Chronic fatigue syndrome (CFS) is characterized by medically unexplained chronic and disabling physical and mental fatigue. There is growing evidence of organic abnormalities 2 but the involvement of psychological factors in its aetiology and chronicity should also be recognized 3.
One approach to the complaint assumes it is post-viral in origin with psychiatric and social antecedents 4. The sufferer attributes the fatigue and myalgia which persist beyond an initial infectious episode to a continuing viral infection, and interprets them as indicating that activity hinders recovery. A vicious circle is established in which avoidance of activity leads to deconditioning, depression and the perpetuation of symptoms. This view has encouraged the use of cognitive behaviour therapy to increase exercise in graded stages by inducing a more positive attitude towards activity an approach that has met with encouraging results5. Nevertheless, it would seem wrong to attribute CFS entirely to inactivity and sufferers’ illness attributions, if only because there are sufferers who are moderately active and working part-time. Such a model also has difficulty explaining why the symptoms fluctuate within a day, or over longer periods. Furthermore, many sufferers strongly believe that exercise, even in a carefully controlled schedule, will make them feel ill and prolong the complaint. They refuse to contemplate any such therapy 6.
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Source: Gregg VH. Hypnosis in chronic fatigue syndrome. J R Soc Med. 1997 Dec;90(12):682-3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1296740/