Patients with Multiple Sclerosis in Psychotherapy: Processes of Meaning Making and Self Transformation 2020

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Abstract
Background
Recent empirical literature on autoimmune diseases has focused extensively on the implementation and evaluation of psychosocial interventions. Psychotherapy and counselling processes for multiple sclerosis (MS) have gained special attention given the cognitive and behavioral dimensions of the symptoms as well as their unpredictable course. The current study aims to gain a deeper understanding of the meaning making processes for persons with MS (PwMS) who are in psychotherapy treatment.

Method
The sample of this study consisted of ten PwMS who described their experience of the illness and of psychotherapy of choice through semi-structured interviews. Data collection and analysis adhered to Interpretative Phenomenological Analysis guidelines.

Results
The results revealed that PwMS struggled with understanding the initial symptoms, contemplated taking medication, and related symptom development to psychological factors such as depression. Participants were preoccupied with disability representations and questioned the trustworthiness of their bodies. They worked towards integrating the illness into their identity and described how psychotherapy encouraged psychological agency whilst feeling supported and "accepted".

Conclusions
Psychotherapy contributes to the processes of shaping participants' life worlds, offering a space to self-organize and reflect within genuine therapeutic relationships.

https://clinmedjournals.org/article...gy-and-psychoanalysis-ijpp-6-046.php?jid=ijpp
 
Attributing MS symptoms to psychological variables
Participants concluded that MS presented itself as a counterblow to depression, stress, loss and anxiety. They followed this line of thinking regarding understanding the causes of MS. The illness for them came as a retaliation, "reaction", or "reply" to their lifestyle up until that point. Two participants understood MS as something punitive: "my body punished me, I was doing something wrong." Five participants discussed the connection of MS with motherhood and how the symptoms escalated after their pregnancies. Participants mainly associated the onset of symptoms with grief. Such associations included: "I had one strong relapse in 2012; my mother had died and psychologically I was really bad" and "I had stopped working in 2010 and I was really sad, I was staying indoors and perhaps that is how I got it [MS]." Participants described MS as a "psychological disease" and insisted that "it is not biological." All participants reflected on how disease progression was closely related to their psychic world: "if you think of what I have been through, I should be in a wheelchair."
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you have to ask what on earth the patients were being told by their therapists(?)
 
Sly Saint said:
you have to ask what on earth the patients were being told by their therapists(?)
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If we are talking a fairly standard approach to psychotherapy then the input from the therapist would be minimal - the point is for the client/patient to give reality to their inner world by having the therapist as a supportive audience - however as there's no data on what therapeutic approaches were used its not possible to be confident one way or the other. The relevant part of the text is:

"Eligibility criteria included being 18 years of age and above, with the diagnosis of MS and involved in psychotherapy in a context of their choice during the time of data collection." - which I take to mean that participants had chosen their own therapists - and were likely being seen as private clients which is something which I think should have been made explicit.

There is this on psychotherapy in Greece: http://www.europsyche.org/app/uploads/2019/10/Greece_Information-about-Psychotherapy-in-Greece.pdf

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"A big differentiation is evident: the Universities on the one hand, give some kind of training to psychologists and psychiatrists, with very little clinical practice and no emphasis on personal therapy. Most of the private training centers, on the other hand, offer training in psychotherapy as a postgraduate course to graduates of the whole spectrum of humanistic and social studies
(psychiatrists, nurses, social workers, sociologists, occupational therapists, teachers, etc.) without excluding graduates of other scientific branches. These centers actually follow a minimum of four years programme, with the first year as an "introductory" course (mostly theory and personal therapy / experience) and the other three years programme comprising theory, personal experience /
therapy, and clinical work under supervision. The training programmes are either in a continuous basis or a "weekend" basis (training hours are distributed either through the whole week or only in weekends). There is a difficulty with some organisations to secure for their students a way to work with clinical populations, while others have no difficulty as they are both therapy and training centers."

list of psychotherapy schools
1. Athenian Institute of Anthropos
2. Athens Synthesis Centre
3. Gestalt Foundation
4. Greek Institute for Vegetotherapy and Character Analysis (E.I.N.A.)
5. Hellenic Biosynthesis Center
6. Hellenic Focusing Centre
7. Laboratory for the Study of Human Relations
8. Institute of Group Analysis Athens
9. Institute of Family Therapy
10. Institute of Psychodrama-Sociotherapy
11. Institution for Councelling and Psychological Studies
12. Art and Psychotherapy Centre
13. Training Institute of Dramatherapy and Playtherapy “Athyrma”
14. Hellenic Society of Daseinsanalyse
15. Hellenic Association Society for Existential Psychology “Gignesthai”

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so it's anyone's guess what the 10 PwMS actually ended up with, but from my limited experience and comments from others, the grim narratives, self blaming etc ' are par for the course in going through psychotherapy without any need for prompting by the therapist, obviously though it depends what the starting point is and what demons it is that the client is seeking to excise.

Of note is that the study (rather than the psychotherapy) was informed by "Interpretative phenomenological analysis" analogous to the study discussed here: https://www.s4me.info/threads/the-f...e-me-cfs-2022-krabbe-et-al.30439/#post-446466
 
Participants described MS as a "psychological disease" and insisted that "it is not biological.
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They "insisted" uh? Uh huh. Sure. Why not? And other things straight from the corporate brochure by pure random coincidence, I'm sure. "Boss, I swear the kid looked me straight in the eye and said, completely unprompted: 'I'm McLoving it'. They love it. No, they McLove it!"

Again, anyone running marketing focus groups for a corporate client who would simply report what they think the client wants to hear, not what's true, simply will not continue working in that field anymore and very quickly. This whole thing where people put their own opinions as if they came from the patients should be an extreme concern to the field. And yet it's clearly not.

I'll never understand the need to make up some fake narrative for illness and symptoms. They suck, they are suffering, they impact function. End of story. There is no need to give depth to single data points and their impact is not their meaning, damnit. It's basically trying to find karmic justice or "everything happens for a reason" nonsense. Most bad things are random. As are most good things. This is trying to make the universe being all about the small subjective perspective of whoever is making this stuff up.

I remain convinced that the best case scenario for the discipline of psychology is if everything that has been done so far were simply erased, including in everyone's brains, as if it never happened so it can simply start over without all this silly mythical baggage carried from pre-science ideologies. Upstream errors carry downstream, and there is a bullshit factory piping hot raw sewage right at the start.
 
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