The Body Scan for CFS by Cort Johnson

 

Chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM) can effect virtually every part of the body; from headaches to jaw pain, neck and shoulder pain, chest pain, muscle pain,  cramping, bloating, aching in the gut, to tendon pains in the arms and legs, burning skin, tingling in the extremities; the list of possible symptoms is extraordinary.

In the face of this barrage of discomfort and pain the natural tendency is to try and ignore or suppress the symptoms and just get through the day. In fact some therapists fearing that chronic fatigue syndrome (ME/CFS) patients will just get more wrapped up in their symptoms discourage dwelling on them at all.

Catastrophizing vs Conscious Attention.  There is an immense difference though, between ‘dwelling’ on ones symptoms and engaging with them in a conscious manner. Dwelling can lead to catastrophizing - a legitimate worry with any disease.  Catastrophizing involves focusing on the negative implications of a symptom – a process which inevitably sets off a cascade of thoughts which triggers the ‘stress response’ (shortened breathing, increased heart rate, constricted muscles) and which ultimately increases a symptoms virulence. 

 If any disease would lend itself to ‘catastrophizing’ one would think that a disease like ME/CFS would.  No one knows, after all, what causes it or how it will progress or even, given the fluctuating nature of the symptoms, how the disease will manifest itself from day to day or even, at times, from hour to hour. The fact that the post-exertional malaise so evident in the disease  usually occurs well after the over-exertion takes place means people with CFS are often hit by symptoms they can’t tie an event to - an anxiety producing event. ME/CFS patients also don't have the luxury of ascribing X-symptom to Y-cause.  All they have are symptoms and a boat load of questions regarding what their cause, whether they will get better or worse, etc… ie. if any disease would lead itself to catastrophizing, one would think this one would.  A more legitimate question might be why more people with chronic fatigue syndrome aren't catastrophizing.

 Mindfulness and CFS 

meditation and CFS

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Conscious Attention - The body scan and other meditational techniques turn the 'ignore the symptom' approach on its head. Practitioners of these practices propose that attending to body symptoms and the minds thoughts in a conscious, gentle manner can reduce their force leaving the individual calmer, happier and healthier.

The body scan gives ME/CFS and FM patients can be frightening at first given the turmoil occurring in many patients bodies. Some symptoms may increase in severity and people with ME/CFS/FM can be shocked at the degree of discomfort they uncover in parts of the body they had little awareness of previously. The body scan is a powerful tool that can allow individuals to turn down the arousal in their nervous system to emerge calmer, more relaxed and ultimately more at home in their bodies. As with any practice take it slowly and consult your physician.

The Body Scan Can be Effective in ME/CFS (Chronic  Fatigue Syndrome) Because

  • It relaxes the muscles of the body reducing tension and putting the body at ease. Through the body scan one can reduce tension in areas that are particularly problematic in ME/CFS and FM such as the neck and shoulders, jaw and head.
  • Simply fully experiencing a symptom is often enough to diminish it markedly. 
  • The body scan helps to re-knit body and mind, turning down central nervous arousal that leads to increased pain, agitation and fatigue, leaving one more at home in one’s body.  
  • Because the symptoms in disorders like CFS and FM are so widespread the body scan may be more helpful than other meditational techniques in calming the body down.
  • The body scan trains the mind to focus attention on where one wants it – a particularly helpful ability for people with cognitively challenging illnesses.

 Doing the Body Scan

There are several ways to do the body scan.dy scan. You can read the scan or simply remember the directions as you move through your body. The most effective way to do the scan is probably to buy an audio tape that helps you focus on the process in a relaxed and comforting manner.  The best time to do the body scan is probably in the morning when you wake up and in the evening before you go to bed. Relaxing the body before bedtime can be quite helpful in gaining more restful sleep.

As with any mindfulness/meditative technique (and indeed with most medical treatments) the power of the body scan is only revealed with time. Consistency and persistence is important with mindfulness techniques; in order to give the body scan a good try do at least once a day (hopefully twice) for 20-30 minutes over several weeks. You may very well roar through the body scan in short order when you first try it; if so, run through it again. You may find that your ability to stay in (and enjoy) the body scan will increase over time.

  1. Get into a comfortable position, either lying down or sitting and allow at least 30 minutes for the scan.
  2. Relax and as you enter the scan note to yourself that your job is simply to be present in the moment and accept what comes up. Throughout the process you will focus on your breathing and the sensations of your body.
  3. As you feel your breath moving in and out of your body let yourself experience your body; feel the points where your body is contacting the floor or chair. If you feel yourself start assessing how your body feels, if you feel some chatter start up in your mind about this or that sensation just let that discussion go and return your attention to the experience of your body right here and right now.  Notice, however, how active the mind can become – and what triggers its activity and how it effects the sensations in the body.
  4. body scan for CFSBring your attention to the toes of your left foot. Notice if you can feel any sensations in your toes or if you can't feel anything at all. (I couldn't do that at first) Try at some point to direct your breathing in and out of your toes. See if you can feel the breath going in and out of your toes and as you do sharpen your focus on what you're feeling in your toes. If you can't do this (I couldn't!) simply focus your attention on your toes. See if you can go toe by toe and differentiate the different toes from each other.  If you can’t do this don’t worry about it. When your attention wanders simply gently refocus it back on the area.
  5. After a time let the toes and go focus on the bottom of your left foot.Try to direct your breathing in and out through the bottom of your foot and as you do feel the sensations on the bottom of your foot. If don’t notice any sensations notice that and let it go and continue. Then move to the heel, the top of the foot and then the ankle. Keep mindful of your breath you continue to explore the sensations in your calf, your knee, your thigh and your hip.
  6. Continue the same process as you move to your right foot and leg then up through your torso,  then up your left hand and arm, your right hand and arm and up through your head. Take some time to dwell on the different sections of the head, the jaw, the eyes, the nose, etc.
  7. Now connect the body back together: feel how your head is connected to the neck, your arms and legs to your torso and your feet to your legs.

  8. Finally feel the sensations on your skin across your entire body. How do you feel? Body more relaxed? Mind more at ease? Focus on these nice feelings. During the day see if you can simply call them up again. Gently ask your body to relax and see if it complies.

    If you experience even small benefits from the body scan be sure to revisit it again. Remember that it takes time to build the muscle to do this kind of 'focusing' and that the power of these techniques often builds over time.

    Some people may find some of their symptoms temporarily increase and this is normal. I found, for instance, that doing a scan of my head - a particularly sensitive area for me  - caused more pain later in the day. I refocused the attention on the rest of my body and the pain went away. I was later able to revisit my head without problems.