Journal of IiME Volume 2 Issue 2 www.investinme.org “ “TThhee mmoorree tthhiinnggss cchhaannggee,, tthhee mmoorree tthhiinnggss ss ttaayy tthhee ssaammee”” ( (ccoonn tt ii nnuueedd )) active, the body is felt more acutely by the same proprioception as a moving body, moving in a variety of dynamic patterns. Selfobservation of this embodied and embedded movement, both inside and in relation to outside, is continued into the environment by the rods of peripheral vision, which are especially sensitive to movement and patterns of movement, and work faster than the complementary colour sensitive cones. Symptoms arise from this proprioceptive base as signals to modulate bodily activity in coordinatation with patterns in the immediate environment. Thus they form a coordination dynamics (18). Since proprioception is a reflexive sense, its truth conditions are of a different kind from those of the distancing senses. They are directly and reflexively felt (nondual), not as an outside observer separated from its object (dualistic). If bodily you feel fatigued, it is time to rest. If you feel energized with more potential to move, you may choose to become active. We have all learned about this causal flow and how to modulate it in relation to the environment since first becoming mobile in infancy. This learning happens semi-automatically, depending on our choice, training and circumstance. What happens if this regulatory system becomes disrupted? What if fatigue becomes “delayed”, and it becomes harder to causally connect the fatigue with the preceding activity. Fatigue does not follow activity in the expected causal rhythm, and the situation becomes confusing since there has been a change in the dynamics. “The goal posts have shifted”, as I tell my patients. A new “attractor” or pattern of activity has been formed in the language of dynamical coordination theory (18). What do we do? At first we try to ignore the fatigue and get on with the work of our life despite the feelings of fatigue by “will power” or the use of Invest in ME (Charity Nr. 1114035) stimulants. This is the King Canute strategy. What happens then? We “crash” as the fatigue gets worse. The more we try to overcome this fatigue, the worse it gets. It is this dynamical pattern change in the activity regulation system of the whole brain-body-world that we must address. It is addressed by pacingadding your consciousness into this ordinarily semi-automatic regulatory system with added regulation using self-directed, non-dual mindfulness(19) that you can begin to connect the fatigue/ activity relationship which has been dissociated. With temporal dissociation from activity , the cause of fatigue is put into turmoil. It could be caused by numerous intervening variables, as it is not work in its usual rhythms. One cannot rely on these subconscious dynamic pattern any more. One needs to intervene with the conscious mind which can re-assert the connection between activity and fatigue if it is there, or search for other answers to the problem that has been posed by consciousness (using mindfulness). Then the pacing of activity can begin, however delayed the causal connection between activity and fatigue has become. While essential for the repair of your basic activity self-regulator, this conscious symptom guided proprioceptive system must learn to discern other kinds of fatigue with varying causal backgrounds- induced by lack of sleep, by intercurrent infections, cognitive overload, exposure to too much noise, light, odours, cognitive work, circumambient noise or busyness, stress, emotional overwork, toxic exposure, etc. This all gives you clues as to what is causing your present state of fatigue. These are the interactive commonsense causal factors coming in from the environment in which it is embedded with variable temporalities. Causal variables also come from the embodied inside. The symptoms of the syndrome will disturb the basic control system depending on how interactive they are. Better regulation of the whole activity/fatigue control system will not come from learning to ignore (continued on page 28) Page 27/74
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