Parenting Your Homebound College Student with Type 1 Diabetes: Empathy Above All


It was early August and we were making the final preparations to send our son with type 1 diabetes (T1D) off to college for the first time. Like so many parents, the newly purchased necessities like cozy bedding and fresh pillows were ready to be loaded for the car ride. Unlike most parents, the stockpiles of pump supplies, insulin, and juice boxes for lows were piled high and deep. My husband and I would have a two-hour window to get him moved in due to COVID-19 restrictions, and we had to plan for where our younger son would wait during this bittersweet process of seeing his brother off.

Jack, who was diagnosed with T1D at age 11, was headed to his dream school in his favorite U.S. city. Still, there was an undercurrent of trepidation that contained our enthusiasm. It felt surreal that a packed up car was going to pull out of the driveway in a few weeks while a pandemic was sweeping the nation. Jack knew this uncertainty first hand since his dad is an intensive care unit physician who had been on the front line treating people with COVID-19 since March. It turned out that Jack’s school elected for a virtual semester. Jack took the news better than we did because he expected it all along. Such is the resignation and resilience of kids with T1D; they have lived with levels of disappointment and daily adjustments since their diagnosis.

College did unfold here within the confines of our home and relationships commenced with new friends from all over the country via online learning. So did an internship in local government with long hours spent masked up for his and others’ protection. “Adulting” was starting and many new routines emerged, including a necessary shift in our parenting style.

Embarking on college for T1Ds, whether they were diagnosed as babies or at any other time in childhood or adolescence, signals a vulnerable time for parents who have kept a steadfast watch on their children’s tricky condition. No matter how independent your child is, it is daunting to think of them living away with no opportunity for you to respond to a low that they are sleeping through, or assist them with a pump change when they are tired and weary from a long day at school or work.

So, with tremendous guilt, I did utter a small sigh of relief when I learned that Jack’s milestone leave-taking would be delayed for a while. However, as both a mindful parent and a psychotherapist, I knew that perspective-taking and empathy would be essential in my response to Jack’s disappointment. If I stayed stuck in the comfort zone of my old routines and behaviors, thus clinging to my relief, I would be invalidating Jack’s feelings, potentially alienating him from me, and thwarting his self-actualization. What I did not realize is that I would be short-circuiting my own development as a parent.

This was a golden opportunity to shift our entire family into a new configuration of having an adult child in our constellation and this required a new rule book. Early on, we fell back on familiar parental scripts with admonitions about staying up too late or eating certain foods too close to bedtime when blood sugars are likely to fluctuate harshly disturbing his sleep. None of this landed well for Jack who was trying to adjust to college and an internship while processing his disappointment over not being on campus. Truly, we were adding insult to injury, so something had to give.

I kept being reminded of one of my brilliant grad school professors at the University of Pennsylvania, Dr. Sharon Ravitch, and her writings at the beginning of the pandemic. “Flux pedagogy” was her trauma-informed characterization of how to thrive amid constant, and often frightening levels of change and threats. Dr. Ravitch applied this to teaching and learning, but I borrowed from it heavily in terms of my parenting. Taking an “inquiry stance” as she said, would allow me to back off of my usual burdensome need for control. As Ravitch emphatically suggests,

“Now more than ever, it’s important to situate yourself as a learner, to examine yourself and your practice through a reflexive lens that helps you to engage, understand, and relate with others through your own curious humility about yourself and your ever-changing practice.”

Being a learner permitted me to focus less on the alleviation of my insecurities about sending Jack away soon with his diabetes, and more on his perspective on his world. I could enhance his life by intentionally giving him the space to be an adult, or I could make his world smaller and more claustrophobic by my hovering with constant focus on his glucose monitor readings, among other things. If I did the latter, I would be thwarting so many wonderful aspects of Jack’s transition into adulthood such as self-efficacy, problem-solving, and autonomy. During an already stressful time with COVID-19, letting Jack succeed on his own would only make his goal attainment more satisfying as well as grit-promoting for his future endeavors.

So, I bit my tongue when I saw the light on at 2:00 am. My guiding principle would be to ask myself, what would he be doing in college right now? He certainly would not want to be answering an annoying or intrusive phone call from his parents. I remain very careful not to show sympathy to Jack which can come off as condescending or to voice to him any platitudinous hidden benefits of him being home. In this vein, author and researcher Brené Brown cautions us that when we impose our “at least” statements or “silver linings” on others we distance ourselves rather than build connections through authentic empathy. If there are any upsides to Jack being at home now for college, I have left them for him to discover on his own.

The result of my flux pedagogy parenting mindset has let me bear joyful witness to Jack’s management of his T1D as well and independently as ever. Balancing work and school while seeing friends in a socially distanced way, he has practiced “adulting” while living with dignity and privacy among other adults, his parents. There is solidarity from a shared experience with empathy, a top of mind practice in our home. In my psychotherapy practice, I have shared this mindset with clients and their families as they adapt to life under the trials of COVID-19.

For T1D parents, be guided by the principles of flux pedagogy by showing compassion to yourselves and your young adult children during this stressful time of uncertainty. We can parent capably through the fog, and as anyone who has driven through fog knows, you need to slow down. If you turn up the intensity of your headlights, it will only obscure your vision. Instead, just decelerate, listen more, empathically join your kids, and your families will emerge from this chapter stronger and more connected.

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