Mentally Managing FM


Mentally Managing FM

Excerpt from "Fibromyalgia: Up Close & Personal" by Mark Pellegrino, M.D.
By Mark Pellegrino, M.D.
(Reprinted with kind permission of the author)

Physically, fibromyalgia (FM) bothers our bodies with pain and other problems. Mentally, it causes depression, mental fatigue, poor concentration, anxiety, fibrofog, and more. The mind can have a powerful healing effect on the body, so we need to keep our minds healthy and use them to help the healing process. Hope is the most important tool in a loaded mental toolbox.

Mental strategies can reduce the ill effects of stress on our bodies. Notice I said “reduce the effects of stress,” not reduce stress itself. Stress is a major factor in FM. A catastrophic stress may have caused it, and any stress can certainly aggravate it. Life is stressful, so we can never get rid of stress. We can learn how to reduce stress and minimize its effect on FM. Everyone with FM can benefit from mental techniques to manage their physical problems. There is no one right way; many ways can work. It takes motivation, practice, and perseverance to learn a new mental management strategy. It is hard!

Through the years, each of us has evolved a highly specialized thought process to view ourselves and our world. For example, we always think of ourselves as young and healthy forever! Then all of a sudden, FM comes along. Now these rules and processes are no longer effective. We are then asked to change our lifestyle, not only physically, but mentally. This is not an impossible task, but it involves a willingness to take that first step and make a commitment to change our lifestyle. It is natural to be scared or even terrified of this process because we are not sure what to expect. But with encouragement, patients with FM are truly impressive in their ability to change their thinking and achieve a positive mental outlook.

How can one make mental lifestyle changes? I approach this in a series of small steps that are integrated into a big leap to a successful new mental approach—to change the way you think about life with FM. You have to take baby steps before you can jump. I have devised a mental strategy which I call the Five Repairs.
  1. REcognize and REdefine
  2. REalistic REtraining
  3. REliable RElationships
  4. RElax and REfresh
  5. REspect and REsponsibility

Each pair of “REs” is intimately related and addresses a different aspect of the mental approach to FM. The ultimate goal is to be able to integrate all five into a positive mental strategy that works.

1. Recognize and Redefine
Fibromyalgia makes it easy to think negatively. Before we can correct this tendency we need to recognize the ways in which we think negatively.

Here are some examples:

We over-generalize. One small incident seems like a catastrophe. For example, if we forget something, we think we are getting Alzheimer’s disease.

We anticipate bad things. If someone invites us to a party, the first thing we think of is that the party will cause a flare-up in our pain.

We blame ourselves for everything. We believe it is our fault that we have fibromyalgia or that we have flare-ups.

We label ourselves negatively. We think that because we are having a lot of pain, we must be bad or useless people.

We expect things to get worse. If we talk to someone older than us who has fibromyalgia and is having extreme pain and disability, we expect that we will end up in the same way when we get older.
Continuous negative thinking about ourselves and our situation will ultimately lead to other negative emotions such as anger, frustration, hopelessness, and feelings of guilt and depression.

We also tend to be perfectionists and overachieving individuals, and this can lead to negative consequences when trying to cope with fibromyalgia. Our perfectionist nature can create “negative” traits which include:

  • inability to handle criticism
  • fear of failure
  • fear of rejection
  • feelings of inadequacy
  • anxiety
  • lack of control

By being overachievers, we also risk developing negative behaviors which include:

  • always searching for a fibromyalgia cure
  • doctor shopping for that magical treatment
  • inability to delegate tasks to others
  • feelings of being overwhelmed
  • procrastination
  • impatience
  • extreme guilt when unable to accomplish what we used to be able to do

Once we’ve recognized this, we can change our thinking patterns. Fibromyalgia forces us to redefine our physical ability. Since we can no longer do what we used to, we must seek a new physical lifestyle that our fibromyalgia will tolerate. We also have to redefine our thought processes. We must now think of ourselves as persons with chronic pain, and from that perspective, try to imagine how we can feel better about ourselves.

To redefine, we ask ourselves, “What goals do we wish for ourselves?” and “How do we want to see ourselves?” and “What can we do?” A part of redefining our thinking is to redefine what it means to feel good. When we are so focused on feeling bad all the time, it is hard to look for things about ourselves that make us feel good.

You know how a picture can look bad to you at first, but when you move it to a different light is looks better? We must picture ourselves in a more positive light. We were not singled out to have this painful disorder for something we did or did not do, so we must stop blaming ourselves. Redefine ourselves as good, normal people who just happen to have fibromyalgia, and work on believing it. Focus on your strength and expect to live a good quality life in spite of having fibromyalgia.

For our tendency to be perfectionists and overachievers, we should try to redefine those qualities and see the positive. Examples of positive outcomes from our perfectionist tendency include:

  • organization and efficiency
  • industriousness
  • responsibility
  • trustworthiness
  • reliability
  • punctuality

Being overachievers can also have positive consequences:

  • innovative thinking that allows us to create new strategies
  • active participation in our care and decisions regarding fibromyalgia
  • proactive approach by reading everything we can about fibromyalgia and therefore acquiring knowledge
  • flexibility in learning to budget our energy and breaking big tasks into smaller tasks

Ultimately, we need to accept that fibromyalgia is a chronic illness. We need to take inventory of all the thoughts we have and the ways we feel about ourselves because of fibromyalgia. We then sort through this inventory to determine what we want to throw out, modify, or change – what we want to redefine. The next step in the process is realistic retraining.

The preceding is an excerpt from "Fibromyalgia: Up Close & Personal" by Mark Pellegrino, M.D., published by Anadem Publishing and reprinted with the author’s permission. To see the remaining four Repairs, buy this very helpful book written by a popular and caring doctor who has FM, is available at bookstores across the country, at and from Anadem Publishing (for more information contact Kate at 1-800-633-0055). © Anadem Publishing, Inc. and Mark Pellegrino, M.D., all rights reserved.


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