Some of you may have seen my recent 10 part series in Gary Craig’s EFT newsletter (emofree.com) on "Calming and Clearing Chronic Pain." I thought you might be interested in reading this account by Dr. Nancy Selfridge. She and I taught a class together using EFT with Fibromyalgia. She would present the "enlightened medical perspective," and then I would do EFT with the group for FM symptoms. We both learned a lot from our partnership.
This account below is what Nancy wrote as a foreword for my book, The 8 Master Keys for Healing What Hurts.
EFT and a Neurobiological Model for Fibromyalgia
Presently, the conventional medical model frames fibromyalgia as a syndrome diagnosis. As such, it is simply a name applied to a set of symptoms, primarily pain, and the finding of tender spots on examination occurring in a patient for whom no other explanation exists for this state of being.
In many ways, fibromyalgia is like so many other diseases in our Western medical history. Our understanding of the pathophysiology of this disorder is reliant on an exquisite understanding of the physiology of pain and pain perception, the effects of trauma and stress on the brain, and the ways the emotions are translated into the physiology of symptoms.
In fact, we are still in the infancy of exploration of these complex processes and, therefore, a complete understanding of how someone with FM gets sick and stays sick eludes us.
As I suffered through my fibromyalgia symptoms over many years, I remained convinced that this was a problem with my central nervous system and I was reasonably certain that it had been brought about by stress/trauma (in my case, the intensity of my medical training and also a difficult marriage). Still, there was nothing in my medical training that prepared me for understanding and managing my own symptoms, though I really did try about everything that conventional medicine had to offer.
The body bears the burden
Fortunately, I was introduced to the work of John Sarno, MD, a physiatrist at the Rusk Institute of Rehabilitation, who posited that chronic back pain, and likely all chronic pain, has an emotional base of unresolved rage even when a person is functioning without specific psychological impairment (1). In the words of Dr. Scaer, a gifted neurologist, chronic pain, including FM, is a circumstance where the “body bears the burden” of mental stress and trauma (2).
When I was ready to accept that my FM symptoms might be the neurological equivalent of emotional burden and trauma, and I began focusing on emotion rather than my physical suffering, my physical symptoms evaporated!
Interestingly, I never achieved any physical relief from any of the years of psychotherapy that I did, but this simple association and its complete acceptance in my mind was sufficient. In essence my thinking shifted from assuming that something awful was happening to my body, to wondering what troublesome emotion was “talking” to me in this form of pain.
Sensitivity and stress
After I “healed,” I began forming, to the best of my ability, a rudimentary pathophysiology model for FM and sharing this with patients, fine tuning the model as needed to fit the variety of experiences I was hearing in patient histories and also reading about. I noted that almost all of my FM patients were temperamentally similar to me—very sensitive people—and I started asking people if they identified with the traits described by Elaine Aron, PhD, in her books about highly sensitive people (3). Most could readily see themselves in this description.
Of those who had ever taken a Myers Briggs personality test, most were “intuitive feeling” types, also described by David Keirsey, PhD, as “idealist” (4). It seemed as though a certain temperament, or way of being in the world and processing information, might predispose a person to developing chronic physical symptoms when stressed or traumatized. It is an idea yet to be proven, but in my clinical practice it still holds true.
So, what might be actually happening in the brain and body of the FM patient and what is the scientific support for this?
First, it appears that a sensitive temperament is fertile ground for the development of this disease, almost a “risk factor,” you might say.
Then, in nearly all FM patients, there is a stress or trauma (large or small) or a stressful period of time that serves as a forerunner and trigger for the FM symptoms. The stress/trauma can be physical, mental, emotional or environmental, and in my practice has been as varied as accidents, difficult childbirth, surgery, a significant illness, toxic exposure (such as carbon monoxide), loss of a loved one or a job, a period of too much work, a difficult relationship at home or work, the illness of a loved one, unrelenting financial stress, the intensity of school and studies, lack of adequate sleep, too much caretaking, not enough time for self care for any reason, etc.
After the initiating stress, symptoms start and include pain, fatigue, sleep problems, mood problems, mental fogging, digestive problems, and evidence of autonomic dysfunction such as irritable bladder and fainting. The symptoms vary in location and are unpredictable in their severity. In this respect, they seldom have a pattern that makes any sense, making them even harder to manage. Many people have trouble maintaining a predictable and reliable work schedule, but only 1/3 actually are classified as disabled.
From scientific research, we know that there is abnormal activity in the brain in certain prefrontal cortical areas in response to painful stimuli, that there are abnormal levels of peptides in the brain (chemicals that communicate between brain and body), that there is a deranged pituitary hypothalamic axis mediating the body’s endocrine system, but none of these findings has, as yet, emerged as pathognomonic, or diagnostic, for the disease.
A nervous system insult
In essence, though, it appears that there is a dysregulation of multiple body functions, including pain perception, as the net result of this nervous system insult.
Conventional approaches to pain seem not to be helpful, and even therapeutic doses of narcotic pain medication rarely control the FM pain. Perhaps this is because the areas of the brain responsible for FM allodynia (pain amplification) have no opiate receptors. Nonetheless, until we have a better understanding of normal brain function and how FM actually deviates from normal, we will likely be unable to create a “magic bullet” for this disease in the conventional allopathic model.
Ultimately, in my experience, some patients were like me, getting better simply with understanding and accepting a model for their disease that linked the physical symptoms with emotional experience and trauma. I worked with patients on journaling and simple cognitive exercises to reinforce this idea. However, some patients would find this model easy to accept and still did not have much symptom relief with these exercises.
Thanks to Rue, I was introduced to Emotional Freedom Techniques and energy psychology, which I believe is a breakthrough for the treatment of trauma and post-traumatic stress disorder, and, as such, a treatment for the trauma that appears to induce FM. In fact, many patients achieve remarkable relief for their painful symptoms with EFT.
EFT to the rescue!
Under Rue’s guidance, foundational beliefs are explored along with the initiating traumas and their deepest meanings. EFT is applied to all aspects of the thoughts, sensations and emotions associated with this exploration, and the FM symptoms improve.
What might be happening here?
It is my belief that the areas of the brain that appear to be affected by FM in recent fMRI studies are fairly resistant to “quieting” with purely cognitive activity—such as thinking and talking.
Instead, there seems to be an energetic influence from EFT and other therapies like EMDR (Eye Movement Desensitization and Reprocessing), and also with the left prefrontal activation of a meditation practice, that may have a dampening or corrective effect on the problematic prefrontal cortical activity of FM.
It has become apparent to me that FM patients are like “canaries in the coal mine” responding to our stressful culture and environment with real illness and debilitation. There is nothing about this that is factitious nor evidence of psychological disease or bad character. This disorder demands an expansion of our understanding of stress and disease.
Live your heart’s desires
As my own awareness of the multiple stressors we are exposed to increases, I expand my counseling of my sensitive FM patients to include diet and nutrition to avoid inflammation and illness, supplements to correct nutritional deficiencies and diligent counseling about stress management strategies and interventions.
Most of all, I give permission to patients to live for their own hearts’ desires, to explore their limiting beliefs and to honor their sensitive temperaments. It is this latter path that will best help the sensitive soul from becoming sick again.
Nancy Selfridge, M.D., currently Chief of the Integrative Medicine and Wellness Clinic of Group Health Cooperative HMO in Madison, Wisconsin.
1. Sarno. John. The Mindbody Prescription: Healing the Body, Healing the Pain. New York: Warner Books, 1998.
___________. The Divided Mind: Epidemic of Mind Body Disorders. New York: Regan Books, 2006
2. Scaer, Robert C. The Body Bears the Burden. New York: Haworth Medical Press, 2001
3. Aron, Elaine. The Highly Sensitive Person. New York: Broadway Books, 1996
4. Keirsey, David. Please Understand Me II. Del Mar, California: Prometheus Nemesis Publications, 1998
Sending you all my best love and blessings –
Rue
