Therapists of all kinds sometimes express reluctance to work with people who have Multiple Sclerosis (MS). This paper looks at possible sources of such reluctance. Identification with the client can cause distress at thoughts of present or future disabilities. MS can create feelings of impotence, frustration or anger: where these feelings are unbearable they may be evoked in others, in a process of projective identification. Damage to parts of the brain necessary for cognitive and emotional processing can disrupt communication in many ways, often below the level of perception, causing both sides to see the other as simply awkward or difficult. The author also suggests that ‘the fewer people with MS one knows, the greater the propensity to generalize’, and suggests that generalizing may lead to false assumptions, particularly where cognitive and emotional functioning is concerned. Many people with MS function perfectly well, cognitively and emotionally; but the small proportion who do not may sensitize those therapists who do not understand the impact of MS on these areas of functioning.