It’s Not Just in Your Head: Therapy to Help Cope With Fibromyalgia

Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, exhaustion, digestive problems, disrupted sleep and chronic fatigue, muscle stiffness, impaired memory and concentration, and more. It affects 2-5% of the population. Most of those who suffer from it are women, who make up 80-95% of all reported cases.

It usually takes a long time to arrive at a fibromyalgia diagnosis, and until the diagnosis is reached, those suffering from it constantly face people doubting their pain and assuming it is psychosomatic. Because there are no tests to unequivocally identify the syndrome, fibromyalgia is still diagnosed on the basis of self-reported symptoms, and medical treatment focuses solely on trying to alleviate these symptoms.

The reasons for the onset of fibromyalgia are still unclear. Studies suggest that genetic factors increase the risk of developing the condition, as well as infections, hormonal changes, and physical or mental trauma. Many of those suffering from the syndrome report traumatic life events, such as physical or sexual abuse during childhood, which were repressed and did not receive recognition or proper treatment.

Living with an Invisible Disease: Life after the Onset of Fibromyalgia

Fibromyalgia severely affects the quality of life of those who suffer from it, and it is accompanied by psychological symptoms in addition to the physical ones. Unlike diseases and syndromes that manifest externally, fibromyalgia is not visible; this makes it difficult to mediate between the internal struggle and the surrounding environment, which sees only a healthy-looking person.

As a result, people suffering from fibromyalgia are forced to push back on claims such as “it’s all in your head”, and contend with doubt on the part of both their surroundings and the medical system. This only intensifies the frustration and feelings of loneliness.

Living with the syndrome involves difficulty in daily functioning: moving from place to place, housekeeping, child care, building and maintaining a career, and maintaining relationships of every kind. This often leads to feelings of guilt, loneliness, depression, and anxiety, and can harm relationships, family, and social life.

My patients compare life with fibromyalgia to a nonstop roller coaster ride. There is no knowing what to expect, it’s impossible to make plans, and there is no continuity or stability.

“I Lost Confidence in My Doctors and Myself – I Thought I Was Losing My Mind”

Women I have treated have told me about their agonizing journey until the diagnosis was confirmed. Even after the diagnosis, as the knowledge that they were suffering from a chronic illness began to sink in, my patients had mixed feelings: on one hand, release and a sense of relief that the “burden of proof” had been removed; on the other, a sense of loss and profound grief about the “verdict”.

S., 42, said: “For years I have been living my life with pain all over my body, fatigue, headaches, and digestive problems. I just don’t feel well. I was sent to do test after test and they all ended the same way – with no findings to explain what was wrong. I saw doctors who dismissed me by diagnosing a mental condition and referring me to a psychiatrist. So many didn’t believe I had a real physical problem. I would panic and scream, ‘why can’t you tell me what I have?’ Before I received the diagnosis, I lost confidence in my doctors and myself. I thought I was losing my mind.”

Even after the diagnosis is received and a name is put to the feelings experienced for years – life with the pain continues. Fibromyalgia sufferers now must seek the right path for them and treat the condition to allow relief from the physical and mental pain that accompanies it.

Why Treat a Physical Problem With Therapy? Fibromyalgia and Psychotherapy

Therapy for those suffering from fibromyalgia will provide a toolkit to complement medical treatment. In psychotherapy aimed at coping with the syndrome we will learn, among other things:

• How to emotionally handle the loss of health and declining function.
• How the patient can adapt their lifestyle to their abilities, significantly reducing the frustration resulting from a disparity between desires and reality.
• How to create tools to develop and maintain beneficial relationships with spouses, family members, friends, and colleagues while living in the shadow of the syndrome.
• How to search for and develop meaning in life even while struggling with illness and chronic disability.
• How to acquire cognitive and behavioral tools for changing perception and thinking.

My experience shows that therapy may uncover mental factors that contributed to the onset of the syndrome, such as traumas that were not given recognition, which try to make their way out of the unconscious by manifesting physically. Sometimes, when the trauma is revealed and talked about, and recognized and treated as a result, it becomes possible to let go of and relieve some of its physical expression.

A fibromyalgia sufferer I treated has agreed to let me share her story: in therapy, it became clear that she had been sexually abused as a child. Her parents believed her, but told her to hide her distress, not talk about it with anyone, and go on with her life as if nothing had happened.

In adulthood, the patient developed a successful career and started a family. She worked around the clock, met all her family’s needs, and even did volunteer work; but she neglected and repressed her own suffering. Over the years she gained a large amount of weight, and ultimately developed diabetes and fibromyalgia. As a result, her function was gravely impaired and her life changed beyond recognition.

Over the course of therapy she realized that her repressed trauma had found expression in her body. This recognition brought great relief and enabled her to change her life, as she learned to take care of herself and treat herself with compassion. She stopped automatically fulfilling the needs of the people around her, and the pressure she was experiencing decreased. As a result, she found time for herself, for pleasurable activities, and even for moderate physical activity (something that had seemed impossible to her in the past) – and her mental state vastly improved.