Doing deeper psychological work can contribute to biological change. Learning to become aware of and express emotions may help to foster greater psychobiological regulation. Processing traumatic experiences updates the brain and wider nervous system that the threat has passed.

Interventions targeting the nervous system, the immune system, and the gut are likely to aid recovery. Developing a coherent understanding of what is happening in your body is likely to be important for recovery. Responding to symptoms with coherence and safety, rather than fear, can help reverse vicious cycles.

Certain personality traits have been observed in people living with ME/CFS and long Covid. For some, it may be useful to explore how these traits may have made them more vulnerable to ill health. Disconnecting from one's own needs may be better understood as a learned pattern than a fixed trait. One hypothesis is that disconnecting from one's needs undermines the brain's attempts to balance the body.

I’m proud to have been a co-author of a letter in response to a piece in the British Medical Journal on ME/CFS. The original piece attracted a lot of criticism, and so a group of people who have recovered from ME/CFS, along with clinicians, felt it important to make clear that recovery is absolutely possible, and that there is mounting science demonstrating possible biological mechanisms underpinning this.

The new science of predictive processing is prompting researchers to understand fatigue in a new way. Persistent fatigue may be the result of the brain's hyper-vigilance following multiple stressors. Positively, we can harness the brain's neuroplasticity to nudge it to become more flexible in its outlook.

If you are living with ME/CFS and long COVID, you may be asking: Why has my body gone into shutdown mode? A viral infection or another trigger may act as the final straw after cumulative stresses. The brain may then conclude that the body is unable to meet the challenges facing it. The brain may revert to a hyper-protective state. This may cause a lasting "sickness response" in the body.

Understanding the body's need for balance can help make sense of how things go awry. We can manage acute stress, but when stress becomes chronic, our bodies may become imbalanced.

We expect modern medicine to be able to make sense of our health difficulties. What then, when it fails to do so for people living with ME/CFS and long covid?

I was pleased to see contributions from fellow psychologists and other health professionals with clinical and lived experience of long covid in The Psychologist in January. However, I also noted that some contributors made some quite startling claims about the condition.

Counselling Directory just published an article I wrote, offering five reasons working with a psychologist or therapist can be helpful for those living with ME/CFS or long covid.

I was more than a little dismayed to read an article by Monbiot about ME/CFS in The Guardian back in October 2024. In the piece, Monbiot makes a clearly well-intentioned appeal for people living with ME/CFS to receive greater recognition and support. Monbiot wrote about the tragic death of a young woman with ME/CFS, Maeve Boothby O’Neill. Naturally, I second his sentiments on this.