On Chronic Fatigue

Some people struggle with a sense of ‘tiredness’ that is sometimes medically labeled as ‘chronic fatigue.’  Howard Schubiner – a well know chronic condition specialist – describes chronic fatigue as a ‘mind-body syndrome’ meaning that chronic fatigue is often an habituated brain-body response to stress; that is, the fatigue is a brain generated danger signal.

Often, I see clients who are searching for the cause of their fatigue. They describe life as a struggle against fatigue, as if fatigue were a constant reminder of their ‘brokenness’ or a sign of their abnormality, difference, or separateness from others.  And when I suggest to clients that fatigue is the brain’s interpretation of danger and that the constant struggle against it reinforces the sense of danger, I often get bewildered expressions in return.  Clients look at me as if I am an alien psychologist from Pluto. Some even ask, ‘What do you mean fatigue is a danger signal?’ 

Just as with pain, it seems so intuitive to respond to fatigue with an urge to push it away.  And when I describe to clients that the way through fatigue – as with neuroplastic pain – is to lean into it while communicating messages of safety, they look on in disbelief.  I have often wondered why this is such a common response.  Perhaps it is because fatigue can feel so all encompassing and vague, and the thought of leaning into it evokes thoughts of getting overcome by a large blanketing fog and never getting out from under it.  Cue fear response!  Put simply, there is fear at leaning into fatigue: fear that it will swallow one whole. 

But clients can find reassurance in the knowledge, as they lean into fatigue, that the tiredness is just a small part of themselves.  What is the worst that could happen after all?  When you lean into fatigue and fall asleep, so what?  You can learn to enjoy the rest.  Eventually, with practice clients soon realize that opening to fatigue with curiosity does not produce more fatigue; in fact, it is when they fight against the fatigue that it grows stronger and feels more overwhelming. 

And when we learn to trust the truth that like neuroplastic pain, fatigue is often a brain generated pattern amplified by struggle against it, we can develop the courage and wisdom to apprehend the deeply resilient part of ourselves that can lean into the fog, and in the paradox of that acceptance, find a way through it.