Diabetes in Real LifePublication Exclusive

Power of the theater can enhance the provider–patient encounter

In this issue, Susan Weiner, MS, RDN, CDE, CDN, talks with performing artist and patient advocate Marina Tsaplina and clinical psychologist Kenneth Gorfinkle, PhD, about their work with The Betes Organization helping people with diabetes address the mental and emotional health aspects of their condition through theater and puppetry.

Susan Weiner

What were the unmet needs in diabetes care that led to the founding of The Betes Organization?

Gorfinkle and Tsaplina: First, much of diabetes care has been approached as a “mathematical” problem, leaving aside the subjective and varied experiences of each individual and their diabetes, that exist in unique personal, cultural and social contexts.

Second, the emotional and mental health components of diabetes have only recently come to the forefront. These issues are connected, and both are further exacerbated by the current state of the physician–patient encounter. The relationship between patient and health care provider has never been under as much stress as it is now. This hurts both clinicians, who want to take care of people and by so doing find meaning in their practice, and patients, who want to be heard and understood and, in the best circumstances, be healed. (How we define and understand “healing” and “cure” is a separate topic.)

We wanted to create unique and creative opportunities for both the clinician and the patient to process their experiences and bridge these gaps.

How does The Betes organization address these needs?

Gorfinkle: Through puppetry and metaphor, we narrate this lived experience of diabetes, offering meaning, validation and normalization so people can come away saying, “I’m not alone, and I can do this.” The dramatic process of tension and resolution helps produce catharsis and insight. Our aim is for our work to deepen the traditional doctor–patient encounter, which is a potent locus for healing, and bring dimensionality to the therapeutic setting.

Tsaplina: Art is a research practice. We listen to a broad base of patient and provider experiences through surveys and interviews, identifying the common narrative themes that unite their individual experiences, distilling them into evocative scenes using the art and tools of puppetry and theater. The power of puppetry has the ability to give form to the internal and invisible. How does shame reveal itself in a person’s sense of self and their diabetes? How does that affect self-care? The artist’s role is to inspire in each person a sense of their own humanity and possibility. We do this by focusing on areas of diabetes that are too often silenced.