Guilt is another frequent companion of people with CFS and FM. Sometimes people blame themselves for becoming sick. At other times, guilt is triggered by the sense of not contributing to the family or to society. 

If you experience guilt, what can you do to ease the burden it imposes? Here are seven strategies to consider.
 

Adjust Expectations

Guilt is often triggered by a difference between a person's expectations and their capabilities. You can reduce guilt by adjusting your expectations downward to match your 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." Another wrote 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 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 baby sit my grandchildren." 

Another said that she used to think of scheduled rest periods as "doing nothing, a waste of time," but now sees them as "part of a cure to my symptoms, just like taking a medication." 

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 Taming Stressful Thoughts.
 

Shift Attention 

Feeling guilty is inevitable, but 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. (See next strategy.) 

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." 
 

Apologize and Make Amends

Guilt can be helpful if it motivates you to take better care of yourself in the future and to treat those around you with more consideration. One person said that if she does something to hurt her husband or her children, like lashing out at them verbally, she apologizes. 

Others say that they have used guilt over canceling out on commitments as an impetus to be more consistent in their pacing, making themselves more dependable. 
 

Educate Others

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 long-term 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 "Educate Others" 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. 

One person in our program 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. 
 

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