CHARTERED CLINICAL PSYCHOLOGIST SPECIALISING IN ME/CFS, LONG COVID, FIBROMYALGIA & BURNOUT

I know from personal experience that living with fatigue-related conditions can rapidly breed despair, overwhelm, rage and hopelessness. We can be gaslit and stigmatised by others. We may lose our jobs, our social roles and our very sense of who we are. This can be deeply isolating and traumatic. Just getting through the day with chronic fatigue can feel like a gruelling, lonely battle. 

It can be incredibly powerful to have a space to express exactly how hard this is. What’s more, feeling seen and understood by another person who actually gets it can aid healing! It can help our nervous system come into greater balance through a process called “co-regulation”. 

Most of us tend to have an "inner critic" - or a part of us that gives us a hard time about things. I know I do.

Has your inner critic become awfully loud since you became unwell? Does it criticise you for not being able to do the things you used to do, for letting people down or for having crashes and flare-ups? 

Drawing on Compassion Focused Therapy (CFT), we can support you to be kinder to yourself. This can help you to learn how to detach from your inner critic, and instead learn to treat yourself as you might a close friend. Learning to treat yourself with kindness can help the body to shift out of “threat mode” and into a healing state.

Fatigue-related conditions are not well understood in medical terms. However, drawing on research across scientific disciplines, we can build a shared understanding of some of the possible biological, psychological and social factors which may be playing a role in your illness. 

This commonly means looking at the stress that you have been carrying in your body and the demands you have been placing on yourself. Stress is fatiguing, and fatigue is stressful. Building a coherent understanding of what is happening in your body can make it much easier for you to do what matters to reverse this vicious cycle.

When you are living with a fatigue-related condition, you may feel like your body is failing you. The dizzying array of symptoms you experience can be deeply unpleasant, and so you may understandably try to avoid them in any way you can. This response can send signals to your brain that your symptoms are dangerous. This ramps up your nervous system’s threat response and can cause symptoms to intensify. It's a bit like pouring petrol on the fire.

Paradoxically, accepting your symptoms right now can make it easier for them to fade away in future. Drawing from the latest neuroscience research, Pain Reprocessing Therapy (PRT), Acceptance and Commitment Therapy (ACT), and somatic psychotherapies, we can support you to learn to live in your body - even when it isn’t a pleasant place to be.

Over time, practices to drop the struggle with difficult symptoms can help enormously. This is a bit like slowly depriving the fire of oxygen.

Do you find that small things can trigger you much more easily than before you got ill? People, places, situations, noises, and lights that once would have been totally manageable for you can be enough to cause a flare up of symptoms. 

When you have a fatigue-related illness, your capacity to tolerate stimulation and activity becomes very small. Learning to live within these limits is hard. However, gradually nudging our brain and nervous system to feel safe doing more, enables us to expand this "window of tolerance". Over time, we can move back into the world with more confidence and begin to reclaim our lives.

No two paths out of the prison of chronic fatigue are quite the same. On your journey, you will need to take many thousands of small, repetitive steps that inch you towards your recovery. Your particular steps will be unique to you - whether this involves doing gentle yoga, setting boundaries with other people, changing your diet, meditating, journalling, taking rests between tasks, changing your sleep routine, doing things that bring you joy, or any number of other activities. 

Doing what matters for your health, again and again, in the midst of very difficult thoughts, feelings and symptoms, is exceptionally difficult. Drawing on Acceptance and Commitment Therapy (ACT), we can help you to move through the storm, even when it is raging, one step at a time.

On our journey together, we may explore the "parts" of you which could be getting in the way of your recovery. These may include any tendencies you may have to be self-sacrificing, people-pleasing, hyper-responsible, relentlessly striving and perfectionistic.

Drawing on “parts work” in experiential psychotherapies, such as Internal Family Systems (IFS) and Coherence Therapy, we can get to know these parts of you, and explore how they got their roles. By befriending these parts and understanding how they are trying to protect you, we can unburden them of these more rigid ways of behaving. This can free up significant energy for you to live the kind of life that you want for yourself. 

Many people with fatigue-related conditions have learned to “stuff” their emotions. One research study even found that people with ME/CFS were more likely to suppress their emotions than people without fatigue. However, the study also found that despite suppressing their emotions, the participants with ME/CFS experienced more distress and their nervous systems became more activated. This higher nervous system activation is likely to contribute to fatigue and other symptoms.

In our work together, we can explore whether you are someone who tends to bottle up your emotions. Drawing on Emotional Awareness and Expression Therapy (EAET), we can support you to begin to find new, healthy ways of noticing, naming and expressing your emotions.

This might be through directly communicating how you feel with others, or finding creative ways of connecting with your feelings, like journalling or making art. In doing so, we can support you to acknowledge difficult thoughts and feelings, without letting them take control. 

For some people living with fatigue-related conditions, the weight of past adverse or traumatic life events can keep their nervous system stuck in an energy draining “threat mode”. This makes sense, since when we haven't been able to process trauma, the body hasn’t had the chance to learn that it is now safe.

Working through traumatic experiences from the past can help fatigue recovery by allowing your nervous system to shift from an energy-draining “threat mode” into a profoundly healing “rest and restore mode”.

If this feels relevant to you, we can make use of trauma-focused psychotherapies to help your mind and body to process adverse experiences or traumas. The trauma-focused psychotherapies I use include Eye Movement Desensitisation and Reprocessing (EMDR), Narrative Exposure Therapy (NET) and somatic psychotherapies. 

Many of us find that we learn some powerful lessons on our journey of illness and recovery. In particular, we may come to realise that certain aspects of our lives before we got ill were unsustainable. This may have been true of our relationships, our work, or our expectations of ourselves. 

As we get stronger and move back into the world, we are naturally relieved to have moved through the worst of the physical symptoms. And yet, we may also find ourselves facing new challenges around how to build a life that is sustainable. 

Drawing on psychological concepts such as post-traumatic growth and the “true self”, an important part of our work together might involve supporting you to more closely align your life to your values. This can create important foundations on which you can build a more authentic, meaningful and nourishing life moving forward.