TW: Mentions of child neglect and abuse (not graphic)
It’s really important to me to spread awareness of how trauma is at the root of most mental health issues. As I briefly explained in my Trauma And Dissociation Part 2 video, there are also a ton of physical ailments that can be caused by trauma. Today I’m going to look more into one that affects me personally and which I think is still very misunderstood.
I will talk about CF symptoms, what happens inside the body, how this is linked to emotional repression and gender norms, the link to trauma responses, some of my own experience, an outlook on healing, and what helps me.
What Is Chronic Fatigue?
Chronic Fatigue (CF) is one of many sufferings which is still very poorly understood by the medical system and thereby society, particularly its causes. It’s a good example for body, emotions, and mind not being separate entities at all – this split exists as a concept in our heads, but it doesn’t represent reality. I will use the term bodymind in this article to refer to this unity.
First, let’s look at the symptoms of CF. They include:
-No energy/no drive
-Gets extremely exhausted by seemingly mundane tasks (physical, emotional, and mental ones)
-Symptoms get worse with physical exercise, but aren’t caused by it
-Muscle and/or joint pain
-Heavy limbs or whole body, difficulty to move
-Sensations of short breathing
-Sore throat and other flu-like symptoms
-Dizziness
-Headaches
-”Brain fog”, difficulty in thinking and remembering (i.e. a type of dissociation, but usually not recognised as such)
-Irritable Bowel Syndrome
-Sleep Disturbances
-Low body temperature (especially in the hands and feet)
-Intolerance to extreme heat and cold
-Sensitivities to food, smells, light, noise
Most websites about CF will tell you that CF can often be triggered by an infection. But a trigger is not the same as the cause, and the website Chronic Illness Trauma Studies points out this important difference as well.
Although it speaks from a medical point of view, it’s trauma-aware. It cites various studies that found that the CF symptoms are caused by how the cells of people with CF react to real or perceived threat, clearly marking it as a condition of the immune system. It’s not the same as an auto-immune disease, but operates in a similar way – the defences of the immune system are low and a seemingly minor threat (which might be an infection or an emotional event) can trigger the body to go into the CF state, which the author(s) of the website rightly recognise as a trauma response.
As Gabor Maté wrote in his book When The Body Says No, the immune system and emotional system are as much one as the bodymind. You can read the first chapter of this book, which heart-breakingly exemplifies this truth, here. To quote him:
“Repression—dissociating emotions from awareness and relegating them to the unconscious realm–disorganizes and confuses our physiological defences so that in some people these defences go awry, becoming the destroyers of health rather than its protectors.”
Gender Differences
When we look at the different gender roles and thereby taught repression styles, it is unsurprising that autoimmune diseases affect women much more than men (with various sources reporting it to be as much as 80%). Of course the medical search for the cause of this focuses on biological differences, proposing the X-chromosome or sexual hormones, for example. When the obvious, holistic answer is misogyny (or rather the trauma caused by it).
As narrated in the above linked example of Maté, women learn early on that it is expected of them to put their own needs aside and take care of others. They are more likely to self-blame, feel responsible for others’ shortcomings, and to make themselves small. As though their own needs and wants are an obstacle to the role that society forced on them. They also learn that their body is never good enough and that they have to modify it constantly to please others. Is it any wonder then that their body comes to see itself as an enemy and attacks itself?
On the other hand, men usually are more affected by infectious diseases, more likely to experiencea heart disease or a stroke, to suffer from diabetes, and suicide is the leading cause of death for men under 50.
To sum this up with the knowledge about toxic masculinity, you could say that many men are taught to be stuck in a bodymind fight state, which makes them more likely to die of violence, have increased blood pressure, or to basically have no energy left to fight off an attacker on their immune system, because the system already is overloaded, being in fight mode (or close to it) all of the time (and taught, gender-based attitudes towards health, hygiene, and nutrition, as well as taking care of yourself, play into this as well).
Fittingly, the information from the Chronic Illness Trauma Studies website, states:
“The actions of the acute fight/flight response are consistent with Naviaux’s acute cell danger response (CDR), which is the opposite of what he found in ME/CFS (paraphrased from his 2016 article on ME/CFS):
The acute CDR is found in acute infection, during acute inflammation and in the metabolic syndrome (a cluster of conditions that include high blood pressure, high cholesterol, insulin resistance and high blood sugar levels, and increased fat around the waist area. These symptoms, also known as Syndrome X, are associated with increased risk for heart disease, stroke and diabetes).
In this acute sympathetic nervous system response, our bodies also decrease or suppress functions that aren’t important for immediate survival, such as digestion and rest. (or social functions, as I’d like to add here)
If stress continues for a long time, an increased degree of fight/flight arises in which cortisol is released, the immune system is suppressed, inflammation rises and symptoms can occur.” (emphasis by me)
Freeze Is Not Collapse
Sadly, when it comes to CF, the authors of this website (like most others) don’t seem to be aware of the difference between the freeze and the collapse state, treating both as one and the same. Even though they used the very fitting metaphor of pressing down both the gas and the brake pedal at the same time (which is freeze – the sympathetic system being the gas, and the parasympathetic the brake), they mix up examples for the collapse state with examples for freeze and call both hibernation/freeze response (to learn more about how to tell the two states apart, keep an eye on my YouTube channel, as my next video will be about that).
So while they link CF to the freeze state, they actually mean the collapse state. They then go on to talk about what they call “wired and tired”, calling it a combination of “freeze” and underlying fight/flight – but this is the real freeze.
In my own words, I think that CF is a result of having been forced to go into the collapse state repeatedly in childhood (most likely during infancy, which will be impossible to remember consciously for people). You could say it’s a chronic collapse state, which increases the likelihood of infections (because the immune system, as well as the whole bodymind system, is under-active) and also can be triggered by illness, as much as by emotional events. Which explains why the CF symptoms are a mix of extreme exhaustion (to the point of a death-like state), depression, dissociation, and an infection (and why they can differ wildly from person to person, as everyone’s survival technique, triggers, and trauma history will be very individual).
Furthermore, people who got stuck in the chronic freeze state can also develop CF, but I would argue that this is because their childhood survival strategies were freeze AND collapse, and that people who have other combinations with freeze (such as freeze-flight, for example), won’t be likely to develop CF. I think the freeze and collapse state combination is frequent, because they are similar in being both about immobility (the simplistic difference being that the muscles are tense in freeze and completely slack and heavy in collapse). To quote the Chronic Illness Trauma Studies website again:
“What both Naviaux and trauma science help to explain is that, while a serious “disease” like ME/CFS may begin after an environment stressor such as an infection, a vaccine, or a stressful or traumatic event, this trigger is the final straw in a series of life long exposures rather than the single or actual cause of the “disease”.” (quotation marks and emphasis mine)
My Experience
It’s no surprise then that CF typically develops in early adulthood or early middle age. While I’ve had low blood pressure and cold hands/feet since I can remember, developed IBS as a teenager, and had a long episode of dizziness as a late teen/young adult, the fatigue didn’t start until my mid-twenties, beginning with feeling extremely exhausted after social meet-ups, and then outbreaks of the collapse state in dissociative-depressive episodes. I didn’t actually realise that what I was experiencing could be called CF until some years ago and then I immediately connected it to trauma. While I usually talk about the collapse state when referring to my own experiences, I guess it can be very useful to others when I mention the link to CF.
Returning to the gender differences I pointed out earlier - when I look at my own experience, it has a bit of both in it, which makes perfect sense from the realisation that I had been cast into the dysfunctional roles of the Lost Child and Scapegoat in my family (see my resources list for websites that talk about these roles in more depth and my YouTube channel). I’d say that the Lost Child role is very similar to one part of the role that the patriarchy forces on women. A Lost Child is the Forgotten Child of the family – they are ignored and their needs and wishes aren’t ever considered. These children learn to make themselves small, to become invisible, to hide, and to see themselves as burdens for others.
When we look at the trauma responses, I see that my role of the Lost Child is connected to the collapse state, and in general I see the correlation between that state and extreme neglect. The collapse state kicks in when all other trauma responses have failed or aren’t accessible, which will, importantly, be true if you are a baby or infant.
For example, when a baby is neglected, they will scream. That is the only thing they can do – the social response, to ask for help. If that doesn’t give them the attention they need in order to survive, they can only dissociate and collapse. Fight, flight, or freeze are not possible for such a young person, nor would they be of any help, because what they need is their caregiver’s love. And when this happens frequently, the child gets stuck in this trauma response. So if the neglect continues, it will continue to trigger the collapse state.
I realised that there’s a connection between me feeling lonely and depressed, and going into the collapse state. There are also other triggers, because it became one of my primary trauma responses, but the root cause for it is the experience of abandonment as a baby.
So the Lost Child role connects to the collapse state and in terms of the immune system, it leads to my Chronic Fatigue, and also my chronic low blood pressure. What I would also put here, is that I suffered from sleep paralysis as a child and teenager, but at one point I found the advice of not sleeping on your back in order to keep this from happening. Luckily this did the trick for me and I haven’t experienced this in ages, while also very rarely having nightmares surrounding immobility or not being quick enough (which were frequent for me growing up) – actually, in terms of the nervous system, nowadays my dreams are more about social interactions (the ventral vagus) or about attacking my past abusers (fight).
Looking at the Scapegoat role, it means to be the human punching bag of the family. Everyone dumps their frustration onto you and you exist to be blamed and shamed. Everything is your fault and you can’t do anything right. Some abusive parents like to provoke their scapegoated child into the fight response, so they can get the sadist pleasure of crushing them. As a young child, I experienced that getting angry would lead to either being laughed at/humiliated or my anger being ignored. I don’t know which is worse.
So I learnt that I mustn’t get angry. I dissociated and went into the freeze state, pretending not to be impacted by the attack. I had to disconnect from my naturally very expressive and emotional nature, in order to survive.
The freeze state is a lot about hyper-vigilance. Watching and waiting. The whole body is tense, the sympathetic system being held on break by the parasympathetic.
As a teenager, I became more and more prone to explode into anger by provocations or other triggers from my parents, continuing into early adulthood, until I broke off contact completely. This was like the final and full embodiment of the pushing away reaction that I had already displayed as an infant. There are photos of me as a 1-year-old, being held by my mother, where I pointedly look away from her with a disinterested expression, in which I can read both aggression and a sense of defeat.
Pushing someone away is on a spectrum of passive aggressive to violent, as any form of the fight reaction. I remember scenes of my childhood in which I would just go mute and turn away from my sister or mother, in the rare instances where they’d ask me what was going on. This was not a conscious decision, but a state that came over me, as any other trauma response. Sometimes it was like an out-of-body experience, because I was dissociating so much. I had learnt that their sudden, apparent good will could not be trusted, because the few times that I did open up when prompted, I just experienced the same attacks and rejections as always when expressing any emotion.
Putting things together, my Scapegoat role is then primarily connected to the freeze reaction, with a sub-layer of the fight response. What fits this perfectly in terms of my immune system, is the fact that I have a lot (and I mean a lot!) of allergies. My immune system is just as hyper-vigilant as my emotional system, having rightfully learnt to expect enemies everywhere. These allergies became more and more when I was a teenager and young adult, but decreased significantly in the last four years, which coincides with my beginning of therapy.
Additionally, I rarely get sick (as in, usually once every three or four years), but when I do, it’s really hard for me. Again, my immune system is super-active, which is great. But it can also mean for a person that once an infection does happen (which is inevitable, sooner or later), the immune system doesn’t have as much energy left to fight it off, because it’s already working over-time all year round. So basically, if everything is treated like a threat, it’s just really, really exhausting (which brings us back to the statistic of men struggling more with infectious diseases). What makes being sick especially hard for me emotionally, is that it throws me into the collapse state, because being ill in my childhood meant to be ignored and abandoned again.
Connection Is Everything
What does all of this mean for people with CF? First of all, their condition is not a disease, it’s a chronic trauma state, which might become a feeding ground for diseases. Secondly, it means that the healing for their suffering needs to be as holistic as their organism, so to come from an understanding of the bodymind.
Of course the first step would be to look at your own life’s history and scan your childhood for trauma or your parents’/care givers’ stress level in your childhood. Counselling can help with that, but of course it needs to be a trauma-informed counsellor, otherwise they’ll know less than you did after reading this article. Additionally, someone who’s heavily influenced by the medical/psychiatric system won’t be of any help. It needs to be someone who knows about the unity or at least the connection between body and mind.
So basically the healing for CF is trauma recovery. And when I say healing, I don’t mean a cure, because something that has been so hard-wired into your nervous system when your brain was developing, will be unlikely to go away 100%-ly (though I might be wrong). Which doesn’t mean that it’s hopeless, because with healing I mean to heal from past traumas, so that you can be your whole, true self and live in harmony and balance with your self and others.
It’s all about finding out what helps you when you go into the collapse/CF state. For me, I realised that what I need most in those extreme shut-down states, is warmth. Both physically and emotionally. The perfect embodiment of both would of course be cuddling with a loved one. If that’s not possible, the physical might be a source of heat, like a (real or fake) fireplace, a heating, a hot shower/bath. Personally I never found just lying in bed to be helpful, it’s not enough.
For the emotional, it’s all about connecting to whatever part inside of you is hurting. I realised that it’s usually two of my very young child parts that feel abandoned and hopeless in the collapse state, so I talk them, soothe them, and reassure them that I won’t leave them alone, that I love them, and that it’s okay for them to feel the way they do. Depending on your trauma, it might take years of trauma work to actually get to the point where you will feel this kind of deep connection to yourself (as with any other relationship, it takes time to build trust, especially for traumatised people).
And from there it’s all about listening to yourself and knowing what brings you joy, what makes you feel connected and alive. For me, there’s nothing that makes me happier than music and nature. As going outside is not an option in the collapse state, I’ve started to sometimes make videos when I go on a forest walk, especially in summer. So I might gradually try to get out of the collapse state - after warming up as stated above – by watching these videos, but more often it’s listening to some slow music (and then transitioning to more lively, faster music or whatever feels right).
Again, the important thing for me is that it feels warm. So that’s a lot of harmony and usually something in a major key (that can still be a sad song, and actually I find sad songs in major to be the most powerful music about grief). Also, something with instruments that are reminiscent of the human voice or choir music are very powerful catalysts for connection, because we are hardwired to attach to other humans.
I also learnt that nothing soothes my child parts as much as humming a lullaby melody for them. It’s important for me that it’s something I invent spontaneously, but a known lullaby or favourite song might work just as well for other people. And starting from that humming, I began to explore my voice more and now I'm experiencing the most amazing healing through singing.
So you see that it’s all about the bodymind, because what affects you physically also affects your emotions, and vice versa. Music is just another great example for this.
What’s also crucial, is that you feel safe in your surroundings. An overstimulated or otherwise triggered nervous system can’t come out of a trauma state. So any stressors like certain sounds, other people, uncomfortable clothing, and other possible triggers (could also be pressure from your thoughts), need to be taken into consideration.
Ultimately I think that what brings long-term healing is a healthy, safe relationship with your self and with other people. As this would seem like a “purely” emotional thing, it’s not surprising that this probably won’t be prescribed by a doctor for CF. But literally nothing is better for your whole health than this (and most of the time it’s disconnection that brings about any sort of ill health in the first place). Your body already knows that, your cognition just needs to catch up.
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