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Guilt is another frequent companion of people with CFS and FM. We feel guilty about things we've done and about things we failed to do. For example, we may blame themselves for becoming sick. At other times, we may feel guilty about not contributing to the family or to society. 

True Guilt and False Guilt


If you experience guilt associated with CFS and FM, what can you do to ease the burden? One potentially helpful approach for reducing this source of mental suffering is to distinguish between true guilt and false guilt, and to use separate strategies for each..

True guilt is guilt that arises from the recognition that we have harmed others. One appropriate response to true guilt is to apologize and make amends.

Another is to use guilt as a motivation for change. For example, some people in our program say that they have used guilt over canceling out on commitments as an impetus to be more consistent in pacing in order to make themselves more dependable.

In sum, true guilt can be helpful is it motivates you to treat those around you with more consideration and to take better care of yourself in the future.

False guilt, on the other hand, is guilt triggered by things over which you lack control. This type of mental suffering is a negative feeling triggered by not living up to standards that are no longer realistic or because of things out of your control. Here are six ways to respond to false guilt. 

Adjust Your Expectations

Guilt is often triggered by a difference between a person's expectations and their capabilities. For example, some people with CFS and FM may feel guilty because they are not the parent they hoped to be or are not contributing to the family as they did before they became ill. You can reduce guilt by adjusting your expectations to match your new level of functioning.

Such guilt can be reduced by adjusting expectations to match you new level of functioning. As one person said, "I've lowered my standards for myself. This isn't easy, since I'm a recovering perfectionist."

When self-condemnation is harsh, some people find it helpful to imagine how they would react if they observed another person saying the same things about themselves. A person in our program said that she tells herself, "If I were caring for an injured loved one, in distress, how would I take care of her? I should treat myself the same way."

Reframe (Change Your Self-Talk)

Part of the process of adjustment is changing our internal dialogue or self-talk, so that it supports our efforts to live well with illness rather than generating guilt. 

One person describes how she has changed her self-talk about naps. In the past, when she took a nap, she told herself it was because she was lazy, but now she tells herself, "I am helping myself to be healthy. I am saving energy to spend time with my husband or to babysit my grandchildren." 

Similarly, when feeling tired, you can say "This fatigue is not my fault; it came with CFS. So I don't need to feel guilty about not being able to do everything I used to." Or: "I didn't ask for FM, so why should I feel shame when it prevents me from doing things." 

For instructions on how to recognize and change self-talk to be more realistic and more positive, see the article Changing Self-Talk.

When Feeling Guilty, Shift Your Attention 

Even if feeling guilty is inevitable, we can control how we respond when feelings of guilt arise. One person said that she asks herself "Is this feeling productive?"

In some cases, the answer will be "Yes." Guilt can draw our attention to ways in which we have failed to live up to our standards and can motivate us to act differently.

If the feeling is not productive, however, it may be better to respond to guilt by turning our attention elsewhere. As another person wrote, "It's better not to go some places in your head, so I've learned how to control my own thoughts."

Another said that when she is caught up in feeling guilt, she tells herself "this isn't my fault" or "these feelings will pass as long as I don't allow myself to act on them."

Educate Others (Within Limits)

Some guilt may be triggered by how others treat you. In addition to adjusting your expectations for yourself, you can work on changing the expectations others have of you as well. 

This involves educating the people in your life, emphasizing that CFS and FM are chronic conditions that impose significant limits and require adjustments of the person who is ill and those around her. For ideas on how to do this, see the "Educate Others" section on the Relationship Strategies page.

Learn Assertiveness

Another strategy for reducing guilt is to be assertive, standing up for yourself by stating what you will and won't do. 

For example, you can teach your family and friends to respect your need for regular rest breaks and can make your limits clear by telling others how long you'll talk on the phone, how much time you will spend at a party and so on.

One person in our program, wanting to strengthen her resolve to set limits with others, posts notes all over her house saying, "I'd love to but I just can't." The notes remind her what to say when people make requests. She says "seeing the notes so often ensures I remember to use this answer without feelings of guilt."

Practice Relationship Triage

A final strategy is to reevaluate your relationships, practicing what we call relationship triage: making explicit decisions about whom to include in your life, concentrating on the more valuable or necessary relationships and letting others go. 

You may decide that some people will never understand your condition or accept that you are ill. In some cases, you might choose to end a relationship. For relationships you decide are necessary, you might limit the frequency or length of contact.

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