Miriam Franco, MSW, PsyD

Photo of Miriam Franco, MSW, PsyD

Professor, Sociology Department
Immaculata University, Immaculata, Pennsylvania
Member, MSAA Healthcare Advisory Council

…on the emotional and cognitive changes in MS


“Psychological understanding of MS has evolved greatly since the beginning of the 20th century. For many years, cognitive impairment was rarely distinguished from mental symptoms. The relationship between mood, cognition, and disease course were not known. Early efforts relied on psychoanalytic case histories correlated to findings on the Rorschach (inkblot) tests to try to characterize the type of individual who was prone to MS.

“Well into the 1970s, research continued to identify a standard MS personality or a particular emotional response to the disease. Advances in mental health, neuropsychology, and medical technology in the 1980s discovered that depression was a symptom of MS, as well as a reaction to the life consequences of having MS. By the 1990s, major advances in neurologic testing detected subtle and specific cognitive changes through brain-imaging techniques. Combined with a greater collaboration between neurologists and neuropsychologists, these advances led to a better understanding of depression and cognitive changes in individuals with MS.

“Gradually, a bio-psycho-social model of MS emerged and psychological treatment approaches to MS were expanded. These not only included symptom management of depression, anxiety, and cognitive changes, but also improvement of social and economic support. Complementary interventions, such as guided imagery and meditation, were also included to lower stress and improve wellbeing.”

Dr. Miriam Franco is a psychologist in practice in Wayne, Pennsylvania and is a professor at Immaculata University. She is a certified MS and Guided Imagery (GI) specialist and has published on GI to reduce anxiety and injection anxiety with MS. Dr. Franco consults on improving quality of life for caregivers and persons with chronic illness. She also trains professionals to use GI to lower stress, anxiety, and depression. As founder of The Guided Imagery Foundation (a nonprofit organization), Dr. Franco seeks to develop research funding for GI programs in the community.