- Chronic Pain
We will look at these in order, so if one or more condition is relevant to you, please scroll down to the appropriate paragraph. In the following we will be primarily concerned with the mental health aspects of these physical conditions. In doing so I in no way wish to suggest that these conditions are caused by psychological factors.
Chronic Obstructive Pulmonary Disease (COPD)
COPD is a physical disease which can bring with it some major mental health challenges. Some of the difficulties that COPD can bring with it include:
- The challenge of quitting smoking after diagnosis
- Difficulty breathing
- Increased awareness of physical limitations
- Loss, including loss of identity. job, relationships, or other of aspects of personal lifestyle
All the aspects of COPD can lead to anxiety and depression, as well as a need to talk things through and come to terms with the reality of the condition and the significance of what the condition means. Here, effective counselling tailored to the health condition of COPD can help with work on addiction, in order to better facilitate smoking cessation. The NHS is clear that severe COPD can be prevented, and that stopping smoking is the single-most effective way of preventing severe COPD. Counselling can help you achieve this difficult, often anxiety- or even anger-provoking task. Also, counselling can help with learning relaxation and breathing techniques, including how to cough without causing fatigue. Stress management techniques can also be invaluable when faced with flare-ups and panic attacks. Sometimes learning the difference between the symptoms of COPD and the symptoms of anxiety or a panic attack can be invaluable. In terms of how COPD can impact of the way the person sees themselves, the world, and the meaning of life in general, counselling can provide a unique space in which to talk things through, without having to worry about being a burden, fearing judgement, or needing to censor oneself.
Chronic Fatigue Syndrome (CFS)
CFS is a long-term, physical health condition resulting in persistent fatigue on a daily basis that doesn't go away with sleep or rest. Depending on its severity, CFS can lead to a regular need for days off work to rest, limited mobility, disrupted sleep patterns, and difficulty concentrating ('brain fog'). For many, chronic pain is also an aspect of CFS. CFS can also lead to other mental health concerns, such as depression, due to a reduced quality of life, as well as anger and frustration about the limits this condition brings. Relationship difficulties can arise also, as others fail to understand the limits and significance that CFS can have on the person living with the condition. Often this lack of understanding in others can lead the person with CFS to feel frustration, anger, upset, depression, and shame. Feelings of loss and grief can also be an issue as the person with CFS is faced with the challenge of a changed identity and a changed way of life.
CFS is a physical condition and there is no known agreed cause or cure. However, psychological support can be invaluable in finding ways to reduce the symptoms of CFS. The NHS recommends CBT, tailored physical exercise, and pain management as a way to help reduce some of the more debilitating symptoms of CFS. CFS is a long-term health condition and different people respond to different psychological and physical interventions. However, research has shown that CBT counselling can and does often help reduce the symptoms of CFS, especially when combined with a tailored physical exercise program, something which an effective, trained counsellor can provide. Counselling can also teach deep relaxation techniques that can lead to real feelings of rest and restoration.
Diabetes (Type 2)
Type 2 Diabetes is a life-long physical condition that impacts on blood sugar levels and leads to weight-change and fatigue, among other physical symptoms. Obesity is sometimes a co-morbid condition with diabetes, and so may require a weight-management program, where psychological support can also be invaluable (see below) as weight-management is often far more than mere dietary control. Though not often highlighted by medical professionals, the impact of diabetes on maintaining depression, and also, the impact of depression on the person's ability to manage their diabetes, is a significant factor for many people struggling with diabetes. The very diagnosis of diabetes can lead to a deep sense of loss, or grief, which can bring feelings of anger, shame, fear, even denial, which if left untreated can lead to chronic depression, making diabetes management, such as a healthy diet and exercise, harder, if not impossible for the person with depression and diabetes to implement. Here, counselling support from a counsellor who is trained and knowledgeable when it comes to working with physical health conditions can help the person with diabetes reduce both their symptoms of depression and their diabetes by approaching the conditions from both a physical (diet and exercise) and psychological (mental health) perspective. This can greatly increase the chances of better managing of the condition.
Weight-management is often approached merely from a dieting perspective. However, people struggling with weight management tend to agree that a more psychological approach to weight loss was what they were seeking. People struggling with weight management or obesity speak of addiction, craving, and using food to regulate (or avoid) their feelings, and so they felt that it wasn't food that was the problem, it was how they related to food that led them into difficulty. Also, there is the factor of how society sees obesity and the shame and pain that such social perceptions and stigma can bring. Here, using a range of counselling techniques from the areas of motivational counselling and addiction counselling, as well as others, including CBT, people find that they come to have a greater understanding of the psychological motivations beneath their relationship to food, an increased motivation to change, and a greater knowledge of tools and techniques to help them face the more addiction-based aspects of weight-management. Often having the issue recognised as a serious condition that requires expert help to tackle can be helpful, as many in society fail to understand the difficulties that are often present for those struggling with weight-management.
Chronic pain can be caused by a range of things from repetitive strain, a sudden accident, or even an psychological trauma in one's life. It can also be an aspect of CFS (see above) or other physical or mental health issues. Dealing with chronic pain involves making use of a range of physical and psychological interventions that can initially seem quite daunting, especially as different interventions can be more or less effective depending on the person. Often a structured program, designed together with a counsellor trained in working with health conditions can be helpful. Interventions can include graded exercise, pacing, relaxation techniques, and mindfulness, as well as otherCBT-based techniques to help break the vicious cycle of stress and pain. Through these techniques research has shown that chronic pain itself, and not just the mental health issues, can be measurably reduced, sometimes totally alleviated.
Important note: if you feel you have experienced a traumatic event in your past, such as an accident, abuse, or bullying, or if you feel you have experienced a loss or grief that you are struggling to come to terms with, and you feel your chronic pain may be connected to these events, counselling can help as chronic pain can often be a symptom of trauma or grief.
For more info on how psychological treatments can help with chronic pain, please read this article.
So, if you are struggling with any of the above long-term health conditions it is possible that psychological support from a counsellor trained and experienced in working with health conditions could help alleviate or ease some of the symptoms of the health condition. If you think counselling might be useful, you could seek out a counsellor in your local area. If you are in the Bristol area, visit my contact page to arrange a consultation session.
If you wish to make a comment, ask a question, or give feedback on any of the above, please feel free to comment below.