Chronic Fatigue Syndrome and the Alexander Technique
An alternative view of Chronic Fatigue Syndrome - Thoughts about CFS, The Western Medical Model, Ayurveda and the Alexander Technique
by Martin Finnegan
What exactly is Chronic Fatigue Syndrome?*
Sometimes referred to as ME or Myalgic Encephalomyelitis, it is a term that describes a chronic, debilitating disorder that affects the immune and central nervous system. Typical symptoms are a profound fatigue, totally out of proportion to physical activity and independent of mood, plus a range of other symptoms that can affect any organ of the body.
Causes and symtoms
The causes of CFS are unknown. There appear to be any number of apparent causes and in many cases the onset seems to be linked to a stress to the immune system such as an acute infection, especially viral in nature. After the stress or virus has run its course the symptoms do not abate as usual but become chronic and are often associated with profound fatigue and feelings of being generally unwell.
The Chronic Fatigue Society of NSW states that the symptoms of CFS are a prolonged and disabling feeling of exhaustion lasting at least six months. The symptoms are often made worse by any activity and are often unrelieved by sleep. Symptoms vary between people but may include persistent and profound fatigue, exhaustion, flu-like symptoms including a sore throat, fever and sore lymph glands, muscle and joint aches, pains and weakness, headaches, nausea, balance disturbances, dizziness, vision problems and sensitivity to light and noise, sensitivity to foods and common chemicals, thoracic symptoms including palpitations and breathing difficulties and sleeping problems including insomnia and an excessive desire to sleep. Cognitive dysfunction and poor temperature control can be also added to the long list of symptoms.
Fibromyalgia
A simlar related condition is known as fibromyalgia syndrome (FMS) which has substantial symptom overlap with chronic fatigue syndrome. The Fibromyalgia Network* describes FMS as a “widespread musculoskeletal pain and fatigue disorder for which the cause is still unknown. Fibromyalgia means pain in the muscles, ligaments, and tendons – the soft fibrous tissues in the body. Most patients with FMS say that they ache all over. Their muscles may feel like they have been pulled or overworked. Sometimes the muscles twitch and at other times they burn. More women than men are afflicted with FMS, and it shows up in people of all ages”.
Diagnosis
Western medical science has no specific diagnostic test at the moment for either condition. As a result diagnosis must be made by excluding other illnesses. This can be a long, difficult and costly process. Many CFS symptoms overlap with those of a number of other illnesses including multiple sclerosis. Nor are the symptom of chronic fatigue confined to CFS.
Just about anyone can get CFS however it seems that it is most common among 20 to 40 year olds and women outnumber men. Symptoms can last from a few months to years. Some people make a gradual recovery, some never fully recover and others become progressively worse.
Research Findings
Recent (March 2006) medical research comes from a seven-year tracking study from the Dubbo Infection Outcomes Study. The research team comprises scientists from the University of NSW, the University of Sydney and the Queensland Institute of Medical Research. The report, published in the Journal of Infectious Diseases ( the premier publication in the Western Hemisphere for original research on the pathogenesis, diagnosis, and treatment of infectious diseases ) has scientists describing chronic fatigue as brain 'hit and run'. Briefly, they “suggest” the cause may be an infection which hits parts of the brain controlling perception of fatigue and pain during the early stages of a viral infection. They further speculate the brain remains inflamed, taking months, or even longer, to heal - hence a diagnosis of chronic fatigue.
Commenting on the findings, the research team leader UNSW Professor Lloyd said: "Our findings reveal that neither the virus nor an abnormal immune response explain the post-infective fatigue syndrome. We now suspect it's more like a hit and run injury to the brain.”
"We believe that the parts of the brain that control perception of fatigue and pain get damaged during the acute infection phase of glandular fever. If you're still sick several weeks after infection, it seems that the symptoms aren't being driven by the activity of the virus in body, it's happening in the brain."
See University of NSW website
Descartes and Alexander – a fundamental difference in views
There is a persistant and very unhelpful view, reportedly held by 'skeptics', that CFS is 'all in the mind'. Another slightly more enlightened though distinctly Cartesian view that CFS is 'a condition in which the 'physical and psychological intermesh'. These ideas, views and theories are interesting from both an holistic and an Alexander Technique perspective.
From his earliest experiments F.M. Alexander realized that it was impossible to separate the physical and the mental and spoke of the indivisible unity of the body and mind, a concept that is hardly revolutionary today. He was one the original holistic thinkers. Yet we see a persistent Cartesian influence in the dualistic thinking of western medical experts and others who perceive 'mind' and 'body' as distinctly separate elements. Is there really any doubt that the physical realm – in particular our bodies – is permeated, indeed controlled by the subtle world of the mind? How could it be otherwise that the physical and psychological intermesh, for as Alexander puts it, we are psycho-physical beings.
The Western Medical Model
The western medical model has the underlying assumption that each disease has a single cause that can be identified by objective testing and that this information determines the best treatment. The model also suggests that the solution to any health problem depends almost entirely on the actions of physicians and the health care system and very little on the actions of the patient. This approach virtually ignores the patient's thoughts and feelings and effectively relieves them of the responsibility for getting better. This can lead to a terrible kind of passivity and feelings of helplessness.
When it comes to something like CFS it is obvious that the medical model has some substantial limitations. In “Steps to an Ecology of Mind” Gregory Bateson talked about how the medical model has accumulated a lot of very clever tricks that work very well, such as the vaccine for polio; but the minute that such a vaccine is found nothing further is researched about it. The end result is a medical system that has no underlying wisdom, no superstructure that binds it all together in an holistic way.
Despite the undoubted good intentions of researchers, persisting solely with an aetiological process that seeks to attribute a single cause for CFS can never produce a profound, holistic remedy. On the other hand medical research of this kind is valuable in that it does add to the general store of knowledge about CFS. It also adds credibility for CFS as a valid and real condition with conservative medical practitioners, Government beaurocracy and even sceptical family members.
Western medicine advocates rest, counseling, adjusting lifestyle and support as the best approach to treating CFS and this is all good advice. This can certainly help a lot and good medical care should always be sought as a first step. One thing you should never accept is being told by any doctor (as happened to me) that there is nothing more that can be done, so 'go home, take some vitamins and learn to live with it'!
A Problem of Perception
It seems to me that the problem with the orthodox/medical approach is really one of faulty perception. The condition is labelled with a name and is then perceived as a single thing. Personally, I don't believe CFS is a 'thing' at all (which is the reason that no definative cause or diagnosis can be found). What we call CFS is probably more comparable to the process of a human system running down, with multiple causes and 'inputs' contributing to the process. This accounts for the wide variety of symptoms and similarity of symptoms with other dis-ease.
Ayurveda to the rescue!
The rise of alternative therapies is an indication that people recognize that sometimes, western medicine can only do so much. So if in certain situations, the model is inadequate what can we do? Well, we can always try another model! In my own experience, the Ayurvedic or traditional Indian model worked very well, returning me to health within about 2 years and also helped me to make some major life adjustments along the way.
The Ayurvedic perspective is extremely enlightening - Ayurveda's causal factors for CFS describe the variety of ways that the human systen runs down. They include “excessive physical and mental stress, low immunity, bad diet and nutrition, poor digestion and elimination of wastes which leads to a build-up of toxins in the system”*. This is made worse by a lack of proper rest and rejuvenation and the consumption of too much of the wrong food, both physical and mental!
One of the key advantages of Ayurveda (literally the 'science of life') is that it eschews western scentific skepticism of anything non-material and assumes (not unreasonably) that human beings are made up of physical, mental and emotional parts and addresses all of them. This assumption is not based on some feelgood, new age mysticism but on a profound system of knowledge backed with literally thousands of years of wisdom, learning and experience. Neither is the spiritual aspect ignored – it is so profoundly part of Ayurveda as to be inseparable from it, yet espouses no dogma or belief system that you need to adopt for its effectiveness.
Every aspect of this approach is subtler and more intuitive than its western cousin, including a profound method of diagnosis (pulse diagnosis) and a recognition that what goes on in the subtle realms of the mind has a dynamic impact on our physical being. The quality and kind of 'mind-food' you consume (music, literature, television, movies etc) can have just as great an impact on your wellbeing as the physical foods that you consume.
The Ayurvedic solution is not to attempt to 'fix' any particular physical part of the body but to pragmatically address the needs of the whole person - physical, mental, emotional and spiritual though a series of time honoured and effective means.
Where the Alexander Technique fits in
So how does all this relate to the Alexander Technique? Like Ayurveda, the Technique takes a completely holistic approach, recognizing the intrinsic connection between the physical, the mental and the emotional centres.
Alexander Teachers however, are not in the business of treatment or therapy. They are in the business of education. Marjorie Barstow, a renowned Alexander Teacher and a student of F.M. Alexander, once described the technique as 'the study of the conservation of energy for human beings'. This is an apt description and especially relevant for CFS sufferers for whom the issue of energy conservation is critical.
Many people afflicted by CFS may be depressed, angry, bitter and resentful at the sudden loss of their health and vitality and at the skepticism of others about their condition. A qualified Alexander Teacher has the skills to help create change in the way a person uses themselves - and their available energy – which can make a huge difference.
Using the Alexander Technique, we would seek change in the 'whole' person through their thinking, feeling and moving by peeling back the habits of mis-use that manifest as chronic tension, pain or dis-ease. Perhaps it is these very habits that have contributed to the condition we have labeled CFS in the first place? Habits are by their nature below our level of awareness and by bringing them into our field of observation we are in a position to bring them under conscious control thereby giving more choices about how and where our energy is spent. This is especially the case regarding the amount of energy expended in inappropriate muscular tension.
Conclusion
The Alexander Technique does not offer any kind of quick fix, nor does it seek to replace standard medical care, whether western or eastern. Alexander Teachers never exclude help or therapy from any valid source.
The Technique is really all about thinking and it directly addresses how our thinking and moving work together. This is no small undertaking! Many prospective students are discouraged when they learn that there is no quick fix or magic bullet for their problems but that they will have to work for their wellbeing .....and take full responsibilty for their own situation! The path to learning the Alexander Technique is not an easy one – work is required - but it is ultimately extremely gratifying and fullfilling.
What the Alexander Technique does offer is a practical and proven method of self-care and energy management that places the responsibility and the power of recovery back into your own hands. It can be a powerful addition to your arsenal of resources on the road to recovery from CFS.References:
*Information about ME/Chronic Fatigue Syndrome was supplied by the ME/Chronic Fatigue Society of NSW Inc. C/- Royal South Sydney Community Health Complex, Joynton Ave Zetland NSW 2017 Telephone: (02) 9439 6026
* The Maharishi AyurvedaSM Approach to Chronic Fatigue SyndromeClick here for The Complete Guide to the Alexander Technique