03 Oct NO, It is NOT “All In Your Head” but it very well might start there.
Cultural blindness in regards to the power of our emotional responses to the world is often stunning. This blindness can involve deeply unconscious patterned behavior that includes fear, anger, sadness, much of which is repressed- and therefore not fully recognized. When we refer to someones’s cultural blindness it does not necessarily imply “blame”, but when presented with it, people tend to respond with anger. However, if one is able to listen, and make the effort to shift their focus just a teeny-tiny bit, and become aware of how powerful that blindness is, then it is astounding how quickly it can be seen everywhere we look.
Sometimes this blindness manifests itself as hearing “it’s all in your head” when a doctor says “we think there is a possible mind body connection and that the emotions are involved”. What I mean is that people are often so unaware – so blinded- to the power of the mind body interaction, that they quite literally can’t comprehend what this might mean. If asked to repeat what they heard they might respond, “you just said it’s all in my head” because even though these were not the words used this is the way their brain processed it and replied. For them this might mean that they are being told that they are “faking” their symptoms, or that their symptoms aren’t “real”, or that they are “lazy”, or even that it is their own “fault” that they are ill. This idea is very enraging to people who have been diagnosed with chronic fatigue (or believe they have it, but have not been given a diagnosis). This might be because there is some discussion about the fact that many people who present with Chronic Fatigue symptoms tend to be people who hold themselves to a very high standard and work immeasurably hard.
Now, if in fact it is this tendency to push oneself beyond one’s capacity – because of a sense of self that involves living up to an image of someone who works hard, does well, takes care of others – that might be involved, it’s easy to see why that idea would make someone angry; and why that person might hear “it’s all in your head,” even if it is not said. However, if it is said outright, that also explains why this might be so enraging. Go ahead and google “chronic fatigue all in your head” (I got 4.5 million hits). While there are certainly some doctors who have uttered that phrase, my guess is that most simply are flummoxed by the range of symptoms and can’t find an etiology, or cause, for them. They also might make the connection between elevated levels of cortisol and other stress responses (including and out whack immune system) and therefore see it as stress-related, and say so.
Here’s where the angry response to the idea is interesting. If we respond with rage to the suggestion that the symptoms are in our head, it means we can’t comprehend that there might be a connection between our brain and our body that is causing some of the symptoms. If we can’t comprehend it, there is no chance we can respond to it. In one search I found this study which finds that a very high percentage of fibromyalgia patients show signs of “the inability to identify and describe emotions in the self”.
In the current study, we have focused on the following four aspects of personality and psychological coping: Alexithymia—the inability to identify and describe emotions in the self; Type D personality—the tendency towards negative affectivity (NA) and social inhibition (SI) and personality components, based on the psycho-biological model of Cloninger regarding temperament and character; Level of positivity—self-confidence, optimism and satisfaction with life; Social support.
Alexithymia has been studied in patients suffering from chronic pain (Celikel & Saatcioglu, 2006; Lumley, Smith & Longo, 2002) and FMS (Sayar, Gulec & Topbas, 2004; Steinweg, Dallas & Rea, 2011). In a recent study, Castelli et al. (2012) reported alexithymia traits in 20% of a sample of FMS patients. Thus, it has previously been suggested that the inability to correctly identify physical manifestations of emotions makes alexithymic individuals susceptible to incorrectly attributing innocent physical symptoms to physical disease (Tuzer et al., 2011). Originally identified by Denollet et al. (1996) as a predictor of long-term mortality among patients suffering from coronary heart disease, type D personality was characterized by a tendency towards NA together with SI. Type D personality is strongly associated with both musculoskeletal pain, psychosomatic symptoms (Condén et al., 2013) and sleep disorders (Condén, Ekselius & Åslund, 2013).
Ashok Gupta, who cured himself of chronic fatigue by researching the issue for years, believes that an unconscious fear response can drive the body to be stuck in a flight or fight mode, flooding the system with stress hormones that begin to attack the body. However, if we come to understand, and be aware of this process we have the ability to change it.
If we resist the idea that our mind and body are connected we lose our ability to address the problem. When I searched for “chronic fatigue all in your head,” among the 4.5 million articles that popped up were thousands and thousands about studies that found some kind of bio marker which might lead to a possible diagnostic tool or a cure.
This article from last August is about a doctor discovering bio markers linked to severity of Chronic Fatigue. It popped up in my search, and it’s of no particular significance to this discussion. I was drawn to the title, “Chronic fatigue syndrome is NOT all in your head”, wherein the all caps “NOT” signals that the “truth” has been found once and for all. There are hundreds just like it, each one finding a different bio marker, or bacteria, or virus, or other “physical cause” for the syndrome (a syndrome is a constellation of symptoms). Near the end of the article there is this quote:
“Much as different organisms can cause pneumonia, Montoya and his team believe that multiple pathogens, including viruses, can wreak havoc on the immune system, triggering chronic fatigue syndrome. But the precise triggers have not yet been identified.”
What if the trigger is the repression of emotions, the stress of which causes the autoimmune system to misfire, backfire, get out of whack? We know that when we are stressed out our immune system is weakened. What about if we are incredibly stressed out all the time so that it has become a new normal and our immune system is like a dishwasher who has worked for 222 hours straight…
What if the out-of-whack autoimmune process starts in the brain rather than with the introduction of a possible pathogen? What if it starts in the thoughts? What if…. unfortunately, our culture is so terrified of asking those questions that those who do are met with intense anger. In this case, the writer – and the research – and everyone else can’t even seem to comprehend that it might be a question to ask. What if the precise trigger is emotional? In that case, taking an ENTIRELY bio-physical approach won’t solve the problem. However, we can’t answer the question if we are afraid to ask it.
Science is about asking hard questions – even ones about the questions we are often too unconscious to ask.