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Hi Aaron,

Thanks for your question.

Chronic fatigue is a symptom that I see frequently in my practice. It is one of those symptoms that has a more abstract presentation which is why I think it can be so perplexing. I see some similarities between fatigue, insomnia, and generalized anxiety in that they are not as cut-and-dry as symptoms like back pain or joint pain. I think this is why some folks tend to get stuck when the symptom imperative roulette wheel lands on one (or all) of them. That said, fatigue is most definitely a mind body symptom which can be conquered like all the rest.

One thing that is important to emphasize is that getting rid of fatigue symptoms is no different than getting rid of any other symptom.

I would suggest that this symptom appears to be stubborn because you are preoccupied with it. Your statement that you are "100% certain it is TMS" may be an example of reaction formation. This is a defense mechanism that basically substitutes certainty for ambivalence because uncertainty is so hard for a TMSer to tolerate. It is important to acknowledge if you have lingering doubts or ambivalence about the cause of your symptoms. You have to be able to see the ambivalence in order to successfully confront it. Really work on squashing any persistent doubts using the evidence that you have gathered to date and reassuring your unconscious mind that you absolutely can and will get rid of it.

Don't problem solve around the symptoms and work towards authentic indifference to the symptoms and becoming more outcome independent.

Stop trying to make the symptoms go away. If you're tired, take a short power nap and get on with your day.

The work-related stressors that you mentioned could certainly be generating symptoms, especially if they are bringing up difficult emotions for you. That said, I don't want you to develop the belief that you must have all of these issues resolved in order to get better. Think of yourself as a work-in-progress rather than expecting yourself to be a finished product. Continue working through these issues on your own and/or with a therapist. Work toward embracing the idea that having total clarity on these life issues is not a prerequisite for feeling better physically.

Regarding the emotional trauma and issues from your childhood, I would hazard a guess that some familiar emotional dynamics are appearing in your work setting. Working through these emotional issues will inform any logistical decisions in the future.

Keep at it and and be present.

You will get there.

-Derek

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Any advice or information provided here does not and is not intended to be and should not be taken to constitute specific professional or psychological advice given to any group or individual. This general advice is provided with the guidance that any person who believes that they may be suffering from any medical, psychological, or mindbody condition should seek professional advice from a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions. No general advice provided here should be taken to replace or in any way contradict advice provided by a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions.

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