Your Autoimmune Disease Is Telling You to Go to Therapy

by Laurel van der Toorn, LMFT

I'm a therapist. I've spent over a decade thinking about the relationship between the mind and the body, studying it, talking about it with clients, writing about it.

And still, when my own immune system started acting up, my first instinct was to treat it as a purely medical problem.

That instinct wasn't entirely wrong. Autoimmune conditions are medical conditions. They require medical care. One thing that frustrates me about mind-body discourse is how quickly it slides into suggesting that people could think or rest or stress-manage their way out of diseases that require real treatment.

But the medical management and the emotional dimension of living with an autoimmune condition are not separate tracks. They interact in meaningful ways, and the emotional side gets significantly less attention than it deserves.

Here's what I've learned, both from the research and from personal experience.

Laurel van der Toorn, LMFT

Laurel is the founder of Laurel Therapy Collective and an EMDRIA-certified trauma therapist. She has personal experience navigating autoimmune disease and brings both clinical training and hard-won perspective to this work. She is licensed in California, Colorado, Florida, Michigan, Texas, and Washington, and sees clients online throughout those states.

A Quick Answer: Why Therapy and Autoimmune Disease?

Living with an autoimmune condition involves a sustained psychological experience that most people are left to manage alone: the uncertainty of an unpredictable illness, the grief of a body that no longer behaves predictably, the cognitive labor of self-advocacy in a medical system that doesn't always take you seriously, and the specific exhaustion of being sick in ways that are often invisible to everyone around you.

Therapy is not a substitute for medical care. It is support for the person navigating that care, and for the full weight of what chronic illness actually involves.

The research also consistently shows that psychological stress influences immune function. Not in a way that makes autoimmune disease a stress problem, but in a way that makes stress management genuinely relevant to disease course. I'll come back to the important caveats on this, because the nuance is where it gets clinically meaningful.

The Stress-Immune Connection: What the Research Actually Says

There is a substantial body of research on the relationship between psychological stress and immune function. The consistent finding is that chronic stress influences immune regulation in ways that are relevant to autoimmune conditions, through effects on cortisol, inflammatory cytokines, and the activity of the hypothalamic-pituitary-adrenal axis.This does not mean stress causes autoimmune disease. It doesn't, at least not in any simple or direct way. Autoimmune conditions have genetic components, environmental triggers, and complex pathophysiology that are not reducible to psychological factors.What the research does suggest is that stress can influence disease activity in people who already have an autoimmune condition. This is not the same as saying you can stress-manage your way to remission. It means that reducing the chronic background load on the nervous system is genuinely relevant to health outcomes, not as a primary treatment, but as something that operates in parallel with medical care.The distinction between 'stress is relevant' and 'stress is the cause' is one I take seriously. People with autoimmune conditions hear a lot of advice about managing stress, meditation, lifestyle changes, and so on, often from well-meaning people who are subtly or not so subtly suggesting that the illness has a psychological origin. That framing is harmful. The actual research is more nuanced and more useful.

The Part No One Talks About: What Chronic Illness Actually Asks of You

Managing an autoimmune condition is a part-time job that doesn't pay and doesn't come with sick days.There are appointments to schedule, labs to track, medications to adjust, symptoms to monitor, and an ongoing relationship with a medical system that, in my experience, often requires significant self-advocacy to get appropriate care. If you have a condition that affects multiple body systems or involves overlapping presentations, the complexity compounds.

And then there is the invisible labor of being sick in a body that looks fine to everyone else. Of canceling plans because you can't explain why you're not okay today. Of having a symptom dismissed. Of being told that a reaction you clearly experienced was probably something else. Of the particular exhaustion of being right about your own body and having to fight to be heard.

I've experienced this directly. Part of what makes it so depleting is that it requires you to hold two things simultaneously: genuine uncertainty about your own health, and the cognitive effort of advocating for yourself within a system that sometimes makes that difficult. The burnout in healthcare that providers experience is well-documented. What gets less attention is the burnout that patients experience navigating that same system.

Alexis Harney, LMFT

Alexis is an EMDRIA-certified EMDR therapist who works with adults navigating medical trauma, chronic illness, and the psychological weight of living in a body that requires ongoing management. She sees clients online throughout California and Florida.

On Self-Advocacy

I want to say something specific about self-advocacy, because I think it's undervalued as a clinical skill and undertaught in medical care.

In my own experience, the things that have shortened the diagnostic and treatment path have consistently come from tracking my own symptoms carefully, making specific observations, asking direct questions, and in some cases explicitly requesting tests or referrals. Not from waiting to be told something was wrong.

This requires a particular kind of confident persistence that isn't always easy when you're unwell. When a provider dismisses a concern, the path of least resistance is to defer. When a follow-up doesn't get scheduled, it's easier to assume it will happen than to follow up yourself. When a test comes back negative, it's tempting to read that as closure rather than as one piece of incomplete information.

Negative test results are not the same as nothing happened. They mean the test didn't detect the mechanism it was designed to detect. That is important information, but it's different from the question being answered. Learning to hold that distinction, and to continue advocating on the basis of your own experience rather than what testing has or hasn't confirmed, is a skill. It requires a settled sense of your own perception.

Therapy can help build that. Not by making you more aggressive or confrontational in medical settings, but by helping you stay grounded in your own observations when they are questioned.

The Grief That Doesn't Have a Name

Autoimmune disease involves loss that is hard to name and often goes unacknowledged.

There's the loss of the body you had before. The version of yourself that could eat without worrying, exercise without consequence, sleep without waking up with symptoms, move through a morning without taking stock of how each joint feels. Even if you were sick for a long time before you knew it, there's a before and after to living with a diagnosis.

There's the loss of certainty. One of the things autoimmune conditions take is a particular kind of baseline trust in your body. You can't always predict how you'll feel tomorrow. Plans become tentative. Commitments come with an internal asterisk.

And there's the grief of the things you've had to advocate for, the appointments that didn't get scheduled, the tests that weren't ordered, the reactions that were explained away. There's something exhausting and demoralizing about being right about your own body through a process that required you to fight to be taken seriously.

This kind of grief is real and often undertreated. Ontological loss, the grief of a future or a body you expected to have, is a recognized phenomenon in trauma-informed care. It deserves acknowledgment and support, not just management strategies.

Making the Invisible Visible

Tatevik Sarkisian, AMFT

Tatevik works with adults managing anxiety, chronic stress, and the nervous system patterns that make it hard to feel okay in their own body. She brings a warm, grounded approach to helping clients throughout California.

One of the specific challenges of autoimmune conditions is that many symptoms are invisible. Fatigue, pain, morning stiffness, cognitive fog: these are real and often significant, but they don't show up on other people's radar in the way that more visible symptoms do.

I've learned to be strategic about making invisible symptoms visible when it matters. Scheduling an early morning appointment so a provider can observe a symptom that resolves by midday is different from trying to describe it in a note. Tracking data over time creates a picture that a single visit cannot.

This is a kind of clinical self-advocacy that requires both the cognitive bandwidth to track and the confidence to present observations directly. Both of those things are harder to maintain when you're depleted, anxious, or demoralized by previous dismissals.

Therapy supports both. It gives you a space to process the demoralization, so you go back into medical appointments without the accumulated weight of every previous dismissal. And it builds the grounded self-trust that makes direct advocacy feel possible.

What Therapy Offers When You Have Autoimmune Disease

I want to be real about this, because vague claims about mind-body connection are what makes people appropriately skeptical of this topic.

Processing medical trauma

The medical experiences that come with autoimmune disease, particularly those that involve being dismissed, being unwell without answers, emergency situations, or having a reaction explained away by providers, can be genuinely traumatic. EMDR therapy is particularly well-suited to processing those experiences. Our post on EMDR for medical trauma covers how that works specifically.

Building tolerance for uncertainty

One of the hardest things about chronic illness is the ongoing uncertainty. You don't know if this symptom is a flare or something else. You don't know if the medication is working or if you need a different dose. You don't know how you'll feel next month. Therapy builds the capacity to tolerate that uncertainty without it consuming your attention or derailing your functioning.

Managing the cognitive load

Self-management of a chronic condition takes cognitive resources. Tracking symptoms, managing appointments, following up on referrals, adjusting behavior based on how you feel, these are all demanding. Therapy provides a space to offload some of the emotional weight of that labor, which frees up cognitive capacity for everything else.

Supporting self-advocacy

Staying grounded in your own observations when they are questioned requires a settled sense of self-trust. Therapy builds that over time. It also gives you a space to debrief after difficult medical interactions, so the frustration and demoralization don't compound into something that makes future advocacy harder.

Addressing the grief

The loss of a predictable body, the grief of an altered future, the specific losses that accumulate with chronic illness: these deserve space and support. Naming them explicitly in therapy, rather than managing around them, tends to make them more workable over time.

Regulating the nervous system

Chronic stress and chronic illness exist in a feedback loop that's worth actively managing. Why your nervous system gets fried covers what that looks like and what it costs. Therapy, particularly somatic and trauma-informed approaches, supports nervous system regulation in ways that are relevant to that loop, without overclaiming what regulation can do for disease activity itself.

Daniella Mohazab, AMFT

Daniella works with adults navigating anxiety, burnout, and the specific psychological toll of living with bodies that require ongoing management and advocacy. She helps clients build the internal stability to keep showing up for themselves even when that's hard. She sees clients online throughout California.

What Therapy Is Not

The wellness industry around autoimmune disease is full of claims that range from overstated to harmful.

Therapy is not a treatment for autoimmune disease. It does not replace medication, rheumatology, endocrinology, or whatever medical care your condition requires. A therapist who suggests otherwise is outside their scope.

Therapy also cannot reverse inflammatory disease through stress reduction alone. Stress influences immune function, but that influence does not work in a way that makes stress management a meaningful substitute for disease-modifying treatment. People who are told their condition is driven by stress and that they can manage it through lifestyle changes often end up undertreated while their disease progresses.

The stress-immune connection is real and relevant. It is not a license to minimize what is happening in your body or to suggest that the right mindset would change the underlying pathophysiology.

What therapy can do is support the whole person navigating a real medical condition. That is a meaningful thing. It is not everything.

A Word About Working in Healthcare

I'm a licensed clinician. I work in healthcare. I know how to read labs, how to ask questions, how to document symptoms.And I have still been talked down to by providers. I have had symptoms explained away that turned out to be real. I have had to connect dots that I expected providers to connect. I have had follow-ups not scheduled and labs not ordered that I had to request myself.I say this not to criticize the providers who have given me mostly good care, but because I think people need to hear it. If navigating the medical system is hard for someone with clinical training and insider knowledge of how it works, it is harder for people without those resources. That difficulty is not a personal failing. It is a feature of a system that is undersized for the complexity of what it is asked to manage.Having a therapist who understands this, and who can help you process the specific frustration of being an expert in your own experience and having that expertise not always be recognized, is not a luxury. It is part of the full treatment picture.

Common Misconceptions About Autoimmune Disease and Mental Health

"If stress causes flares, I just need to reduce my stress."

It’s not that simple. Stress influences immune function, but autoimmune disease is not primarily a stress problem. You cannot out-meditate an inflammatory process that requires medication. Stress management is relevant and worth pursuing, but it operates alongside medical treatment, not instead of it.

"My doctor said my test results were fine, so I must be okay."

Negative results mean the test did not detect the mechanism it was designed to detect. They do not mean nothing is happening. Continuing to track your symptoms and advocate for further evaluation when results don't match your experience is appropriate. Results are one data point. Your lived experience is another.

"Therapy is for mental health problems, not physical ones."

You’re right. But the mental and physical dimensions of chronic illness are not separate. The grief of altered health, the trauma of difficult medical experiences, the cognitive load of ongoing self-management, and the psychological cost of advocacy in a dismissive system are all legitimate therapeutic territory. You do not have to be struggling psychologically in isolation from your illness to benefit from support.

"I should be handling this better by now."

Chronic illness is genuinely hard. It is not harder because you're handling it badly. The expectation that you should be adapted, accepting, and functioning well by a certain point is not based in anything real. Struggling with it is a normal response to something that is, in fact, a significant and ongoing challenge.

Holistic Therapy in Los Angeles, San Francisco, and Online Throughout California and Florida

At Laurel Therapy Collective, we work with adults navigating chronic illness, medical trauma, and the full weight of what it means to live in a body that requires ongoing management and advocacy. Our therapists bring a trauma-informed perspective to this work and understand the specific territory of autoimmune disease.If you're carrying more than the medical system has space to hold, we'd be glad to help.

► Schedule a free consultation

► Learn more about holistic therapy

► Read about EMDR for medical trauma

Frequently Asked Questions About Therapy And Autoimmune Disease

Can therapy help with autoimmune disease?

Yes, in specific and meaningful ways. Therapy can help you process the medical trauma that often accompanies autoimmune diagnosis and treatment, build tolerance for the ongoing uncertainty of unpredictable illness, manage the cognitive and emotional load of chronic self-management, develop and sustain effective self-advocacy, and grieve the losses that chronic illness involves. It is not a treatment for autoimmune disease, and it does not replace medical care. It supports the person navigating that care.

Does stress cause autoimmune disease?

Stress influences immune function, but it does not cause autoimmune disease in any simple or direct way. Autoimmune conditions have genetic components, environmental triggers, and complex pathophysiology that go well beyond psychological factors. What the research shows is that chronic stress can influence disease activity in people who already have an autoimmune condition. That makes stress management genuinely relevant, but not as a primary treatment, and not in a way that minimizes the need for appropriate medical care.

I have an autoimmune condition and my symptoms are often dismissed. What can I do?

Track your symptoms in detail, including timing, severity, and what makes them better or worse. Bring written documentation to appointments. Schedule visits when symptoms are most prominent so providers can observe them. Be explicit about what you are asking for rather than waiting to be offered it. And debrief the difficult appointments with a therapist or trusted person, because accumulating dismissal is demoralizing in ways that make future advocacy harder. You are the expert in your own experience. A provider's inability to confirm something does not make it untrue.

What is medical trauma and how is it treated?

Medical trauma is the psychological impact of frightening, dismissive, or overwhelming medical experiences. It can include the trauma of a difficult diagnosis, the experience of being dismissed or disbelieved, emergency medical events, or the ongoing stress of living with uncertain or undertreated illness. EMDR therapy is particularly effective for processing medical trauma, because it works at the level where traumatic memories are stored rather than requiring detailed verbal narration of the experience. Our post on EMDR for medical trauma covers what that treatment looks like.

How do I find a therapist who understands chronic illness?

Look for a therapist who identifies chronic illness, medical trauma, or somatic work in their areas of focus. In a consultation, ask directly whether they have experience supporting clients with autoimmune or other chronic conditions. A therapist who understands the specific terrain, including self-advocacy, the grief of altered health, and the relationship between stress and immune function, will be more useful than one who treats the psychological dimension as separate from the medical one. At Laurel Therapy Collective, this is work we understand from multiple directions.