Thriving with heart disease may require that you learn new ways of coping. To do so, you must first identify your personality-based coping habits. Next, honestly note whether your coping habits are actually helping or interfering with your ability to make healthy choices.
A practical and sensible way to understand personality and coping patterns come from the field of transactional analysis. This theory proposes that coping patterns revolve around one or more of the following six themes. These patterns become so familiar and habitual that they seem to drive our ways of thinking, feeling, and behaving, especially during times of stress.
As you read on, try to identify your own (and, perhaps, your loved ones’) typical styles of coping and reacting to stress. Note that there are certain positive and negative consequences that come with each coping pattern.

1. Being Strong. You know you have this “driver” if you were taught to be tough and to shoulder problems without complaining. When afraid, you are likely to go numb and pay attention to powerful feelings, such as anger. And you are likely to cope with illness by remaining quiet about your fears and worries. You might even deny that you have any concerns.
The Pitfall of This Coping Pattern: You probably have difficulty asking for the help and support you need.
You know you’re trying too hard to Be Strong when…
-You find yourself often feeling numb, lonely, angry and sad.
-You quietly long for more support than you ask for.
-You may feel depressed, convinced that no one cares for you.

2. Being Perfect. Anxiety and guilt fill the lives of people who are stuck in efforts to be perfect, because there are no perfect people! When faced with the fears that come with heart disease, you are likely to cling to the belief that, if you can just follow your plan for rehabilitating perfectly enough, your anxiety will go away.
The Pitfall of This Coping Pattern: You are guaranteed to feel that you have failed. The less perfect you are, the more guilt and anxiety you feel, and these feelings are likely to lead to excessive worry (obsessing).
You know you are being perfectionistic if…
-You are worrying too much about small details.
-Your all-or-nothing thinking keeps you from doing small things that can make big differences over time.
-You seldom feel like you have done well enough or made good enough progress.

3. Trying Hard. If you learned to be soothed by trying harder than the next guy, you may feel anxious if you pace yourself, and guilty if you try to relax and play. The more anxious you feel, the harder you work. People with this coping script tend to overdo,and they confuse feeling exhausted as indicating that they have had a good day.
The Pitfall of This Coping Pattern: You never quite reach the point of feeling “I”ve done enough for now; time to relax.”
You know you’re stuck in Trying Hard if…
-You find yourself feeling exhausted, stressed, depressed and without joy in your life, no matter how hard you try to do the right things.
-You are having difficulty pacing yourself as you go through rehabilitation
-You lock into a “wait-until” mentality, always putting off feeling good about how you are doing until you achieve just one more goal.
-Your attitude seems to be: “When rehabilitation is over, I’ll get on with enjoying my life.”

4. Pleasing Others. These are the folks who feel that they were put on earth to take care of others. If you are scripted to please others, you probably have difficulty taking appropriate care of yourself, especially if doing so means that you must say no to a loved one. Heart disease (your own or that of a loved one) is likely to stir your need to take care of others by staying quiet about your own needs.
The Pitfall of This Coping Pattern: Because you are so busy focusing on what others want,you may find it difficult to identify what you really think, feel, need , or want.
You know you are stuck in Pleasing Others if…
- You have difficulty saying no without feeling guilty.
-You feel martyred or taken advantage of.
-The only time you can say no is when you are depressed or sick. Then, you withdraw from others but feel guilty about doing so.
-You stay stuck in feeling guilty--- about having heart disease (if you are the patient)or "allowing" a loved one to get sick (if you are a care giver).
-Your fear of disappointing your loved ones or medical providers leads you to downplay your worries or your symptoms.

5. Hurrying. “Whoever gets there first wins” seems to be the motto of people driven by a Hurrying script. These are the people who were taught to rush through life. If you are driven by a Hurrying message, you have probably grown accustomed to an internal sense of urgency.
The Pitfall of This Coping Pattern: When you slow down, you may feel discomfort and anxiety, rather than relaxed.
You know are stuck in Hurrying when…
-You find yourself constantly frustrated, agitated, or anxious about the slow pace of rehabilitation.
-Your efforts to hurry through rehab only leaves you feeling frazzled.
-Frustrated with the slow pace of recovery, you may start to shop for a “quick cure” or to overdo your efforts to heal.
-You may overwhelm yourself by trying to change too many things at once, rather than pacing your recovery.

6. Being Careful. Here, you learn to fear change. It’s as though you were taught, “When change hits, freeze!” Such fears may paralyze you with anxiety and prevent you from learning that you can, indeed, thrive in the new normal that came when heart disease entered your life.
The Pitfall of This Coping Pattern: If your worrying leaves you frozen in fear, and you become a spectator in your life, you will lose your joy. You may even drift into depression that comes from feeling helpless.
You know you’re stuck in Being Careful if….
-You are “freezing” rather than exploring your new life territory
-Anxiety that comes from what-if thinking keeps you from adjusting
Examples: “What if this doesn’t improve.” “What if my family gets frustrated with me.” “What if my doctor has bad news?”

All of us use each of these coping patterns sometimes, and each pattern is sometimes helpful But getting stuck in an extreme version of any of these patterns will work against your thriving.

For more information on transactional analysis, see I. Stewart and V. Joines, TA Today. Nottingham, England: Lifespace Publishing, 1987.

This article was adapted from information presented more fully in Thriving With Heart Disease, by W. Sotile with R Cantor-Cook. New York: The Free Press, 2003. Copyright W. Sotile, 2003. All rights reserved.

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