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Dr. Carol Burckhardt

I have a new dog. We’ve named her Sydney after the city because she’s an Australian cattle dog, so says the humane society. They follow that dubbing with a cautionary X which means that they really don’t know what breed she is but this comes close. Well, whatever she is, she is definitely what I would call sensitive--loud noises, crowds, any food but chicken and rice, being touched unexpectedly all cause her to cringe, wilt, tuck her tail between her legs, or throw up. On the other hand, she’s strong, cute, soft, smart, playful, and attentive. Obviously, I like her a lot.

But she did set me to thinking about the issue of sensitivity as did the subject of the "Sharing Symptoms" feature of the newsletter this month. Just what does it mean to be sensitive? My first strategy when asking a question like that is to go to the dictionary. Here’s what mine says, "subject to excitation or responsive to stimuli, having power of feeling, of such a nature as to be easily affected." I’d like to explore this concept a little more in the strong belief that to understand is to become empowered. To be sensitive to something is to be responsive to a stimulus. Much of the etiologic basis for FM, CFS, and MCS currently rests on the premise that the body is responding to something--stress, injury, infection, chemicals. What isn’t very well understood is why some people get sick and others exposed to the same stimulus don’t. The other two definitions of sensitive appear helpful to our understanding of response to stimuli because they make two points: (1) the individuality of responses to stimuli and (2) the force with which stimuli are felt.

After reading a dozen articles about MCS over in the past few days, it occurred to me that the crux of the problem regarding MCS and sensitivities common to FM and CFS is this: No one denies that a stimulus causes the reactions we know as symptoms of these three syndromes; no one denies that people react differently to the same stimulus; and no one denies that the same stimulus can produce different levels of reaction. The problem seems in lie in whether the cause of the sensitivity problem is an external stimulus (e.g. virus, car accident, chemical fumes, sexual abuse) or an internal stimulus (e.g. compromised immune system, depression, anxiety, negative thinking, secondary gain) and whether different levels of reaction to the same stimulus are legitimate.

It is at this point that the fateful branching of the Western world into separate realities of body and mind continues to haunt our consciousness and prompt health professionals to say inane things like "I can’t find anything wrong with you, it’s all in your head." (Poor Descartes, he always gets the blame for this unfortunate development when all he was really trying to do was explain the growth of physical science discoveries in such a way that the inquisition wouldn’t burn him.) Nevertheless, the legacy for us has been a legitimizing of diseases for which biological explanations are readily apparent and a minimizing of those that are not.

Yet, In some ways today I suppose we’re lucky really, because the last 10 years has witnessed an unprecedented growth of understanding in the relationships between the mind (central nervous system, in particular, the conscious brain), and the endocrine, immune, peripheral and autonomic nervous systems. (We would do well to remember that other medical and healing cultures never lost that connection or ever separated these systems in the first place).

So what are the take home lessons here? I’d like to make four points: (1) No matter what the etiology of sensitivity, no matter what the causal explanation, the fact is that some people suffer from painful, fatiguing, life-altering symptoms. There will likely never be an easy "germ theory" to explain these symptoms just as there is no one cause theory of cardiac disease, cancer, or even tuberculosis. Moreover, continuing to focus solely on biological explanations of etiology and waiting for the pill that will cure is not likely to help anyone get on with their lives now. (2) Most physicians and other health professionals believe in their heads as well as their hearts that the body and mind interact to allow illness whether it’s FM, CFS , MCS or any other illness. What’s important is that the belief does not get translated by either health professionals or persons with the illness into an issue of psychological weakness or pathology as the causal explanation for the symptoms. The fact is that the syndromes of interest to us here are clusters of, at present, medically unexplained physical symptoms that are legitimate expressions of distress. There is virtually no evidence in the scientific literature of any of these three syndromes that proves a causal relationship between pre-existing psychiatric disease and the onset of the syndrome. There is no way to prove this cause-and-effect relationship in someone who already has the syndrome. (3) How you will be affected by FM, CFS and MCS is a product of your sensitivities, that is, the response both your body and your mind make. It is that interaction and personal response that determines the severity of the syndrome as well as the disability that may accompany it. (4) Syndromes without known causes have no curative treatments. Therefore, a multi-focused treatment regimen aimed at developing healthy life styles and coping skills is the most powerful strategy currently available.

Deciding what it means to be healthy in body, mind and spirit is the first step, one that no one else can make for you. But here are some tips gleaned from my reading on MCS. First, find and surround yourself with people who believe that your symptoms are real because they are. Second, think carefully before you separate yourself from all possible provocative chemicals, make stringent changes in your diet, take powerful medications or large doses of diet supplements. There is at this point no evidence that avoidance treatments or detoxification work very well. Isolating yourself from every possible irritant can lead to a severely decreased quality of life as social life and intimate relationships become increasingly restricted and severe dietary restrictions can have serious medical consequences. And finally, find something outside your illness to give your life meaning. Concentrating your limited energy exclusively on your symptoms is unfortunately not likely to make you feel better. However, over time, finding pleasure in life, eating a healthy diet, exercising moderately, cultivating nurturing relationships, and fostering a calm, inner spirit will enable you to meet the irritations of your sensitivities in a way that does not minimize their reality but challenges their capacity to control your life.


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