Christina Surawy is a teacher and trainer at the OMF. She spent many years working with people with conditions such as Chronic Fatigue and IBS and developed therapies based on CBT and also MBCT. In this blog, Christina shares a review of the book ‘‘Mindfulness-Based Therapy for Managing Fatigue: Supporting People with ME/CFS, Fibromyalgia and Long Covid” by Fiona McKechnie.

I read this book with a great deal of interest. When I began it, I wondered what had changed in the field and what more could be said about offering mindfulness to those suffering with debilitating and poorly understood conditions like ME/CFS and Long Covid.

I was soon drawn in.

What is most striking is the compassion and deep understanding of the author. She clearly knows the population well and has many years of experience. I was delighted to meet her nearly twenty years ago and since then she has developed a mindfulness-based programme based on sound theoretical principles and clinical knowledge that will be a real asset to anyone working in this field.

We begin to learn more about the nuances of living with these conditions and how mindfulness can be helpful in bringing not only kindness and clarity to what is experienced, but the possibility of living in a different way with more choice and flexibility.

The book is divided into four sections with helpful summaries at the end of each. The first section sets out what we know (and don’t know) about Fatigue as a health condition and the principles of a mindfulness-based approach to self-management; the second outlines adaptations, practices and teaching considerations (all trauma-informed); the third discusses how to apply all of this in daily life, mainly through activity management; and finally, the course itself is outlined in detail.

We begin to learn more about the nuances of living with these conditions and how mindfulness can be helpful in bringing not only kindness and clarity to what is experienced, but the possibility of living in a different way with more choice and flexibility.

As one participant describes: “asking myself ‘what do I need now?’ reminded me to take care of myself and to meet any physical emotional or mental need that I would once have ignored’’ (p.237).

Many interesting ideas are discussed and I particularly liked the section on how mindfulness can offer people the possibility of moving from a ‘fixed identity’, which has been lost (“who am I if not a fit and active person?”), to a way of life in which joy and achievement can be experienced more readily through a process of recognition and letting go. In other words, a more fluid and open way of living.

Fiona also talks about the importance of adequate training and being part of a coherent and well-supported team, both of which are essential to offering mindfulness programmes to these groups.

The emotion regulation systems – soothing, drive and threat – are also a really interesting way of describing how people can get stuck and how becoming aware of which system is present can offer skilful choices. So, for example, a boom bust cycle of doing too much (drive system) alternating with crashing (which can activate the threat system) can be undermined by noticing what is going on and then choosing to slow down or rest or engage in a nourishing activity (soothing system).

There is also really useful discussion of the cognitive aspects that play out here, and examples of how participants can learn to relate differently and with greater friendliness to thoughts and feelings with the help of a skilful teacher.

The mindfulness programme itself is described in helpful detail in the last section, and is easy to follow. It even has timings! It is brought vividly to life by one of the participants, Rhonda Knight, who talks about her experience of the course and how it helped her. Usually this would be a few lines long but there is an entire chapter devoted to this story (CH 16).

Fiona also talks about the importance of adequate training and being part of a coherent and well-supported team, both of which are essential to offering mindfulness programmes to these groups.

Finally, what really struck me was the pragmatism of her approach. It would be easy to skip over the importance of contextual factors such as poverty, housing, family and job status. But Fiona repeatedly states that these need to be addressed otherwise mindfulness could easily be unhelpful. This to me is the mark of a thoughtful, compassionate clinician and teacher.

Mindfulness Based Therapy For Managing Fatigue: Supporting People with ME/CFS, Fibromyalgia and Long Covid, by Fiona McKechnie was published by Jessica Kingsley Publishers on 21/09/2023, ISBN:9781839973451

View on the publisher’s website

Author Bio

Christina Surawy is a clinical psychologist and accredited BABCP cognitive therapist. She has been involved in teaching, training and researching MBCT with the OMF via the OMC collaboration since 2008 and has been particularly interested in developing MBCT for other conditions e.g. health anxiety and IBS.