When Your Therapist Doesn't Understand Your Chronic Illness

I’ve heard so many tips on how to deal with chronic illness, and I’m sure you have, too. From the obvious and annoying “drink more water” to the more eccentric suggestions. One of the better suggestions I hear a lot for people with chronic illness and depression is to start therapy. Therapy doesn’t magically fix anything, but it can make life more bearable – even if only a little.

I have been in and out of therapy all my short life. Currently, I’m on a two year streak. I had to switch therapists after a few sessions when I started back up because she only repeated inspirational quotes. Literally. Not to mention she yawned during our sessions and had very little interest in what I had to say. So I moved on.

My current therapist is a very genuine, compassionate person. Still, she struggled to understand what my chronic illness was like. She admitted to me that she wasn’t always sure what to say or how to help. (I actually found that refreshing, compared to doctors I’ve had who pretend to have all the answers when they don’t.) Therapists are trained to help with many other forms of trauma. Some have experience with those who’ve had injuries or life-threatening conditions, but my experience is that most don’t. So, if you decide to go to therapy and find a kind therapist who doesn’t quite get it, what do you do? Here are a few tips I wish someone had told me from the start.

1. Take off your mask.

I’ve only done this one a thousand times. When you have an invisible illness, the instinct is to blend in and “fake it ’till you make it.” As you probably know, this survival mechanism is good in the short-term but awful in the long-term. It makes you feel inhuman – like you are constantly projecting a fake persona. Like no one actually knows you. Like you have no real connection with anyone.

Like I said: Awful.

It’s really easy to carry this into therapy. To say what you think they want to hear. To smile and laugh when you’re supposed to. Please don’t. I made a habit of doing this, and it prevented me from getting the help I needed. It’s difficult to break the cycle of putting on a mask, but if there’s any safe place to let down, therapy is it. Your therapist can’t help you if you’re not honest with them. Obviously, you don’t have to bare your soul in the first session, but the idea is that over time, you can have a safe place to vent honestly.

2. Be specific.

This was something that killed me in the beginning. Pain is never an isolated sensation in your body. It reaches in and changes every part of your life – your ability to get out, socialize, participate in your favorite hobbies, go to school or work, etc. Be specific. You can’t solve your health, but occasionally, you can solve other problems that are made worse by lack of energy.

My therapist didn’t understand why basic tasks or mediocre problems stressed me out so much. I wish I had realized that what I needed to do was explain how my health was affecting these things. I seemed over-reactive, because she wasn’t connecting my health and my other problems. I was already running on an empty tank. Anything else taxed me beyond my ability to cope. This is something healthy people struggle to understand. So make sure you gently remind your therapist why problems that may seem “easy” to them are not when poor health is factored in.

3. If you’re still having problems…

Unless someone has had chronic pain, they probably won’t understand it in full. I’ve had people tell me that’s cynical, but in my experience, it’s simply the truth. I’ve only had one healthy friend who understood quite a bit, and that was because her mother was chronically ill. Call me a cynic if you wish, but I keep low expectations for therapists and doctors in general. That way, if they pass my low expectations, I can enjoy it, and if they don’t, it’s no big deal. I consider it realism.

Your therapist may not understand completely. Sometimes they might say something inaccurate or judgmental about your health that ticks you off. Please let them know. (I believe their reaction is usually a good measure of what kind of person they are – if they can handle feedback.) I don’t mean telling them off. You can just say, “My health is very personal to me. When you say (insert here), it makes me feel (ex: unheard, hurt, misunderstood).” My main requirement is that my therapist tries. They don’t have to be perfect, but they do have to try to understand.

That’s why it’s so important to be open and honest with your therapist. If they don’t know something isn’t helping, they can’t find something that will. Granted, there are unkind and uncaring therapists out there, but they’re not the norm. There are more compassionate therapists than non-compassionate ones. The recommendation I’ve always heard is that you should go to three to six sessions before deciding whether that therapist is for you. The first appointment is always basic background information. You typically have to get in the swing of things before you can make an informed decision.

Of course, this isn’t a comprehensive guide. It’s not meant to be professional advice in anyway. This is just what I wish a friend had sat down and shared with me over a cup of coffee. I wish all my fellow spoonies the best, and I hope that if you decide to try therapy, you’re able to benefit from it.

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