Chronic Migraine, Coping, Mental Health

Stumbling Upon a Therapist

“It seems to me you have two equally important things going on: chronic migraine and grief about what chronic migraine has meant for your life.” With those words, the naturopath I saw Friday became my new therapist. Although I knew before the appointment that she practices as both a therapist and naturopath, counseling was not on my agenda. However, anyone who can see so readily that the emotional component of chronic migraine has affected me as deeply as the physical illness is someone I need to talk with.

Throughout the two-hour initial appointment, I kept mentioning things I wrote about last week. Like that the emotional toll of chronic migraine is enormous. That almost all my emotional and physical strength goes into taking care of myself, thus continuing my isolation from others. That I’m envious of successful women my age because I believe I, too, should be able to support myself and pursue my dreams. That for the first 10 years of chronic daily headache, no one believed I had a physical illness. Although I told the naturopath repeatedly that I’m so much better off emotionally now than I was a few years ago, the fact that everything I just mentioned was so fresh in my mind that I felt the need to write about it just last week indicates I’m not as “over it” as I thought I was.

I’ve been to therapists in the past, some of whom have been helpful with other issues, but no one seemed to really get what it means to for a young, intelligent, ambitious woman to be rendered housebound by a debilitating chronic illness. (The last one I saw thought I needed help setting goals and following through with tasks. If only it were that simple!) I’d thought this was a failing of the therapists, but now I wonder if the problem was in how the appointment was structured.

Every time I see a new therapist, I introduce the role of migraine in my life by describing all the ways I try to live a good life despite chronic illness. I always came out looking strong and motivated. I wasn’t misrepresenting myself, but was focusing on the positive — because who wants to meet anyone new and tell them all the bad stuff right off the bat? Besides, unless I’d just had an acute emotional crisis, the hard parts are rarely at the top of my mind. Usually such a crisis would spur me to make the appointment, but by the time I saw the therapist three or four weeks later, I’d moved on.

Meeting with the naturopath was more like a standard medical appointment. I started describing my symptoms and what my life looks like with migraine as such a large component of it. Because I wanted to convey the gravity of the physical experience (though I made sure to tell her that I’m so much better than I used to be), I was willing to address unpleasant aspects I’ve held back from therapists in the past.

I’ve long advocated for people with chronic illness to see a therapist, though I readily admit finding someone who understands the complexities of it is difficult. The best advice for finding a good therapist I’ve been able to give is to ask your doctors. But I’ve also always assumed the therapist sets the tone for the sessions. Maybe the person who is receiving counseling is responsible for determining the conversation’s course.

Based on my very recent experience, I’m going to change my recommendation. Yes, ask your doctor and check Psychology Today for therapists who specialize in chronic illness, but also keep a running list of issues that are bothering you. Perhaps write in a journal and see what comes up — I often don’t know what’s eating at me until I see the words written on the page. The most intuitive therapists may be able to figure out what you need to talk about all on their own, but you’re the only one who truly knows what’s bothering you.

I’m writing this advice as much for myself as for anyone seeking guidance on getting the most out of talking with a therapist about chronic illness. I’ll let you know how it works out after a few sessions.

4 thoughts on “Stumbling Upon a Therapist”

  1. So glad I found this tonight. I was JUST having a conversation with a friend of mine (who tries so hard to understand). He was asking me what I had planned for the weekend. The question is always depressing. What I WANT to do for the weekend and I what I have come to learn my weekend will more realistically look like are very different. I know my weekend will consist of an acupuncture treatment, lots of resting — to catch up on the exhaustion from the physical pain and all the efforts put forth to make it appear that I am “normal” all week — along with some time on the couch with my favorite blanket and ice pack. I WANT to have an exciting story to tell. I WANT to have big plans that I don’t have to worry about canceling at the last minute. I WANT to have energy left over every day at 5PM. I’m ranting, sorry.

    Anyway, it was this that struck me “That almost all my emotional and physical strength goes into taking care of myself, thus continuing my isolation from others.” So. True.

  2. People cannot truly understand what they do not experience. One can close one’s eyes and briefly empathize with blindness, but the same person cannot know the unique emotional and physical sensations of migraine. I had 8 or so years of infertility. When I started fertility treatments my GYN suggested that I not tell anyone at work because the possible disappointments would be so emotionally difficult to discuss. This made sense but I did the opposite. I had spent so much time hiding and downplaying the migraines that it felt liberating to talk about the fertility process and the ups and downs.

  3. Wow! I wish we could see your naturopath. No one we have met with so far understands what my husband has lost because of his chronic illness–to be understood and listened to in that regard would be miraculous!

  4. This post really hit a nerve for me. I feel like I’ve been stuck in grief for YEARS over how my health has affected my life.

    Whenever someone asks “so what do you do?”, I’m overcome with dread and panic. I never know how to respond! I’ll usually say, “oh, I’m not working right now”. Meanwhile, “right now” has been many years. haha

    Being a very private and easily embarrassed person, I don’t like sharing that I have chronic pain and severe fatigue. Even my friends and family don’t know the extent.. although the fact that I don’t work should be clue..

    I suppose I feel embarrassed about my situation because it’s abnormal in my area to be supported by one’s husband, making me a childless housewife.

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