Role of Thoughts

Thoughts, emotions, behaviours, and physical sensations are interlinked, and can impact on each other. For example, if you see that you need to tidy the house and you think “I should do that, it’s up to me”, you might feel determined to do so. As a result, you may decide to do it all in one go, or to not stop even if you feel tired. Unfortunately, the consequence of this might be a flare-up of your ME/CFS symptoms, perhaps you feel exhausted or in pain, and it might leave you feeling frustrated or guilty for pushing yourself too far. This then makes it even harder to be active in the near future.

Similarly, if you think “I should tidy up, but what if I don’t have enough energy, I’m useless” you might feel angry, frustrated, or anxious. If you are unable to tidy up, you might feel guilty, or low, and might criticise yourself.

These distressing emotions and feelings are linked with activation of your sympathetic nervous system, which is responsible for our “fight or flight” response (which is often already more active in people with ME/CFS  (see our fatigue pie ). When this system is active, it can leave you feeling tense, breathless, increasing your heart rate and other physical sensations. These changes in your body can contribute to your ME/CFS symptoms, leaving you feeling more fatigued, or in pain, and less able to do an activity. You may feel hopeless or overwhelmed, and then be more likely to think “I won’t be able to do that” or criticise yourself moving forward.  

In this way, when you “buy into” or get hooked by your thoughts, you can get stuck in a vicious cycle between them, your feelings, your behaviour, and ME/CFS symptoms. This can make your symptoms worse and continuing to be hooked by these thoughts can team up with symptoms of ME/CFS to get in the way of the life you want to lead. The video below shows you how difficult thoughts and feelings can ‘hook you’ and impact on your life.  

  • What can we do about unhelpful thoughts?

    It feels natural that when you have an unpleasant, unhelpful, difficult, or negative thought, we often want to simply get rid of them or push them away. It can also be easy to buy into these thoughts and see them as a reality. However, these ways of dealing with difficult thoughts come at a cost. When the strategy does work, the battle does not end there, as there are more difficult thoughts that can come up in the future. This means that you have to keep struggling with these thoughts, and this can quickly become exhausting. At other times the same thoughts may simply come back no matter how hard you try to push it away or resolve it.

    An alternative for dealing with these thoughts is a technique called defusion that comes from Acceptance and Commitment Therapy. Put simply, this means ‘unhooking’ from your thoughts and creating some distance or space from them, reminding yourself that they are just that…thoughts. This also means you can free up energy from the struggle with thoughts, and use that energy for something more helpful or important to you.

  • How can I unhook from difficult thoughts?

    The first step to unhooking from thoughts is to notice them and the emotions that come with them. Try to notice the meaning those thoughts have for you, in that moment.

    Practising mindfulness skills can help you learn to do this more easily.


    Once you have identified difficult thoughts and feelings, you can unhook by trying some of the defusion strategies below. Some strategies may feel more helpful than others, and you can try them out to find the right ones for you.

    • Try and remind yourself that thoughts are thoughts, not facts, by adding the words “I’m having the thought that…” For example if you had the thought, “Fatigue is dictating my life” you might say to yourself, “I am having the thought that fatigue is dictating my life.”
    • You could try giving your mind a name, like ‘Bob’ or thank your mind for sharing its thoughts with you.
    • You could try singing the thought to a funny tune, for example Happy Birthday.
    • You can try repeating the thought to yourself, again and again. For example, if you say “Milk”, at first you will have an image of milk, a white liquid. After a while, you will likely notice how the images fades away, and the word loses meaning. If you apply this to your thoughts, you can start to rob the thought of its power.

    Remember, these strategies may not get rid of the thoughts, or stop them from coming back. However, they can give you space from them, enough to live your life and focus on what is important and your values.

    You can read more about the role of emotions here.