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Chronic Fatigue Syndrome and Psychotherapy

Posted: 03/01/11 11:36 AM ET

"Psychotherapy Eases Chronic Fatigue Syndrome, Study Finds," read the headline in the February 17, 2011 edition of The New York Times. Within a few days Chronic Fatigue Syndrome (CFS) ranked third on Yahoo's 'Trending Now' list. For the misinformed reader it's likely these headlines translated that CFS is all in your head.

Until now, I've told no one except a small inner-circle of family that my mysterious breakdown in health, vitality, and cognition that started the night of May 5, 2007 was not due to an exotic virus I picked up in the Congo while on assignment for National Geographic. The truth? I'm actually a textbook case of someone with CFS, a syndrome I sniffed at until it happened to me. For the sufferer CFS means a total health breakdown, like a plane that inexplicably begins tearing itself apart mid-flight. Together, all the various dysfunctions associated with it leave the patient in a state of health more debilitating than chronic obstructive pulmonary disease, heart disease, or multiple sclerosis.

There is no known cause for CFS, and most terrifying from where I sit, no cure.
I've now decided to come out of the closest -- so to speak -- because it's ultimately self-defeating living a lie. Plus, someone has to start owning this syndrome in public. The more people who fess up to having it -- and there are many more who have it than let on -- the better off we all will be in the end.

When you have CFS one of the greatest battles you fight are the ignorant smirks and expressed disbelief of those who think it's all in your head; that is, those that don't live with you and live the truth of CFS everyday. Negativity and doubt amount to an energy drain you can ill afford. It's the reason I have refused up until now to identify myself as a person with CFS.

That which medicine can't explain we tend to label psychosomatic and blame the patient, a cruel phenomenon all too familiar to those who've had MS, rheumatoid arthritis, and lupus, and a myriad of other ailments in decades past.

And this brings me back to the latest round of articles and speculation about CFS in the news. It was all triggered by a rigorous study exploring treatment options for CFS in Britain published in the prestigious medical journal, The Lancet. At first glance the headlines suggested CFS is best treated with psychotherapy -- a not so subtle conclusion that it's all a psychological condition. Upon closer inspection, however, the study itself says no such thing. It states quite openly that CFS, or Myalgic Encephalomyelitis (M.E.) as it is called in the U.K., is a syndrome of various debilitating physical dysfunctions. The thrust of the article is that CFS is best treated by a combination of medicinal intervention, exercise, and Cognitive Behavioral Therapy (CBT). CBT is intended to help the patient deal with the ugly reality that they will never get better, that they are forever changed, and that the old you is gone and the new 'CFS you' needs to be embraced. The theory is from this acceptance and surrender peace will be your reward.

And therein is the rub. I have no problem with CBT as part of overall treatment for CFS. I'm still fighting to get better and am not yet ready to surrender to a life where I spend 20 hours a day horizontal, lack the physical energy to sleep with my wife, and hold my new baby girl for more than a minute. But I have actively sought out CBT treatments, and all other forms of psychotherapy. Anything to help is my motto, from exotic herbs to the couch. And this openness to CBT is one I'm sure is shared by many with CFS.

The problem is good luck finding a psychiatrist or therapist who has ever worked with someone with CFS, or even knows the symptom profile. I've seen four therapists to find an outlet for my frustrations. Instead, I have found each time a good-natured, well-intended professional who -- when I tell them my textbook symptoms of CFS -- only shake their heads and say, I never heard of that. It must be awful. Thereafter I spend my money and more importantly my precious energy stores educating them on CFS while they in turn struggle to fit me into a paradigm of psychological dysfunction. In the end the only help I've ever received from a therapist, or non-CFS specialist doctor for that matter, was to seek one who has a loved one who suffers from CFS. It seems in this era only they know the devastating truth and take you at your word that you're sick, not sick in the head, which for me is the best therapy I know of right now.

 
 
 
 
 
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Toni Bernhard
I wrote How To Be Sick: A Buddhist-Inspired Guide
12:58 PM on 04/11/2011
I wanted to bring people's attention to a short article I just posted at Psychology Today on Chronic Fatigue Syndrome called "The Stigma of Chronic Fatigue Syndrome." I, like John, am trying to get people to pay attention to this debilitating illness. Here's the link: http://www.psychologytoday.com/blog/turning-straw-gold/201104/the-stigma-chronic-fatigue-syndrome
08:58 PM on 03/30/2011
Hey John - I'm suspecting that your "sudden" article and then trying to respond to all of those that were so thankful for your "coming out" has lead to a downfall of your health. I certainly hope not and that you are just swamped in some other project or article.

Anyway - we miss your commentary and I left a contact method in one of your earlier responses where I asked that you contact me - so look back at some of your earlier response and perhaps we can do something more in this area.
Thanks again for your whirlwind of comments - hopefully it didn't set you back a bunch!
04:51 PM on 03/23/2011
I had fibromyalgia in childhood but got CFS after getting mono in college. It does turn you into a zombie and just steals your life. If you're not careful, you will run on pure adrenaline and then it will take days, or weeks, to get back to your version of normal. Since you look fairly good, people assume that you want attention or that you are a slacker. I wish talk therapy and exercise COULD cure it, but it doesn't. Of course any counseling to help you adjust, and mild exercise to keep you supple are good, but certainly will not end the ordeal, unfortunately.
Thanks for coming forward and letting people know. I have heard that there are several well known people in the film industry with it, but they are terrified that they would lose work. Most people who have CFS are actually very driven and talented people - certainly not the type to seek sympathy.
09:08 PM on 03/30/2011
I agree - No doubt that some CBT would help anyone whose life has just been turned upside down. Not help in a sense that you could somehow learn something that will deem the disease no longer to effect you, but there is no such thing.

Talking to someone about the life you had just doesn't exist anymore - is not a bad thing. I've done it and after educating the psychotherapist we became friends and she had much more benefit of the sessions than I.

Having a family member in college and one in high school, loving my job, never sick, and suddenly becoming stricken with this disease takes a huge adjustment. Talking with someone - other than family who typically have been talked out, or friends that seem to be disappearing by the week, becomes old quick for both yourself and those that you're communicating with. So an outside source isn't a negative thing.

Unless of course if this psychotherapist thinks like many docs that it's "all in your head" than by all means run away because they don't have a clue.
01:37 PM on 03/16/2011
Thanks for bringing light to this, I've quoted this post in my blog post about "coming out" about chronic conditions: http://community.wegohealth.com/profiles/blogs/coming-out-about-your Would love to here your thoughts.
04:08 AM on 03/10/2011
Welcome to the land of the surviving dead.

The specific carbohydrate diet is pretty stringent. If that doesn't work, maybe check into food allergies.

Best to you. Thanks for bringing attention to this malady.
07:55 PM on 03/08/2011
Thanks a lot John. I have had CFS since May 1988. I came down with a flu and have never recovered. I wish someone like you with notoriety, a Voice that can organize the masses of isolated, powerless CFS sufferers can unite with one voice to get things accomplished...I have money to donate, but don't know the best place...I can sign petitions, make phone calls .... is there a way someone like you could lead us in a unified, effective way? Kind of like a "MoveOn.org" for CFS.

BTW, I tested positive for Enterovirus .. this is the only "evidence" of what I have... Dr. Chia of Torrance California...I wonder why he is not mentioned more as a researcher at the forefront of CFS research....he's found 86% of CFS/FMS/LYMES patients with Enterovirus...this seems significant to me.

Love to All
Our Reward is in Heaven!!!
08:52 PM on 03/08/2011
You know I've been into this internet "new type of format" that is streamed through the internet. Perhaps I can send them the link to this story and have them see all the feedback and who knows. The whole thing is it's a big "energy" zapper.

That's the reason Laura Hillebrand isn't a big advocate. It's certainly not that she wouldn't love to - but I believe once she finished her book she couldn't even go on a book tour with the success of the movie and all.

I personally don't know how she did it as I've thought of the book route and even have one pretty much laid out - but that's a project I've not really done much with in about 5 years. It's a simple choice I had to make of do I want to exhaust all my energy doing this or do I want to take some of my time to appreciate a bit of the world around me - things I didn't lose along the way. You know the whole take the time to smell the roses saying.

Choices are very limited you learn the deeper and longer you're into the disease - at least my thinking is that way. I'm now in a place where I can enjoy Mother Nature from my patio - at least when the sun isn't beating on it. Who knows maybe I'll just take my laptop out there and when it warms up again. Thanks for your enthusiasm
06:34 PM on 03/07/2011
Hey John - man I'll tell you it's so great you came out in a public manner re your battle with this debilitating illness on a forum where people can interact like here at the Huff Po. I've not seen such a positive forum on this disease in the decade I've been dealing with it.

John please be judicious in your "giving" as we really don't need you to wipe yourself out and disappear on us. That invisible line that we at times "overlook" is real and so shockingly devastating. Only those of us that have experienced taking a few steps over that line and ended up months later wondering where all that time went really understand those consequences. So my friend let caution be your guide and stay within your limits. But thanks again!
09:41 AM on 03/07/2011
http://www.meassociation.org.uk/?p=4965

This is how the UK press was able to report so irresponsibly on PACE trial results. So called experts from Science Media Centre feeding them lies. It's truly shocking and sinister.
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08:18 PM on 03/06/2011
The findings that were reported on February 23rd are the best news we've had yet. 738 unique proteins discovered in the spinal fluid of people with CFS. Yes,Virginia, CFS is a "REAL" illness.

This is the first step to a treatment, if not a cure.

CFS/FM/ME has ruined the lives of countless people for too long and it's time for the snickering to stop.
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John Falk
09:10 AM on 03/07/2011
Amen. New study on spinal fluids in CFS patients is due to come out soon, too. Through the grapevine it has similar results. Be nice beachhead.
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10:46 AM on 03/07/2011
Study on the "unique" proteins? I get all the newsletters so I'll be watching for that!
11:25 PM on 03/05/2011
Good analysis. The honest personal point of view is always the most powerful. Until a cause can be discovered, this syndrome is so frustrating to understand and endure. My hat is off to you for describing your thoughts and experiences and research on the subject. At this point for each sufferer, it is only the sharing of these personal points of view which can bring some relief in knowing that one is not alone. Thank you.
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John Falk
05:45 AM on 03/06/2011
yes, that is what I think. CFS/ME is so abstract and the 'life' we live in so beyond the comprehension of the uninitiated that personal narratives mixed in the latest research and basic CFS information is key to getting more people aware of the severity of this issue - for everyone,whether you have it, are imminently at risk, or not.
07:48 PM on 03/05/2011
I did, in fact, get sick while working in Congo. But infectious diseases specialists have failed to find a cause. Thank you for "coming out". Having a respected journalist on our side helps enormously. Please continue to write and to check your facts thoroughly. For example, the "rigorous" study you refer to was far less rigorous than it ought to have been - see:http://www.investinme.org/IIME%20Statement%202011-03-01.htm

The trial investigators did not use objective outcome measures apart from a six minute walking test in which patients in the CBT arm were able to walk an extra 21 metres in 6 minutes (354m) compared to baseline [1] - a distance well below that of healthy elderly subjects (631m) [2]. The clinical benefit is insignificant in relation to the trials cost.

It would be more consistent if the researchers had adhered to their initial intention of using actigraphy at the end as well as the beginning of the trial [3] to see if patients traded their other daily activities for exercise. The hypocrisy of the researchers is demonstrated by their comments [4] especially as patients chosen for the trial had to be well enough to attend clinics.

Of the 3158 patients screened for eligibility for the trial from secondary fatigue clinics 1011 did not meet the inclusion criteria, the Oxford criteria [2]. These criteria exclude those with neurological signs and symptoms so by definition this trial had nothing to do with myalgic encephalomyelitis (ME) as classified by WHO [5].
05:53 PM on 03/05/2011
Thank you for the article...and thank you for all the comments. It is hard to live with a chronic fatigue condition of any kind. You take it day to day. Personally I have RA, Hypothyroidism, and two other autoimmune syndromes. I have gotten completely away from GMO foods, beef, take Cod liver oil, and a multitude of other self treatments that only go so far. I think a huge amount of this is environmental and the rest is genetic that might be triggered by environment. Why do some get over it and others (most) do not? I have spent years looking for simple answers only to realize there are none.
05:50 PM on 03/05/2011
John,

Thanks for giving all of us an opportunity to say "me too"! I also can remember the precise day I became ill, a November Sunday in 1997. My quality of life after 13 years is reasonably high, but it is becoming difficult to manage with a fixed income based on my salary level 13 years ago. And I am fortunate to have disability pension benefits and reasonably-priced health insurance - many are financially devastated. For many years, major disability carriers made life a living hell for those trying to gain benefits for a permanent disability.

I have great hope for those like you who have become ill more recently. The scientific community now seems more focused on finding answers, and as people like you push for answers, the chances for the rest of us to benefit from new discoveries and therapies increases as well.

This illness is still misunderstood, and the personal toll on patients as a result of that misunderstanding is still too high. It is encouraging that over the last five years I have found an increasing awareness of our devastating illness in the general public.

Life can still be good, just different. But I still pray for a cure!
04:52 PM on 03/05/2011
God bless you for 'coming out.' I have been suffering with CFS for 8 years. I went from a successful careerperson who had tons of energy for volunteer work and fun nights out, to where I am now. Every type of stress (physical and emotional) completely sends me to bed and I cannot work anything more than a few hours a week.

As hard as it is financially, emotionally, and physically, I think the hardest part is feeling that you can't be there for people when they need you. My folks are in their 80s with failing health and, although I am their primary caretaker and still do a lot considering my CFS, I can only do so much before I have to crash for days. I want to be their rock through all of the bad times but my body won't let me.

To all the people who don't believe that what we are dealing with is real, I say, "Try being me for one week and then we'll talk."
04:28 PM on 03/05/2011
John,
I have suffered from CFS for 20 years & fibromyalgia for about 10, so I can intimately relate to your story. I was working a high-profile job in NYC, and one day just couldn't get out of bed. I experienced everyCFS symptom and spent about 6 weeks in bed. I finally returned to work, hiding the fact that I felt sick, and was able to fake it on and off for years. I would go to work and come home and get in bed. I basically became a recluse because I didn’t have any energy left for friends. It finally got so bad that I had to go on disability.

I realized how much stress I was causing myself by hiding my illness. I decided I no longer was going to identify myself by my illness, and it wasn’t going to control every aspect of my life. I had missed out on all the fun of my 30’s, but being bitter wouldn’t change the past. I also decided to leave NYC’s toxic environment and move to the west coast. I love the outdoors, so I started walking. I learned not to overdo it on days that I was feeling better to avoid a relapse. Also focusing on something other than myself is a good idea. I’ve rescued 2 dogs, and having to walk motivates me to take care of myself. I’m also constantly experimenting with different foods, supplements and medications because my body’s needs change all the time.