An excellent article by Jo Marchant addressing chronic fatigue syndrome recently appeared in The Observer. Interestingly, the following question was posed, “Is it physical or mental – or a combination of the two?”, highlighting the on-going dichotomy that is seen to exist in both society and in healthcare.
I spend a fair amount of time helping people to understand their perceptions and experiences, usually involving pain and suffering. This is about giving a meaning to their pain, validating their lived experience before looking at the ways in which they can change direction towards a healthy and meaningful existence. Importantly, a vital part of this working knowledge is understanding that there is no body-mind separation. There is a general shift towards people’s acceptance of this fact, yet there is still some way to go before this could be seen as mainstream thinking across society. However, this is certainly not alternative thinking, as we have a significant amount of scientific and philosophical literature that is dedicated to this very question.
To answer the question quoted at the start of my blog, chronic fatigue syndrome is not physical, it is not mental and it is not a combination of both. Chronic fatigue sydrome is a whole person experience, much like pain, when the symptoms emerge in the person, in a location or in locations felt and described anatomically for convenience. Yet the biology of both CFS and pain exist well beyond where the feelings are felt. Similar to the notion of mind that does not only exist in the head, or the brain or behind the eyes as can be thought. There are no controllers pulling knobs and turning dials behind our eyes, although there can be the sense that we ‘see’ the world, the perceived world, through these eyes, creating the illusion that the thinker is in the cranium. Fascinating.
However, my mind exists in me, the whole person. I think and I am my whole body and my whole body is the thinker, hence there being no separation. As a simple example, anxiety is usually viewed as a psychological state of mind, yet where do we feel anxious? The stomach, the gut, the chest perhaps. Not in my head, that’s for sure. Same for pain — it is not in the head!!! I am sure many readers have either heard this about pain, either as a patient or a patient tells you that is what they have been told because no ’tissue’ or structure has been found to explain their pain. This is actually because structures do not explain pain as many now know.
Accepting the notion of a whole person opens a range of avenues for therapeutic purposes as we seek to give the person suffering symptoms the knowledge and skills to resume a meaningful and healthy life. The key principle and underlying thinking (with my whole person as the clinician or therapist) is that the individual in front of you is complete and the sum of parts that only exist as a whole — e.g./ as we are conversing or exploring movements (also known as tests, assessments etc.), seeing how the that person moves and experiences movement or expresses themselves with certain words and gestures that illustrate the meaning that they wish to convey.
The aim of a health-giving programme is to provide the individual with the knowledge and skills he or she need to overcome their problem and steer their change (we are designed to change; it is one of the very few definites) to a meaningful life. There maybe treatment within this programme, but in essence it is about giving the person the independence with regard to thought and action, which they understand are emergent from themselves as a whole person, enabling and empowering decisions that lead to action that is congruent with health. Understanding this means that the individual knows which levels they can use, combining movement and thought for best outcomes. This would include working knowledge of symptoms allowing for wise thought and selecting best action, specific techniques and strategies that promote the meeting of basic needs (i.e./ nutritional intake, fluid intake, security, movement, rest), movement and exercise for health and building tolerance for activity, resilience and motivation, and skills to deal with unhelpful and distracting thoughts (e.g./ practical mindfulness). These are some of the key elements of the Pain Coach Programme, when you become your own coach, conceptualised as a compass that one can use to determine current direction and motivate a shift in direction when needed, moment to moment. Essentially, with chronic fatigue and pain as lived experiences, it is the moment to moment thinking and actions that are vital in heading towards the healthy you.
Contact us on 07518 445493 | Pain Coach Programme for Health & Living