Understanding Chronic Fatigue

by John Sparkes

www.itcanbbetter.com

As a Christian counsellor I have met many people who have Chronic Fatigue (CF). Over the years I have found an understanding of the four main temperament types to be very useful and have made what could prove to be some helpful observations.

The first observation is that all the people I have known who have CF have all had one of the temperaments in common – the one that Hippocrates called the Melancholic.

The second observation is that this particular temperament is coupled with one or other of the two outgoing temperaments, making a combination of extrovert and introvert – in one person.

These observations fit what is generally known about CF, namely, that it often affects people with drive and ambition, who are capable, at least at times, of being outgoing. It used to be called, quite unkindly, ‘yuppie flu’ because so many ‘go-getters’ were affected as they drove forward in their careers or pursuits. But there was a side to these people that others were hardly aware of and that was a deeply feeling, sensitive side, with the capacity for depression. The need to drive forward in life and, often the person’s own lack of awareness of this part of their personality, meant that this side was undeveloped and therefore provided a ‘dragging effect’ within their personality. The result is comparable to a car being driven with the brakes on; eventually the stress and tension within the system causes something to overheat or breakdown, leaving the car powerless. And often it is some physical illness (for example, a virus), stress or a particular trauma that provides ‘the straw that breaks the camel’s back’. The physical symptoms are very real but my observations are that if we can help the person understand themselves, as a Melancholic, and begin to handle that side of who they are, then the symptoms will disappear.

It is appropriate at this point to look a little more closely at the temperament types – particularly the Melancholic. Only a brief description can be given at this stage. Other booklets have been written which give fuller descriptions of the temperaments.

Hippocrates (460-370BC), known as ‘the father of modern medicine’, first named and recorded his observations of the temperament types:

Melancholic
This person is creative, a reflective thinker and deeply sensitive. He is perceptive and has a great feel for life. He tends to see things in ‘black and white’ terms, has a strong sense of justice and can be very loyal and self-sacrificing. He has high standards for himself and others. However, he can be negative about himself, struggle with feelings of worthlessness and be prone to moods and depression. His high standards can become a quest for perfection that can put himself and those around him, under real pressure. He is usually happy with his own company and easily retreats into his own world.

Choleric
This person can be outgoing, even dynamic, optimistic and full of ideas. Being goal-orientated, he is usually either doing something or going somewhere. He is strong, determined, self-sufficient and quite willing to take the lead. Take care not to get in his way or you will meet his frustration or anger! He is a visionary but his vision may be narrow and he may use you to reach it. Beware of the competitive spirit and control – he has to be the best. Although he has his own deep emotions he suppresses them to control them and would regard those who display their emotions as ‘weak’. He is quite capable of using humour and sarcasm to put himself above those who do not conform to his way of thinking and his logical mind wins endless arguments – even when he is wrong!

The Combination of Choleric and Melancholic
It can immediately be seen that these two temperaments are opposite. Unless there was a very good understanding in the home of this child then the chances are that this child would rely heavily on the Choleric temperament for everyday living. It is also clear that the Choleric’s way of handling any awareness of the Melancholic feelings would be to condemn the ‘weakness’ and suppress the feelings. Thus that deeply sensitive side of the person, which is already negative towards itself and full of feelings of unworthiness, increasingly feels the pressure. In order to survive, such a person is increasingly driven to depend on the outgoing temperament until the system ‘overheats’ and all the pent up pressures of worthlessness, pain, and inadequacy break through and engulf the person with feelings of helplessness, lethargy and exhaustion. At this point the physical symptoms are very strong, for the buried emotions, which now refuse to ‘lie down and keep quiet’, produce endless patterns of thoughts which threaten to overload the brain. Even the normal environment becomes too much, and darkened rooms become necessary. Steps forward are taken – sometimes large and sometimes small but often the feelings of weakness rise up and overwhelm the person again.

Sanguine
This person is full of fun, surrounded by friends and is the life and soul of the party. He is kind, generous, enthusiastic, carefree and warm. Unfortunately, he can also be superficial, weak, impulsive and undisciplined. Being aware of his weakness he will often try to avoid the painful realities of life and he is quite capable of arguing that black is white. This temperament also has a need to be ‘centre stage’ and, in any given situation, has the tendency to take over and be bossy.

The Combination of Sanguine and Melancholic
Much of what has been said concerning the Choleric-Melancholic applies here also but with this difference. The Choleric expresses feelings through his mind, in thoughts and words, while the Sanguine expresses them physically. Therefore the Sanguine will try to fill the emotional gaps with anything which satisfies physically, for example food or alcohol. Also if the person has lived just as a Sanguine then the Melancholic part will be in a muddle and this, for the Sanguine, often expresses itself in a variety of physical ailments, sometimes running alongside the CF.

Helping Yourself with CF

It is vital that the CF sufferer acknowledges the Melancholic part of their personality.

We have noted that most CF sufferers have this combination of extrovert and introvert. It is important that you concentrate on dealing with the introvert until you feel a deep sense of peace within yourself.

In doing so you will probably discover that deep down you are depressed and possibly have been for a long period of time.

Learn to communicate your thoughts and feelings on a regular basis with someone you trust. Try to avoid ‘going round in circles’, and take the positive advice that is given.

Recognise your strong natural tendencies to feel unworthy and to be negative about yourself. That has been your way of coping, deep within, over the years, whatever positive messages you have tried to convince yourself with. Try to catch yourself thinking negative thoughts about yourself and replace them with something positive. Be aware of words and phrases that you use to run yourself down.

Gradually build a structure to your days but not as an attempt to ‘strive forward’ but as a natural expression of your creativity.

Find a creative activity which you could take up – e.g. making music, artwork, some form of handicraft etc. Being creative is not ‘a waste of time’.

Above all….

I have found, as a Christian counsellor, that a relationship with God, through faith in Jesus Christ, alone brings:

• A deep sense of security
• Freedom from guilt and fear
• Unconditional love and acceptance

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written by rhonda chapman, December 25, 2009

I have greatly benefited from reading this article. I am so happy that I now understand exactly what has happened to me over many, many years concerning my depression and health problems. I always read in various books that a person with a melancoly temperament could NEVER EVER blend with a sanguine temperament because they were complete opposites. I almost cried when I read that I have been wrong and that my misunderstanding about the blending of introvert and extrovert has been the basis of an enormous amount of angst in my life. THANKYOU so much for your advice. It has been an answer to long awaited prayer that has been deep in soul for so long now. I feel like crying, laughing and singing all at the same time. Freedom at last from the box I had locked myself up in for so long. It could never understand how two people could be inside me at the one time and wrongly assumed the sanguine temperament was false and needed to be squashed because it wasn't the real me. How totally wrong I have been all these years! Now, I fully understand how Jesus Christ tells us in His Word that the truth will set us free. Praise God. I feel so excited I could just holler out loud. It is Christmas day today and I couldn't think of a better gift other than our Saviour's birth. Thank you, thank you and God bless. I pray others will benefit the way I have by reading your online article.

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written by A happy secure CFS/Lyme suffer - Karen E., June 09, 2010

I find this article to be sad and so in line with the stigma that many of us with a chronic illness that presents with extreme fatigue face. I am rarely one to post into response but when I read the following:

"In doing so you will probably discover that deep down you are depressed and possibly have been for a long period of time.

Learn to communicate your thoughts and feelings on a regular basis with someone you trust. Try to avoid â€˜going round in circlesâ€™, and take the positive advice that is given.

Recognise your strong natural tendencies to feel unworthy and to be negative about yourself"

it appalled me and I could not silence a reply.

By your assumption you have placed an article about dealing with CFS online with the focus once again slanted to the perspective that it's in our heads, or it must be caused from our inability to handle stress, and the biggest misconception that our symptoms are due to depression.

Not once in my 32 years of life that God has granted me, have I ever dealt with depression or had "strong natural tendencies to feel unworthy and to be negative about yourself".

Trust me when I say that after struggling with Chronic Lyme and CFS symptoms for the last several years I have explored every avenue through both health care and mental care and I can assure you that no one who has taken the time to know me or provide health care has ever come to the conclusion or diagonosis that I suffer from depression.

Do I feel sad or fustrated sometime? Yes. Can life at times be overwheliming? Sure, but modifcations to my daily expectations and procees allow me to cope and function hapily even though my body and energy level no longer respond the way they use to.

Sure there are many that present with depession who have a chronic illness. How would you feel if you deal constanly with people making the assumption you are lazy, faking it, depressed, just not a strong enough person, able to snap out of it and then present this view point to those around you.

I would venture to say that every of us who suffer from CFS, Lyme, Fibro, etc.. on has dealt first hand with the loss and disbeleif of a friend or multiple friends, our family, and many times our spouse.

For even the healthiest person, I imagine that if you felt unwell and had those around you who you counted on as your support system pull away or insist you are depressed and need to snap out it you too would expereince a deep sadness in the face of their rejection. Is it any wonder why depression might not set in for many after that.

If you have stumbled on this article and are a loved one, friend or spouse of someone suffering from and illness like this, I implore you to not base your reponse on this misinformation.

I am not faking it. I am not depressed. I am also no longer the same person I was 4 years ago. I am not lazy. I wish that I could just pray and have it all go away or take a anti-depressant and my life would show sings of improvement. I hate how this affects those around me. I mourn and miss how capable I use to be. I also love and accept myself right where I am. I hope that I get better. I will survivie and still enjoy live if I don't. Friends, Family and my spouse - I value your support and acceptance more than you could ever know. For those of you who believed me or worked through your misconceptions, thank you from the bottom of my heart.

If someone takes this view point in the medical commnuity - run or change providers as fast as you can.

I have a deep love for my Creator and I know through accepting the Grace of Jesus dying on the cross that I have a relationship with the one who brings:

â€¢ A deep sense of security
â€¢ Freedom from guilt and fear
â€¢ Unconditional love and acceptance

I also believe in complete healing but neither the fact that I am a Christ follower or believe in prayer changes the fact that I suffer from CFS and Lyme and have never beed a depressed or negative person.

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written by Maff, June 09, 2010

Hello to both of you,

Rhonda - Great to read that you benefitted from reading this article. I hope you are still positive and doing relatively well!

Karen - Thank you for your excellent post. I am glad you took the time to write such a well thought-out and common sense response. I am sure it will benefit many future visitors.

I did have reservations about posting this article because the section pointed out by Karen didn't sit well with me either - even though after being diagnosed with CFS 19 years ago, aged 11, I have actually experienced depression. All depression has some element of physical illness associated with it - it is strongly associated with inflammation for example as well as reduced ATP (energy) production - both of which are key in CFS also. Both CFS and depression are as much physical illnesses as diabetes or cancer. All illnesses involve interactions between the mind, body and spirit so arguments over whether an illness such as CFS is a physical illness or in the mind are to all intents and purposes irrelevent in coping and recovery. There needs to be a paradigm shift in the way illness is perceived. It is never solely in the body or the mind - it is a result of dysfunction in both as they are inseperable on a cellular and biochemical level.

I chose to post this article because I believe to cope effectively with CFS and eventually recover it is important that we explore our own patterns of thinking and if they are destructive attempt to adapt them to be more health-promoting. While I also disagree with the comments you pointed out Karen I do believe the author of the article is offering useful advice when it comes to creativity and spirituality. However, I would never advise anyone with CFS to simply rely on these types of intervention. As a soon to be graduate in nutritional health and a practicing nutitional therapist I believe in a holistic approach and that those with CFS should pursue every avenue to improve their condition including conventional care, nutritional medicine, complementary and alternative therapies (e.g. acupuncture, reflexology etc), environmental medicine and lifestyle changes to avoid toxic exposures and allergens, and self-help strategies be they psychological, creative or spiritual as described in this article. It is also my philosophy that each individual with CFS is just that - an individual. Management and treatment therefore needs to be tailored to each individual's needs based on both measurable organic contributors such as infections (Lyme in your case Karen) and psychological make-up and current coping style.

CFS is perhaps one of the most complex illnesses one could have to deal with so exploring all avenues is essential at this stage given the lack of definitive testing and treatment.

Thanks again to you both for your contributions. I had a strong feeling this article would draw both positive and negative responses!