Living with Long-term Conditions2nd May 2017
“Courage doesn’t always roar. Sometimes courage is the little voice at the end of the day that says I’ll try again tomorrow.”
Mary Ann Radmacher (2009), Courage Doesn’t Always Roar.
Receiving a diagnosis of a long-term condition can be a life-changing event that reverberates across all aspects of your life. Maybe you had been healthy up until that point and are now facing unwelcome changes to how you live your life; the role that you have in your family or at work, in the activities you enjoy or your independence. Perhaps you are currently symptom-free but facing an uncertain future. It may be that you have known of and lived with this diagnosis for some time, but recent changes, perhaps with new or worsening symptoms or changes in other aspects of your life, such as a relationship breakdown or becoming a parent, has affected how able you are to cope now.
How can a clinical psychologist help with a physical problem?
Long-term conditions are very common and there are many different problems that can enter our lives, bringing an infinite array of symptoms and treatments. Many of these things will be beyond your control and more likely than not, you will have had many consultations with medical professionals to help you treat or manage the symptoms as optimally as possible. However, living with long-term conditions, is not only about managing the physical symptoms. Chronic ill-health has wide-reaching implications for your emotional and psychological well-being. We also understand that achieving good mental health, may impact upon symptom management, your need for medication and the number and length of hospital admissions.
Clinical psychologists are very interested in the interaction between mind and body. We understand that we cannot treat one without considering the other. A cognitive-behavioural model is often used to try to understand what happens psychologically when we experience health problems. In cognitive-behavioural therapy or CBT, we try to understand how a person thinks about and understands their symptoms or illness and the impact it has on them. We want to know how the person then behaves or responds to try to manage the unpleasant effects on them. This then helps us to understand why a person feels a certain way. All feelings or emotions will have physiological changes associated with them, that will often exacerbate the physical symptoms they were already suffering from. We call this a vicious cycle or maintenance cycle, that can sometimes be very difficult to escape from. It is a common experience to feel stuck or overwhelmed. The good news is that once have an understanding of the links between your thoughts, feelings, responding and physiological changes, you are progressing on the journey towards improving your psychological well-being.
In addition to understanding the maintenance cycles that may be troubling you, a clinical psychologist will be interested in the broader picture of your life, in order to tailor your therapy to be the best fit for you as a unique individual. We will ask about your physical health, the symptoms, the treatments and your prognosis. We will also want to understand all of the things that will affect how your illness impacts on you. These may include aspects of your personal history, past experiences of ill health, your current relationships, work or activities and important aspects of your personality, for example are you normally anxious and introverted or optimistic and outgoing. We understand that when people come to us, they have, more often than not, lived with their illness for some time. They know what has helped and what has not. We want to draw on all that knowledge and experience to enable you to identify what you would like to change. Once we have agreed goals that are realistic and achievable, you will be supported to work towards these. We hope that by the end of therapy, you will feel more empowered and able to cope with your long-term condition and that you have a greater sense of psychological well-being.