplifies my compulsion to over-function.
My new goal is this - can I start tuning into my coping strategies and catching myself when I'm over-functioning? I know over-functioning has damaged my relationships, and I know it's adding stress to my already very full plate of stress. Can I strive to take 100% responsibility, not 150%, not 120%? To let go of the responsibility I've claimed for other people's problems, and hardest of all, to LET GO of the responsibility I've shouldered for the parts of my own life that are outside my control?
I would love to hear your thoughts about this in the comments.
You are strong. You are beautiful. You are worth it.