Living with a health condition changes more than the body
A health condition rarely stays in the body alone. Whether it is a new diagnosis, a condition you have lived with for years, recovery from a serious illness or persistent pain, it reaches into mood, sleep, relationships, work, and how you see yourself.
Many people describe a kind of bracing: planning every day around the risk of a flare-up, and feeling life narrow as a result. For others, the hardest part isn’t the condition but not being believed, by employers, sometimes by family, occasionally by clinicians.
Working with a psychologist doesn’t mean anyone thinks your symptoms aren’t physically real. It means the psychological weight of living with the condition deserves its own attention, separate from, and alongside, whatever medical treatment you’re already having.
Living with a condition that doesn’t run in a straight line
Many health conditions don’t follow a predictable course. Living with a fluctuating condition, or a diagnosis with an uncertain outlook, brings its own particular weight: not knowing whether today is a good day or the start of a bad patch, planning a life around a body that won’t commit to a schedule, and the specific anxiety of waiting for results or a next appointment.
What usually helps is making sense of the uncertainty itself: building a life that can flex around a condition that won’t stay still, rather than either ignoring it or being ruled by it.
Conditions we often work with
People come to us living with a wide range of physical health conditions, including:
neurological conditions, such as multiple sclerosis (MS), Parkinson’s and epilepsy, and adjusting to life after a stroke
autoimmune and gut conditions, such as lupus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis and irritable bowel syndrome (IBS)
fatigue-related and post-viral conditions, such as ME/CFS and long COVID
heart and lung conditions, such as heart disease and COPD
diabetes
cancer, during treatment and afterwards
persistent pain, including fibromyalgia
What matters more than the name of your condition is what it is doing to your life. If yours isn’t listed, you are still welcome to get in touch: we’ll tell you honestly at the first conversation whether we’re the right fit.
After a diagnosis or a serious illness
Sometimes the hardest part is the change itself. A new diagnosis can take time to absorb, and can bring grief for the future you had expected. After a serious illness, major surgery or a long stay in hospital, you may be told you have recovered well while feeling far from it. Fear that it will happen again is common, and understandable.
When pain is the main difficulty
Pain is produced by the nervous system, not simply transmitted by it. When pain persists, the system that carries it often becomes more sensitive over time: the volume is turned up, so signals that once registered as mild are experienced as severe. This is a real, physical change in how the nervous system processes information. Your pain is not imagined, and it is not exaggerated.
This is why psychological work helps: not by talking you out of pain, but by working on what keeps the system sensitised. That includes the fear of movement that leads to less movement, until more is lost to the avoidance than to the pain itself; broken sleep, which lowers the threshold further; and the cycle of overdoing it on good days and paying for it for a week.
What this can include
You’re unlikely to recognise all of these, and that’s normal. They aren’t a checklist to work through, just some of the more common patterns.
Low mood or anxiety connected to a diagnosis, prognosis, or flare-ups; worry while waiting for results or appointments; fear of activity making symptoms worse, and working out what is a sensible limit and what has become avoidance; fatigue, and learning to manage energy as well as activity; adjusting to a changed sense of independence or identity; the frustration of feeling reduced to “the condition” rather than a person; the daily work of managing treatment, medication and appointments; sleep disruption tied to pain or symptoms; strain on relationships or working life.
What working with us is actually like
We draw on acceptance and commitment therapy (ACT) and cognitive behavioural therapy (CBT), adapted to living with a physical health condition, and on pain psychology where pain is part of the picture. ACT and CBT are the psychological therapies named in NICE guidance on chronic pain.
Where pain is part of the picture, we won’t tell you to push through, and we won’t tell you to rest completely either. Both extremes tend to make things harder over time: overdoing it feeds the boom-bust cycle, and avoiding activity altogether often means losing more function to the avoidance than to the pain itself.
Instead, we work on pacing: building activity back up in planned, deliberate steps, based on a schedule rather than on how you feel that day. This can feel counterintuitive at first, and sometimes harder before it settles, because it means doing less on good days than you’d like, and a bit more on bad days than feels comfortable.
With ME/CFS and other fatigue-related conditions, the approach is different. We don’t use programmes that increase activity in fixed steps, which NICE advises against for ME/CFS, and psychological therapy is not a cure for ME/CFS. It can help with living with it: managing energy within your limits, and the uncertainty, loss and frustration that often come with the condition.
We work at a pace you agree to, review how it’s landing regularly, and adjust it together as we go.
How therapy can be funded
You can pay for therapy yourself, at the fees shown on our fees page, with no package and no minimum commitment.
If you have private medical insurance, our clinicians hold individual recognition with Bupa, AXA and WPA. Many policies limit cover for long-term (chronic) conditions, so it is worth checking your policy before you start.
If your condition or pain follows an accident or injury and you are making a claim, therapy may be funded through that claim. Your solicitor or case manager can refer you directly; see information for referrers.
What you tell us stays private
What you share with your clinician is confidential. There are a small number of exceptions, and we would rather you knew them now than discovered them later: if we believe you or someone else, particularly a child, is at serious risk of harm, we may need to share information with your GP or another service. Your clinician will explain all of this properly before you start.
If this isn’t the right place
We work in three areas, not everything. If what you’re dealing with sits outside them, we’ll tell you at the first conversation and point you toward someone better suited.