The Four Phases Of Chronic Illness

The Four Phases Of Chronic Illness | Solve ME/CFS Initiative

The following is an excerpt from the updated, 2012 edition of The Chronic Illness Workbook: Strategies and Solutions for Taking Back Your Life by Patricia A. Fennell, MSW, LCSW-R.

The Four Phases

the four-phase model does not assume that you will eventually be cured. Instead it seeks to integrate your illness into a different but meaningful life.

…unlike the traditional medical approach, it also uses palliation as an active treatment option.

Often health-care workers believe they are providing palliation when they reduce physical symptoms. But true palliation actually includes the relief of suffering in the psychological and social aspects of the patient’s life as well as in the physical aspect

The phase model recognizes that you are liable to be thrown back into earlier phases when new and unforeseen crises occur in your life. … It’s also important to remember that you experience each phase in three different areas. Changes occur in your physical life, in your psychological life, and in your social and work life

Phase One: Crisis

Phase one is characterized by crisis and chaos. In this phase you move from the actual onset of your illness to an emergency stage that usually forces you to seek some sort of relief.

Phase Two: Stabilization

In phase two, you have reached a plateau of symptoms, and because they stay more or less the same, they become familiar.

You usually keep trying to behave as you did before you got sick, and this attempt frequently leads to relapses. These are very upsetting and feel like personal failures.

Phase Three: Resolution

Phase three may bring a plateau of symptoms or you may have relapses

You’ve also finally learned that you can’t be the person that you used to be before you got ill. This can be a devastating perception, one that can makes you experience a “dark night of the soul.”

Phase Four: Integration

In phase four, you may experience a plateau of symptoms or periodic relapses, but you’re now able to integrate parts of your old self from before the illness with the person you are now. …locate your illness experience within a larger philosophical or spiritual framework

In total integration, you arrive at a new, whole, complete life, of which illness is only one part, even if it is an important part.

Five Capacities of Improvisation | Solve ME/CFS Initiative

Applying the techniques used in acting improvisation, here is a fresh concept to guide us as we integrate our chronic illness/pain into a new way of living.

Improvisation, the skill of top artists, can offer new ways to respond better to change (including the vast numbers and variety of life changes caused by CFS, fibromyalgia, or any other chronic illness)

In improvisation, we use our existing knowledge and skills to create something new in an unplanned, innovative way.

Instead of trying to drag our old identities through a now painful and exhausted life, let’s just start over.

Tolerate Ambiguity: This capacity recognizes that ambiguity is unavoidable and it’s possible to survive in spite of not knowing what lies ahead. Here, people take the time and allow themselves to feel uncomfortable in order to get where they need to be.

Become Curious: This capacity understands that change is an opportunity and that curiosity leads to innovation and change

Take risks: Risk taking can be very difficult for many people. The very act of “sticking your neck out,” intentionally engaging in activities without a certain outcome, is uncomfortable

Take action: To improvise – to respond in the moment to present circumstances – requires making a choice to take action. This statement or choice results in an action. This action then produces a reaction, to which you must then react, and the cycle continues.

Innovate: Once a person has been curious, taken risks, made choices, and taken action, innovation is the result. It’s important to recognize that the result – an idea, a paragraph, a picture, a song – whether small or large, is a victory.

Using The Five Capacities To Respond To Change

An attitude of persistence and fortitude is a key element of the five capacities. This willingness to fail is crucial in developing the self-reliance and resilience in the face of change, trauma, and crisis that are integral with the chronic illness experience.



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