I have worked with people with chronic pain, fatigue, dizziness, POTS-type symptoms, gut symptoms, migraines, Long Covid and a whole host of other persistent symptoms for years now. People often ask me what those who recover have in common.
There isn’t one personality type, one practice or one magic programme. Bodies are different, illnesses are different, circumstances are different, and I am deeply wary of anyone claiming there is a single psychological explanation for chronic illness. Biology and your individual genetics influence your particular strengths and vulnerabilities. Sleep and circadian rhythms are really important. Nutrition to fuel cells and healing tissue is important. Hormones, gut infections, inflammation, structural problems, medications and social circumstances can all need to be taken into consideration. Good medical care, something to accessible to some - can also be important.
But when I look at the people I have worked with who have recovered significantly, there are some common threads. Not rules. Not a checklist you need to perfect - in fact perfectionism in getting recovery 'right' is one of the first things I heal with people. Just patterns I see again and again in my wonderful clients who are now living full lives.
• They stop treating every symptom as an emergency.
This is a big one. Symptoms can be horrible without necessarily meaning something horrible is happening. People gradually become less frightened by every increase in pain, dizziness, fatigue, heart rate or strange sensation. They learn when something genuinely needs medical attention and when their alarm system is simply being very loud.
• They change the meaning they give their symptoms.
Instead of 40 symptoms meaning 40 separate things are going wrong, and attaching those symptoms to diagnostic labels, they begin to understand sensitisation, predictive processing, learned associations, stress physiology and the extraordinary role the brain plays in constructing our experience of the body. And also understand their unique needs as humans, to learn how to live in ways that their brain and body enjoys.
That does not mean symptoms are imaginary. The brain is involved in every symptom we experience, including completely uncontroversial physical ones. Understanding that gives us another place from which we can influence what happens next.
• They become less reactive.
Less checking. Less Googling whilst triggered (this does not mean do not learn to self advocate, it means notice that patterns of what motivates that learning, is it to build health, or out of anxiety). Less catastrophising. Less urgently trying to work out what they did wrong yesterday. Less changing five things because symptoms increased this morning. This usually happens gradually. The aim isn't to become indifferent to your body. It is to become more discerning about what actually requires a response.
• They learn to notice their mind.
This is why I bang on about mindfulness so much in our classes in the community hahaha. Many of us don't realise how much we predict, catastrophise, rehearse, analyse, control, compare and mentally time-travel because we have been doing it for decades. Thoughts simply feel like reality until we grow the skill and brain capacity to clean our windscreen of perception to see HOW we digest life is something that is flexible. We see that world as WE ARE, not as it is. Learning to observe your mind gives you a little more choice about which thoughts and ways of meeting life deserve your attention and which are simply your brain doing what brains do - like predicting, controlling, catastrophising, black and white thinking etc.
• They stop making recovery another perfectionism project.
This one is enormous. Doing the practices correctly. Eating perfectly. Regulating perfectly. Never getting stressed. Doing your morning routine. Tracking everything in long lists. Taking 19 supplements. Trying desperately to feel safe all day. At some point, recovery itself can become another source of threat and vigilance. The people I see doing well become more flexible, not more perfect. That is a sign of growing agency and safety. Control is usually about fear, anxiety, and actually feeling helpless in the face of symptoms.
• They start looking beyond symptoms at how they do life.
This doesn't mean your personality caused your illness. Nothing is our fault here. But chronic over-functioning, people-pleasing, pushing, perfectionism, hypervigilance, helplessness, emotional suppression, difficulty resting, catastrophising, black-and-white thinking or feeling responsible for everyone and everything can create an enormous amount of ongoing stress. These patterns are not universal, but when they are present, evolving them into more balanced ways of doing life can matter enormously.
• They develop influence rather than chasing control.
Control says, “What do I need to do to make sure I don't have symptoms tomorrow?” Influence says, “What can I practise today that supports my brain, body and life over time?” This distinction is incredibly important. We have far more influence than we sometimes realise, but considerably less control than we would like. Learning to live well inside that reality is part of psychological health generally, not just chronic illness recovery.
• They become more able to experience uncomfortable sensations and emotions.
Instead of immediately needing anxiety, pain, dizziness, sadness, anger or activation to stop, they build the capacity to experience more without interpreting it as catastrophe. Sometimes this involves somatic tracking. Sometimes emotional work. Sometimes gentle exposure. Sometimes simply noticing, “Oh, my body is doing that thing again,” and carrying on making dinner.
• They become curious about what is happening in their lives.
Stress isn't only having too much work. It can be resentment, financial uncertainty, a relationship that requires constant self-abandonment, caring for everyone except yourself, grief you haven't had space for, or living in a way that continually conflicts with what you need. None of this means emotions secretly caused your illness. It means we are biological, psychological and social creatures, and our bodies don't exist separately from the lives we are living.
• They gradually reverse avoidance.
When the brain has learned that standing, walking, driving, exercise, particular foods, socialising, screens or bodily sensations predict danger, avoiding them makes complete sense. But where something is medically safe and appropriate, people often need new experiences that contradict those predictions. This can be incredibly gradual. It isn't about bulldozing through genuine physical limits or pretending symptoms aren't there. It is about helping the brain learn from experience rather than fear alone.
• They stop seeing every flare as failure.
Recovery is rarely a beautiful diagonal line upwards. Symptoms change. Life happens. Hormones happen. Viruses happen. Stress happens. Bodies are frankly quite mercurial creatures! We are learning to accept that and influence what we can, knowing you cannot control a body or recovery. It is like trying to control a river. We are instead, learning to flow with it. People who recover tend to become better at having a difficult week without constructing an entire future from it. A flare becomes something to respond to rather than proof that everything has gone wrong.
• They become kinder to themselves, but not more frightened of challenge.
Compassion isn't wrapping yourself in cotton wool. Sometimes compassion means resting. Sometimes it means eating better to gennuinely care for your body, asking for help or cancelling something. Sometimes it means gently encouraging yourself to walk another five minutes, have the difficult conversation, tolerate uncertainty or try something your frightened brain would rather avoid. Good self-compassion includes discernment. We teach the difference in the community between compassion and self pity, because many people confuse the two.
• They build a life again before everything is perfect.
This may be one of the biggest common threads I see. Attention gradually moves away from monitoring the body and towards friends, work, dogs, gardening, sex, cooking, travelling, creativity, family, learning, laughing and all the ordinary stuff that makes a life. At first, people often do these things partly because they hope it will help them recover. Eventually, they start doing them because they are living.
And perhaps that is the common thread underneath all the others. The people I see recover don't become people who can perfectly control their nervous systems. They become less afraid of having a nervous system, a body, a heart, an imperfect life, a history that is less than nurturing. They accept and grieve and feel what they need to about what they did not get to choose. Then they step into all the tin and large ways they can choose from today. How they treat themselves, their beliefs, their ways of meeting life, their understanding and influencing of their stress responses.
They understand themselves better. They recognise old adaptations and build new capacities. They become more flexible in how they think, feel and behave. They learn what deserves attention and what doesn't. They support their biology while also working with their psychology and environment. They develop more trust in their ability to meet discomfort, uncertainty and life.
And slowly, recovery takes up less space in their days and their psyche. The massive preoccupation we have (yes I have been there!) begins to recede and this isnt because aha we fairly got it 'right' - it is because we have genuinely learned to live in new ways that engage us in life, and recovery continues alongside that in a balanced way that often surprises people in how much easier it is after learning how to treat themselves with dignity, encouragement, kindness, and deep empowered influence.
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