If you’ve thought about booking a counselling session and haven’t, there’s a good chance one of two things is stopping you. You’re not sure what you’d even say. Or you’re tired just thinking about explaining your whole MS history to someone new, again.
Both are fair. This post is about what a first session is actually like: no script, no tidy story, and no need to have it all worked out first.
What Happens in a First MS Counselling Session?
A first session is a conversation. It’s 40 minutes, one-to-one, online on Zoom, so you can do it from home.
You don’t need to arrive with a clear problem or a plan. I’ll start by explaining how the session works and what stays confidential, then ask what’s brought you here. You lead, and I follow. You can start wherever is easiest: something that happened last week, or a feeling you can’t explain yet. It doesn’t have to come in order.
By the end, you’ll have a sense of whether this feels right for you. That’s what the first one is for.
Do I Have to Explain My Whole MS History?
No. It’s a common worry, and a fair one. When you’re already tired, retelling the diagnosis, the relapses and the medication changes can use up the whole session before you’ve said what you came to say.
Tell me as much or as little as you like. A couple of sentences is plenty: when you were diagnosed, what type you have, how things are right now. Skip the rest.
And there’s a lot you won’t have to explain. What fatigue is. Why “but you look so well” lands badly. Why a good day still costs you. I’ve lived with MS for nearly 20 years, so I already know.
What Do We Actually Talk About?
Whatever is weighing on you most. Often that’s fear about the future, grief for the life you’d planned, feeling like a burden, or not recognising yourself anymore. Sometimes it’s smaller and just as real: a conversation with family that went badly, or being told you’re coping so well when you’re not.
You don’t need a tidy story. People start in the middle, change direction halfway through, or stop and wonder why they’re saying it. That’s all fine. You can cry or you can not. A pause is allowed too.
How Is MS Counselling Different From General Counselling?
The difference is what you don’t have to do first. In MS counselling:
You’re not teaching me about MS. Session time goes on you, not on a crash course.
Fear and grief aren’t treated as overreacting. They’re a reasonable response to an illness that won’t give you a straight answer.
Fatigue and brain fog are part of the conversation. If you lose your words halfway through a sentence, we wait.
I’m a counsellor, not a psychologist or a doctor. I don’t diagnose, and I don’t give medical advice. Questions about your own disease belong with your neurologist or MS nurse. If you want to know how a counsellor and a psychologist differ, this post covers it.
What If I’ve Tried Counselling Before and It Didn’t Help?
Then being wary makes sense, and it doesn’t mean counselling can’t work for you. Often the problem is fit. If most of a session went on explaining what MS is, there was little time left for what was actually going on.
I go into this more in Does Counselling Actually Help With MS?. The short version: a first session is also your chance to see whether it feels right. If it doesn’t, you can say so.
What Happens at the End of the First Session?
I’ll be honest about whether working together makes sense, and if something else would suit you better, I’ll say so. There’s no ongoing commitment, and it isn’t a pitch.
If you want to keep going, we talk about what that could look like. If you don’t, that’s fine too.
Is a First Session Worth Booking?
If you’re not in crisis, but you’re carrying more than you’re saying out loud, that’s exactly who it’s for. You don’t need to be at breaking point. You don’t need to prove it’s bad enough. And you don’t have to figure this out alone.
If you’re wondering about cost, this post covers what’s available in Australia, and the counselling page has the details.
This post is general information, not medical advice. Please talk to your neurologist or MS nurse about any questions about your own health. Em West Multiple Sclerosis Counselling is not a crisis service. If you’re in crisis or thinking about ending your life, please reach out now: Lifeline 13 11 14 (Australia), or your local emergency number (000 in Australia), or your local crisis line.
