People with chronic fatigue syndrome frequently face difficulty recognizing their condition as a disease. In my practice, every day, I repeatedly hear that the complaints and symptoms of my patients are not taken seriously in the professional environment and their circle of friends.

Only very slowly does a rethinking take place here. Thankfully, there are good results in working with my patients, which recent research has confirmed.

I have developed this self-help program, especially for people who have difficulties or cannot attend treatment in practice or any health institute. Above all, this program is about breaking through the feeling of being helplessly exposed to this disease at the mercy of others.

This method is, of course, by no means a substitute for medical treatment. Therefore, if you are already undergoing medical treatment, please talk to your doctor about best integrating this self-help program into your treatment plan.

The seven steps self-help program contains:

Seven theoretical chapters will inform you about the scientific basics of fatigue disease and information on practical laboratory tests. Additionally, it provides hints for dealing with evaluation processes in disputes about recognizing your severely handicapped status and pension procedures and mental techniques to strengthen your coping mechanisms while dealing with the chronic disease.

In the accompanying correspondence, you will find the following:

-a self-observation guide in form format;

-a guide to Amygdala Retraining, in other words, mental exercises for calming the amygdala;

– instructions for a scanning program to sharpen the perception of your own body;

-a guide to a more benevolent approach to self-acceptance for self-protection against resignation and frustration;

-a manual for Progressive Muscle Relaxation Training (PMR) adapted, according to Dr. Jacobson, for fatigue patients;

-a guide to a breathing technique that calms the parasympathetic nervous system;

-a manual about pleasure training according to Dr. Lutz;

-a guide to a phased activity training to strengthen positivity in your everyday life; and

-a guide to nutritional science findings for fatigue patients.

The Seven Steps contains information about mental and cognitive methods and further information you can initiate yourself to influence ME/CFS Symptoms positively.

Read through these steps, perhaps one at a time and at your own pace. You may then return to one of the steps over the next six months if this is mentioned in the accompanying e-mails you will receive every week.

Indeed, these weekly correspondences are the therapy program. They are designed to guide you step-by-step in the process of again being the captain and creator of your life, as opposed to being helplessly subjected to and controlled by this chronic illness.

Feel free to share the Seven Steps information with your loved ones and attending physicians and therapists.

Yours sincerely,

Prof. Dr. Michael Stark

Patients often have had a large number of visits to the doctors. The doctors could not diagnose CFS/ME and, therefore, have not initiated any treatment.

Check your symptoms with the “Canadian Interview.”

Dealing with the examining doctors

In the case of CFS patients, the usual previous diverse findings typically do not contain any somatic (physical) indications. Instead, doctors suspect a diagnosis of a somatization disorder or a depressive episode. The problem is that the doctors’ evaluations are usually carried out purely as a cross-sectional examination or only examine the previous findings. As a result, no findings point to the way forward. The neuropsychological tests usually yield average to slightly below-average results.

From these facts, it is then concluded that CFS patients should be able to work at least 6 hours a day. If anything, they are granted an impairment due to psychological reasons.

In these assessments, without prior knowledge of CFS/ME clinical pathology, it is overlooked that the usual statistical determinations cannot do justice to the endurance abilities of the patient’s situation.

The determining and significant factor for an appropriate assessment of CFS patient performance is that the individual symptoms are often subject to extreme fluctuations within a short time. These are performance-limiting. On the one hand, it does not consider the environment in which the person is acting. On the other hand, it is unsuitable for defining adequate limits for such complex symptoms, which fluctuate enormously within a short period without recognizable causes.

The fundamental dilemma with CFS/ME disease is that patients can produce nearly average performance. By using up energy for both cognitive and physical/muscular performance, the system’s resources are depleted to such an extent that the exhaustion phase, during which the previous version can no longer be accessed, lasts more than 24 hours and sometimes several days, depending on the intensity of strain.

These functional impairments and performance loss cannot be systematically perceived or detected in the usual cross-sectional assessment of CFS/ME patients. Therefore, expert statements of evaluation that do not explicitly consider this aspect systematically lead to an incorrect diagnosis.

The explanation for this incorrect diagnosis is that doctors, who are unfamiliar with CFS, misinterpret the diverse symptoms from previous findings. This is done so that the doctors attribute the symptoms more to a common somatic disorder or a depressive illness, both of which do not exhibit the phenomenon of sustained exhaustion after exertion, which automatically leads to the lack of regular and continuous availability of energy. Based on these assumptions, the doctor concludes that the CFS patient can perform/work in everyday life.

In the case of CFS patients, experts repeatedly argue that those affected either exaggerate the complaints or deliberately make too little effort during examinations. The most sweeping criticism is that the CFS clinical picture is not scientifically proven and remains confined to a few outsiders. This only reveals the scientific literature’s ignorance or lack of information.

Diagnostic guidelines have been developing since 1994 (Fukuda) and are continually adapted to current research findings. Consequently, the disease was included in the International Classification of Diagnostic Diseases as a “Neurological Disease.”

Laboratory and imaging tests are only used to exclude other diseases since a definitive diagnostic test does not exist. As a result, such tests do not provide any indications of the cause or therapy for CFS disease but only help the detection of comorbidities.

Given the current state of medical knowledge, it is by no means a question of selecting highly differentiated test procedures proving the disease and pointing to the disabilities caused by it, in particular work-related performance. Instead, the diagnosis is based on scientifically elaborated interviews and the plausibility check of CFS pathology.

If CFS/ME disease is suspected, this phenomenon of sustained exhaustion, lack of energy, and, thus, unpredictable efficiency must be considered. Indeed, it is the main symptom in terms of diagnostic criteria.

To that extent, the examining doctor’s pre-conception of CFS/ME’s existence or medical credibility of CFS/ME determines its evaluation results.

A commission set up by the Centers for Disease Control and Prevention (CDC) was mandated to review the diagnosis and specificity of the disease, differentiating it from mental and neurological conditions. This commission concluded that CFS is initially not a mental disorder. Additionally, the commission found the term “Myalgic Encephalomyelitis” misleading since encephalomyelitis is an inflammation of the meninges, which cannot be diagnosed with the usual head CCT or MRI. Furthermore, this suggests that Myalgia (muscle pain) is not the core symptom, although present. Is not the core symptom

After reviewing all research findings on this topic, the committee concluded that the reported core symptoms indicate a failure in signal transmission structures, whether nervous, hormonal, or immunological. This is the only way to explain the massive limitation in performance (especially in repeatability) and the limitation in the lasting availability of energy to perform.

This overexertion of the physical “information system” physically, cognitively, and emotionally affects sick people in all organ systems (a basis for diagnosis) and all aspects of their lives.

The Commission, therefore, recommends a new name more appropriate to current scientific findings: Systemic exertion intolerance disease (SEID). 

Chronic stimulation of the warning function of the amygdala (danger warning sensor) in the limbic system (emotional processing center) leads to chronic stimulation of the vegetative nervous system via the pituitary-adrenal cortex stress axis. The result is a chronic imbalance of the sympathetic and parasympathetic nervous systems, further diminishing the recovery function via the parasympathetic nervous system. This leads to changes in the chronobiological structures. Regular cortisol release changes. The daily rhythm of the cortisol level adjusts at a high point. This leads to the absence of evening relaxation necessary for recovery and REM sleep with the effect of soon-to-be perceived sleep disorders. In addition, the high cortisol level accelerates the metabolic system, which leads to thermal overheating. This is experienced more drastically at night, such as unexplained sweating. This results in increased permanent tension in the muscular system. If chronic stress persists, the chronobiological rhythm changes, whereby the cortisol release during the day stabilizes at a low level and a higher level in the evening.

As these processes progress in a vicious cycle, in terms of neurobiology, they encapsulate the amygdala from the regulating systems – hippocampus (movement) and frontal brain (reason). Thus, the body system retreats into a flight or fight mechanism.

This sets autonomous processes and mechanisms in motion. The frontal brain no longer controls these. Psychologically, this process is perceived as diffuse fears and feelings of paralysis regarding intentional willingness to perform. Somatically, it is experienced as the narrowing or tightening of the heart and tightening of the muscular system resulting in tension and diffuse pain. Further consequences are in the respiratory parameters, a system that has to adjust to seemingly dangerous situations as the amygdala feigns, causing the need for more oxygen. This leads to increased oxygen demand; the breathing volume increases over increased breathing rate. Shortness of breath occurs, and the pulse rate rises.

Meanwhile, there are first indications of effective treatment methods for CFS at the research level. The persistent pain, which is also partly resistant to analgesics, and the massive exhaustion lead to a deficit structure and reduction of the daily range of movement and training and a widespread avoidance of rapid movement. As a result, the natural ability of the autonomous nervous system to regulate decreases to the disadvantage of the parasympathetic system. The sympathetic activation increases due to the psychological effect of the negative evaluation of the life situation and the threatening symptoms perceived by the patient, which, according to the literature, are to be interpreted as an existential physical threat.

The patients are unable to access their usual performance level. They are confronted with many somatic complaints for which the doctors consulted have no well-founded explanation or therapy approach.

Commonly, patients are dismissed as having a psychological disorder, which is a far-reaching stigmatization. This isn’t very comforting. A secondary vicious circle of anxiety and thread is starting right now.

We have developed a unique therapy program based on the new scientific findings, which have also led to a reformulation of the concept of this disease. This CFS therapy program rests on two pillars:

• • Psychotherapy is phased according to the clinical picture to restore the patient’s trust and ability to act by providing a conclusive explanatory model (psyche).

• • Restoration of the regulatory abilities of the autonomous nervous system (body)

Specialized therapists at the doctor’s practice carry out the CFS therapy program. However, there are exercises that the patient can do independently at home. The Seven Steps provide the necessary background knowledge. The weekly emails accompany you with helpful hints, tasks, and training for half a year.

With the proven methods from CFS therapy by Germany’s renowned CFS expert Prof. Dr. Michael Stark, you can regain more strength and zest for life. In “Seven Steps,” the body can find strength, the soul courage, and the whole person is helped back into everyday life. The “Seven Steps” summarizes the theoretical basics. You will find the concrete therapeutic instructions in the weekly accompanying correspondences for about six months.

Learn more about Prof. Stark and how he became interested in CFS.

“The Seven Steps”: proven methods from the CFS therapy program of Prof. Stark

People with chronic fatigue syndrome often find it challenging to recognize their condition as an actual disease. In my daily practice, I repeatedly hear my patients’ grievances that they are not taken seriously in their professional environment and circle of friends. Only very slowly is a rethinking taking place here. Fortunately, there are good results in working with my patients, which confirm the newest research findings.

I have developed this self-help program, especially for people who find it difficult or impossible to come to the office.

• All booked contents (The Seven Steps) can be accessed online anytime. Whenever, wherever, and as often as you want or can.

Of course, this online self-help program cannot substitute for medical treatment. If you are already undergoing medical treatment, please discuss with your doctor how these services can be integrated into the treatment plan.

You don’t have to work alone: Get yourself help!

Remember, with all the work coming your way; you are not alone! Ask your God/Creator to send his guardian angels to your side if you have a religious approach. If not, connect to the standard healing energy of all people facing this path. With such a sense of security, it is easier to motivate yourself repeatedly.

Your body is not the enemy.

Remember that your body is not your enemy but a marvelous wonder. It always tries to help you, sometimes quite drastically and, admittedly, awkwardly. However, the amygdala is not intelligent and not up to date and can only provide you with its old reactive patterns – fight or flight. You have to initiate the differentiation with your intellect/mind.

Finding a new and more benevolent self-conception

After decades of experience with people suffering from CFS, only those who could develop a new and more benevolent self-image successfully followed this path. When the time came to say final goodbyes, they said, “I am no longer the same person that I used to be; I had to reinvent myself.” Most of them did not return to their old professions as they had freed themselves from the inner slogan that earlier guided their lives. These slogans included: “Work before play/pleasure,”; “A true man knows no pain,”; and “Not to be scolded is praise enough.” Now they could again say: “I can feel and enjoy the sun again, not just see it.”

I wish you the necessary strength to help you stay on track. I will be happy if these guidelines and illustrations make this path easier for you.

Your Prof. Dr. Michael Stark

I specifically developed this method for CFS patients to support them during treatment and positively influence the course of their treatment. To alleviate your suffering, you can now benefit from my many years of experience in the treatment methods I use daily. The Seven Steps contains the essential information and the latest findings from cognitive behavioral therapy on restoring the balance of your autonomous nervous system and achieving better regulatory abilities. This includes a variety of techniques on how we can curb our sympathetic nervous system (the stimulator/exciter) and how to strengthen the parasympathetic nervous system (the erector and the repairer).

This regaining of the vibrational ability of our autonomous nervous system is an essential requirement for strengthening the self-healing powers of our body. Take time to read through all these steps. The accompanying weekly emails are similar to the weekly therapy sessions in practice. They contain the respective tasks for the Seven Steps and should encourage you to persevere. I do not want to promise you a cure; nobody can guarantee that. But I can say that with my Seven Steps method, you will gain a new perspective on regaining self-competence in dealing with the illness.

You can book the “Seven Steps” here. All courses are available online for your PC, mobile phone, or tablet anytime and as often as you like or can.

• After the booking, you will receive your access data by email and can log in on my website. No installation is required, and the whole program is immediately available. Go to START in the header bar and enter your email address and password. A list of the courses you have booked marked with a green arrow will be shown. In the Seven Steps CFS Course, you will see a list of the steps you can successively access. Just click directly on the respective stage to repeat a specific action. If you have any further questions, please do not hesitate to contact us at contact@prof-stark-selbsthilfe.de

With this easy-to-understand, small exercises you can do comfortably from home, you have proven help available anytime. You do not need any previous knowledge and only about 5 to 10 minutes daily, at your pace and according to your strengths and possibilities.