If you have fibromyalgia and a job, I already know you often wonder in despair, "How much longer am I going to be able to do this?"
Maybe you try to play off your pain with a tense smile, keeping your suffering private. You worry that your brain fog is noticeable, slowing you down, and could even be the reason you haven't been promoted.
Maybe you spend your lunch break hiding in your car or the bathroom, trying to recover enough energy to push through the rest of your workday, only to hurry home and climb straight into bed.
Maybe you're afraid that losing your job is only a matter of time.
I bet it's easy to go there. I'm guessing you've already lost a lot to fibromyalgia, and that you often feel sad about that.
Your Symptoms Aren't Fortune Tellers
And I'm not a mind reader. I just have a lot of experience helping people similar to you.
Many of my clients have chronic symptoms—from fatigue and pain to nausea and weakness—that have interrupted their education, careers, relationships, and independence. Some have left graduate programs, crashed out after landing their dream jobs, or moved back home with their parents.
My clients are intelligent, conscientious, ambitious, and determined. They are the people who push through. They have dreams they've worked incredibly hard to make real, in bodies they're afraid won't let them enjoy the fruits of their labor.
So here's something really important I work hard to help my clients understand:
Your symptoms are real, but the predictions you make because of them are not.
Sometimes your brain has “misunderstandings.” In fact, it often does.
Your Brain Is a Prediction Machine
One of your nervous system's primary jobs is to protect you, to keep you alive. To do so, your brain uses past experiences to make predictions about your future.
Scientists call this “predictive processing” or “predictive coding,” and I think we should all be talking about it a lot more.
Behind the scenes, your brain is constantly scanning for danger, anticipating what's next, and deciding what you might need to stay safe.
Except your brain isn't very good at fortune-telling.
When you slow down and reflect on your automatic assumptions, there's a good chance you'll notice some distortions.
Your brain may overgeneralize (using words like always, forever, or never), build a case on rocky evidence (using feelings instead of facts), and exaggerate (or minimize) the risks.
For example, let's say you've had several difficult days at work and start to notice increased pain while sitting in the same chair you always do.
Eventually, before you even get to the office, you start feeling anxious about spending another eight hours in what you're now calling the “pain chair.”
You can't imagine sitting in it again without wincing, even though you used to sit there regularly feeling fine.
When you have these “pain thoughts,” you may also notice places of tension, bracing, and restlessness in your body.
You may start checking your body for signs of the anticipated flare-up. You make choices to avoid what you're afraid might happen and sit somewhere else.
Suddenly, work feels threatening, and nothing has even happened.
The Pain/Fear Cycle Is Real
When your brain remembers what happened the last time you sat in that chair, because of predictive processing, it may cut to the chase and kick-start the pain you've been expecting.
Like going to your browser's cache to quickly render a screen instead of loading everything from scratch, your brain will draw on what it already knows.
Unfortunately, your fearful predictions will contribute to the very painful sensations you've been worried about and trying to avoid.
This is called the “pain/fear cycle,” and it's remarkably easy to step into.
In the words of one of my favorite people, "It's diabolical."
The Difference Between Pain & Danger
We typically think of pain as a signal that something dangerously wrong is happening in your body that needs to be fixed in order to stop your discomfort.
But with fibromyalgia, this isn't necessarily the case. Instead of being a sign of ongoing tissue damage, it's understood to be “neuroplastic.” This means that neural pathways in your brain have mistakenly learned how to generate and amplify pain signals even in the absence of a physical injury or structural cause.
Neuroplastic doesn't mean imaginary. Your pain is obviously real because you feel it.
This is one of those misunderstandings we’ve been talking about. A kind of memory or “habit energy,” a pattern playing out in your body informed by your brain's predictive coding.
And it's critical to know that these misunderstandings aren't just informed by experiences that have felt physically dangerous, but also by experiences that are mentally, emotionally, and relationally threatening.
We call this a “biopsychosocial” understanding of pain. And it's based on the observation that all these life domains use the exact same system to communicate your needs—your nervous system.
This Is Where We Find Hope!
Because of neuroplasticity, your brain can update its predictions through new experiences of safety.
Of course, not every pain signal is a misunderstanding. Sometimes symptoms tell us something important about our physical limits or a medical problem that needs attention.
But when an activity is medically appropriate and isn't causing additional damage, yet your nervous system is sounding the alarm, it's worth getting curious about what your brain might be predicting.
You’re not pretending your pain isn't real. You're checking for misunderstandings.
How This Can Help You Stay at Work
Let's go back to your dreaded “pain chair.”
Tomorrow morning, instead of approaching it like an instrument of torture, try getting curious with a little experiment:
❥ Notice your prediction. Is this always true? Are there exceptions?
❥ Assess your safety. Is there something actually dangerous about this chair?
❥ Give your body a new experience and your brain new information. If your chair looks safe, be curious about what could happen if you only sat down for 30 seconds and try it.
❥ Praise your brain. Whether or not you experience discomfort, acknowledge your willingness to try something different. “Good job, Brain! We're learning!” Then sit wherever you want.
Avoiding your chair out of fear would reinforce the neural pathways predicting your pain. But approaching it with curiosity, helps your brain remember what is more true—that you are often safer than you are afraid that you aren’t.
Each manageable experience helps update the predictions that keep you afraid of being at work.
Your Future Is Still Being Written
I'm really good at helping my clients learn how to get back to work and keep their jobs while healing from neuroplastic conditions like Fibromyalgia.
Often their first change is simply noticing that a familiar discomfort doesn't have to mean that the worst is on its way.
Check in with yourself before jumping into your typical response.
Ask what's actually happening. Get curious about what your brain might be mistakenly predicting as threatening (across all the domains of your life). Clear up misunderstandings by experimenting in small ways with reminding your nervous system what is more true—you are often safer than you feel.
Your brain makes predictions, but does not tell your future. Let's start clearing up some misunderstandings and see what's possible.
Jump on my schedule for your discovery call. I know how to support you, and would love to :)
