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    You are here : Home » About MS » Multiple Sclerosis Treatments » Counselling

    Counselling

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    Multiple Sclerosis CounsellingCan counselling help? You can't actually change anything, can you?

    Counselling means many things to many people. For some people, it is an indulgence; a waste of time talking about oneself when "you can't actually change anything, can you?" For others, counselling is supposed to solve everyone's problems, both physical and mental, with the least possible pain.

    Help is often seen in terms of physical assistance or direct advice, as in the help offered by the physiotherapist or the dietician, but counselling offers a different sort of help.

    Counselling deals with the emotional turmoil that having Multiple Sclerosis brings. It offers a way of sorting through the confusing and conflicting feelings that come about when the known 'well' self disappears and unfamiliar circumstances and problems present themselves.

    In fact, of course, people make different use of counselling. A physiotherapist was astonished to find that discussing a difficult situation at work with me had made a huge difference. She said she could now see what her patient was doing; she felt less out of control and much less threatened by him. I had not told her what to do, though she had asked me. All I had done was to help her to tell me what was happening; to take it seriously and to understand it for what it was, without pretence or fear. This may sound simple, but there are many situations in life which we find difficult to approach with a clear head. Many people find counselling helps them to sort out their thoughts; perhaps to disentangle unrealistic worries, or thoughts or fears which actually belonged to another situation, perhaps last week, or last year or many years ago.

    Taking one's thoughts and feelings seriously is not something we are commonly taught to do. When those thoughts are frightening ones about MS, or about being dependent, or being out of control or not being loved, it can be very hard to allow the thoughts to flow. People can spend a lot of energy trying not to think of such things. This means that they have very little idea of how serious or how frightening the thought would be if it were allowed to finish.

    Counselling can sometimes provide a safe place in which thoughts can be thought through - and this can change them. If there is real reason for grief or fear, sharing those thoughts with the counsellor changes them in the way that the dark is less frightening when you are not alone. Often it turns out that the thoughts that frighten people most look quite different when taken to their real conclusion - not the exaggerated conclusion which was most feared, but a more realistic one. Thoughts can only be tested against reality when they are taken seriously; in my experience the reality always turns out to be less frightening than the fantasy. As I say to my clients sometimes, frightening thoughts can be pushed back under the carpet when they leave my room - but the lump is likely to be smaller and less likely to trip people up.

    Counselling can give people a chance to grieve for losses they have suffered; to sort out what has been lost, and to let it go; and to disentangle it from what remains and can be kept. An unresolved loss gets in the way of life; makes it hard to function and to move on. Left to ourselves we find ways of dealing with our losses or other painful feelings; but they may be ways which involve cutting off feelings - and becoming hard or inconsiderate of others; or constantly ruminating on them - which may make us seem self-absorbed. The presence of an understanding person who can focus on the losses without being personally involved can make an enormous difference to the way we handle them.

    However understanding those around us may be, it may not be right to burden them with certain worries. MS anxieties in particular often affect others, and it is hard to think through all the feared consequences for yourself if you are having to think about the consequences for the person who is listening too.

    Counselling does not solve all the problems of the world. It will not make MS go away - but it may change the way someone experiences it. As one client said, "My MS has moved from centre stage to somewhere off left". But counselling is not a self-indulgence either. Someone who is less anxious or worried or self-absorbed is less of a burden on, and more of a pleasure and support for, other people around.

    Speaking out loud

    Speaking out loud the things that are going round inside one's head is a basic human need. Yet it is not often that the opportunity presents itself to do that.

    When friends ask 'How are you?' they quite often mean 'Hello' and there is a sense that they may not really be prepared to hear how awful you feel that day, how frightened you feel, how much pain you have.

    There is often a mistaken belief that people should be distracted from their bad feelings and should put on a 'Happy Face'. A lot of effort is expended in trying to take peoples' minds off their problems - when all the person really wants is a chance to just let it all pour out.

    Even when there is a chance to do just that, the natural need we have to protect the people closest to us may make it difficult to be as honest and open as we need.

    To unload on a partner or friend may feel like you are burdening them and will leave them with something that they won't be able to deal with - especially when the practical needs of the illness itself may already be experienced as a burden on them.

    Counsellors really hear what you're saying

    Speaking out loud to a trained professional counsellor can feel very helpful indeed. A counsellor doesn't just listen, they also really hear what is being said and so does the person saying it. It is amazing how the things that go around in our minds in a loop seem different when they are said out loud. We make sense of our lives by giving everything that happens a meaning.

    So what does MS mean?

    Quite often it can mean failure, or punishment, or complete confusion as the known, familiar, busy, coping part of one's personality disappears in the welter of unpredictable and unwelcome MS symptoms. A working mother who is used to running the house as well as holding down a job can feel an enormous sense of failure and frustration when her MS means she has to start delegating chores to the children and involving her partner more in shopping and housework. Yet in another household with a fit mother, this distribution of tasks may well be the norm.

    Breaking free from old mind-sets

    It is not just the effect that MS has on life, it is also the meaning we put on it. A counsellor can help people understand this and show how, very early on in life, we get into mind-sets about what is acceptable and what is failure.

    It is very common to set a great deal of importance on what we do. It cuts out a lot of potential conflict to know that in the last instance we can always 'do it ourselves'. To have that option taken away by MS leaves people feeling very vulnerable and needing to ask for what is wanted. It's not easy to ask especially when it is something that has been successfully avoided in life up until now.

    Yet why should this be so? Is there some past experience that has produced a belief that it is somehow weak to ask? Is there a leftover voice from childhood saying "Them as ask, don't get"? Counselling helps people question thoughts and beliefs that have never needed to be questioned before when the body was fit and ready to just obey these ideas.

    To have to live inside a body that no longer obeys instructions is a tremendous loss. It is not only the loss of the function, but also loss of reasonable expectation. It is reasonable to expect one's body to go on functioning into old age, so MS is a bit like prematurely getting old.

    To lose the self you knew yourself to be has to be grieved for in the way you would grieve over the death of a real other person. It may resurrect old griefs. A counsellor will understand this and can offer explanations about why old or seemingly inappropriate feelings are emerging.

    Because MS is such an individual and unpredictable disease, new problems and difficulties emerge as different stages occur. What a marriage or family can deal with in the early stages may only start to cause problems when a major change happens, like having finally to give up work, or needing constant assistance.

    Opening up communication in couples

    A husband and wife often bottle up their feelings of anger, frustration and resentment. "I can't say that, he/she already has MS to deal with." "I can't say that, he/she does so much for me already." But the feelings don't go away and what often happens is that a space opens up between the couple, which then makes it even more difficult to talk to each other - to communicate.

    Counselling can help people confront these issues, so that feelings can be expressed in a way that clears the air and brings closeness and deeper understanding of the other. Much in the same way that houses have to be adapted to accommodate the disability, so do relationships.Sex is often another difficult area. For many couples, sex happens and doesn't have to be talked about in any great depth. So when sex stops happening it takes a great deal of courage to find ways of talking about it.

    Good satisfying sex can be achieved in a variety of ways, but it needs a lot of open communication to get round whatever problems MS has thrown up. Loss of desire doesn't mean someone can't give pleasure, which has its own rewards, and may bring about a feeling of confidence in one's sexuality.

    It may be that lack of confidence could have been responsible for the loss of desire in the first place. Again, counselling may help people explore their needs and desires, and help them find their own solutions.

    Which is the main point of counselling: to help people re-evaluate their lifestyles; to question the "oughts" and "shoulds' ', and come up with something that feels more in their control, even with MS.

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    © Multiple Sclerosis Resource Centre (MSRC)

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