3 Difficulties with Mental Health Therapy in Chronic Illness

August 27, 2019 Miranda Card

There are difficulties with mental health therapy that you should know about when being treated for a chronic illness. I thought therapy was going to be easy -- but it isn't. I experienced three difficulties with mental health therapy that I'd like to share.

When I was diagnosed with Behcet's Disease, a chronic autoimmune disorder, my doctor told me that my illness would likely affect my longevity unless I could better manage my symptoms. At that moment, I realized I could no longer pretend that my body was like everyone else's and that I would have to make some lifestyle changes. Managing these changes was too much to do alone, so I hired a therapist with experience working with patients with chronic illness. As someone new to therapy, there are some practices I wish I had better understood earlier. Since learning them, I've been able to help my therapist better help me through my illness.  

3 Difficulties with Mental Health Therapy

  1. Not every therapist is the right fit. One difficulty with mental health therapy was that it took me a while to find the therapist I needed. I began working with a therapist last year who did not have a background in chronic illness. While she was a lovely person, I often left our sessions feeling like she somehow missed my point or was unable to understand my experience. Additionally, we didn't speak about problems in the same way. I grew up with a mother who has a Ph.D. in clinical psychology. Similarly, I'm a graduate student in biobehavioral science. When there's a problem or a feeling that I bring up in therapy, I want to speak about it in terms of processes, research and most of all I want to understand why my brain is doing what it's doing. This wasn't her thing. I had to find someone able to approach my life in a way I could relate to. 
  2. The therapist-patient relationship is unique. One aspect of therapy that's been tricky for me is that I don't have anything to model my relationship with my therapist after. There are several things that make therapy unique: you share more with your therapist than with your doctors, but there isn't the same back and forth that exists with friends; the power dynamic feels similar to that of a teacher and student, but the task is not as clear; finally, there's the fact of a money exchange. Finding a rapport with your therapist that feels natural takes time. 
  3. Being honest with your therapist is harder than you think. This difficulty with mental health therapy is one I didn't expect. It's really difficult for me to be honest with my therapist. You'd think that honesty would come easily when you're paying top dollar for someone to help you, especially when that help is often contingent upon your therapist knowing the full picture of what you're going through. Paradoxically, I often feel that because my therapist is supposed to know me intimately, I am tempted to paint myself in a more flattering light.

For example, I remember early on complaining to my therapist about frustration surrounding my diet -- I wasn't able to eat enough to fuel my day, nevermind the grueling workouts I put myself through. Next time, he asked if I had been eating more. For some reason, maybe because of shame surrounding my inability to force myself to eat through my pain, I lied and told him I had been eating more. In my experience, a good therapist who's also right for you can make you feel comfortable enough to be honest with him or her. For me, it's gotten easier with time. 

What difficulties with mental health therapy have you experienced? I'd love to hear about them in the comments.

APA Reference
Card, M. (2019, August 27). 3 Difficulties with Mental Health Therapy in Chronic Illness, HealthyPlace. Retrieved on 2024, July 14 from

Author: Miranda Card

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