Chronic Fatigue Syndrome: What is it?

We had a staff training today; our practice is to bring in patients who need extra help to discuss their problem with them. Today, we saw a gentleman who has been sidelined for four years with Chronic Fatigue Syndrome. Very few know what it is, which is why he has been shuttled from one doctor to another, getting one type of medication after another and he still is unable to work. He did receive the diagnosis, however, which shows how useless a non-dynamic diagnosis is: Chronic Fatigue Syndrome. He is exhausted at all times, cannot drive or go to work; just lies around. Let me explain this affliction and see what can be done about it. And in do so doing I will try to help us see what the act-out is. And the act-in, as well.

Chronic fatigue can often be so subtle as to be undetected. In the case under discussion exhaustion was his act-out. What that means is that he is not just tired now because he has no energy. There is an imprint of exhaustion from far back in time that that dominates his life and drains his energy. He really is tired in the same way that someone deprived of love early on acts out sexually trying to get touched as much as possible to make up for that past deprivation. She really needs love and touch, and is really sexual; driven by the past and its imprinted pain. Or in the case of early food deprivation, especially during womb-life, (the mother on a strict diet to keep her form), they are really hungry…out of a memory!

All of these patients are acting out their need from the past in the present; that is called symbolic acting-out. It is never satisfying or fulfilling no matter how much one does it; and if one is dissuaded from the act-out in therapy the need and imprint are still there doing damage down below.

During the birth process our fatigued patient struggled mightily to get out only to be smothered by a massive anesthetic given to the mother. He couldn’t struggle any more, so that failure set in. He exhausted any and all resources he had in the battle to get born. The exhaustion became an imprint. Later, he felt chronically fatigued and unable to struggle. It wasn’t so evident during growing up except that he disliked exercise or “making a move,” and he had less energy. Making a move originally was impossible. He gave up easily when he should have pushed forward. So when I say “he gave up and couldn’t struggle any more” I am indicating nothing thought-out; it was a biologic memory that had nothing to do with conscious-awareness. The imprint was purely physiologic with no awareness counterpart. It can only be understood after the fact of reliving the imprint when the feeling rises to the top level for comprehension, at last. Clearly, there is no “reaching” for the imprint because the patient does not know it is even there. So he cannot deliberately think it out to go there.

Our fatigued patient began to run off the imprint over and over throughout his life, with no idea what was wrong. The distance between the birth trauma and current-day fatigue is so large as to make it seem absurd. It is not. One way we know is through patients who suffer from it; they relive and relive, first the terrible struggle to get out, then the lack of oxygen and near death sensation back then from massive anesthetic given to the mother, followed by shutdown of many key biologic systems, and giving up…the struggle-fail syndrome. It is that syndrome that is carried through life and acted out without cease…until there is conscious awareness. For it to stop one needs connection; it is the only way, the only way, to stop the act-out. Yes, we can smack some man who gets erect when seeing a picture of a nude man or of someone who salivates at the sight of a juicy steak but it is only temporary until the imprint again rears its head, which it will certainly do. That is why anger management cannot work. We can find tricks to push down anger but the imprint dominates and never lets up. Nearly every treatment in the anger management armamentarium has to do with suppression, pushing back. Anger is not to be managed; it needs to be felt in context; then it is over. We have to manage it, like food and sex addiction, when the person does not feel the feeling. So either feel or manage. It is one or the other.

The imprint is a memory that is unconscious because that is where it resides. And it resides there physiologically, put in place long before the neurological capacity for full comprehension. It is an imprint, nevertheless, and agitates us and forces the act-out without stop. It was physiologic originally and remains so. It is impelling and compelling. Because it is purely physiologic, treatments that work on the physiology such as tranquilizers do work. What is diabolic is that the there are mental consequences, impulsions from below, that force compulsive ideas that lead us to believe, somehow, that it is mental in origin. Not so.

Obviously, the reliving cannot be faked because the memory has been hidden and does not become conscious until it is relived. No patient can foresee this and “decide” to relive it. And no one would want to fake it since it can be uncomfortable. Since several thousand patients have gone through it with success, some long before I wrote about it, we have a good idea that our hypothesis is right. There is nothing quite so liberating as that reliving process. Once relived and the sequence completed it is over and one is no longer driven by it. The compulsion is over because the imprint has been experienced. Meanwhile, until then, it captivates and rules most of our lives. We are often bedeviled by our need to eat, or our constant exhaustion. Now we know what to do about it and treat it properly.

Until there is connection for this fatigued man the smallest effort now leads to exhaustion and giving up; he does not want to try any more. The birth has been hijacked and is run off continuously. Effort, struggle, blocked, smothered by drugs, anoxia (diminished oxygen) exhaustion, failure. To be clear, the physiologic component of the original imprint is run off and will be run off until it is experienced and made conscious. That is, the entire biologic panoply, all of the physiologic components of the imprint, are there and active all of the time. We act it out because there is no conscious connection; like a headless chicken.

If our patient even thinks of going to look for a job he is literally paralyzed into inactivity. It is as if the anesthetic is administered all over again after his birth struggle. In this case, the act-out was giving up and failure. This was then a repetition compulsion where any kind of effort he made exhausted him, the analogue of the birth imprint. Unfortunately, he could never waver from this scenario because it was held fixed by the imprint itself, which never allowed any wavering or alternate behaviors originally. If we want to know the hidden feeling we have only to examine the act-out; it is nearly always a direct reflection of the hidden feeling. As we see in chronic fatigue. This is not to say that it is always thus, but close enough. It is often hidden by some kind of concocted philosophy or theory but it is still the outcome of an imprint.

Why isn’t the act out fulfilling? Because it is symbolic; the fulfillment is for a past event and not current. And it is not fulfilling because it is driven by an unrelenting memory of “no fulfillment”; that is what is driving us. And will continue to do so. The “no fulfillment” is always there no matter how much we eat because it is an ineluctable imprint. If we do not understand the imprint (explained by me in the blog…the mechanisms of methylation and acetylation) we can never understand what drives our compulsions and how to treat them. Understanding is primordial. Otherwise, we are forever prisoners of pain.