A while back, I started a short series on fear and the over-activated nervous system, and now I’m finally coming back to it.
If you haven’t read Part 1 of the series, I recommend checking it out because I explain my hypothesis on what I now suspect are the two underlying sources of fear that trigger a lot of chronic illnesses and pain.
As a quick reminder, I suggest that, at the most basic level, we either have a fear of the symptoms, or we have a fear of both the symptoms and our repressed emotions. I suspect these two different sources of fear may be at the root of why some people are able to recover more quickly and easily, while others of us take a lot longer and need to do more work to recover.
Today I want to look at the fear of symptoms.
The fear-symptom cycle
Let’s say someone injured their knee. They get it taken care of and it heals. But maybe their nervous system had already been primed with stories of other people having chronic knee pain, and so that worry was always in the back of their mind. Or maybe the recovery process was frustrating or they didn’t like how long they were unable to walk normally.
Their brain and nervous system quickly learned that this is something to try to avoid in the future.
As a result, their unconscious nervous system will begin to take preventative actions to make sure the person doesn’t get injured again. For example, their brain may become more sensitive to sensations in their knee, and it will send signals of pain in order to get the person’s attention, even if nothing serious is wrong. Again, this is a subconscious, preventative safety measure that their body is taking without them being consciously aware of it.
But because they don’t understand what’s happening, when they feel the sensation of pain, they think something is wrong.
They might worry that the activity they’re doing is too much for their knee, and so they back off. When that happens, their nervous system learns that the activity is something to worry about, and so when they try to do that activity again, the pain signal might get stronger.
At this point, the person also consciously expects to have issues with the activity, and they can find themselves in a feedback loop in which the symptom activates the nervous system, which triggers more pain, which triggers more fear and activation, which triggers more pain, and so on.
This is a situation that has been documented in studies.
For example, as this article describes, “Using brain imaging, [a team of researchers] found that individuals who expected greater pain showed more neural activity in regions of the brain involved in fear and threat response, even before they experienced the unpleasant stimulus used in the study — a painful but harmless application of heat to their arms or legs. Once the stimulus was applied, participants cued to expect higher levels of pain reported higher pain ratings, even when they actually received low-pain levels of heat. Their brains also generated greater activity in areas associated with pain.”
It’s essentially a miscommunication between our conscious mind and our subconscious nervous system and brain which are trying to keep us safe.
We think something is wrong with our physical body when in actuality, we developed a problem with how our pain signals got wired.
Most of the research that I’ve come across so far has focused on chronic pain (here’s another), but this fear-symptom cycle also seems to be a root cause of a lot of symptoms that people experience with long covid, ME/CFS, and other chronic conditions. For me, one of the most surprising health issues that seems to have been triggered by the fear-symptom cycle was my seasonal allergies.
This is all good news because our brains are neuroplastic, which basically means that we can change that wiring.
Just as our brains learned to be fearful of certain things, we can retrain them to not have a fear reaction and not to send those pain signals.
I’ll talk about how to retrain your brain shortly, and I also have more examples and information about the fear-symptom cycle here and here. But before I go further, I want to consider a possible pathway from the fear-symptom cycle to long covid.
Fear and Covid 19
The last few years have been tumultuous, to say the least. I feel fairly confident saying that most people’s nervous systems were triggered to a certain extent by some combination of major global, local, or individual issues. Then our bodies got hit by a brand new virus. As it is, in order to fight off a virus, our nervous systems already activate our immune functions, which is an activated state.
But COVID-19 was a new virus that our bodies hadn’t seen before. It was deadlier, it produced some weird symptoms, and it often required a lot more time for our bodies to fight off than most of us are used to.
Most of us expect to feel healthy within a few days of getting sick. Very rarely do we give ourselves more than a week to recover. Covid was different. It lingered. Many people required weeks and even months to return to full health.
In many cases, my own included, we got covid and tried to return to our normal lives before our bodies were back to full health and while our nervous systems were likely already over-activated as a result of any number of life stressors that were happening.
That was too much for our bodies to handle, and we crashed.
The lesson we learned was that even if we felt we were mostly better, there was still something going on in our bodies that could damage us, and so we became hyper-vigilant about our symptoms.
When that happened, we entered the fear-symptom cycle. The cycle can then spiral out of control as we become more sensitive and hyper-vigilant about every single weird feeling in our bodies and as our brains send increasingly loud signals to let us know that the scary sensation is happening again.
Of course, none of this means that the symptoms aren’t real or that they’re in our heads or that it’s our fault.
These are very real and very physical and very debilitating. My goal here is only to offer an example of a possible pathway that could lead to our nervous systems becoming out of whack and hypervigilant about symptoms and anything else that our brain perceives as “wrong with us.”
In order to stop the fear-symptom cycle and reset your brain’s response to symptoms, you’ll need to retrain your brain.
Brain retraining and my favorite technique: somatic tracking
Fortunately, there are quite a few programs and studies that have been geared toward understanding brain retraining and neuroplasticity, which means it’s easier to find resources online to help you with these techniques (versus the emotional work). There are also a lot of techniques, practices, meditations, visualizations, etc. that can help you retrain your brain to feel safe with symptoms and get back to your life.
I write about some of the techniques I found most helpful here, but my favorite free resources are Alan Gordon’s 21-day program and his podcast on the topic.
And of the brain retraining techniques that Gordon teaches, my favorite was somatic tracking.
Somatic tracking is a mindfulness activity that helps you learn to feel safe with the symptom. It doesn’t get rid of the symptom, but rather it’s a first step in retraining your brain and nervous system to feel safe and to remain in a calm state.
Your only goal is to sit with the symptom in question and be okay with it. This is both simple and incredibly challenging.
I started with easier symptoms first to get used to the practice. In fact, I started with physical discomforts that had nothing to do with long covid, namely, mosquito bites and foot cramps. Itchy bites and foot cramps are unpleasant, but I wasn’t worried that they were a sign I was deteriorating, which was the reaction I had to many other symptoms associated with long covid.
I would put my attention on the bite or cramp and I would just sit with it. I would feel the itch, or I would feel the intense pain in my foot, and I would just practice being okay with it as it was, without any negative judgements, without resistance, and without wishing it would go away.
As you try this, you can focus on the sensation and begin to notice different qualities about it.
How intense is it? Does the intensity change or pulse or shift in any way as you keep focusing on the sensation? Does the sensation stay in one place or does it move around? I was surprised to realize that even an itchy bite didn’t always seem to be itching in the exact same location. Are there colors that you can associate with the sensation? Is the sensation dull or prickly or sharp, etc?
A key aspect of this technique is a sense of curiosity. If you can remain curious about what’s happening, you’re less likely to pass judgement on it, and by simply being curious rather than resistant, you send the signal to your nervous system that you’re okay.
[Aside: Personally, I also found that being curious was a more honest state of being than trying to convince myself that I was okay or using the positive messages that I saw in a lot of brain retraining practices. For me, being honest with what I was feeling and sensing was an important part of healing. I learned a lot about the value of curiosity in Judson Brewer’s book, Unwinding Anxiety, which I highly recommend, as the tools he teaches apply to all healing, and not just anxiety.]
I like starting with somatic tracking because it’s a skill that’s equally helpful for a fear of symptoms or a fear of both symptoms and emotions. I found it to be a surprisingly valuable technique in learning to feel safe with emotions, which involves getting curious about what emotions feel like in your body.
When to push through and when to be cautious
One of the more controversial brain retraining practices is to give yourself lots of positive messages about being okay, and then push through an activity that triggers the pain and fatigue and symptoms.
Sometimes this works for people. There are lots of stories online of people recovering from long covid in just a matter of weeks or months because they learned that this was a nervous system issue and so they decided to just push through the symptoms.
Unfortunately, there are also many people who try this and then crash, or they get worse, or they just can’t manage to get through the push. Some people may even begin to think (or even be told!) that it’s their fault they’re not getting better because they’re not doing brain retraining right.1
This is where my hypothesis about the two different kinds of fear comes in.
I suspect that the people who recovered using standard brain retraining techniques probably had a nervous system that was over-activated primarily by the symptoms themselves, and therefore, they only needed to focus on feeling safe with the symptoms.
My experience was that, if my symptoms were a result only of the fear-symptom cycle, then once I understood that my hypervigilance around the symptoms was making me worse, I was able to get rid of my symptoms quite quickly.
For me the two big areas where this was the case were my reactions to food, which got badly exacerbated by long covid to the point where I was down to about 3-5 foods that I could safely eat, and my seasonal allergies, which had nothing to do with long covid. I was able to clear up the food reactions in a matter of weeks2 and the seasonal allergies cleared up even faster.
It was only the fear of the symptoms that was triggering the cycle for me, and so those particular issues were much easier for me to address.
However, if you also have a fear of repressed emotions and repressed thoughts, then that may mean there’s more you’ll need to work with in order to retrain your brain and nervous system. It also means that there are layers to the fear and the symptoms.
It may seem like certain activities trigger certain symptoms, and that it’s the fear of the symptoms that’s keeping you from doing the activity, but the situation may be more complicated.
I found that many activities that triggered my symptoms were actually activities that triggered repressed emotions, however, because the emotions were repressed, I was only consciously aware of the symptoms.
If I tried to push through the symptom and continue the activity, then I would get worse because the fear of the symptom wasn’t actually at the root of what was triggering me. Instead, I had to deal with the underlying emotional issue, which usually took more time to identify and process.
I also found, that when it was, in fact, just the symptoms that triggered my fear of the activity, then I was able to use standard brain retraining techniques and get back to the activity fairly quickly.
If you have tried pushing through the symptom and just gotten worse, then you may also have to work through the emotional stuff,3 and I’ll write more about that when I get to the next post in this series. For now, somatic tracking and all of the other brain retraining techniques I list on The Healing Pathways *should* be safe to try, even if it turns out you need to deal with emotional issues as well.
Are there brain retraining resources you like?
I’m sure there are readers here who have tried brain retraining programs. If there are any you like, please consider adding links to those in the comments below.
It’s not your fault! No matter what you try, if it doesn’t work, it’s not your fault! There are any number of reasons why any or all of these techniques may not work for you, and it’s not your fault. You should never blame yourself or let others blame you for being sick. Not only is it not your fault in any way, shape or form, but blaming yourself can contribute to your nervous system being in an over-activated state. If you’re ever working with a practitioner who suggests it’s your fault that you’re sick or not getting better, then you might need to consider if they’re the best fit for you.
I had also been taking Claritin for a while by that time, which I think helped keep the histamine issues in check while I started this work. I had a lot of histamine issues, which, in general, seemed to require emotional work, but I was at least able to start eating almost all foods again quite quickly. This may or may not be the case for anyone else. We’re all unique.
Something else to keep in mind is that living with a chronically over-activated nervous system may lead to other health issues because your nervous system isn’t functioning optimally. So even if the fear is originally triggered by symptoms or repressed emotions, you may have symptoms that aren’t directly connected to either and that aren’t necessarily part of the cycle. However, as you calm your nervous system and return to a non-activated state, then many of those health issues will hopefully clear up.
Thank you, Ariel. This came together for me when I became aware of how my nervous system was triggering my immune system, leading to inflammation, histamine intolerance, and a whole cascade of long covid symptoms. Using somatic tracking, I have established new pathways for those unconscious and automatic nervous system-to-immune -responses to follow. I would use this when I would feel the familiar physical symptom, or even physical sensations in response to my own thoughts (which may be analogous to repressed emotions you write about).