The problem is never having learnt that saying No is okay.

When the body says No, it can scream it through Chronic Fatigue, Fibromyalgia and other inflammations, and autoimmune disorders such as Motor Neuron disease are a result in one way or another of chronic stress, and many studies have shown that one common factor in them is that in essential areas of the lives of people who have and are suffering with these conditions is that they have never learned to say no.
Having worked with people who, despite knowing they are being silenced every time they voice their opinions or their needs to their partners, maintain that they are wrong for voicing their thoughts and feelings. Men and women, though women get it more than men, work in jobs that drain their energy, demand their time, and do not satisfy their curiosity, creativity, caring, and compassion for others and the world.

The most common symptoms of chronic fatigue are extreme tiredness, broken sleep, and poor memory or concentration. Headaches, sickness, and heart palpitations all feel like flu and can, as one woman, Isha (pseudonym), say, “feel like I cannot think about anything because I just feel empty, no motivation.”

According to the NHS, there are known infections or situations that can predispose someone to chronic fatigue, which is also known as myalgic encephalomyelitis, and they recommend CBT (Cognitive Behavioural Therapy) as a treatment option.

The known infections are:

• Viral meningitis
• Epstein-Barr virus
• Q fever

Isha’s first experience with CBT through the NHS left her feeling anxious and wrong and questioning her own what felt like a thread of sanity and hope that there was somebody who could understand her and treat her kindly. To be clear, this is not suggesting the CBT therapist was unkind; merely saying that telling someone with chronic fatigue syndrome that they do not want to think about the distortion of their beliefs about themselves and their relationships, as examples, and proving this to them by pointing out their ‘inability’ to complete a task in session is hugely unhelpful and I feel, unkind. Isha was left shell-shocked by her CBT experience and, by the time she arrived in my consulting space, sobbed her heart and bones out!
She had meningitis as a child and had subsequent similar illnesses. Though neuro-divergence is not a disease but rather a unique and different brain, she did have undiagnosed neurodiversity, and this ran through her children and was very difficult for her to come to terms with. It was difficult because her wider family were embarrassed and saw this as a problem of discipline in the child instead of a cry for help.

According to Gabor Mate, this woman’s deep-seated problem is never learning to say no. What can we do in therapy to restore people’s ‘right way of living’ because somehow chronic fatigue is saying that the ‘way we live is wrong’? What can we do to help people recover their NO? It might be too late to say no to the people/situations that held you down somehow, but it is not too late to say no to the wrong way of living.

How does therapy work:

I work within a co-creative and relational framework, meaning we will determine what is creative and meaningful in your life within your limits.
Instead of CBT, Isha experienced CCC: Compassion, Curiosity and Care. In her case, it was not too late to say No to extra demands at work and in her family and realise that her upset at not feeling she can manage the demands at work only hurts her; instead, she accepts that she cannot manage them, her neurodiversity does not need to be tortured any longer but can find an understanding and allowing the environment to work and be creative in and, this, in turn, helps her find her right way of living.