Exercise and chronic fatigue

G'day,
I've had chronic fatigue for four years and, having tried every possible (physical) approach to therapy and having them all not work, I've turned to Dr Sarno (et al).
Sarno's approach makes sense to me because I can trace, very directly, the advent of my CFS to a period of protracted and extreme stress. I also seem to fit the personality profile quite well, being the classic goodist.
Anyway, one thing about CFS (although, I don't call it that anymore, of course - it's TMS!) is something called PEM - post exertional malaise. Basically, exercise makes one feel bad.
I was wondering if anyone else out there has tackled CFS using the Sarno approach, and how they've worked their way through the exercise conundrum? I'd like to exercise more, to 'normalise' my unconsciousness' view of it, but I don't feel I can just go out and go hell for leather, as I don't think I'm there yet, on several fronts.
Any tips on a graduated exercise programme, or on the TMS approach for CFS, in general, would be much appreciated.
With thanks,
Dave

 

Thanks for your response, Forest. Makes sense, mate.
I've just read Sarno's 'Mindbody Prescription' and am about the start on 'The Great Pain Deception'. In fact, I'm reading anything I can get my eyes on, TMS related.
I think I might have a little bit of a swim this afternoon. See how that goes...
Again, cheers for getting back to me.

 

Hi Dave, how is it going with the post exercise malaise? I also am in a similar boat; a year into tms treatment and too much exercise and my brain doesnt work as well for a few days, more tired and spacey and fatigued; my tms therapist says attack on two fronts. which is what I've been doing to pretty good effect so far. First focus on the unconscious stuff, and at the same time get mad at the fatigue as you woud pain; get pissed at it and do stuff you formerly avoided. You are right it is tricky fatigue I believe is the worst because you cant challenge it quite the same way as you do pain or anxiety. One other thing I've noticed is that when my I've really challenged my pain and anxiety to the point they really occupied me my fatigue wasnt quite so bad; so if you deal with other tms symptoms maybe try shotgunning it and see if the fatigue subsides if you can get yourself into enough pain or anxiety.

 

I would also add to mix up your exercise; this (in my case) has had the effect of confusing my brain. I used to always do the same routine every week, now I am doing yoga twice a week, skipping some workouts some weeks and doing other things, etc. Overload your brain with enough stuff and variety and it may ease up on you. Forest had a great idea with doing stuff you like. I am absolutely in love with yoga and even though the 1.5 hour workout is more than what I do alone with my exercise in terms of muscle fatigue (my teacher enjoys pushing us) I dont "pay" for it as much the next day ; I nelieve because I am enjoying it so much. I really feel incrfedible by the end of it.

 

Hi Dave, Joey2276 and Forest,

I don’t have CFS as such (I’ve been diagnosed by one doc as having fibromyalgia) but I also get what I can only describe as post-exertion malaise as well as pain. In my case, I can’t even get to any kind of formal exercise, because I get post- any kind of activity malaise and the bar for me has become really low. I have low-level pain most of the time, but it gets worse when I do stuff, just the ordinary stuff of life, especially just ordinary walking in the course of work or home. Any more walking than usual (and that’s about a minute a time at the moment) and I get more pain than usual, fatigue, and a particular kind of malaise or unwellness – a feeling like I’m coming down with something – that tends to come with an awful distress and sense of despair. The symptoms get progressively worse and can sometimes be delayed – I can get ill the day after. The fear of these symptoms have led to my being partially disabled.

Luckily I never got sucked into the fibromyalgia story but one thing I was taught early on probably led to the conditioning/pattern of post-activity pain and malaise. Early on I was put onto a graded exercise program and advised to ‘pace’. That’s probably what reinforced the early patterns and led to my brain learning to expect post-activity symptoms. Now that I understand that I have TMS, it’s all making sense, and I can see how the early pain symptoms have developed into the more complex symptoms I have now.

Now that I have this pattern, though, I find that the only progress I‘m making in unlearning them is by changing things slowly. I’ve had some success with the approaches advocated on this forum. In particular, I find that the less I fear those symptoms, the less power they have over me. I’m slowly learning to ‘float through’ the pain and the malaise, just focusing on the now, telling myself I’m OK and safe, and not allowing the old ‘I can’t cope’ and ‘this is terrible; when will it ever end?’ stories to take hold. I’m getting less of that distress and despair reaction when I have the post-malaise symptoms. I try to do subtly more, a little bit at a time. (I’m talking tiny amounts here, like doing a tiny bit housework when I wasn’t doing it at all some months ago, or not stopping to rest on the way to the loo.) I meditate every day and allow myself to be involved in things around me. I work four days a week, and even though that can be difficult, it allows me to feel a sense of empowerment and it gives the pain strategy the message that I won’t let it fool me.

I also see a psychologist with whom I’m doing Schema Therapy. This involves uncovering the emotional patterns a person has developed from childhood and learning more helpful/appropriate responses to life and to present stresses in particular. This seems to me entirely compatible with the journaling I’ve been doing and the other inner work I’ve done based on the SEP.

So I'm in a much better psychological and emotional space than I was say, 6 months ago. However, the symptoms seem so far not to have changed a lot, or are changing so slowly it’s quite discouraging. It’s hard to overcome the fear of the symptoms when it feels as though they don’t let up or even get worse. So I continue to do more very, very slowly, which is pacing of a sort, but I wouldn’t engage in a formal graded exercise program again because in my case, it only encouraged obsessiveness and put additional pressure on me.

I don’t know how much of what I’ve written will be helpful to others on this thread because I’m not doing what anyone could call exercise (and this is quite depressing, as I used to be very active). But if I can make some progress, little as it is, then maybe others with similar symptoms can as well.

 

I just realised that what I said about graded exercise isn't quite correct. I no longer do graded exercise in relation to my walking capacity, but I do still do a very basic graded exercise program (not at a gym) involving simple movements during the day, using a stretch band for my legs and a filled water bottle as a weight for arm movements. I think this works because I'm quite relaxed about it, but it's hardly what you guys would call exercise (I'm only doing between 5 and 7 movement per exercise and it's very low level)!

 

Exercise or walk at your own pace. A little is better than none, but keep in mind what Dr. Sarno advises, not to push too hard too fast.
Forest is right-on with his advice. I'm almost 85 and I miss the miles I used to walk with my dog. Annie's almost 14 and is slowing down.
We both do what we can. Porpoise, I like the exercise you are doing. I found a morning tv show where a woman shows how to do leg and arm
exercises while sitting down. It's a good start to the day for me.

 

Thanks, Walt. I miss the dancing and walking I used to do, but those exercises I do (and I'm able to do them standing up, thankfully) keep my muscles at least vaguely active!

 

Jumped on here, looking for something about exercising when afraid of injury... this is what I found.

I have meditated for years and since bottoming out on physical symptoms, again, a few years ago, I have integrated a yoga-flow-somatic-experiencing aspect to my meditation. The past two days I noticed a new, sharp pain in my left hip and glute. New! I sat with it. It's my depression. Again. It is a huge part of who I am and it seems almost impossible to shake. It's not depression that is unfounded. There is a wildfire nearby, over 30,000 acres are destroyed, I am breathing in thousands of dead animals, burnt homes and everything chemical that was in them. The grief is palpable. But I must acknowledge that I can take up residency in depression and lie down in it and... yes, luxuriate. And my hip was crying. Sobbing. Wailing. Angry.

It's like TMS, one day at a time recovery, and so I did all the yoga asanas I would do if my hip didn't hurt, while giving myself love and kindness and understanding for the hurt part of me that never seems to fully heal.
Then, I rode a spin bike for a half hour killer class and did another 15 minutes of floorwork for lower body. Guess what? No hip pain!

It's cognitive, it's spiritual, it doesn't seem to make sense, it's like placebo, squared. All I can say it I am about ready to write my success story. Soon.

So grateful to my willingness to connect here. For Schubiner's workbook, for all Sarno's books, Jon Kabat-Zinn and others! Mindfulness-based TMS recovery is serving me beautifully, so long as I am willing to do the work.

Palms together, you guys,
bg