The MSing Link – Episode 248

How to Process Chronic Illness Grief (When Talk Therapy Isn't Working)

Host: Dr. Gretchen Hawley, PT, DPT, MSCS
Guest: Ashley Milas, Trauma-Informed Somatic Grief & Life Transition Coach
Date: September 3, 2025

Episode Overview

This episode explores the often-overlooked experience of grief for people living with chronic illness, specifically Multiple Sclerosis (MS). Dr. Gretchen Hawley speaks with Ashley Milas, a somatic grief and life transition coach who draws on her own 13+ year chronic illness journey. Together, they discuss why grief is frequently unrecognized or minimized in the chronic illness community, the limits of talk therapy, and the potential of somatic (body-based) approaches to emotional healing. Listeners are introduced to practical, gentle ways to process emotions through the body and nervous system, with insights into how somatic work can help move forward after loss.

Key Discussion Points & Insights

Why Chronic Illness Grief Goes Unrecognized

• Focused on Survival: Many people are so consumed by managing their diagnosis—doctor visits, medications, treatments—they don't realize they're carrying unaddressed grief.

  "I don't even think I recognized that I was holding so much grief because I was so focused on just the diagnosis itself...I don't think that left a lot of room to even pay attention to what it was doing to me emotionally." – Ashley (05:41)

• Minimizing Emotions: Individuals often compare their situation to others, thinking theirs isn't 'bad enough' to warrant grief, or suppress their feelings to avoid discomfort or to protect others from emotional discomfort.

  "We tend to minimize our grief...Because I see a lot of people comparing, ‘Well, there’s always someone that has it worse...I should feel grateful’...Sometimes feeling that can minimize what we’re going through as well." – Ashley (06:42)

What Grief Might Look or Feel Like (08:09)

• Symptoms of Grief: Disconnection from self, others, and life; loss of identity; not feeling like oneself anymore.

  "Disconnection, I think, is a really big symptom. We start to feel disconnected from ourself and disconnected from other people and kind of disconnected from life in general." – Ashley (08:16)

• Yellow Flags: These sensations can be early indicators signaling unrecognized grief.

Somatic vs. Talk Therapy (11:33–13:55)

• Talk Therapy: Valuable for cognitive understanding but can fall short for those feeling stuck—they may intellectually ‘know’ what’s going on but not feel any emotional shift or relief.

  "People will come to me...they say, ‘I get it, but I just don't feel different.’ And so that's the body piece, because the mind and the body have to go together..." – Ashley (12:12)

• Somatic Work: Focuses on experiencing feelings within the body (sensation, movement, nervous system responses), not just talking or thinking about feelings.

  "We’re really focusing on how we’re feeling and sensing things instead of how we’re thinking about things...By listening to this language of the body, we’re able to gain a much deeper understanding of what's truly going on within us." – Ashley (14:00)

Overcoming Fear of Feeling Difficult Emotions (15:38–17:33)

• Gentle, Slow Approach: Somatic work proceeds at the individual's pace, exploring only safe, ‘bite-sized pieces’ of feeling at a time.

  "It's very slow and gentle, at the pace of the person and their nervous system." – Ashley (17:28)

• Building Comfort: Work may begin with simply finding a small sense of safety in the body before engaging with emotional material.

The Role of the Nervous System (19:19–22:18)

• Constant Survival Mode: Chronic illness disrupts feelings of safety, causing people to get stuck in fight, flight, or freeze responses.

  "When we're in a chronic illness...we can stay kind of chronically in these responses and we can actually get stuck there." – Ashley (21:22)

• Impact of Getting Stuck: Prolonged nervous system dysregulation can worsen physical symptoms and halt emotional processing, keeping individuals stuck in grief.

Moving Toward Resilience (23:44–24:49)

• Flexibility, Not Perfection: Aim is not to be calm and peaceful at all times, but to fluidly move in and out of emotional states—a resilient nervous system adapts.

  "There's no state that is good or bad...we just can't get stuck in one place too long." – Ashley (24:25)

• Key Elements of Rebuilding: Supporting one’s emotional needs and nervous system through self-compassion and practical tools is essential to creating a new sense of normalcy after loss.

What Somatic Coaching Looks Like (29:08–31:18)

• Highly Individualized: Sessions differ based on safety, comfort in the body, and emotional readiness.
  • May begin with noticing sensations (e.g., heaviness in the chest), exploring them in detail (qualities, images, associated memories), and following the body's cues.

  "We're just really following whatever comes up...I never know when I’m working with someone what the session is going to be like—I just follow whatever is present for them." – Ashley (30:54)

Notable Quotes & Timestamps

• On Unacknowledged Grief:

  "We're just really trying to survive it...I don't think that left a lot of room to even pay attention to what it was doing to me emotionally." – Ashley (05:41)

• On Why Somatic Work Matters:

  "By listening to the language of the body, we're able to gain a much deeper understanding of what's truly going on within us." – Ashley (14:24)

• On the Fear of Facing Emotions:

  "It's very slow and gentle, at the pace of the person and their nervous system." – Ashley (17:28)

• On the Normalcy of Nervous System States:

  "There's no state that is good or bad. They're all important in their own ways, but we just can't get stuck in one place too long." – Ashley (24:25)

• On Accepting New Normals:

  "We have to work with what's going on within us before we can get to that next place." – Ashley (26:36)

• On Session Structure:

  "I'm just their guide, kind of through their own body, but I'm taking them through whatever they're experiencing from within, inside themselves." – Ashley (19:07)

Memorable Moments

• Ashley’s Vulnerability:
  Ashley shares her own introversion and pride in pushing comfort zones by taking part in podcasts. (03:47)
• Dr. Gretchen’s Insights:
  Highlights that processing grief somatically offers a sense of agency and control—something often lost with chronic illness. (17:33)
• Metaphor of Emotional ‘Yellow Flags’:
  Disconnection is positioned as an early warning sign, not necessarily a crisis, for listeners to tune into. (08:52)
• Book Recommendation and Resources:
  Reference to “The Desire Map” as a unique approach to goal-setting based on feelings rather than achievements, paralleling somatic principles. (27:01)

Timestamps for Major Segments

• 02:38: Introduction of Ashley and the theme of unspoken chronic illness grief
• 05:33: Why grief is often overlooked in chronic illness
• 08:09: What chronic illness grief can actually feel or sound like internally
• 11:33: Talk therapy vs. somatic approaches—strengths and limitations
• 14:00: What is somatic work? Key differences and overview
• 15:38: Addressing fear and resistance to experiencing difficult emotions
• 19:19: The role of the nervous system and survival responses
• 24:49: How to rebuild after loss and build resilience
• 29:08: Walkthrough of what somatic coaching looks like in practice
• 31:53: Where to find Ashley and how to reach out for a consult

How to Connect with Ashley Milas

• Website: ashleymylas.com
  Ashley offers a free 45-minute consult for anyone curious about somatic coaching and grief work.

This episode is recommended for anyone with MS, other chronic illnesses, or those supporting loved ones confronting unspoken grief. It provides validation, gentle guidance, and a fresh approach to emotional healing beyond traditional talk therapy.