The Next Step? Ashok Gupta at the IACFS/ME Conference
by Cort Johnson
Ashok Gupta recovered from chronic fatigue syndrome (ME/CFS)almost ten years ago. His research into his condition lead him to develop a new theory of the disease and novel techniques for treating it. He believes that the fear center of the brain - the amygdala - has become chronically activated - causing the body to over-respond to virtually every stimulus presented to it. Over time this results in exhaustion, hyper-sensitivity, increased pain, etc. After treating patients for about five years in his clinic in London he created a DVD program patients can use to guide themselve through his program.
The cognitive behavoral therapy studies presented at the IACFS/ME Conference did not have good results. Ashok Gupta’s - admittedly using quite primitive statistics - did. Are therapies utilizing neurolinguistic programming (NLP) the next step in the mind/body efforts to tame this disease? Ashok Gupta thinks so and he was busy trying to get funding for a study that he believes will show that the program can make a difference in this disease.
I’ve used the Amygdala Retraining techniques and found them over time to be very helpful and so was glad to sit down with Ashok at the IACFS/ME Conference to ask him more about it. Happily he came across in person as the same relaxed and grounded person (with the same tie!) I’d seen on his DVD’s.
How did you get started on this?
I had gone to two CFS units that formally diagnosed what I had as CFS. I went through all the blood tests, etc., etc. I could feel that my body was full of adrenaline or whatever you want to call it - that I was on edge. I was sitting at home I could feel that some response was going on in my body – some stress response – and when I was speaking to somebody or put into a mildly stressful environment I could feel my heart start pumping but it wasn’t anxiety per se - the feeling was distinct to anxiety. I’d always had some anxiety in my life but nothing had been comparable to this complete exhaustion. There was something unique happening. So I started looking into the stress response and anxiety disorders.
I looked into the latest research on what causes severe anxiety - the answer was the amygdala. I read Joseph Ledoux’s work and said to myself you know this stuff is exactly what’s going on in my body and I looked at all the CFS literature and put all that together as well and said there is a really obvious mechanism.
I challenge anyone to read Joseph Ledoux’s work and not see parallels with CFS. He looks at the HPA axis and says the HPA axis is simply a response unit of the Amygdala.
The Amygdala is the fear center of the brain - is research on the Amygdala oriented towards panic disorders and things of that ilk?
Originally I would say that research on the amygdala was focused on anxiety and panic disorders but now it’s being implicated in depression and autism and addictions. The Amygdala is essentially our protection system to help us respond to many sorts of emotional or physical stressors. But my question is what if the Amygdala is also responding to a viral threat? Or an immune threat or a potential allergen?
The issue with chronic fatigue syndrome is that the Amygdala can get it wrong and over respond.
In ME/CFS (chronic fatigue syndrome) sometimes it’s like you don’t have control over the body; the body seems anxious in and of itself. The connection between anxiety disorder and ME/CFS is an intriguing one. I know someone who had an anxiety disorder for a time. At one point he was in his car outside his house and he couldn’t get out of the car – his body would not obey him – he was actually frozen in place. ME/CFS, to me anyway, seems like you’re caught in a slow freeze – the body seems less stuck but it’s stuck all the time - like you’re driving around with your parking brake left on. Dr. Baraniuk believes that the filtering mechanisms of the brain aren’t working and the brain is being flooded with too much information and this is impeding everything.
That’s what I’m saying; the Amygdala magnifies the signals from the body and from the outside world. You ask a CFS patient – how do you feel when you’re put in stressful situation? And they’ll tell you they feel much more stressed than before when they didn’t have CFS. It’s because the amygdala is magnifying every mental, physical and emotional stressor that that person is experiencing.
They’re saying the exact same things in Fibromyalgia – that the pain signals are being magnified in the brain in fibromyalgia. The most obvious ‘guy’, the most obvious ‘person’ that could be doing this is the Amygdala. I’m flabbergasted that no one is looking into this idea.
When the Amygdala is responding it compromises the functioning of the immune system. We know when we’re stressed our immune systems are less effective. People are talking about oxidative stress about autonomic nervous system problems, over sympathetic nervous system arousal, chronic arousal…the only thing that can cause that is a conditioning event; you have a stress, you have a virus, you put them together – and you have a chronic period of post-viral fatigue which causes a trauma to the Amygdala. I think of these as Amygdala conditioned syndromes.
Is it possible that the gateways that are controlling the flow of information to the brain are broken and the Amygdala is responding all the time; i.e. the Amygdala has not chronically gotten turned on it’s just responding all the time to this constant overflow of information?
Consider if you’re in a dangerous situation; your eyesight is sharper, your smelling is sharper, your senses are enhanced so that the Amygdala can take in more critical information to give you a better chance at survival. So the question for me is who opened the floodgates?
In CFS the body still thinks it’s being stuck in illness mode – it feels like it’s still being attacked. If you ask patients they’ll tell you that they feel like their body is under attack. They like their bodies are constantly overreacting; that they don’t feel right in their skin. They do feel anxious but it’s not a normal kind of anxiety; it’s a sense of a lack of control over their bodies.
My hypothesis does not say that you’re worried about your body. My hypothesis says that at the periphery of consciousness there will be a continuous cycle may be going on that you may only have fleeting glimpses of but those fleeting glimpses are an opportunity to control the Amygdala.
Researchers have shown so much interest in the HPA axis in ME/CFS and it plays a big role in the stress response but you believe they’re kind of missing the forest for the trees.
I believe that the Amygdala is the master gland when it comes to stress responses, anxiety response and oxidative stress. It’s the gland that makes the decision whether the body should be stimulated or aroused. It then sends a signal to the hypothalamus (the ‘H” in HPA) – so the hypothalamus is the servant of the Amygdala.
If you talk to people who are doing anxiety research and fear research they’re all talking about the Amygdala whereas ten years ago they were talking about the hypothalamus ,so in those particular areas they’ve moved on and realized that the Amygdala is one of the most important glands in the brain and yet in CFS research we seem to be mostly ignoring it.
In my mind the reason for that is simply that the research on the Amygdala is something that is fairly new.
Where did your interest in Neurolinguistic Reprogramming begin?
I could see that what was going on in my body was completely unconscious – I had no control over it – which is one thing that makes me think this is not a psychological but an neurological illness. But I thought that there must be a way that I might be able to consciously control this reaction. So I trained in NLP, I learned meditation, breathing techniques, etc. because I’d known that patients had found some relief from meditation. A lot of patients have tried meditation and relaxation techniques and it helps them.
I became healthy using these techniques and set up a clinic. It took me a few years to figure out what works. In early 2006 I began to work on the DVD program. I didn’t do that until I’d gotten my techniques as good as they could be. I would estimate that my program has relevance – will help – 80-85% of the CFS population.
What about people who are really ill – bed bound – can they benefit?
Yes. There are people who’ve been bed bound who have improved on the program enough so that they have a normal level of functioning; they can’t exercise but they can travel, etc. Their process can take longer. I had an e-mail from a lady who’d had CFS for 30 years and had never walked up the stairs and she was pretty much bed bound and now she can go on day trips, she can go up and down the stairs – she can’t exercise yet but she can do many things that she wasn’t been able to do before.
People who are at 40-50% functioning can actually get to the point where they can get to fully exercise but to get to that level probably takes them from 12-18 months. In my mind this can’t be some sort of cognitive reprocessing – I believe there’s actually something very deep and profound going on in the bodies of these people.
People are suspicious of any behavioral approach to ME/CFS…… What has the response been to the program?
The response has been very good generally. Obviously there are some people who, unless it’s a drug or surgery, will dismiss what I’m doing because what they’ll say is that what I’m doing is psychological. CFS is not psychological but neurological. The Amygdala retraining techniques involves neurological not psychological techniques.
This isn’t a semantic trick. The AR is redesigned to retrain the brain – to rewire the brain neurologically. We’re talking about structural changes in the brain based on these techniques – and that makes it a neurological technique. This separation between the brain and body, in my opinion, is completely ridiculous.
Cognitive behavioral therapy is like using a fire extinguisher on a warehouse blaze; it might be able to help in some situations but it’s not getting to the root. I can understand why some people are naturally suspicious (about my technique) but all I can say is that these are neurological techniques.
Sleep is obviously a big challenge in ME/CFS patients and you recommend doing relaxation exercises before going to sleep. You also recommend something called Indian Head Massages. What are those?
I find Indian head massages so powerful because you’re increasing blood flow to the brain and stimulating the muscles and the nerves. Before you go to sleep try to massage the front of the head, the side of the head and the back of the head and you’ll have better sleep at night. If a person can get their nervous system calmed down in the last two hours before sleep it means that they’re have more restorative sleep. The last two hours before sleep are incredibly important for Amygdala retraining.
What does the Amygdala Retraining bring to the table that you don’t find in meditation and other mindfulness activities?
The Neural Linguistic Programming (NLP) is the most important bit. Many patients already have tried a bit of relaxation/meditation etc, but it does not make them recover necessarily. The NLP retrains, the meditation and breathing is simply there to support and accelerate the retraining.
Are you 100% recovered?
Yes. The thing I have to do is to make sure that I eat healthily, that I meditate, that I get regular exercise and that I monitor my stress levels.
If you speak to patients that have recovered and they will tell you that if they encounter something stressful in their lives that their symptoms come back. The Amygdala is vulnerable. Even after you’ve recovered from CFS there is a period of time; maybe six months to a year where you have to make sure that you are not stressing yourself out. That doesn’t mean escaping from the world – that means controlling the stress response.
I take common sense measures to maintain my health and yes, I’m completely healthy - I can do anything a healthy person can do.
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