Phoenix Rising - Cort Johnson's Column
...Presenting complex chronic fatigue syndrome (ME/CFS) research in a way we can all understand.
Fibromyalgia and Chronic Fatigue Syndrome: 7 Proven Steps to Less Pain and More Energy by Fred Friedberg, Ph.D. 2006. - A Review
by Cort Johnson
‘7 Proven Steps to Less Pain and More Energy’ doesn’t promise what most CFS patients understandably want – a cure. In fact Dr. Friedberg believes that the need for a cure (when one isn’t present) and the demand to be well (when that probably isn’t possible) only makes things worse and possibly, given the nature of this disease, much worse.
Dr. Friedberg is not talking off the top of his head; as a long-time chronic fatigue syndrome (ME/CFS) patient himself, he notes he wasted a good deal of time, money and energy struggling against the confines of this disease and that substantial improvements came only when he learned how to interact more skillfully with it. Dr. Friedberg still has ME/CFS but his quality of life and his ability to function are much improved. While he is no longer the long distance runner he once was he can now play vigorous games of volleyball without relapsing.
With no new treatments looming on the horizon Dr Friedberg proposes that the most effective thing patients can do is to learn how to ‘cope’ effectively with this disease. Coping sounds like the kind of palliative term medical professionals trot out when they’ve exhausted everything else; you should learn ‘good coping skills’ as if poor coping skills got you into this mess to begin with.
But Dr. Friedberg means something very different from what’s usually associated with the word. Instead of tinkering around the edges of this disease the program he’s created has the potential to mount a real assault on it. Even if his program doesn’t get you well Dr. Friedberg asserts that the vast majority of patients who do give it a try will feel better and lead fuller and richer lives.
The Seven Steps are not new; they include relaxation strategies, sleep strategies, pacing, identifying negative emotions and getting support and involve doing breathing exercises, making activity logs, doing mindfulness exercises, etc. What’s different about this book is the attention given to each and by the fact they’re presented in a package by a medical professional who’s successfully used them on himself and his patients.
The book is short and easy to read and Dr. Friedberg does an excellent job of explaining each technique and why it’s relevant to ME/CFS. I would have liked a bit more text than Dr. Friedman provides; a deeper exploration of the different meditative techniques, more on the scientific underpinnings of the ‘mindfulness stress reduction’ approach as well as worksheets patients could use to organize their efforts but the book covers the basics.
It’s important to realize that Dr. Friedberg’s behavioral approach is more complementary to the march of research than adversarial to it. If the stress response is out of whack, as an increasing amount of research suggests, and the post-exertional malaise in the disease implies, then Dr. Friedberg’s recommendations to engage in activities that can help to rebalance it only make sense.
In the modern ‘take a pill’ and see me tomorrow era of medicine Dr. Friedberg’s program stands out in its emphasis on lifestyle management. It’s not sexy and it doesn’t provide the ‘big’ answer that will make ME/CFS go away tomorrow but it may very well provide the most good for the most people at this juncture.
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