Ashok Gupta’s Amygdala Retraining Technique For Chronic Fatigue Syndrome (ME/CFS): Cort Johnson’s Blog I (Feb-July 2008)

Ashok Gupta, a former chronic fatigue syndrome (ME/CFS) patient, believes damage to a part of the brain called the amygdala has locked chronic fatigue syndrome patients into an ongoing stress response. The stress or ‘fight or flight response’ has many manifestations including shortened breath, tightened muscles, impaired digestion, poor sleep, rushing mind, etc. His techniques turn on the idea that it is possible to turn the stress response down and re-initiate a pattern of healthy, relaxed functioning. He proposes one can do this ‘retraining the amygdala’. In 2004 he published a paper in that Medical Hypotheses Journal that outlines his theory.

I was interested in this technique for several reasons. First Ashok Gupta claims quite high success rates. Second while the initial of the DVD’s ($160) may be high for some high its only a one-time output of money and a money back guarantee is offered. Thirdly its become clear to me over time that my stress response system is on high alert. I noticed for many years my racing mind, my stiffened muscles, my tightened chest and shallow breathing, my anxiousness and lack of calmness and inability to really relax and these could all be manifestations of a chronically activated stress response. Plus there is now good research evidence that the stress response (fight or flight) is ‘on’ and the relaxation response (rest and digest) has been turned off in chronic fatigue syndrome (ME/CFS)

I won’t describe the Amygdala Training Techniques. They’re Ashok Gupta’s property and I couldn’t do justice to them if I tried. What I will say that they’re different – they’re quite different! – but they don’t appear to be particularly difficult. The DVD set is a package that’s designed to guide you through the process. At about 3 hours per disc the twelve hours of explanation and instruction plus an audio CD are a good price for the money. The DVD’s are professionally done in a calm, reflective, well organized manner. Ashok Gupta seems quite young to have come up with a novel theory of ME/CFS but he’s excellent guide throughout.

2/11/08 – First Training Session: The first training session was a success which was surprising. I was feeling poorly, this is a time of year when I engage in more activity which leaves me worn out. Plus I haven’t been getting alot of sleep; 6-7 hours of quite broken sleep a night. Still it seemed to work. I felt more energy afterwards. What really surprised me though was that I felt even better an hour or two later. I had to do some computer work in a library that really ignites my chemical sensitivities. I could smell and feel the chemicals and feel one part of my body start to react but it was like I was observing it rather than getting involved. Some the symptoms like the heart pounding just did not click on. It was fascinating. It was like I short-circuited the stress response – which is what Gupta is trying to do.

2/12/08 – Reno, our dog does not like the retraining process. Every time I tried to do it outside he got quite excited and jumped on me – I can’t say I blame him.

I often feel encased by the sensations of my body; the heaviness of my limbs, the different pains, etc. I think of much of what I’ve tried to do with CFS is to try to get clear of them. If I understand him right, Dr. Gupta believes our rather freaked out amygdala is telling us something is very wrong with our bodies and asking us to scan them constantly for problems. Interesting the CDC CFS research team appears to believe the brain doesn’t scan the body correctly at all and that is the problem.

We were asked to create a list of thoughts regarding our symptoms. I had trouble coming up with mine but I used someone else’s. I was floored when it worked during the process. Again it seemed to shut off the stress response; the pounding heart, the heaviness of the limbs, the attention to the body. The mind is a powerful, powerful thing.

Besides the technique itself I like Gupta’s suggestions about how to apply it. I’ve been on this mindfulness trail a bit for quite awhile. I’ve noticed that meditation, chanting, etc. all seem to relieve my symptoms at least temporarily but I’ve missed some practical guidance that Gupta provides.

2/14/08 – Ashok’s program is certainly beneficial and it seems to make more sense to me as I go along. I’ve done it intermittently over the past few days. At times it brings surprising results – more relaxation, a feeling of graceful movement, increased energy – I feel more like ‘me’. At times it doesn’t. I’m still getting a handle on this technique – not sure if I’m applying it correctly. I wonder if Ashok is acting on the stress response from one end (brain/mind) while other doctors are from the other (body).

2/16/08 – I was doing the retraining – quite automatically – it didn’t seem I was connecting with it well but then I felt my posture shift; my shoulders came down and I felt centered and relaxed and stronger. This more than anything makes me feel that people with CFS are locked into a chronic stress response. As I watched it was as if I could see the stress response lock back in; my breathing shifted from my belly to my chest, muscles became locked in in their familiar stiffened position and my heart started yammering and I immediately I felt fatigued, uncomfortable and basically almost overwhelmed by my body sensations. When my shoulders ‘fell down’ and I relaxed I felt different than I had in years.

One part of the training technique asks that you feel the energy flowing through your body. I’ve had a lot of trouble with this – when I close my eyes my attention has gone straight back to how bad my body’s feeling but yesterday when I close my eyes I started feeling the clean energy, not for all that long, but what a luxurious and unusual feeling it was. I think that’s will turn out to be an important step.

These are temporary ‘timeouts’ from chronic fatigue syndrome (ME/CFS). Yesterday my energy was just ok. Today though it’s been quite good – I’ve felt quite relaxed and ‘light’. I’m very pleased with program thus far.

2/18/08 – Slow but I think steady. Not particularly energized. Nothing dramatic to report. I just feel a bit better overall. The most significant thing is that I can now feel the ‘stress response’ (breath rising to the chest, heart pounding, muscles feeling heavier) rising and tamp it down to some extent. Dr. Natelson is focusing on hyperventilation and lowered CO2 levels in chronic fatigue syndrome (ME/CFS) and I wonder how many of our symptoms are due to this shallow, chest derived breathing pattern. I see that breathing properly is one of Dr. Podell’s key target as well. I’ve tried to push my breathing down to the abdomen level before but it didn’t work over time. Gupta’s training appears to more get at the source; without thinking about it the breathing slows down.

Still don’t feel I have the hang of the training program yet. I’m doing my twice yearly garden work – a killer.

2/24/08 – No breakthroughs. I had two excellent sessions; both of which constituted a step forward. I think I’m calmer. My energy levels, however, don’t seem to be any higher. I have to say that this is not a particularly good time to try out anything; its a time of year when I do exercise more and I always take a hit with that. Plus I’ve haven’t been sleeping well. I have to sleep in the car and that’s always pretty dicey.

I’m having trouble incorporating the retraining into my daily life. I do sessions in the morning and the evening but during the day I don’t seem that much opportunity to do it. You’re supposed to do it when you encounter certain triggers or thoughts but I don’t notice those thoughts coming up. Instead I simply notice that my body hurts or is tired. When I do catch an underlying thought it can be quite powerful but its rare. Maybe they’re simply really incorporated into my psyche – I have had this for several decades! Another problem is that I simply cannot imagine myself being really healthy – which is another part of the technique. I only have the glimmest picture of that.

When I do the technique I generally have results; sometimes very good results and sometimes not so noticeable but I don’t do it all that much. I did just go back and look over the training and I was doing some things wrong. My best session was my first one and one about a week later.

I like Gupta’s approach; I think an activated stress response is definitely a part of ME/CFS – I’m a believer with regards to that but how deep does it go? That I’m not clear about. Its hard to believe right now that it could clear up everything. I should note that I still haven’t gotten past the second DVD! I should have heard all of them the first week.

3/08/08 – I got some advice from Ashok via e-mail and I’m enjoying the processes much more; in fact I’m looking forward to the feelings of clarity and energy they bring. I can feel it incorporating itself more in my life. I’m doing this at the most difficult time of the year for me – when I put in a garden. This always leads to greatly increased fatigue, hot, stiffened muscles, difficulty concentrating, etc. My body generally feels like its screaming at me to stop for a couple of weeks. Quite a test for any program!

My benefits from the process include increased calmness, being able to tell when the stress response ramps itself up and being able to calm it down at least somewhat and I’m beginning to feel some increased energy. There are many times when I’m overwhelmed by body sensations of fatigue, stiffened muscles etc. but I think I’m beginning to gain some separation.

In one part of the process you’re asked to to remember yourself when you were well. For me that was over 25 years ago and I’ve had great difficulty doing that. Two days ago I was able to get back there for a short time and it was quite an experience – I literally felt I was there and doing so did seem to ‘retrain’ me for awhile; I felt loose and relaxed.

I don’t want to overstate my progress; its slow but I’m more encouraged now. In fact I wouldn’t dream of stopping it now. I have not been a good patient either. I’m in trying to fit it in in bits and snatches – not the best way to do this program; and I haven’t been doing the exercises recommended outside of the main retraining program. Still need to finish the third DVD! Lot’s more to do.

3/10/08 – Hopefully my last big workout in the garden. Muscles are tight, stiff and hot. If the amygdala is at the heart of this I imagine it’s shrieking its head off right now. I’ve been able to notice the tightness, shallow breathing, etc. that I believes signifies the stress response is being activated. Now I think I’m starting to get at the thoughts that are driving that reaction.

One morning as I was walking back and forth from the house I could feel waves of stiffness come over me. When I looked closely it seemed like I could get the thoughts driving them; most were alarms like ‘watch out – you shouldn’t be doing this’ accompanied by a sudden intake of breath and a freezing of my body with my muscles stiffening up immediately. Just noticing that that process was going on relaxed me. The amygdala appeared to be going off like a firecracker. It seemed to be protesting any movement I made.

I still need to listen to the last of the 3rd DVD. Someone e-mailed me and told me that doing some of the exercises before bed gave him a profoundly deep sleep (!). That would be a nice experience. Overall I continue to experience more calmness which, of course, equates to a more enjoyable experience overall.

3/17/08 – An interesting week. Still doing too much exercise. Muscles are still generally tight and stiff but I’ve made progress. At one point of the retraining program you are asked to reach back and remember a time when you were healthy and to feel the energy. This is, I assume, a key part of ‘retraining’ the amygdala – I suppose during this step you begin to lock into a new, healthier state.

While I’ve been able to create some good energy I’ve never really been able to get back there – when I was feeling healthy. This week those memories starting flooding back – pretty amazing given some of those memories are over 35 years old. When that happens its like I’m back there, relaxed and feeling those healthy feelings again for the first time in decades – very nice! Quite a change from a month ago when all I could feel was pain when I tried to do this part of the process.

I’m doing the retraining process more frequently – I like these boosts – and have started meditating – that’s going well too – quite calming. Can’t say I’m feeling well – still operating well outside my energy envelope – but overall I like the progress.

3/26/08 – What a week; from feast to famine. The process really kicked in; I was able to produce nice clean shots of energy from it and was able to easily access old memories of health and their accompanying good body sensations. Aside from a general sense of feeling better I was at times able to feel substantial benefits for several hours following the sessions. It did feel like a new me was forming.

Then bang! Off went my ‘reaction’. For some reason every time I produce a clean shot of energy and really start feeling good shortly afterwards I fall apart; my joints start aching, I feel fluey, my concentration lags, I get lethargic, I feel jittery and whatever I’m doing stops working. Gupta strongly recommends meditation but that triggers this problem almost immediately for me.

I’d hoped that the Amygdala Retraining would somehow dig deeper and help me avoid this. Nothing to do now but ramp back; use the technique less and hope to slowly nudge my energy levels higher.

4/4/08 – I’ve done the Retraining at a lower level. That’s definitely helped – once I stopped that energy surge came back and I felt very good; that again is typical. Now I’m going to push back a bit.

One thing that’s gotten better, oddly enough, is my posture. At the end of the process you’re asked to feel the energy rise – when I do this I raise my arms and yes, I can usually feel the energy rise – I can actually feel it build up and up and my arms rise higher and higher and then I kind of play with the energy – I bring it up and down and out and across – its like a dance. It also pushes my arms back and up and relieves alot of stiffness that’s been built up in my upper back. My shoulders have definitely fallen and I think I’m breathing deeper.

I have been able to reach back and kind of re-integrate these old feelings of relaxation in my body. Often when I really connect with that old self parts of body starting twitching and kind of realigning themselves. Afterwards I feel centered. At times I feel some real strength.

Its hard to quantify where I am; I’m more relaxed, I feel more talkative, more comfortable in my body. My ability to exercise is perhaps slightly enhanced – I don’t notice a great deal of progress there. Exercise is, of course, the most difficult test. Real improvement there would be astonishing. From what I hear that can and does happen in this program and Ashok actually expects it to happen but I’ll just stay away from that – a bit too much for me to expect.

Nothing astonishing to report – just what appears to be slow progress. Perhaps the best indicator of the programs effectiveness is that I’m enjoying it more and there’s no question as to whether I want to keep doing it.

4/08/08 – Some good days! I’ve kept a low level of physical exercise – which has been good – and I’ve generated a bit of a reservoir of wellness. This allowed me to see CFS ‘in action’ several times. Once I exceeded my physical limits during a short walk. I was doing okay, went too far and as i did I could watch my muscles tighten up – as they did my mind went banana’s – shooting everywhere – and my breathing rate increased – and I felt absolutely leaden. It happened very quickly. It was like quickly entering into a dark world. It was like a physiological/mental breakdown. I was able to re-instate my sense of at least partial health by doing the Retraining Process.

It hasn’t only been during exercise, though, that I’ve noticed this process. I’ve noticed that negative thoughts can have the same result. The problem is in noticing they’re even there You need to dig a bit – or rather be more aware – to notice them. Dr Friedberg, a CFS patient himself, believes ME/CFS patients are hypersensitive to every kind of stress; physical, emotional, mental. This implies a nervous system that’s been put on edge, that’s always overreacting – to thoughts, to physical exercise, to everything. That certainly fits with Gupta’s Amygdala theory.

I wonder how much of my problem is simply my autonomic nervous system – part of the stress response system – going bananas – when I encounter very common stressors. The ANS controls our breathing – and given the recent episode I just described when my breathing rapidly became rapid and I subsequently felt absolutely leaden – I wonder just how much breathing plays in this disorder. I’ve long noticed that I hold my breath frequently.

When I get to the end of the process where you create the feelings of energy you had when you were healthy – while I’ve been able, at times to get back those good feelings of health back – I’ve never been able to get back to myself actually exercising. I can get myself back on my bike – but I can’t pedal. Nor can I imagine myself running or lifting weights. While I can get my energy to rise my legs and muscles still remain leaden. I wonder if I can get back to those actual memories of exercise if I’ll be able to actually exercise??? A fascinating idea. In this process are you somehow reintegrating these old circuits that haven’t been used or blocked off for years (decades?). What’s ticked this off are some short feelings of ‘strength’ I’ve experienced as opposed to just wellness or better health that I’ve experienced.

Three nights ago I didn’t get alot of sleep and two nights ago I got about 5 1/2 hours of broken fitful sleep. That would ordinarily wipe me out but I was surprised at how well I did – it didn’t really get to me until about 6 pm. I did the process yesterday and was able to build up energy throughout. By nightfall I was really jittery and this morning I was too – had trouble completing my sentences (or making sense) because I was so jittery. By the afternoon though, as I laid off the process I was feeling really well – with a feeling of health I haven’t experienced in a long time. This brought real hope – it was unexpected.

I should say that I’ve been using melatonin during much of the past week as well – and even if I sleep poorly I awake calmly – a real breakthrough for me. They’re both working basically.

4/10/08 – Another good couple of days. I laid off the program until the evening. I was dragging by then – but after I did the training and some meditation sessions I was feeling good – very good! – and that lasted for quite a while -remarkable. The training is definitely having stronger effects.

I talked with Ashok about my ‘reaction’ to energy. One of the things he suggested was that it was tied to anxiety. He suggested CFS patients were engaging in a natural process for someone who was ill – checking out how their body was doing – but that this process had decidely negative effects for them. He believes that simple check triggers an amygdalic over-reaction in CFS patients.

While I was meditating I tried to check this out and my sense was that it was true. It seemed like my ‘reaction’ was associated with a stress response triggered by an impulse that was way under the conscious realm. You’d never notice it unless you were really calm and looking for it.

4/13/08 – I’ve been hitting the program fairly hard – at least for me – doing several sessions of meditation plus the training several times a day. My energy levels are definitely up and my muscles feel relaxed. I seem to be doing well until someone talks to me and I blabber like an idiot from my mental jitteriness. I’m just trying to let this be – not resist it – and see if I can ‘float’ through this ‘stage'(?); bizarrer things have happened I suppose.

4/15/08 – A pretty good couple of days. This is the first time I can say I feel my energy has increased. I walked the dog several times without my usual consequences. It also clear to me that my sleep has improved; I’m not sleeping more but I’m waking up rather relaxed – which is very unusual for me. Am I feeling well? No, but I’ve definitely had several better days with regard to energy and sleep.

The jittery problem disappeared for a day and then reappeared in spades today. It’s just a bizarre problem – it generally happens when my body and muscles are feeling good and relaxed. I feel like I’m doing fine actually – no hint of a problem – I feel relaxed – and then I”ll talk to someone and I’ll babble like an idiot. This can be quite embarrassing but it doesn’t stop me at all because despite the embarrassment I actually feel like talking to people – so I go around chatting with people I don’t know well and cringing at times (and sometimes being quite lucid).

MCS and Amygdala – I’ve been wrestling with the MCS question. Specifically I wondered if I’m ‘catastrophizing’ (overtly dwelling on my symptoms and making things worse) with regard to MCS. I’ve never thought I was with CFS and its symptoms – I’ve always tried to push through them and I’ve always been fairly productive; i.e. engaged in activities of one sort or another – I don’t think I’m catastrophizing – although Gupta would probably suggest that I’m ‘being castrophized’.

But MCS is another question. I’ve definitely developed a habit of what I call ‘sampling’; that is, taking short breaths in and testing what’s in the air. It makes sense – you’re worried about the substances around you and so you check the air for danger – a completely normal reaction to that situation. I now know, though, that taking short breaths is not good period – that doing stimulates the stress response and doing so through my nose is probably particularly bad.

In Ashok’s scenario ‘sampling’ is out of the question – any focus on the body simply re-inforces the amygdalic stimulation going on. Indeed I noticed that ‘sampling’ did engage the stress response – when I do that my heart immediately starts pounding, my mind starts racing banana’s and I start to get anxious and my muscles stiffen up. On top of Ashok’s scenario there’s also the question whether one is stimulating the olfactory nerves leading to the brain when one is sampling. Some researchers believe these pathways are overly activated and that’s what’s causing MCS.

So I stopped ‘sampling’ as much as possible. I’ve decided that if some chemical is going to knock me on my butt then I’m not going to help it along by focusing on it. By and large it’s gone well. I still have my MCS problems; still can’t sleep even outside the house in San Diego (have to sleep in the car) and still have my various reactions but I’m thinking less about MCS. Perhaps what I’ve done is remove the stress factor from that process and that’s helped. Certainly the AR has helped turned down the stress component overall for me Will it fix CFS as well? Is CFS at its heart a stress disorder? Only time will tell in my case.

The Zen of Amygdala Retraining – Oddly enough Ashok told me that the best way to go through the process of getting better is to ignore it as much as possible. This is because focusing on how much better one is itself a source of anxiety. Thinking “Oh God I’m feeling better – is this it ?” is kind of a recipe for a crash. Why? Because when you do that you immediately check out your body to see if its true – and that sends the amygdala – which is on hyper-alert crazy.

This really rang true for me because I’ve noticed before that when those odd times when wellness has all of sudden showed up for its brief periods – that every time that I got excited and checked out how I was doing I felt terrible, just terrible – those feelings of wellness disappeared. Its like what they say about enlightment – every time you try to grasp it slips away – like a avocado pit through your fingers.

Of course this means that the best recovery process using Gupta is boring; this is a boring treatment regimen – if you do it right you don’t burst into health – you just slide into it.

4/23/08 – Had a couple of rough days due to poor sleep – the AR training has not eliminated my sleep problems – but even in the midst of my fatigue I felt a sense of strength – a feeling of solidity – that was new. I had a really intriguing session when my hands just like they were full of energy – like they were energy mitts.

Then I introduced some sleep hygiene into the equation. I’ve come to realize that if I get to sleep late- after 11:30 or so I’m not going to sleep well so for the past two days I’ve gone to bed 1/2 hour to an hour earlier and that really helped! Today I felt nice and calm and rested when I woke up.- which as I said earlier overall has been quite unusual for me. This after sleeping in the single cab of a compact pickup truck that can’t even begin to accommodate a 6’6″ frame.

The training sessions are going well – there was a part I was just glossing over; finally I got into it and it was helpful. I always leave them with increased energy and feeling of well-being. More and more I wonder how much of this disorder has to do with poor breathing. I catch myself time and time again – when something negative happens ( I check out how my body’s feeling or a negative thoughts comes floating along, etc.) holding my breath and feeling my muscles tense up and having this absolutely leaden feeling come over me. It does feel like a stress reaction.

So where am I two months into this program? Feeling hopeful about the future. When I have energy I feel I have more energy; when I feel down I feel like I’m less down. My body definitely feels better – there’s no question at all about that. I’m often commenting to myself about the little surprises; good feelings I hadn’t noticed before, being more naturally outgoing, more talkative, more coherent. etc. Since I got CFS I really felt my verbal abilities in particular got hammered and at times I feel much more lucid. I feel like I have actually increased my ability to exercise (walk) – not alot but there has been some progress in that area – which I regard as the toughest nut of all to crack. A couple of times I’ve raced the dog to the door – something I never ever would have done before – for some reason moving quickly has been so difficult – but I spontaneously did it. Tim not full of energy all day or even most of the day; I still have alot of fatigue – I’m still taking my frequent naps but I feel like my boat is slowly lifting.

So slow and pretty steady progress – I like it! I’m enjoying the program more than ever.

4/28/08 – This will be an interesting day. I got hammered last night. I’m in Las Vegas and have alot of difficulty sleeping outside the house at times. I could tell I was going to have trouble and I did. I tried to relax – tried to do a little Gupta – but it didn’t work. This follows a good sleep the night before in the desert and a terrible sleep the night before in San Diego when the Santa Ana winds swept in from the desert. There’s just too much junk in the air for me to sleep well when that happened and I woke panting several times and was wiped out the next day- which was busy one!

I’ve been doing more meditation. Besides calming me down and picking up my energy it has a nice side benefit – it picks up my almost vanished libido. Probiotics are the only other treatment that has any effect down there but meditation is much stronger. I think the meditative posture really opens up the pelvic area – an area I’ve felt has been kind of frozen for years. I think this is due to the uptight musculature and the inability to relax that has been so much a part of this disease for me.

I’m a consistent meditator but not a good one; it takes me a long time to get into a ‘settled state’. When I do get there – when mind and breath meld – often I feel a ‘strange stirring’ down below – a good incentive to meditate!

I’m definitely much more comfortable in my body than I was; it’s more relaxed, I’m breathing deeper – I even feel some strength at times – and what a change that is. At times before I felt OK but never strong. That inner agitation I associate with CFS seemed to preclude strength and calmness. The strength is also important because it makes me feel like I’ll be able to exercise at some point – which is, of course, the ultimate test. It also makes me wonder how far this can go – after all if you can build a small core of strength – then why not a big core? and ultimately full health? We shall see.

As I watch my reactions amore I wonder about the role anxiety (yes anxiety! but a different kind than you might think with the word), breath and stress hormones play in this disease. Could this slowed breathing/thinking pattern I’m getting into slowly be rejuvenating my body? Slowly washing away the negative effects of 20 plus years of CFS? Perhaps! (Never really felt that before. )

The big challenge right now is getting a good nights sleep. I’m going to have to be in the city for a couple of days. Given last night I’m not off to a good start.

Cort Johnson

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