How a Coach Can Support a Client During Treatment of a Long-Term Illness (e.g., Lyme Disease)

And why it makes sense to understand what is happening in the body

How to Support a Client During Treatment of a Long-Term Illness (e.g., Lyme Disease)

Treatment of a long-term illness such as Lyme disease is not just about antibiotics and laboratory results. It is also a period full of uncertainty, fatigue, limitations, changes of plans, and often the feeling that your body has “stopped belonging to you.”

A person deals with two things at once:

• what is happening in the body (infection, inflammation, pain, treatment),

• what is happening in the head and in the soul (fear, helplessness, frustration, pressure from the surroundings).

A coach is not a doctor and does not intervene in treatment. But they can be the person who helps you not get lost in the chaos, maintain psychological stability, and find ways to handle this journey day by day – practically, realistically, and humanly.

In this article, we will look at three areas:

1.     Meet the opponent – what Borrelia does in the body.

2.     How antibiotic treatment works – a simple and understandable comparison.

3.     How a coach can truly help – concrete situations where coaching has a significant effect.

1. Meet the opponent: Borrelia burgdorferi

1.1 How big is Borrelia and why is it so “sneaky”?

Borrelia are not typical round bacteria. They are spirochetes – thin, spiral-shaped bacteria that look like microscopic worms.

For orientation:

• Borrelia: approximately 10–20 μm (up to 30 μm) long, 0.2–0.3 μm thin

• Red blood cell: 7–8 μm

• Human hair: 50–100 μm

➡️ Extreme thinness allows Borrelia to move through tissues like a “drill.”

1.2 How do they penetrate all the way into nerves?

Three key properties:

1.2.1 Spiral “drilling” movement

Thanks to periplasmic flagella, they:

• rotate like a screw,

• drill between cells,

• are able to pass through dense tissues,

• penetrate deep into muscles, joints, and nerve roots.

1.2.2 Ability to pass through vessel walls

Borrelia can attach to endothelial cells and create small gaps between them. Through these gaps they escape from the blood into tissues – including nerves.

1.2.3 They love collagen

Nerve sheaths and surrounding connective tissue contain a lot of collagen. Borrelia seek out this environment and therefore may cause:

• burning,

• tingling,

• pain in fingers and limbs,

• weakness.

1.3 Does Borrelia also get into the brain?

• Yes – but not in everyone.

• It depends on the bacterial strain, the person’s immunity, and the stage of the disease.

• If it penetrates into cerebrospinal fluid, neuroborreliosis develops, which often requires more intensive treatment.

2. How treatment works and why antibiotics differ

Different antibiotics penetrate different tissues. Therefore, they are chosen based on where Borrelia has settled – in the skin, joints, peripheral nerves, or central nervous system.

Below is a simplified orientational overview to help understand the differences.

Comparative table of antibiotics

(orientational progression of improvement and typical use)

Antibiotic	Onset of improvement	Fuller improvement of symptoms	Nerve regeneration	Typical use
Doxycycline	5–10 days	2–4 weeks	3–12 months	nerve roots, peripheral neuropathy
Ceftriaxone	3–7 days	2–3 weeks	3–12 months	CNS, severe neuroborreliosis
Amoxicillin	7–14 days	3–6 weeks	– (weak effect on nerves)	mild skin/joints

📌 Note: The time frames are orientational. Each person reacts differently and the course may vary depending on their condition, the extent of involvement, and the individual reaction of the nervous system.

2.1 Doxycycline – stops the growth of Borrelia

• blocks bacterial protein synthesis (bacteriostatic effect),

• penetrates tissues and nerve roots well,

• weaker penetration into cerebrospinal fluid.

For whom and when?

• skin forms,

• peripheral neuropathies,

• some nerve forms outside the CNS.

2.2 Ceftriaxone – directly kills Borrelia

• disrupts the bacterial cell wall (bactericidal effect),

• excellent penetration into cerebrospinal fluid,

• used especially in more severe neurological forms.

For whom and when?

• neuroborreliosis,

• meningitis,

• significant neurological symptoms.

2.3 Amoxicillin – safe but weaker on nerves

• bactericidal effect,

• worse penetration into the nervous system,

• excellent for early skin forms.

For whom and when?

• children, pregnant women,

• mild skin/joint forms.

3. How a coach can support a client during treatment of a long-term illness

Now the most important part:

The doctor treats the bacterium. The coach supports the person living with it.

Below are six areas where coaching has a major impact during long-term treatment.

3.1 Managing fear, uncertainty, and stress

What the coach helps soften:

• overwhelming thoughts,

• fear of results,

• anxiety from uncertainty,

• mental chaos.

Concrete benefits:

• calmer mind,

• more realistic view,

• better orientation,

• fewer catastrophic scenarios.

Methods:

• grounding questions,

• separating facts and assumptions,

• short calming techniques.

3.2 Maintaining psychological resilience and energy

Illness is mentally and physically exhausting.

A coach helps:

• find a sustainable pace,

• work with fatigue,

• avoid overexertion,

• stop blaming yourself for weaker days.

Techniques:

• energy mapping,

• working with pacing,

• linking treatment to personal values.

3.3 Habits and daily structure

Illness disrupts routine – sleep, food, medication, movement.

A coach helps:

• keep routine even on bad days,

• simplify daily functioning,

• maintain a small but stable structure.

Methods:

• micro-habits,

• short check-ins,

• implementation planning (“when, where, how”).

3.4 Working with emotions

Fear, frustration, sadness, anger – normal parts of treatment.

A coach helps:

• relieve emotional tension,

• process difficult days,

• find emotional stability.

Methods:

• naming emotions,

• gentle emotional processing,

• reframing / shifting perspective.

3.5 Communication with others and with doctors

Illness often creates pressure in the family and confusion at work.

A coach supports:

• preparation for doctor’s appointments,

• setting healthy boundaries,

• communicating needs,

• expressing your condition simply and clearly.

Methods:

• conversation preparation,

• boundary setting,

• simplifying communication.

3.6 Re-establishing direction, certainty, and identity

A long-term illness can disrupt how you see yourself.

A coach helps:

• regain a sense of stability,

• strengthen personal value,

• clarify who you are “now” and who you will be “after,”

• create a healthier personal narrative.

Methods:

• identity work,

• values exploration,

• creating a personal story.

Conclusion: You don’t have to go through this alone

Lyme disease and other long-term illnesses often change life more than one would expect.

Suddenly you plan according to fatigue instead of your calendar, your surroundings don’t understand why it “takes so long,” and your mind runs at full speed.

A doctor focuses on the infection and the treatment plan. A coach focuses on you as a person:

• how you manage each day,

• how you feel,

• how you protect your energy,

• how you set boundaries,

• how you maintain direction and inner stability,

• how you don’t lose yourself.

Coaching will not cure the illness – but it can profoundly influence how you experience the journey. It can bring stability, clarity, support, and inner strength where it is needed the most.

And this is the real value of a coach:

not being another authority, but a partner who stands on your side and helps you go through treatment with dignity, awareness, and as much inner support as possible.