This article has been published in the June 2008 edition of the newsletter for the specialist section for neurological practice in Occupational Therapy.

Reversing the Symptoms of Chronic Fatigue Syndrome/M.E.

Birgit Rathje-Vale BSc (Hons) OT, AinstLM, of Independent Rehabilitation Services (IRS) came across an effective treatment for Chronic Fatigue Syndrome. IRS started working with Caroline Khambatta BSc (Hons), a Fully Licensed Reverse Therapist and Clinical Supervisor a couple of years ago. "Since working with Caroline we are able to put ‘client centred’ treatment approach into practice in a much stronger way that addresses the clients emotional needs in line with their physical, cognitive and overall functional needs" says Birgit.

Birgit and Caroline explain how Reverse Therapy sees the psychobiology of this illness, how this talking therapy works and reviews the role of carers in the recovery of Zoe, who was bedridden for 2 years with Chronic Fatigue Syndrome.

Historical View of Chronic Fatigue Syndrome

In the past Chronic Fatigue Syndrome (CFS) has received bad press and has been described as ‘Yuppy Flue’. Individuals suffering from this illness have had to combine the distress and discomfort of the symptoms while taking the humiliation from those who did not believe their symptoms were real. To make matters worse there was no ‘absolute’ positive diagnosis. For some patients it took years to receive a definitive diagnosis. Patients who did get diagnosed were typically told that there was no ‘cure’ available and the lucky ones were given access to support that helped them cope with the illness but not address the cause.

The Symptoms

Each patient may experience unique combinations of symptoms, however, they tend to include some or all of the following: fatigue, muscle pain, loss of temperature regulation, headaches, dizziness, digestive disturbance, brain fog (cognitive and perceptual difficulties), sleep disturbance, increased sensitivity to light and sound and fluctuations in blood sugar and pressure. Fibromyalgia sufferers may share similar symptoms but have more pain than fatigue. This pain can be in joints and/or muscles.

There are in fact three stages of ‘dis-ease’ in people with ME/CFS or Fibromyalgia. The first stage is an alarm reaction – or ‘a wake up call’ - where the body triggers a series of hormonal changes that place the body on red alert. If the body’s messages are ignored at this stage, then the ‘dis-ease’ state progresses into a state of resistance. In this stage person’s natural body intelligence (Bodymind) realises that its early warning signals are being ignored and that we are continuing to resist the need for change. In the resistance stage symptoms begin to intensify and become more chronic. Finally, if we continue to ignore the body’s messages – if Headmind keeps blocking our emotions and needs - we eventually reach a state of exhaustion. In the ‘stalemate stage’ Bodymind is still trying to keep the body on red alert but our body’s hormonal system – and other functions within the body - can no longer cope having reached the limit of their ability to keep going under emergency conditions. Symptoms then worsen and become even more chronic and a vicious cycle begins.

The Reverse Therapy view of CFS

The cause of the symptoms is believed to be due to an overactive Hypothalamus which in turn over stimulates the Pituitary and Adrenal glands. When healthy individuals are exposed to external stresses, the body responds by sending chemical messages (in the form of emotions)1 to the body to get the person to address the situation and restore balance. The Hypothalamus temporarily is switched on to red alert (fight or flight) until harmony is restored, when it can revert to its normal functions of homeostasis. With patients suffering with CFS and Fibromyalgia their HPA-axis is believed to be over-stimulated 24 hours a day, leading to the miserable symptoms described above.2

Dr John Eaton, a former psychologist and psychotherapist and founder of Reverse Therapy, has spent some years researching the cause and treatment of CFS and Fibromyalgia. He believes that the lack of response to the Limbic System (emotional brain) causes the individual to stay in a heightened state of red alert indefinitely.

To help patients understand Dr Eaton describes Cognitive thinking as Headmind, which chatters, worries and criticises, while ignoring the natural emotional intelligence of Bodymind, which is driven by the Limbic System. He describes a disconnection between Headmind, our thoughts and Bodymind, our feelings and emotions.

In 2002 Dr Eaton formed Reverse Therapy and trained a team of Reverse Therapy Practitioners. In the last 6 years Reverse Therapy has achieved a remarkable success rate in treating the symptoms of M.E. and Chronic Fatigue Syndrome. Over 1500 clients have been treated and have achieved an 81% success rate in eliminating or significantly reducing symptoms (according to audited results).

Reverse Therapy is an educational process which teaches people how to eliminate symptoms by understanding and acting on 'the message of the symptoms'. It teaches clients to respect and work with their emotions rather than blocking them.

Case Study

Zoe was diagnosed with CFS in 1996. Zoe was working as a carer with some particularly challenging patients. In addition to being exposed to some extremely upsetting situations, Zoe found herself working double shifts due to patient needs and a shortage of staff. Her Headmind justified the need for her to continue doing double shifts while her Bodymind was screaming at her to take care of herself as well as caring for everyone else. During the following 10 years Zoe’s husband died and she finally relapsed with the CFS and spent a couple of years bedridden.

"When I first met Zoe, I did a home visit and found her in bed, surrounded by equipment to move her body from the bed to the bathroom. She had daily carers and could manage to drink but did not have the strength to lift a kettle or to make her own beverages" explains Caroline.

Zoe was in constant pain, suffered with depression and had regular panic attacks. Desperate to return to some kind of ‘normal’ life she decided to try Reverse Therapy. "I found two things really difficult" reports Zoe. "Firstly, learning to tune into Bodymind, there didn’t seem to be anything there. Caroline Khambatta, my Reverse Therapist, helped me learn to listen to part of me I had been ignoring for years. Once I started to get the hang of it my symptoms began to reduce and I felt excited about my life again and a bit scared about doing new things. I learnt that my fear was guiding me to take small steps, be well prepared and ensure I had plenty of support when I did new things.

The second thing I found really hard was the anniversary of the death of my husband. I’d been doing really well and then suddenly all my symptoms came back in great force. By this time I had learnt to speak up and ask for help. I realised I had a huge amount of sadness which was my Bodymind’s way of guiding me through the things I needed to do to acknowledge the loss of my husband. The symptoms came up because I was blocking these emotions and listening to Headmind telling me ‘I should be over this by now’. As soon as I starting taking action like clearing some of his old clothes, visiting his grave and talking about him to close friends my symptoms reduced. I learnt some very important things from that setback. I listen to my emotions now so my body doesn’t have to send symptoms to get my attention, it already has my attention"

Linking Practical and Emotional Needs

Zoe had 2 carers and one of her tasks was to enroll them in her recovery process. She explained to each of them that she wanted to be involved in her own care and start by taking really small steps. With her morning carer, Zoe felt really positive and noticed her symptoms went down as soon as they broke things down into small tasks and she was able to get involved. Her symptoms went up every afternoon with her second carer. Exploring the situation she realised that the second carer has stronger views about how she should recover and Zoe felt she wasn’t being listened to.

Birgit explains "Client centred intervention combining OT with the Reverse Therapy approach means listening to and respecting the clients emotional as well as their physical, cognitive and functional needs. If a client wants to be involved in making dinner and getting the carrots out of the bag is the only thing they can do, then that’s a brilliant first step. When you work closely with the client, observing their emotions during the goal setting process, you can see your client come alive and you know that things are starting to work."

Fine Tuning

Reverse therapy is really an educational process in which clients learn to understand the split between Headmind and Bodymind, raising their awareness of Bodymind communication through feelings, sensations, emotions and symptoms. By learning to attune to Bodymind – and Reverse Therapists use a variety of sensate focusing activities to do this – people gradually uncover the hidden message of the symptoms. A journal is used to pinpoint increases in symptoms and specific situations in which that occurs. At that point the Reverse Therapy Practitioner collaborates with the client in order to put together new strategies for the expression of emotion, and new activities to reduce external pressures. Empowering the client through applied learning is at the core of therapy.

The ingredients that make up Reverse Therapy aren’t new – it has been greatly influenced by the groundbreaking work of Ernest Rossi into the psycho-biology of mind-body healing and also the ideas of Eugene Gendlin (Focusing), Hungarian Psychologist, Hans Selye (Stress disorders), Dr Candace Pert (Neurobiology) and Antonio Damasio (the Biology of Emotion) – although the synthesis and step-by-step treatment process is unique. Dr Eaton also claims that, although the process has taken years to develop and refine, it is in fact a relatively easy process to follow and understand.

"Treatment is essentially a simple, educational and collaborative process where clients not only learn about their illness but become active partners in their own healing", says Dr Eaton. "The solution is in every client’s hands and it starts by them learning how to work with the body’s own intelligence – with Bodymind. Indeed, most clients actually enjoy the treatment, it empowers them. These factors alone are the reasons why Reverse Therapy has been so successful".

Once clients learn to stop blocking their emotions and work with their Bodymind by acting on its message then symptoms reverse and full recovery follows. After 5 sessions Zoe is now symptom free, is driving herself around and has started re-building her life and her physical strength. "I feel well, happy and fantastic. I have my life back! What more could I want?" reports Zoe.

To find out more about Reverse Therapy, visit www.wisesteps.co.uk or read the book – ‘M.E., Chronic Fatigue Syndrome and Fibromyalgia – The Reverse Therapy Approach’ by Dr John Eaton. Or contact Caroline Tel. 01280 822422 for an information pack or e-mail her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Caroline has clinics in Northamptonshire and Milton Keynes and is also a clinical supervisor.

If you want to find out more call Birgit on her mobile on 07966 369647 or e-mail her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

References:

  1. Candace B Pert. Molecules of Emotion. 1997
  2. Esther Sternberg & Philip Gold. The Mind-Body Interaction in Disease. Scientific American Special Issue 199

Declan McNichol

Bill Young

Angela Gordon

Birgit Rathje-Vale

Helen Smart