Willpower in ME/CFS and FM

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By Bruce Campbell

We often think of willpower as a moral quality but recent research suggests it's more like a muscle, which can be strengthened by use. This new view coming from experimental psychology has practical implications for people with ME/CFS and FM.
 

Willpower and Energy

Recent research* has shown that the amount of willpower available to a person at any given time is limited and closely connected to physical energy, measured as the amount of glucose in the bloodstream.

Willpower gives people the strength to persevere, but self-control declines as energy is used. Willpower is depleted through physical and mental activity, through stress and mental conflict, and through the body's using energy to fight illness. Once energy is depleted, a person finds it hard to think, is easily irritated and experiences emotions more intensely. Sound familiar?

Willpower is restored through rest and food. And, research suggests, even though willpower is limited, it can be increased over time through the practices described below. Some strengthen the willpower ‘muscle', while others are oriented to conserving energy.
 

Willpower Workouts

One approach researchers have taken to strengthen willpower has been to test various kinds of disciplined exercises. These have included working on posture (having people remind themselves to sit and stand up straight), beginning an exercise program, improving study skills, and improving finances through budgeting.

The results were doubly surprising. First, all the experiments were similarly effective; whichever exercise people had done, their stamina was increased, suggesting that disciplined activity was generally useful.

And, second, the gains carried over into multiple areas of people's lives. Research subjects gained benefits in areas of their lives that had nothing to do with the specific exercises they were performing.

The bottom line: focusing on one specific form of disciplined activity will lead to a general increase in self-control. For people with ME/CFS or FM, this might mean things such as getting dressed every day, setting weekly goals or doing crossword puzzles or other exercises to strength the mind.

Rules & Habits

Researchers have found that self-control is most effective when used to establish good habit. It takes willpower to create good habits, but once they are established, life proceeds much more smoothly.

This was shown in a study of two approaches used by professors seeking tenure. Those who wrote research papers quickly near a deadline were less successful in getting tenure than those professors who worked at a steady pace over a long period. The lesson: use self-control to form a daily habit and you'll produce more with less effort in the long run.

Research has also shown the value of rules stated in an If/Then format. In this strategy, the idea is to create highly specific plans for certain situations. The plans take the form of If X happens, I will do Y. The power of this approach is that it transfers control to an automatic process and thus reduces your expenditure of precious energy.

Some examples of It/Then rules from people in our program include:

• If I've been on the computer for 20 minutes, then it's time to take a break.
• If it's 11 am, then it's time for my morning rest.
• If it's 9 pm, then it's time to start getting ready for bed.
   

Avoiding Temptation Through Pre-Commitment

One way that people get pulled outside their limits is by giving in to the temptation of doing something that seems appealing at the moment. One strategy for handling temptation is to reduce the likelihood of giving in by taking action before the temptation arises.

The classic example is what Odysseus and his men did to get past the deadly songs of the Sirens. Odysseus had his men lash him to the mast and told them not to untie him no matter how strong his pleas. His men plugged their ears with wax so they couldn't hear the Sirens songs.

In a more mundane example, people in our program set limits on how long they will talk on the phone or get together with others, communicate that limit before or at the start of a phone call or meeting, then enforce the limit when the time is up.

Some people who are tempted to check email any time they are near their computer and then end up spending an hour online, use the pre-commitment strategy of turning off the computer except during certain hours of the day. Others set their computer to turn itself off after a certain amount of use or limit the sites their can visit. (For one tool to limit access to distracting websites, see www.rescuetime.com.) 
 

Stop & Choose

Another way to avoid giving in to temptation is to stop before you act and realize you have a choice. One person in our program carries a card in her purse to remind her of the consequences of overactivity. On one side, it says "What's the Trade-Off?", meaning what would be the price for taking an action. The other side reads "Just Say No." (An alternative to the second part is to ask: "Am I willing to pay the price?")

Another person visualizes how she would feel if she went outside her energy envelope. She says, "Imagining the fatigue and brain fog provides a counterweight to the immediate pleasure I anticipate from doing something that takes me beyond my limit." A third person has sayings she uses to remind her of alternatives, such as "I can finish this task and crash or listen to my body and stop."
 

Support

Research supports the idea long championed by AA and many other programs: you are more likely to succeed if you surround yourself with people who are committed to helping you.

In a study of alcoholism, researchers found support helped to predict whether people would remain sober and how serious relapses would be. The people who were better at getting support ended up abstaining more frequently and doing less overall drinking.

People in our program have used three strategies in their effort to find support. The first has been to educate those closest to them about ME/CFS and FM. Many report that their efforts took time. Sometimes it took a period of a year or more for their efforts to bear fruit, so patience and persistence were important.

A second strategy is to let go of some relationships. A particularly memorable example was provided by a college friend I saw a reunion. She told me that she had FM but had improved substantially in the previous year. Asked why, she responded "I divorced my husband." Her solution was not her first response to a marriage gone sour, but ending a relation may be the best solution in some situations.

Last, many people with ME/CFS and FM build new sources of support, which can include other people with ME/CFS and FM, and also professional support. The power of the former is suggested by comments we often hear in our classes, including "It's so good to feel understood," "I don't feel alone any more" and "It's so good to know that others experience the same things I do."

*The summary of research in this article draws on Ray Baumeister and John Tierney's book Willpower: Rediscovering the Greatest Human Strength (New York: Penguin Books, 2011)