Something Unexpected That May Help Some Common Chronic Medical Conditions

There’s something really interesting and potentially important happening in the space of people suffering from chronic medical conditions that modern medicine provides no good solutions for, such as Long COVID, IBS, functional dyspepsia, fibromyalgia, chronic back or joint pain without injury/disease, ME/Chronic Fatigue Syndrome, PTLDS/Chronic Lyme disease, and so on. I’m talking here specifically about people where all other reasonable explanations for their conditions (e.g., cancer, injury, autoimmune disease, etc.) have been thoroughly ruled out. Importantly, what I say below will definitely not work for everyone with these conditions.

Below is my attempt to summarize patterns across many anecdotal reports. I’d be curious to hear what you think, especially if you currently or have ever suffered from a painful or unpleasant chronic condition that modern medicine doesn’t have good solutions for.

While the evidence on this topic is extremely preliminary, what I say here could turn out to be wrong, and high-quality randomized controlled trials are desperately needed before we can be confident in these approaches being useful, anecdotally, there appears to be a pattern where people with these conditions are reporting substantial benefits (and sometimes even full recovery) from a combination of psychological and behavioral strategies – sometimes even people who have suffered for a decade or longer.

For those who have already tried all the obvious things, ruled out dangerous medical conditions, exhausted all the options presented by knowledgeable doctors, and don’t know what to do next, these ideas may be worth a try.

Important Note: none of what’s below implies that the person in question was never suffering from a disease, or that their pain is any less “real” than any other pain. Additionally, even if this approach works for some people, it will, of course, not work for everyone, and it may even make some people worse, so please explore with caution.

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From what I can tell, the often-repeated common threads reported in anecdotal accounts of those who recover from these conditions (that they attribute their recovery to) appear to have three major elements:

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Element 1: Foundation (this part is boring but important)

A focus on getting the healthy life basics in place, to set yourself up for potential recovery and to help you feel as good as you can (despite the pain). This often includes elements like:

• cutting out junk food and excessive sugar and replacing them with healthy, whole foods, and drinking sufficient water

• focusing on getting enough, high-quality sleep

• daily stress reduction, such as through a daily meditation practice, progressive muscle relaxation, deep breathing, a yoga routine, or massage

• reduce or cut out drugs and alcohol

• daily sunlight through some spent outdoors, ideally in the morning

• whatever daily movement or exercise feels manageable (even if just a short, slow walk outside)

• scheduling enjoyable activities regularly and aiming to find joy in ordinary pleasurable moments

• regular social connection with people you care about or find interesting

• If you are dealing with a mental health challenge (such as depression or anxiety, which are both common for people suffering from painful chronic conditions), seeking treatment from an expert (e.g., a well-trained therapist who specializes in the condition you’re grappling with)

• find ways to explore and process your difficult emotions, whether it be talking with a therapist, a daily journaling habit, just taking a few minutes daily to sit and let yourself fully feel your emotions, or speaking regularly to a trusted friend who is happy to listen

• if you tend to be hard on yourself or engage in a lot of negative self-talk, explore developing self-compassion (treating yourself at least as kindly as you’d treat a friend, and showing yourself compassion like you would to someone you care about)

• getting yourself out of psychologically unhealthy situations to the best of your ability (whether it be an unreasonably demanding work situation, a person in their life who treats you very badly or makes you feel bad all the time, or a people-pleasing mentality of never saying ‘no’ even though you are carrying a huge burden already)

These items in 1, above, are not designed to cure your chronic pain or even to reduce the pain; they aim to set you up for the maximum chance of feeling better, and so are important. Also note that 1 doesn’t involve taking a boatload of supplements or eating a highly unusual diet.

It’s 2 that is the more novel, potentially critical piece:

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Element 2: Reframing and Reprocessing

Completely reframing your perception of the painful and unpleasant bodily sensations. The goal is to:

i) See these sensations as your body attempting to send you a helpful signal (e.g., some people like to start thanking their body for giving them this signal because they know it’s trying to protect them)

ii) Perceive these sensations as a false alarm. The idea is that the symptoms do not actually mean you are in any danger, nor do they indicate a life-threatening disease (since we’re assuming that has already been ruled out). The symptoms also don’t mean that you are destined to feel bad all day, or that the activity you’re doing when the symptoms emerge is going to cause any lasting harm to you.

The attitude to bring here is not one of bracing against the pain, and not one of trying to fix the feeling.

The concept is that these unpleasant bodily signals (which probably began as signals connected to an injury or disease) have somehow become detached from any injury or disease. Unfortunately, the signals persist – whether due to misfiring in your nerves, your brain misinterpreting benign signals as being dangerous, associative learning (X has preceded Y enough that now X causes Y), or some kind of accidental signal reinforcement (e.g., by responding to the signal as if it’s a sign of danger, the signal gets perpetuated).

Here’s my metaphor for this way of seeing things:

Imagine that your pain or unpleasant bodily sensations are like the barking of a very loyal guard dog. You brought this dog into your home to protect you back when you used to be in a very dangerous area, and the dog was very helpful at that time, barking at the very real danger that was frequently around you.

Now you live in a safe area, with nothing important for the dog to bark at. But the dog desperately wants to be helpful, and only knows one way to do so. Due to his extreme overeagerness and an unrelenting focus on potential danger, the dog ends up barking constantly. Whenever it barks, despite the now safe environment, you subconsciously still interpret this as a sign of genuine danger (since that’s always what it used to mean). This constant barking leaves you constantly anxious, on edge, or in a heightened state, and may have downstream consequences on your body (such as impacting your ability to sleep well or digest food), and generally makes you miserable. Due to the well-meaning dog’s misguided attempt to keep you safe, the barking is ruining your life.

The idea, therefore, is to retrain yourself to view the chronic pain and unpleasant bodily sensations as completely safe. You can facilitate this by noticing when you’re having negative thoughts about the pain and gently letting them go, and by practicing observing the sensations neutrally, without judgment. You can even practice accepting the painful feelings exactly as they are (and when your brain jumps in to label the feeling as “awful” or tells you “you can’t handle it” you can acknowledge those thoughts, gently let go of them, and return to observing the feeling non-judgmentally. As many people (including myself) have experienced exploring this way of viewing pain during meditation, shifting our attitude toward pain can immediately reduce the suffering the pain causes us.

Redirecting to something positive after doing so is also something that people report as a useful addition (whether that’s some other part of your body that feels good right now, a humorous re-interpretation of the event, a pleasing visualization, or an activity that’s pleasant that you’d like to do now instead of focusing on the pain, etc.)

Importantly, for many people, their bodily signals really ARE indicating imminent bodily danger (e.g., if you have a broken bone in your foot, you may actually need to stay off it for a while to let it heal) – that’s typically how pain works. So if you’re considering trying these techniques, it’s important to first rule out that you’re in that group.

Additionally, it’s important to distinguish a bodily signal indicating true danger vs. one merely indicating “you need to rest”, which is not inherently dangerous, but is important to heed and not ignore. It’s not that you should learn to ignore bodily signals – many such signals provide us valuable information, and ignoring our bodies is a recipe for potential problems down the road. It’s instead about changing the relationship to our chronic painful bodily signals, such as experiencing them non-judgmentally with peace and acceptance, viewing them as our bodies attempting to give us useful information, and not responding to them as though they are dangerous.

For those interested in trying this approach, here’s the final piece of the puzzle:

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Element 3: Practicing and Expanding

• While adopting the points from 2, above, gently and at a manageable pace, challenge yourself with whatever triggers your immediate (acute) symptoms. That is, test the waters with things that would normally make your symptoms immediately feel worse. Do so while maintaining the perspective that the symptoms are safe, they are there in an attempt to help you, and that they do not indicate any actual harm to you. Aim to view the symptoms neutrally and objectively without judgment and keep trying to accept them as they are, without needing them to be different. Then, once that becomes a bit easier, gently push the limits further toward somewhat more intense potential triggers and toward things you’ve been avoiding out of the fear of their impact on your symptoms. An important note: the idea here is NOT to push yourself more and more in an attempt to build up tolerance, strength, fitness, or resistance to fatigue (as one might try to do in Graded Exercise Therapy) – the idea, instead, is to practice reframing and reprocessing symptoms in progressively more challenging situations, while being careful to avoid overdoing it (which can lead to crashes). Many report that pushing yourself too hard, too fast, can backfire. So go slow, be gentle with yourself, and treat yourself with self-compassion.

Expect some setbacks along the way – progress is not likely to be linear, with lots of random daily variation. Be consistent, working at this daily but at a pace that feels comfortable, and track symptoms at the end of each day (e.g., pain level, fatigue level, stress level), which you can check over time to see whether there is a longer-term trend towards progress.

Part of the long-term goal with this is to end up paying less and less attention to your symptoms – since (in this case) they are not indicative of any actual problem, eventually you can learn to ignore them.

Note: gently pushing your boundary on symptoms doesn’t mean blowing past your limits. For instance, if you know that a 15-minute walk will leave you feeling fine at the time but cause you to crash for the next 2 days, then walking for 15 minutes would not be an example of what I’m describing.

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What’s the point of this whole process? It’s really two-fold:

A) It can simply make it substantially easier to deal with the chronic condition, and mean that you suffer less despite all the pain, and live a happier life even as you have the pain. It may cause the pain itself to feel less bad (through a reframing of the pain), cause you to have less intense negative emotions about the pain (which means reducing the second-order pain and other consequences caused by these negative emotions), and expand the range of activities you engage in that make your life worth living.

This could be a good enough reason to try this approach. And that’s part of why I like this approach. While there’s always a risk of it backfiring, even if it doesn’t cause any huge change, I think it has a pretty good chance of making life more manageable and leading you to suffering less from the pain (i.e., even if the pain is not itself lessened, changing your perception of the pain can mean you suffer less from it).

But, here’s where things get weird and much more speculative:

B ) Some people find that after weeks or a few months of following processes similar to what’s described here, they are completely or nearly completely cured. These reports are still very much anecdotal, and much more rigorous research is needed to be confident in the cause of improvement for such folks (so this should all be taken with a big grain of salt), but it’s quite striking how many people who were sick for years or longer have reported rapid progress with approaches similar to what I’ve described here. Though the exact approaches they use differ, and have a variety of names, and a variety of distinct elements, I’ve included here aspects common to many of them.

Many people will only get benefit A) from this approach, and that alone may make it worth it. So it may be best to think of B) more like a speculative bonus that (based on many anecdotal reports) seems to happen for some people.

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Obviously, there are other major caveats here: people could be wrong about this being the cause of their improvements, and even if this approach does cure some people, it’s unclear what percentage of people would be cured if they were to fully take on such an approach. Additionally, there are lots of people this is not appropriate for, such as people who have a life-threatening medical condition, people who have not yet had a thorough medical workup, people experiencing rapid weight loss or fevers, and so on. The evidence here is not strong, and could turn out to be wrong. Just because modern medicine doesn’t have a good understanding of a disorder doesn’t mean that it’s connected to psychology and behavior. And some people even report having tried this approach and had it backfire, where it left them worse off, so please be careful.

If this method does work, though, why does it work? It seems like one or more of the following explanations may be at play (which may vary depending on the individual):

• Pain signals and negative bodily sensations can occur in the absence of injury or disease (for instance, due to misfiring in the nerve, the brain misinterpreting signals, or other causes). A proof of concept where we know this happens is Phantom Pain Syndrome, where a person who has had a limb amputated may experience intense chronic pain that feels to them to be coming from that (now absent) limb, which, of course, it can’t actually be coming from.

• It may be that pain signals or unpleasant bodily sensations can become reinforced by our reactions to them (though this is not well understood). If so, the way we react may inadvertently cause pain signals to persist even past the point of the injury or disease that originally caused them to start. Perhaps somehow our attention to the signals, or our viewing them as dangerous, convinces our brain that the signals are worth sending.

• Or, a subtly but importantly different mechanism may be at play: our negative reactions to pain signals or unpleasant bodily sensations may leave us in a highly elevated state (e.g., anxiety or cortisol), and this elevated state may generate new pain signals or exacerbate existing signals (e.g., increase tightness in the stomach or an inflamed feeling in joints) or new unpleasant bodily sensations (e.g., trouble with digestion, difficulty breathing) which then generate more negative reactions, in a self-perpetuating cycle

• Or, a related possibility, is that your brain has somehow learned associations that are now triggering reactions. Perhaps your brain learned that when X happens, then the proper response is Y, and your brain is now triggering Y in response to X, despite that reaction being useless now and generating negative side effects for you.

• In some cases, behaviors we engage in to avoid pain may actually increase or perpetuate it – e.g., avoiding using a joint because it hurts may actually cause it to be stiff and painful from lack of use, which may cause us to continue to avoid its use.

Pain can be completely real, disabling, and have a biological origin, even in the absence of damaged or diseased tissue.

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One important thing you may wonder: Is there actually evidence that psychological and behavioral approaches can improve the lives of people with these conditions? Well, while this field is, overall, woefully under-researched, there’s quite a bit of evidence that psychological and behavioral strategies can help (even though the nature of these strategies differs, and may only be partially overlapping with what I’m describing in this post). Here is a quick recap of some of that evidence:

(1) IBS: A meta-analysis of randomized controlled trials of psychological treatments for Irritable Bowel Syndrome looked at 15 studies. It found greater improvement in the psychological treatment groups compared to the control group on symptom severity, quality of life, and abdominal pain, but no difference in diarrhea or constipation. Another meta-analysis on psychological therapies for IBS looked at 41 randomized controlled trials and found that CBT and gut-directed hypnotherapy outperformed education and routine care.

(2) Functional Dyspepsia: A meta-analysis of psychotherapy treatments for people with Functional Dyspepsia. It looked at 5 studies and found that those receiving psychotherapy improved in gastrointestinal symptoms.

(3) ME/CFS: A 2011 meta-analysis of randomized controlled trials of treatments for Chronic Fatigue Syndrome looked at 16 studies on Cognitive Behavioral Therapy (CBT) and concluded overall that those receiving CBT had greater symptom improvement than control groups. As a commenter pointed out, those studies used an earlier definition of ME/CFS that didn’t require post-exertional fatigue. A later 2020 Systematic review of randomized controlled trials looked at 12 studies on CBT, and found that 4 showed it to be effective, 2 ‘Partially significant’, and 6 found no effect.

(4) Chronic pain: a Cochrane meta-analysis looked at 75 studies on psychological treatments for chronic pain conditions, including fibromyalgia and chronic low back pain. A number of types of psychological treatment were included, such as CBT, behavioral therapy, and ACT. They conclude: “On average, compared to people who receive no treatment for their pain, people treated with CBT probably experience slightly less pain and distress by the end of the treatment and six to 12 months later (moderate-quality evidence). They may also experience slightly less disability on average (low-quality evidence).”

So the evidence overall quite strongly indicates that psychological and behavioral strategies can help people with these conditions (though, unfortunately, there is little research that has been done directly testing the specific strategies I’m describing here, and there is a lot of heterogeneity in results, especially with ME/CFS).

The most direct evidence of a technique very similar to what I’m describing (that I’m aware of) comes from just one randomized controlled trial on a method known as “Pain Reprocessing Therapy” (PRT) for chronic back pain. It showed promising results (though more studies are very much needed). PRT has many common elements with what I’ve described in this post.

Of course, if you’re suffering from one of these chronic conditions, you may simply want to try Cognitive Behavioral Therapy if it seems promising to you or (if it’s a gut disorder) gut-directed hypnotherapy as there’s reasonable evidence (as described above) that they improve many people’s quality of life who suffer from chronic conditions, even if they don’t provide a cure for most people.

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The best source I know of to learn about these many anecdotal accounts of people improving from these conditions is the YouTube channel of Raelan Agle. She had ME/CFS for 10 years and eventually recovered, and on her channel, she interviews people who have recovered from ME/CFS and Long Covid. These three videos in particular were very influential for what I wrote in this post:

• What Raelan says she learned from conducting 75 interviews with people who recovered from Long COVID or ME/Chronic Fatigue Syndrome.

• Raelan’s recovery themes from 200 Interviews:

• What Raelan says about why recovery experts disagree and what they agree on.

There are also interesting books related to this topic, such as “The Way Out” by Alan Gordon and Alon Ziv (which teaches a specific method known as “Somatic Tracking” that’s very related to, but not identical to, what I discussed in this post).

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This piece was first written on October 30, 2025 and first appeared on my website on November 10, 2025.