What to Expect from Therapy When You Have a Chronic Illness

If you're reading this, chances are you've been thinking about therapy for a while now. Maybe you're struggling with the emotional weight of your chronic illness, or you're tired of feeling guilty every time you need to rest. Perhaps you tried therapy before and while it gave you some helpful breathing techniques, it didn't really touch the deeper stuff you're dealing with.

I get it. And I want to be honest with you about what therapy for chronic illness really looks like, because it might be quite different from what you're expecting.

Why Chronic Illness Therapy is Different

While helpful, general therapy often misses the mark when you're chronically ill because it doesn't account for your reality. Standard CBT might teach you that "changing your thoughts changes your feelings," but what about when your thought is "I'm in pain and I can't do what I planned today" and that's just... true?

Therapy for chronic conditions isn't about positive thinking your way out of very real limitations. It's not about pushing through or finding motivation to exercise more. It's about processing the actual impact of living in a body that doesn't work the way society expects it to.

We're talking about the stuff that keeps you up at night, like the grief of losing your pre illness self and the future you'd imagined, the internalised ableism that tells you you're lazy when you need to rest, the strain on your relationships when you have to cancel plans again, the identity crisis of not knowing who you are beyond your illness, and the medical trauma from years of being dismissed or gaslit by healthcare professionals.

This is the deeper work that six sessions of "here's a worksheet" just can't touch.

Living with Chronic Illness

So What Happens in Sessions?

I live with chronic pain myself, so I've been on both sides of this. When clients first come to me, they often start talking like I'm another medical professional, giving me their full diagnosis history, medication list, symptom timeline. But what I’m most concerned about is, how is all of this affecting you emotionally?

The First Session

Your first session with me is a bit more structured than the rest. I'll have a short questionnaire that helps me get a basic picture of where you're starting from. I might need to know practical stuff, like if you have seizures or anything I should be aware of during our sessions, but I don't need your full medical history unless you want to share it for a specific reason.

What I really want to understand is what's brought you here, what are you struggling with and what would help?

Ongoing Sessions

After that first session, things get much less structured. Sessions are yours to use however you need. Some weeks you might need to vent about a shit appointment with a consultant. Other weeks we might dig into why you feel so guilty asking your partner for help. Sometimes you'll just need space to cry without someone telling you to "stay positive."

I follow where you want to go because you're the expert in your own life. My job is to help you explore what's underneath the anxiety, the low self-worth, the harsh inner critic. Where did these messages come from? What are you really grieving? What do you really need or want?

And no, there's no written homework. No thought records. No "let's reframe that" when you're expressing something completely valid. This is about going at your pace, creating a safe space to explore your needs, and maybe learning to feel feelings you've been too afraid to sit with.

What Changes Actually Look Like

I'm not going to promise you'll suddenly love your chronic illness or that you'll become some inspirational poster child for advocacy.

But clients often notice little shifts as we work together. They start acknowledging their small wins instead of only seeing what they can't do anymore. Resting doesn't come with the same crushing guilt. They ask for accommodations at work without feeling like they're being difficult. They set boundaries around other people's expectations of them. The voice in their head gets a bit kinder and they speak about themselves less critically. They can cry about how unfair this all is without feeling dramatic. They start figuring out who they are separate from their illness.

These changes take time. Building confidence and compassion for yourself isn't a quick fix, it's a process. And therapy can't take away your illness (I really wish it could), but it can help with the emotional weight you're carrying alongside it.

Is Therapy Right for You Right Now?

Let me be straight with you, therapy with me isn't for everyone or for every moment.

If you're in the middle of a massive, never-ending flare, you might not have the mental capacity for this work right now. Sometimes survival mode is all you can manage, and that's okay.

I also don't work with people in crisis. If you're in immediate danger or need urgent mental health support, your GP or crisis services are the right first call.

But if you're at a point where you're sick of just surviving? Where you want to process what's happened to you and start building a life that feels meaningful despite your health challenges? That's when this work can be really powerful.

The Practical Stuff

I work online, which means you can have sessions from your own home, which comes with the added bonus of no energy spent getting to an appointment, and you can stay in your comfies.

Most of my clients see me either weekly or fortnightly. Actually, about three quarters of them go fortnightly. This helps with costs and accessibility, plus it gives you time to sit with things between sessions rather than rushing through everything.

I do currently have a waiting list, and how it works is that when a space opens up, I email everyone on the list at the same time and it's first come, first served based on timing and availability.

What Makes This Different from NHS Therapy?

Look, the NHS is massively underfunded and I'm not here to slag it off. Those six to twelve sessions of CBT can provide some helpful tools, especially for managing anxiety in the short term.

But what's often missing is context. Your chronic illness isn't just background information. It’s fundamentally shaping your entire experience of life. Generic coping strategies don't account for the fact that your "bad day" might mean you physically cannot get out of bed, or that your anxiety about symptom flares is based on very real unpredictability, not irrational thinking.

My approach isn't about giving you techniques and sending you on your way. It's relational, meaning the therapeutic relationship itself is part of what helps. It's about having someone who gets it, who believes you, and who creates space for you to be yourself without masking your pain or pretending you're coping better than you are.

I work integratively, which is a fancy way of saying I pull from different therapeutic approaches depending on what you need. Mainly person centred (you lead, I follow), psychodynamic (exploring where patterns come from), ACT, compassion focused work, and mindfulness when it's helpful. No CBT homework. Never "just think more positively."

You Don't Have to Figure This Out Alone

Living with a chronic condition is isolating enough without also dealing with the emotional fallout on your own. You deserve a space where you don't have to explain yourself, where you're believed, and where someone gets why this is so hard.

If any of this resonates and you want to know more about working together, you can email me at kirsty@kirstycorvan.com or send me a DM on Instagram @thechronicillness.therapist. I'm happy to answer any questions or have a chat about whether therapy might be right for you.

And if you're not quite ready yet that's completely fine too. Sometimes just knowing this kind of support exists is enough for now.

Here for you when you’re ready,

Kirsty

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