Fibromyalgia – All in Your Head?   7 comments

Fibromyalgia is a purely psychological condition. There is no physical component other than what you imagine. It is simply a case of mind over matter. If you were more positive, and could pull yourself together, this would not be happening to you.

I disagree.

However, maybe at least part of fibromyalgia can be controlled by addressing the psychological issues.

Many sufferers become defensive at the suggestion that fibromyalgia has a psychological component.  This suggestion can be like a “red rag to a bull”: They become visibly angry when this opinion is expressed.

I suspect that this reaction is because many people, and sadly, many doctors, really do think that fibromyalgia is a psychological condition. Perhaps by conceding that this is at least PARTLY true, sufferers are worried that the entire illness could be dismissed as something they could control. All they have to do is try a bit harder.

Fibromyalgia is a life-long, painful, exhausting, debilitating condition. Why would you NOT be psychologically affected by it?

Yet people with fibromyalgia often seem reluctant to pursue any form of psychological intervention for their illness. For example, I ran a poll asking people about fibromyalgia ebooks. I asked what sort of information people would hope to read about. One of the suggested topics was: “Counselling and Cognitive Behavioural Therapy”. In the poll, this was one of the least popular responses.

I must say that I am genuinely surprised by this. Why? Because once you’ve done everything you can to reduce the symptoms of fibromyalgia, and live as normal a life as possible, you still have to be able to cope with what’s left. Most people with fibromyalgia will never be completely well again. To me, that’s a scary and depressing thought. It takes inner strength to accept that you can still live a fulfilling life with fibromyalgia. Why dismiss something that could help you find that strength?

In a recent post, I wrote about having a positive attitude, and how it can be important to acknowledge when you’re having a good day. I got some interesting feedback. There seemed to be two main viewpoints. Some people were obviously offended – What did I think they had to be positive about? Others agreed that if you see even the good days as being miserable, you risk making your suffering even worse.

I see two explanations for why these different views exist. One is that some people suffer more severely than others because that is the nature of fibromyalgia. Your mental attitude has nothing to do with it. Such people find even the good days barely manageable. Therefore, if you are the sort of person that can walk about with a smile on your face just because, “things could be worse”, it simply means you don’t have a severe case of fibromyalgia.

An alternative explanation is that of the self-fulfilling prophecy: People, who believe that they have a terribly debilitating disease, reinforce this belief with their thoughts, words and actions. In doing so, they actually CAUSE their condition to worsen. In other words, a chronic illness, such as fibromyalgia, can be made almost unbearable by the persistent fear and belief that severe suffering is unavoidable.

Many of us think and express negative affirmations, such as “I feel too unwell to go out today”. Such affirmations can become habit, and we find ourselves saying this type of thing all the time. Every time we do so, we reinforce our ill health and actually contribute to it. But POSITIVE affirmations can become habit too: “I feel better today”. Said enough times, this really can lead to an improvement in your health.

Your mind is a powerful thing. Use it well.

We can reprogram our beliefs and, in doing so, make positive changes to our health. By learning to discard harmful habits, such as frequently thinking and expressing negative affirmations, we can use the power of our mind to ease the physical symptoms of fibromyalgia.

I agree.

Posted May 22, 2011 by Dr Chris Moore in Uncategorized

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7 responses to “Fibromyalgia – All in Your Head?

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  1. I am glad I stumbled upon your blog, thank you for a more positive spin on FM. It has made me think about how I treat myself, opposed to how others veiw and treat me. Is fibromyalgia self perpetuating? In someways I have to say I think it is. At the moment I am in ‘flare’ mode and even my girls 18/20/21 avoid me because of my outbursts and somedays,crying. My family love me, I know, they also avoid me, sick and tired of my illness. The way I act I know realise is driving the very people I love away from me! Up until 2008, I was working full-time, single parent, so all the housework,shopping,gardeneing, running my girls around etc, all fell to me. I have hpyermobiltiy syndrome which was not causing me too much trouble, I had a nasty prolapse of my pelvic floor and had to have a hysterectomy and hitch up of other bits and bobs. I wasn’y until march 2008, when I was raped in my own home that I fell to bits, literally. Nervous meldown and self implosion which I now realise, set off the time bomb of fibromyalgia. It wasn’t until the diagnosis that I realised I have had this since a teenager when I suffered my first physical trauma of scoliosis, my spine twisted and disc’s erupted turning me into a cripple over night. From then on a healthy, very physically active young girl turned into a hyperchondriac over night. Its a little more envolved than that, and I still can’t believe how many trauma’s both physical and emotional I have coped with and struggled on, before the biggy, the rape. At present, I find it difficult to go out and ‘mix’ with other folk, rather keep my own company, saves me from danger and being hurt. I have pulled my world in so tight it is suffocating me. As the great queen song says, “I want to break free!” I am still a valid human being that wants to contribute, to have new experiances, make new friends, find love again, my question is How?

  2. Upon reading your post again, I was struck with one pair of opposite explanations:
    — EITHER
    1. people who smile about “things could be worse” are not suffering as bad as others
    — OR
    2. people whose “good days” are a living hell are experiencing a self-fulfilling prophecy.

    This seems an over simplification. Surely the 2 extremes do exist and so do graded combinations of the 2.

    I fully agree with you that the positive mental attitude is vital. I probably suffer less than others, though I am periodically reminded my condition is no joke! But unless a person is blind, deaf, stuck with facial paralysis inhibiting speech, unemployed and having lost all family and friends …. you get the picture … things can always be worse! The sad thing is that there are some people in such conditions … and usually they are the ones who stress thankfulness for the blessings they still have!

  3. I stumbled upon your blog today, and wanted to reply to this post.

    I don’t have fibro, but I am bedbound with severe ME, which I have now had for 15 years. Many of the same issues exist with ME, around whether it is a psychological illness or not. It doesn’t surprise me at all that people would not really be interested in reading about CBT as a treatment option.

    I think that’s because … well, the CBT offered by doctors for conditions such as ME and fibro is generally of the ‘learn that it’s all in your mind, and you’ll be ok’ type. Rather than the therapists helping you learn to live with your illness/disability, as they would in the case of say, MS, they teach you that your illness is in fact not real. That you can control it somehow by your beliefs and positivity, etc. And this treatment has been pushed on so many of us – not in conjunction with any REAL treatment options, I might add – that people are understandably scared of it.

    I believe people dealing with these kinds of illnesses could benefit from therapy… even CBT … but not because it’s all in our heads, but simply because living with severe pain (and other symptoms) on a daily basis would get to the strongest of us, and we need support to deal with it. We also need to learn to live within different limits than we’re used to, and that can be tough to do alone.

    Were this the kind of therapy on offer, I believe many people would go, but as it is, it really just isn’t a safe option for the majority of us.

    • Hi Susannah, thanks for your comments. I’m ashamed on behalf of the “caring” profession that we can’t do better. Sounds like the best place for a therapist, in this context, is within a multi-disciplinary team. The idea of a group of professionals – doctor, counsellor, physical therapist, pharmacist, etc – all in a one-stop clinic for people with conditions such as ME or fibro, would be a dream. I’m not aware of anywhere in the UK where this happens.

  4. Agreed, that would be the best way for things to be. I also am not aware of anywhere in the UK offering these kinds of services. Everywhere is just too focused on GET & CBT of the kind I described above. Sad thing is, were somewhere to offer a safe, appropriate version of CBT, of the type offered to people with other chronic illnesses, I think many people would still avoid it because trust has been so badly broken between the medical community and the patients.

    Some real healing needs to happen there or nothing is going to get any better.

  5. Are you willing to accept that positive attitudes or CBT simply doesn’t work for many patients, and the resulting hostile attitudes from the patient’s support network, “you’re not thinking positively enough, you can do more exercise but you’re not trying hard enough”, is actually damaging the health of patients?

  6. I agree too. By thinking positively you can make your illness subjectively better, and perhaps (due to the mind-body link) objectively better too.


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