Recovering from post-COVID syndrome
This post describes my experience of recovering from post-COVID syndrome (PCS) using the JournalSpeak method. I am sharing this because I think it could be helpful for others suffering from PCS and other chronic conditions. However, I want to emphasize that I am not claiming that this method will work for everyone, and that I am not a medical professional. This is just my personal experience.
Last December I got COVID, and while most of my symptoms went away after a little over a week, the fatigue remained and new symptoms popped up. We had a move planned at the end of December and there were some work-related things I felt like I really had to do, so I kept over-exerting myself and crashing afterwards. Those crashes were quite horrible: on the worst days I could barely stand, had excruciating headaches, was over-sensitive to light, felt dizzy when doing anything and had terrible feelings of depression and anxiety. After the first time I got COVID I was also left with some post-viral symptoms, which were far less intense and gradually went away over the course of three months. So with these much more severe symptoms, I was afraid it was going to take me much longer to recover.
After about two weeks of yo-yoing between over-exertion and crashes, I learned about pre-exertional malaise (PEM) and the importance of pacing yourself. I started taking more rest, which helped to improve and stabilize my symptoms. However, this meant that I could do very little on a day. I was on sick leave at work, let my partner do all the household chores and barely left the house — I could perhaps walk 1000 slow steps spread out over a day. Every time I tried to carefully increase my activity, I felt worse the next day. After about two months of very little improvement, I started to feel desperate. It felt like my life was gone and it just wasn’t going to return any time soon.
This is when I remembered something I had heard a while ago on an episode of the Dutch podcast Damn Honey. A woman had written in to tell how she cured herself from PCS with a method involving journaling about your emotions, called JournalSpeak. Just like the podcast hosts, I was quite skeptical, and had half forgotten about it. However, while being sick I had read several books that mentioned the connection between auto-immune diseases such as PCS and post-traumatic stress. So in my desparation I decided to look into it a bit more.
The underlying (scientifically controversial) theory behind the method is called Tension myositis syndrome (TMS) and was developed by dr. John E. Sarno, initially as an explanation for chronic back pain. According to Sarno this pain is caused by repressed emotions, which the brain perceives as dangerous. In order to distract the conscious brain from these emotions, the autonomic nervous system decreases blood flow to certain parts of the body, resulting in pain or illness. According to Sarno, pain moving through the body is a particular sign of TMS. Not only chronic pain, but also other chronic conditions, such is migraines, IBS, and auto-immune diseases have been considered as possible TMS symptoms. By now, I have also read about similar theories that focus more on the effect of chronic stress caused by repressed emotions on hormones and the immune system, which might be a better explanation for auto-immune diseases like PCS.
This theory of a mind-body connection resonated with me for several reasons. First of all, as I mentioned I had already read about the possible link between PCS and trauma, and I definitely have some developmental trauma. Moreover, I already had some other chronic health issues, some of which came up during emotionally difficult times. I had also experienced post-viral symptoms before, not only after my first COVID infection but also after a common cold or flu virus. So to me it did not seem like what was happening in my body was linked specifically to the corona virus.
I decided to give the JournalSpeak method a try. It was developed by Nichole Sachs, who has worked with dr Sarno. The method is very simple: every day, you set a timer and journal for a minimum of 20 minutes about things from your past, current life, or personality that you find emotionally difficult. The most important part of the process is to express your emotions in a very unfiltered way, as you would not even dare to express them to a therapist. When the 20 minutes are over you do a short meditation to signal safety to the nervous system. The idea behind the method is that by allowing the repressed emotion to enter your consciousness, you teach the nervous system that these emotions are safe and that it is not necessary to cause physical distractions.
When I started doing JournalSpeak, I noticed change almost immediately. Most of my symptoms lessened, some became a bit worse, some new ones came up and I had quite a lot of anxiety. According to Sachs this is a normal initial reaction; the nervous systems panics and tries out new things. The most noticeable change was that my fatigue lessened (despite not sleeping well due to the anxiety), and that I didn’t experience PEM anymore. On day four of JournalSpeak I could go for a walk, did some household chores and worked on a job application, while a week earlier even one of those activities would probably have led to a crash the day after. I gradually built up my activity and felt my symptoms slowly dissipating. After about three weeks I started exercising again and resumed fulltime work, without noteworthy symptoms.
Some questions that arose with me or that I got asked:
Why does COVID trigger TMS? I have absolutely no idea — again, I am not a medical professional. Nicole Sachs thinks that it is the fear around COVID, but I think it is very well possible that the initial trigger that disrupts the autonomic nervous system is physical. There are more chronic fatigue syndromes that start after a viral infection or other physical event.
Is all long COVID actually TMS? Again, I don’t know. Probably not. I think more research into both the physical and psychological sides of PCS are necessary, and would really like to see a clinical trial of JournalSpeak. For now, I just know that the method has worked for me and several others, and since it is free and does not cost a tremendous amount of energy, I would recommend to give it a try if you think there is a possibility that you might benefit from it.
Does this mean that you actually experienced a burn-out? I don’t think so. The symptoms are different and the triggers aren’t necessarily things from daily life, it can be something from your past. To me, it seems closer to a physical manifestation of PTSD.
Why journaling and not another method to feel your repressed emotions, like therapy? According to Nicole Sachs, journaling allows you to be more unfiltered than you would dare to be with a therapist, and the writing process slows down your thoughts, including the brain reflexes that suppress certain thoughts. From my personal experience I can only say that I have gone through therapy, and although it was helpful in some ways, JournalSpeak was more effective in digging up repressed emotions. I do feel like therapy was a good preparation for JournalSpeak, as I already knew quite well which topics I had to write about. If you feel like you need the guidance of a therapist, I would certainly recommend exploring that option. I recently heard about ‘Intensive short-term dynamic psychotherapy’, used to treat both mental and physical problems, which sounds like a therapy equivalent of JournalSpeak and might be a different route towards the same goal.
Resources that I have found useful
Books:
Gez Medinger and Danny Altmann, The Long Covid Handbook (Cornerstone 2022).
Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Penguin Books 2015).
Gabor Maté, When the Body Says No: The Cost of Hidden Stress (INGP 2013).
Pete Walker, Complex PTSD: From Surviving to Thriving (Azure Coyote 2013).
About JournalSpeak:
Nicole Sachs has a website with a short JournalSpeak instruction and links to many resources. I have found her podcast The Cure for Chronic Pain with Nicole Sachs, LCSW particularly helpful. See for example the second episode in which she explains the basics of JournalSpeak, or the episode in which a woman called Lieke (who is not me!) talks about her recovery from long COVID.
