May is Lupus awareness month. I wanted to write this article to bring awareness to this disease and well as to offer some insight into how I approach clients who are living with Lupus or other debilitating chronic diseases.

My daughter became seriously ill in December 2018. On the Saturday she was playing in a volleyball tournament at school as she finished up with grade 11. Within a few days, she was admitted to hospital and so her journey started. Those first few months were incredibly stressful as we stumbled around in the dark and then after around 6 months, numerous
doctors, multiple hospital stays and a lot of pain and suffering she was diagnosed with Lupus!

What is Lupus?

Lupus is an autoimmune disorder. It is incurable and lifelong. While treatable (and we are thankful for these treatments), the side effects from the treatments and medications can sometimes be worse than the actual disease.

What is an autoimmune disorder?

It is a disease where your immune system, the system in your body that normally fights infection, attacks healthy parts of the body instead. In Lupus patients, this often includes the skin, joints, organs such as heart, lungs, kidneys or the central nervous system. As a result of the overactive immune system, the person often experiences massive amounts of
inflammation which causes chronic pain and swelling. 9 out of 10 Lupus patients are woman and the disease usually sets in between the ages of 15-44 years old. (

How is Lupus treated?

Treatment requires medication to reduce inflammation in the short term and long term the immune system needs to be suppressed. This is done through the use of chemotherapy drugs, immunosuppressant’s as well newer treatments called biologics. As mentioned above these treatments often have horrible side effects. They are also expensive and often difficult
to access, even in private healthcare.

I am thankful to have walked this road with my daughter, as it has opened up a whole new world of suffering that I never knew existed and it has equipped me to better understand and help my clients. I have had multiple clients who have autoimmune or other terrible chronic diseases. Some have come to see me for help specifically with the diagnosis and for others, it has emerged as a big part of some of the struggles they’ve been experiencing.

These are the most important things I have learned in supporting my daughter and when dealing with clients in the counselling context:

● Watch out for depression. Make referrals as necessary and educate client on a holistic approach; body, mind and soul.

● Anxiety is often a problem. These types of diseases come with a lot of unknowns. Again, make referrals as needed and make sure to include tools for coping with anxiety type symptoms into your sessions.

● Grief is common. Clients with chronic illness deal with a lot of loss. Try to balance the loss with a gratitude journal (just watch your timing of when to introduce the subject).

● Be ready to deal with existential crisis. It is at times like these that people often look to the heavens and ask WHY? Beware of platitudes. In my experience, they are at best unhelpful and at worst, really hurtful. Most clients just want someone to listen at first. Often they have been pushed from pillar to post before being diagnosed, some being accused of attention- seeking or having their symptoms dismissed. To be SEEN and HEARD in counselling will be novel and life-changing to your client.

● Solutions are important but they need to be well-timed. Once your client has felt heard and you have taken time to fully understand them and their situation, start helping your client to figure out what can be done. I am guilty of pushing solutions too early to satisfy my own need to be doing something seemingly productive. Resist the urge and let your client lead.

● Take time to research your client’s specific illness so that you have a full
understanding of what they are dealing with. I found this very helpful and I gained trust quickly when clients realised I was committed and willing to help.

I hope that this article has been helpful. Please leave a question or comment below, we look forward to hearing from you.

Nikki Lister
Wellness Counsellor in Private Practice and proud mom to a Lupus Warrior

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