All long-term illnesses, especially chronic and autoimmune ones, have a significant impact on the quality of life and our mental well-being. It has long been known that there are certain connections between mental and physical experience and, consequently, between problems or illnesses in these two areas. The simultaneous occurrence of physical and mental illnesses is quite common. Recent global researches report in favour of holistic treatment (physical and psychological aspects of treatment) of patients with chronic and autoimmune diseases. Integrated treatments, which include professional help at the physical and mental levels, increase the impact of treatment on both levels, allow a more individual approach, reduce stigma, and increase access to psychological care for patients. Furthermore, researches also prove the effectiveness of various psychotherapeutic approaches in treating autoimmune diseases (e.i. https://www.karger.com/Article/Abstract/276370 https://link.springer.com/article/10.1007/s10865-009-9235-2 https://europepmc.org/article/med/18214212 https://www.tandfonline.com/doi/abs/10.1300/J015v23n01_01).
Psychotherapy, the treatment of psychological problems through conversation and psychological techniques, with the goal of eliminating or reducing certain symptoms and improving the quality of life, can help alleviate the problems of autoimmune diseases in several ways. Psychotherapeutic treatment can offer:
Help in accepting illness
Diagnosing a chronic or autoimmune disease usually causes shock, which can be followed by a period when we cannot come to terms with the diagnosis, which is perfectly normal. Every person experiences the new situation individually, but most describe their inner experience through the stages of mourning: shock or denial (when we find out about the diagnosis, we try to convince ourselves that it is not true), anger (often directed at doctors or ourselves, e.g. in the form self-accusations that we have not done enough for our health), negotiation (we are convinced that it could be different, we are looking for other opinions, different forms of treatment, etc.), sadness and helplessness (this phase can be long and there is a risk for the onset of depression) and acceptance (acceptance of the disease, which to some extent ends mourning, unpleasant feelings become less intense, gradual adaptation to the new situation and lifestyle with the disease begins).
Help in processing the emotions
Every physical illness is accompanied by a more or less intense emotional experience. In autoimmune diseases, strong feelings of helplessness often occur, as we would like to help ourselves to improve the situation, but these attempts sometimes fail, or after a period of remission, the disease worsens again. It is completely normal and common for the disease to be accompanied by strong unpleasant emotions (e.g. sadness, fear, anger, shame, guilt…), and with psychotherapeutic help we learn to recognize and express them appropriately. Suppressing unpleasant feelings further increases distress.
Help in coping with the physical symptoms of the disease
Some autoimmune diseases can cause severe physical pain or symptoms which cause discomfort or shame that we can process with the help of a psychotherapist. Furthermore, relaxation techniques (e.g. autogenic training, progressive muscle relaxation, breathing techniques) and mindfulness exercises can help alleviate physical pain.
Support in adapting to a new situation
Some autoimmune diseases can cause severe symptoms that can strongly affect the course of our day, so it is necessary to abandon or change old habits and form new ones, which can be much more stressful if we do not have proper help and support.
Help in redefining yourself
Every experience, especially a long-term illness, changes us, which we often resist. Psychotherapy helps us to accept what is inevitable, to know who we were, who we are in the present and who we want to be in the future, and to shape the path towards the set goals.
Help in coping with the stress
The disease also brings an increased level of stress. Our bodies respond to stress in different ways, on both mental and physical levels. On the physical level, it is often shown in the form of increased heart rate, digestive problems, headaches, frequent sweating, painful and tight muscles. On a psychological level, we can be irritable, anxious, helpless, experience more frequent sadness or anger, feel that we have “enough of everything”, lose joy for activities that otherwise pleased us, everything becomes too difficult… Also, sleep problems, loss or increase in appetite and similar signs can be shown. Many of the symptoms attributed to physical illness may therefore be a symptom of increased stress, or increased stress may result in an increase in symptoms. With the psychotherapeutic help, we can recognize stress and reduce it with various techniques.
Help in forming and maintaining relationships
Due to their symptoms, some autoimmune diseases worsen interpersonal relationships or lead to the avoidance of social contacts, which further increase the patient’s personal distress. A psychotherapist can help us explore the dynamics of existing relationships and learn about the causes of problems in them, and accompany us on the path to re-establishing social contacts.
Help with other problems caused by autoimmune disease
Coping with problems that exist due to the autoimmune disease or have been present before (e.g. depression, anxiety, panic attacks, burnout, post-traumatic stress disorder, phobias, eating disorders, addictions, personality disorders, unprocessed patterns and traumas from the past, and other problems and distresses).
Alja Fabjan, integrative psychotherapist and PhD student of marital and family therapy