Chronic Illness: A Four-Phase Journey to a New Life: Move from Surviving to Thriving in the New Year
By Mary J. Yerkes
NABBW’s Living With Chronic Illness Expert

This year, instead of promising to lose weight again, resolve to discover your new, authentic self. One of the most difficult challenges facing the chronically ill is the loss of identity they often feel. Things they once did with ease, they can no longer do. Over time, the reality settles in —the person they once were is gone. There is no going back.

Now what?

It’s true that your chronic illness severely affects every area of your life and creates loss for you and those you love. But that’s not the end of the story. You can transform your illness experience if you understand the phases that people with chronic illness go through and learn how to move through them.

Patricia Fennell, MSW, CSW-R, author of the excellent book The Chronic Illness Workbook: Strategies and Solutions for Taking Back Your Life, and internationally recognized expert on chronic illness, developed the Fennell Four-Phase Model of chronic illness, which I use with my coaching clients.

What follows is an introduction to the four phases identified by Fennell and suggestions for coaching yourself through each. I highly recommend purchasing the book and working through the material on your own or with a life coach.

Which phase do you find yourself in?

The Fennell Four-Phase Model

Phase 1, Crisis

According to Fennell, this phase occurs as you move from the actual onset of your illness to an emergency period, when your world feels turned upside down. In addition to troubling physical symptoms, you are feeling fear, confusion, grief, anger, and more. Your task in phase one is to contain the crisis.

Self-Coaching: To determine what issues you need to address in this phase and steps you need to take to contain the crisis, consider the questions below:

  1. How do I build a support team to support the physical, emotional, relational, and spiritual challenges I’m facing. Who needs to be on that team?
  2. What is my activity threshold right now? What needs to go in my schedule, so I can focus on what’s most important—my health?
  3. What are my responsibilities and others’ expectations of me? What difficult conversation do I need to have to set appropriate boundaries for myself so I can contain the crisis?

Phase 2, Stabilization

In this phase, your symptoms plateau and you find a way to return to the old you. Attempts to revert to old ways of behaving before you got sick leads to relapse and frustration. Your task in phase two is to begin to stabilize and restructure your life.

Self-Coaching: Answer the questions below to determine what tasks you need to address:

  1. What daily and weekly activities do I need to integrate into my life so I can live a fulfilling, significant life?
  2. What emotional issues related to my illness and past traumas must I address to free up emotional energy? Do I need to see a therapist for help working through these issues?
  3. What are my values? Are they values I believe in or are they things others expect me to value? How can I restructure my life around my values.

Phase 3, Resolution

By phase three, you’ve begun to recognize you can’t be the person you once were. This can be devastating and lead to a “dark night of the soul.” Your goal in phase three is to develop a new, authentic self and to rebuild a meaningful life.

Self-Coaching: Answer these questions to determine your next steps:

  1. Is the mourning for my lost self complete so I can move forward, or do I need more time or outside help to facilitate this process?
  2. What activities and interests brought joy to my heart as a child? Which of these activities do I want to explore and develop?
  3. Am I still able to work? If so, what type of employment is reasonable given my physical and emotional challenges? Do I need to change careers? Work part-time?

Phase 4, Integration

By now, you’re able to integrate parts of your old self from before the illness to who you are now. The goal in this phase is to continue to find ways to express the “new you,” to participate in meaningful and significant work or activity, and to place your illness experiences within a larger spiritual framework. Your goal is to continue to chart a course for the future and build a life in which illness is only a part.

Self-Coaching: Answer these questions for insight as to what you need to attend to in this phase:

  1. How do I deepen the work I’ve done in phase three.
  2. What creative and spiritual activities can I pursue for meaning development?
  3. How can I avoid isolation and expand my social horizons. What needs to go to enable me to do so?

Sadly, many clients I work with in coaching have been stuck for years, continually going back and forth between phases one and two. If this sounds like you, don’t let the cycle continue one more day. Get some outside help, whether in the form of a book, therapy, or by working with life coach.

It is possible, albeit difficult, to rebuild a rich and significant life. You were made for purposeful living not just “surviving.” Don’t settle for less.

This year, resolve to discover the new you!

Mary J. Yerkes is a professional life coach who provides transformational coaching to the chronically ill, women in leadership, and new and aspiring non-fiction writers. She helps motivated individuals, groups, and organizations find their purpose and live their passion. With more than 25 years’ experience in the corporate world and church leadership, Mary launched her writing, speaking, and coaching career after being diagnosed with multiple chronic illnesses, including rheumatoid arthritis and ankylosing spondylitis. She is passionate about helping others from all walks of life live life to the full. She is currently working on a book, When Life Hurts: Ten Transforming Choices Every Woman Can Make. Mary is a member of the Christian Coaches Network, the International Coach Federation, and the International Association of Business Communicators, as well as other professional networks. You can visit Mary online at and