Writing about living well with chronic health problems, mindfulness in action and common mental health problems and everyday living. For older articles see archive page and for CFS/ME Support for Family and Friends book click here.
Midlife Challenge and Change - individualised sessions for you.
Are you a midlife professional? Is 2026 the year you will gift yourself some space and time? Ages 45 and above can bring serious questions about life so far and the rest of our time on earth. ‘Am I happy, is this the life I want, is this all there is, what about me…?’ If you are experiencing low mood, dissatisfaction, even burnout and would like the space to reflect on why, you could consider getting some specialist help.
Maybe you’re considering a career change, want more from life, are considering retirement, have recently retired? Are you isolated and lonely and feel unfulfilled. Maybe you are preoccupied with the state of the world or your mortality? Are you are emerging from caring responsibilities and don’t know what you want now. Speaking to a trained professional can support you to understand yourself better, explore potential new paths in a deep way, develop healthier boundaries and balance, consider entrenched relationship issues and get something new started. Perhaps you are facing health changes, declining mobility, the complexity of perimenopause? Whatever is bothering you, you could benefit from taking some time to consider what you need and want for your future.
Individualised therapy provides the space to really engage with your wants, needs and values, and focus on how your life is matching up. It can be the first time a person has spent time reflecting in this way, away from the concerns and responsibilities of daily life. As a non-judgemental professional, I provide space for you that is confidential and very different to talking with friends, family or colleagues whose own needs and biases are also in the frame, meaning you can speak more freely and get in touch with your deepest feelings.
This can involve:
- assessment of your needs
- building trust
- working out exactly what the problem is and deciding what to focus on
- setting realistic goals
- addressing blocks, beliefs, mood & health issues and roles that are getting in the way of making change
- setting action points for between sessions to take achievable steps forward.
After many decades of living we often have unprocessed grief, loss, anger, disappointment, resentment, regret and fear that can keep us stuck and can block us from addressing the things that could enhance our lives. Is the way you’ve always done things working for you? What do you want for your life now? I have helped:
- people stuck in family expectations change their lives to one more aligned with their values;
- women shift from self-sacrifice to a more balanced wellbeing mindset;
- people investigate their beliefs about money and status to live a more authentic fulfilling life;
- those living with disabling chronic conditions make change to improve wellbeing and coping;
- newly retired people feeling lost to find a new routine;
- queer and late-diagnosed neurodivergent people adjust their lives to better fit their authentic selves;
- frustrated creatives reconnect with artistic self-expression;
- people who have lived life in the fast lane slow down and listen to their bodies, and many more.
If you can relate, get in touch to see how we might work together.
As a specialist in the impact of physical health challenges on mental health, I can also help you to consider healthspan, the place wellbeing has in your life, sleep, energy, stress and pain management. My clients achieve better self-care and improved quality of life. Maybe you want to explore the meaning ageing has for you, to take some time to reflect on how you would like the second half of your life to be. I have faced my own challenges requiring radical change in expectations, ways of working and life path and take a holistic view of wellbeing, so I have a deep understanding and compassion for what this can involve.
I have been helping people to improve their wellbeing and mental health and build a more satisfying life since 1998 using a wide range of approaches including counselling, strength-based approaches, activity pacing and strategies to reconnect with creativity. Find out more about me on my other pages about how I work and get in touch to book a free initial call to see if working with me could help you create a more authentic satisfying life. You can also listen to ‘How We Care’ podcast Episode 35 ‘Midlife Challenges and Change’ to find out more https://how-we-care.simplecast.com/. (out soon)
Enabled: 10 reasons why working for yourself can work for people with a chronic illness
https://elizabethturp.co.uk/uploads/E3A75BE4-6C9B-4554-B945-DFF4DBB15DB9.pdf
Chronic pain: What therapy can help with? Article on BACP website - March 2023.
What is chronic pain? How does pain affect your mental health? Can counselling help, and what types of therapy are best for chronic pain? Our member Elizabeth Turp explains. Read here
How can counselling possibly help me with my chronic physical illness? - 21/05/2014
As both patient and therapist specializing in working with people living with chronic health problems, I am passionate about the importance of addressing their emotional impact - in some cases this can be experienced as worse than the illness itself. Addressing the interaction between the body and mind is also vital when learning how to manage a chronic health problem - deny either’s role and physical and mental health can be adversely affected. Seeing a counsellor does not mean that your illness is not real or ‘all in your mind’, but that it affects the whole of you. Having worked with people specifically on coping with the following illnesses: diabetes, epilepsy, lupus, cancer, ME/chronic fatigue syndrome, fibromyalgia, chronic pain and endometriosis – here are 10 ways counselling can help:
1) Dealing with the emotional fallout of becoming ill
Getting a diagnosis of long term illness - usually following an uncertain period of ill health and searching for answers - brings fear, anger, uncertainty, sadness, distress, grief, anxiety and even shame. Suppressing these can result in depression. Counselling provides a safe space to acknowledge and express built up feelings, get reassurance that your feelings are normal and develop ways of dealing with them in the longer term. It is common to feel that you can’t fully do this with loved ones, as you try not to ‘worry’ them, and their own issues and opinions get in the way of hearing your experience fully.
2) Engaging with treatments
Medical treatments and programs such as pain, nutrition management or physiotherapy can require big lifestyle changes and a lot of effort to get the most from. If you are finding following advice difficult or feel resistant, seeking the support of a counsellor who specializes in working with physical health problems can help you work through your difficulties with these changes and consider any blocks you may have. Do you struggle to prioritize yourself; do you not see the point; are you finding it hard to make a new routine? This is often influenced by long held beliefs or roles, and therapy can be a helpful way to make sense of, and so get the most out of your treatment.
3) Reducing the impact of anxiety on symptoms
It is normal to feel anxious as you have tests and see specialists for diagnosis and ongoing treatment. However, sometimes anxiety can start to dominate, especially in conditions with uncertain prognoses, and this is not helpful to your healing or management of your health problem. Using chronic pain as an example, if we are in pain we worry, which tenses up the body, which then in turn can further increase the pain. It is also exhausting. In counselling we can find an outlet for our anxiety, a place to consider our thought patterns, understand the role of adrenaline, break the panic cycle and learn techniques to address anxiety. It is also a place to fully express our thoughts and feelings without feeling foolish or judged.
4) Adapting to limitation
One of the hardest parts of becoming chronically ill is adapting to the things that you can no longer do, which for the conditions listed earlier can range from the simple, such as not being able to do the weekly shop, to the heartbreaking: not being able to play with your child. Adaptation to limitations has two elements that therapy can usefully address: loss of the things you can’t do at all and gradual changes to the things that have such a severe payback in increased symptoms (even relapse) that you can helpfully choose to give them up in order to get a better balance and control of your pain and other symptoms. This can be a long process as we fight to hold on to how things were.
5) Grieving losses
Of all the emotional effects becoming ill can have, grief can be the strongest. The potential losses are diverse: from loss of career, friendships, ability to play sport - to self-esteem and purpose, and can lead to strong grief reactions with the same stages that follow a death: denial, anger, depression and acceptance. Sometimes people are baffled by the overwhelming feelings and tearfulness they experience and don't relate it to their health status. The counselling space provides the opportunity to make sense of these strong reactions and address them. Suicidal feelings are not uncommon in people with chronic ill health and having the support of a mental health professional can lessen isolation and so risk.
6) Learning to live in the here and now
When we become ill we think a lot about the past and what we have lost, worry about what the future will hold and fight our current situation by pushing through pain and fatigue as we try to keep going ‘as normal’, which can often make things worse. All these mean we are focusing on something other than the present moment, how we want things to be rather than how they are, which can add to anxiety. Acceptance - which does not mean that you like your situation but that you acknowledge its reality - helps people with chronic conditions to adapt to the situation they find themselves in and perversely, it is often when you stop fighting that you find you can move forward. Mindfulness is a growing therapeutic approach that some counsellors have trained in, which helps you to make choices about where you focus and to relate differently to your uncertain situation. See my article on ‘How mindfulness can help you cope with chronic illness.’ for more on this.
7) Dealing with changes in role and relationship problems
Illness can bring change that threatens the way we see our place in the world, making our ability to earn money and care for others more difficult, and in some cases impossible. Relationships can change radically. This can be emotionally devastating and hard to talk to loved ones about as we struggle to keep going in the usual way. Taking time for yourself in the form of therapy sessions to consider these issues and work out how you can make changes that will benefit your health and your relationships can really help.
8) Addressing other mental health problems
People with long term conditions can become depressed due to the strain of living with a debilitating illness, and if untreated, this can get in the way of effective coping. Some have other pre-existing mental health conditions that make living with physical health problems worse, so seeking counselling for these is a positive step. For example, if you have chronic anxiety or a childhood trauma that has not been addressed this will impact on your mood and coping, and so your health problem. A skilled counsellor will be able to help you to focus on each issue with consideration to your whole health.
9) Developing good self-care
Therapy can support you to consider how you can use chronic illness management strategies and understand how your life experiences and family role influence your attitude to looking after yourself. This can be fundamental to learning how to minimize your illnesses symptoms through making space for self-care and reducing stress to an absolute minimum. Graded activity, sleep hygiene and pacing will be familiar concepts to counsellors who have trained in CBT. In ME/chronic fatigue syndrome and other illnesses there is a lot of controversy and misunderstanding around the prescribing of cognitive behavioral therapy as a treatment. I believe this comes from therapists with inadequate knowledge trying to 'treat' it without understanding its physiology and physical basis, who have encouraged sufferers to push to relapse. There is also often confusion with ‘chronic fatigue’ or being tired all the time, which is a completely different thing. CBT, when offered by a flexible empathic therapist, is useful for living with all kinds of physical illness so long as it is underpinned by physiological understanding. Just as you wouldn't expect to reverse diabetes with psychological therapy, counselling people with the complex condition such as ME/CFS needs realistic goals about coping and management rather than promising a ‘cure’.
10) Being unconditionally heard, understood and accepted
As mentioned earlier, even with the best friends and family relationships in the world you probably won’t feel that you can be completely honest with your loved ones about how bad you feel all the time. A good counsellor is non-judgmental, deeply empathic and focused completely on you. This separation from the rest of life is one of the main reasons why therapy works. If you are considering counselling for help with your health issue, ideally get a personal recommendation from someone else with your illness, or when you make an enquiry, question them on their experience in your particular area. Just because they have listed ‘cancer’, ‘ME/CFS’, etc. on their directory page or website, don’t assume they have the experience or level of physiological and treatment knowledge you want, ask.
The big issue ‘Everyone wants COVID to be over – but it isn’t’ BACP journal article Therapy Today, November 2022
read here Catherine Jackson meets Elizabeth and other practitioners specialising in supporting the growing number of people impacted by long covid in an article on what counsellors need to know to work with people living with this complex health challenge.
Why we all need to know the truth about Long Covid - July 2022
I have been living and working with chronic invisible illness for over 20 years, and have at times faced losing everything due to health problems. But the most heartbreaking time I have experienced in my career as a psychotherapist is now. I am living in a country that is believed by many to be ‘post-covid’ while infection rates rise again, the number of people developing long-term health issues and disabilities increase daily, and data comes in every week on the increased risk of stroke and heart attack, and memory problems for even vaccinated people experiencing mild Covid.
On 1st June 2022, the Office for National Statistics (ONS) reported that 2 million (3% of population) in the UK now have post-covid health issues. 71% of these report symptoms that adversely affect their lives, 20% have issues that limit them ‘a lot’. People are losing their jobs, their homes, their relationships and hope for the future. There have already been suicides. Many had no pre-existing conditions, some had been super-fit before they caught Covid-19. People just like you.
People I have spoken to for this article alone report post-covid health impacts as wide ranging as: 50% hair loss, inability to find words, full body pain, ‘flutter pulse’ throughout body, sore eyes, tinnitus, lightheadedness, inability to walk more than a few metres, brain fog, pericardial effusion, exhaustion after standing for a few minutes, sleep disorders, sensitivity to sound, metallic taste in mouth, derealisation, being bed bound, and relapsing months after recovery.
It has been a common misconception from the start of the pandemic that the possible outcomes are a binary ‘death or recovery’. Because we are being told that Covid is ‘mild’ and death rates are lower, the average person has little idea of another common outcome: damaged health, disability and restriction: post-covid health issues show across the body and mind in multi-system symptoms. Yet reactions people receive from medical professionals and loved ones include ignorance, disbelief, denial, helplessness, minimisation, even blame. Many have been told that their symptoms are ‘just anxiety’ and refused tests.
Extracts from Paul, 47, a runner & mountaineer’s Long Covid Twitter diary @HumanOnPlanet give insight into the wide symptoms that can be experienced:
‘20/05/22: Three hours of uncomfortable sleep. Awake with fast and pounding heart, sore eyes, squelchy ears. Ashamed to say last night's pizza and small glass of red wine have probably worsened the symptoms of this latest flare-up...23/05 a particularly uncomfortable level of the clunky AC current flutter-pulse feeling and extra-loud tinnitus...25/05 Got active yesterday. Compelled to move. Couldn't sleep afterwards. Too tired to write since. Awake in bed for hours. Resting heart rate thumping into the 90s. Oxygen saturation dipping into the 80s.’
Something that intrigues me: people with a Long Covid loved one holding conflicting beliefs - thinking that no negative outcome is possible for them, despite their friend's similar health & vaccination status. Heartbreaking as this is, it sadly resonates with what I have seen over many years of working with people with chronic conditions: it is very hard for healthy people to fully see the realities of acquired disability. Even when they care deeply for a sick friend, a primal need to protect themselves against considering the possibility that they could become permanently unwell often prevents full engagement, which can be very detrimental to relationships - the ‘it won’t happen to me’ defensive belief in action.
Ableism and the marginalisation of disabled people is at the centre of this hidden situation as health policy now favours the perceived healthy and economically active majority getting ‘back to normal.’ Ironically this is leading to a sizable minority who will never do that again because we are not taking simple precautions as we go about our lives post-lockdown. Masking in indoor spaces reduces transmission risk substantially, ventilation does so even better, meeting outside where possible offers huge reduction in risk. Lateral flow testing, while not 100% accurate, provides at least some guidance before we mix with others.
For those of us who already live with chronic illnesses that limit our quality of life, ability to earn money and reach our potential, watching many more join our isolated and misunderstood ranks is an unprecedented worldwide disaster, but it is not a new situation. The chronically ill, health historians and many scientists knew this was coming as the pandemic took hold. Some of us have been talking, writing and tweeting about it since April 2020, see @lizahpool for my efforts. As many have commented, specialists who claim not to know about post-viral disability can hardly be called experts: mass disability has been a feature of many modern pandemics : MERS, SARS, Ebola and polio.
The ME/CFS community has lived with an illness that maps onto a large section of Long Covid patients’ experiences that have been misunderstood, under-researched, misdiagnosed even mistreated for decades - 80% of them in one Action for ME survey reported a post-viral trigger. Long Covid sufferers have had some of their most helpful information on coping, pacing and the need to rest from them. It is heartbreaking watching people discover the lack of medical knowledge and treatment available and the lack of empathy that can be encountered even from close family when they don’t recover.
T Davies, 52. ‘I had long covid for around 18 months. I was ill in March 2020 for 6 weeks, fine for about 3 months, then floored by fatigue, cough and palpitations. I was lucky to be able to rest whenever I needed to because I'm a family carer and was able to do what I have to, then lie down in between. I'm pretty much better now except if I stress my lungs, say by running.’
The situation has been described as the largest mass disabling event since World War II with now an estimated 100 million people worldwide experiencing changed health. Even if many of these make a full recovery over time, it will leave massive problems on an individual, family, societal, economic and healthcare level. Every day I wonder why no-one with any power seems to care. Unfortunately, I suspect the explanation is similar to the mass ignoring of the creeping reality of climate change: short term financial and political aims dominate; humans often cannot contemplate problems they have not personally experienced; people are using all their energy to survive their own individual challenges and often deal with fear of illness and death using the psychological defence of denial. As any therapy professional knows, this is not always the healthiest strategy.
Long Covid poses a threat to society as we know it, affecting workforce numbers, adults’ ability to provide care, and young people’s ability to complete education. Alongside the challenges of climate change, this could be disastrous. If you are thinking ‘but I don’t know anyone with Long Covid’ there are a few explanations: some people aren’t linking their new health issues to an earlier Covid infection, some are trying to ‘push through’, people with chronic illness often don’t ‘look sick’, shame and fear are commonly experienced with cognitive difficulties and chronic illness so many aren’t talking about their struggle and the rest are at home, off sick from work, unable to socialise, hidden from view. Some may have tried to tell you and not been heard. It’s called ‘invisible disability’ for a reason.
Victoria, 29: ‘My life has been flipped upside down, an unimaginable 18 months with Long Covid. I have been dismissed from my job due to ill-health capabilities.’
If you think that people with chronic health problems who have continued to take precautions such as masking and avoiding indoor socialising, are suffering from an irrational anxiety (I’ve been accused of this and told that I ‘need to get on with my life.’ - I actually have a great life) I urge you to consider that we are actually acting from our hard-earned knowledge and experience and a deep care for our fellow humans’ wellbeing. Despite my vehemence, I am not an advocate of further restrictions, I know we have to live, earn, socialise. I just wish there was some attention being paid to risk management so that people who have no choice but to mix for work, or choose to socially, can be safer and vulnerable people can travel, shop and go to appointments again. You may believe that repeatedly getting covid is inevitable, I don’t disagree. However, emerging evidence on repeat infection’s culminative impact on long-term health strongly suggests caution.
I don’t want anyone to come to me in the future and say I didn’t try to warn them, but I gave up talking to most people about this some time ago because my vocal messaging about the risks of Long Covid have often been minimized, ignored, even pathologized. There have been rifts, friendship problems and a great deal of hurt. But I don’t regret speaking my truth because I wouldn’t wish the sort of health problems I have experienced on anyone. I am writing this because I am a human being and health professional with a duty of care to let people know that in some cases living with chronic illness can be worse than no life at all. If you take nothing else from this, please be compassionate about what people with Long Covid are facing and understand that no one is immune to it.
Please believe us - a call for empathy for Long Covid patients
Article on Counselling Directory 'How counselling can help with stress' 2013
This article gives examples of how I work using different types of counselling that you might find helpful to understand your stress and develop coping strategies.
Article for 'Welldoing' Therapy Directory - May 2015
'The Impact of Chronic Pain on Mental Health'
Articles about living well with chronic illness
Enabled: 10 reasons why working for yourself can work for people with long term health conditions. 02/02/2014. Archived.
How do you cope? Article for International ME/CFS & Fibromyalgia Awareness Day May 12th 2015
Why people say hurtful things to people with chronic illness and what we really want to hear. 24/04/2014 - archived. see archive page
Some tried & tested ways to minimize jetlag - 17/06/2014. Archived
Faced with yet another health issue? - 5 areas for coping - 10/06/2014 - archived see archive page
Modern Sleep Problems – 10 habits for a good night’s sleep. 13/02/2014 - archived see archive page
10 ways to consider yourself on the holidays – ideas for good health during celebrations.13/12/2013. see archive page
Easy tips on increasing your fruit & vegetable intake - 01/04/2014. see archive page
Guest Blog: 06/03/2014
M.E. / chronic fatigue syndrome and Depression written for 'M.E. myself and I' Blog - Living life in the slow lane with an invisible, chronic illness @theslowlane_ME on Twitter
