How To Decode & Conquer Your Fatigue

Life can be pretty bleak, life can look pretty bleak. And just living with a chronic health symptom can be traumatic. One of the things you will learn in this interview is that there is no one magic pill. I know, I am sorry. There is no one answer, no one solution. By the time you have a chronic symptom, there are multiple components that have contributed to the development of that symptom. Trauma being one of them, and whether it contributed to its origin and its development or because living with it has been traumatic, trauma is now one component that needs to be addressed. Let me say that again to make sure you heard me. When we have a chronic health symptom there is no one magic pill, there is no one solution because there are multiple components that cause the development of it, and now it’s ongoing maintenance of it. And when we look at what is our path to healing, we are not going to be looking for just that one thing. We are going to be looking at what are all the different components that I need to address and that is what you are going to learn in this interview. One of those components is going to be trauma. Why? Because trauma perhaps was one of the contributing factors to you developing this chronic health symptom that is to be discovered. But even now that you have a chronic health symptom, because living with it is traumatic, trauma needs to be addressed, and the trauma component needs to be addressed. 

But what I want to share with you is a word of caution. Because what I did myself and what I see many people doing is with good intentions, doing trauma work but in the wrong way. And what do I mean by the wrong way? Even the right things but in the wrong order is still the wrong way. What will happen if you do trauma work in the wrong way and you have a chronic health symptom. You will experience a worsening of symptoms and you will experience a flare-up of symptoms. For me, it would be a flare-up of chronic fatigue, for me, it would be a flare-up of my autoimmune inflammation stuff. Whatever your chronic health symptoms is, and maybe for you, it is sleep, maybe for you, it is your gut, maybe for you, it is brain fog, but you will experience a flare-up of that when you do trauma work in the wrong way. And again in the wrong way can even mean the right thing but in the wrong order. This is why I teach a master class on the essential sequence for starting to address trauma. I can not stress how important it is that you know the right order of things, the essential sequence. Because if we do it in the wrong way it will cause a flare-up of our symptoms even including chronic pain, any of our chronic health symptoms, maybe you have had that experience. You can find a pocketbook guide to the essential sequence on my website. And in fact, let me just share that with you here. If you go to the website traumahealingaccelerated.com, this is the home page and you scroll down and into the trauma healing resources, here you have at the bottom of this list the essential sequence guide. This is going to walk you through why the essential sequence is the essential sequence for addressing trauma. Now, this is different than addressing stress, this is addressing trauma, so that is the essential sequence for addressing trauma. 

The essential sequence is safety, support, and then expansion. And here is what many people do wrong, they try to do expansion first which will always be too much too fast for the body. And too much too fast is a definition of what triggers the trauma response. Even good things can trigger a trauma response in the body when it is just too much too fast. We have to have the foundation. And when we have that foundation of safety and then support, we can move into expansion and have it be manageable for our body. And how would we know that? We do not experience a flare-up of our chronic health symptoms, in fact, we actually start to experience resolution of those symptoms. What are examples of expansion? So glad you asked. Processing our past, processing our childhood, analyzing our childhood, talking about our events, talking about our traumatic events, processing those psychedelic works. A lot of therapeutic modalities are actually expansion in their nature and they need to have that foundation of safety first and then support to be able to have that expansion be in a manageable way without causing flare-ups of our chronic health conditions. In that guide, in that essential sequence guide on my website, and let me just share that with you again. In this guide, the essential sequence guide, download this guide because in this guide, I share with you, why safety, why is safety the first step, why is support the next step. And what do I even mean by those? Because it is probably not what you are thinking. 

But when we experience a flare-up we need to listen to our bodies. And in fact, if you are not sure if trauma is a component for your chronic health condition when you experience a flare-up after doing some form of therapy, that is one way to know, to identify, I have got a trauma component to my health symptoms. Now, I hope that you do not have to do that in order to learn about a trauma component. I am here to help you not have to do the mistakes that I made from my body but be able to teach you those things so that you can have a faster path to healing than what I did. But we have to do safety and then support. And this is why I created the 21-day journey to lead people through this process of laying this foundation of safety, then support, and then the tools for expansion to help make sure you are doing it right. What you think are just simple somatic or mind-body exercises and the 21-day journey are actually starting to change your biology, change your physiology. How do I know that? Because of the physical health symptoms that people experience when they take the 21-day journey. I am going to show you here that when people go through the 21-day journey, they are experiencing changes in their physiology. I am not addressing anything in regards to supplements, diet, lifestyle, biology, labs, testing, nothing in the 21-day journey yet. Because as you will learn in this interview that is not where we start but already just with this mind-body connection, the somatic exercises. Look at this, 26% decrease in daily physical pain and actually, I need to update these numbers because this number actually should be 28% decrease in GI symptoms and a 28% decrease in sleep issues. This is evident that this mind-body connection, this somatic work is actually changing your biology, changing your physiology. And we use a word in this interview called regulation which will provide you the clues as to why that is happening. If you are looking to reset your nervous system do the mind-body connection, want to make sure you are doing it the right way. Then the 21-day journey would be very vaible for you. And I am leading the next group through a 21-day journey in September. 

Now for this interview, I am super excited to have my friend and colleague Alex Howard join me for this. And he is one who I have great respect for his work. And we are going to start this interview with his story of fatigue that will surprise you because that is not the Alex Howard that you see today. The Alex Howard of today is CEO of the Alex Howard Group, an international group of businesses which includes leading the Optimum Health Clinic, an online learning platform called Conscious Life, online coaching program, the reset program, and professional and training programs. Alex is passionate about making physical and emotional healing accessible to everyone after his experience. And in the last few years, his own summit Super Conference series has been attended by several hundred thousand people now. In fact, you may have already attended one of his summits and if you have not I highly recommend you check those out. And I usually tell you when those are because I strongly support his work. He has published academic research and publications such as the British Medical Journal Open in psychology and health and is the author of “Why Me” and “Decode Your Fatigue”. With that let us jump into this interview and learn about decoding your fatigue with Alex Howard. 

Alex, it is so good to have you here. And I know that your story really started with your own fatigue. And this surprised you because you were otherwise healthy. Give us a rundown of your story. When did your fatigue start and how did it present for you?

Alex Howard

Well, firstly, Aimie, thank you for having me. I always really enjoy our time together and our conversations. Yeah, I developed severely debilitating fatigue symptoms just before I turned 16 years old and I thought up until that point I was relatively healthy and relatively normal. I do not know what the basis of those really mean, but 16 years old, nonetheless. And I woke up one morning and it was almost like if there is a lack of energy into your body someone had just pulled it out and initially, of course, it was thought I had a virus, and I would just been doing a bit of what they call GCSEs, a big set of exams here in the UK, and the doctor said, it might take a few weeks, you just need to rest and you will feel better. And a few weeks became a few months and I would be going back and forth to my doctor during this time. And the diagnosis then of ME, otherwise known as chronic fatigue syndrome was used and I said, well, how long is it going to take to get better? And they said it could be three to six months. 

And I remember, having turned 16 at this time, six months felt like a life sentence. If you told me at the time that it was not going to be six months it was going to be seven years I don’t quite know how I would have responded. To cut quite a long story and to be a bit shorter, a couple of years into that, I’ve been to see various medical doctors, alternative practitioners, naturopaths, and nutritionists. My grandmother was quite forward-thinking in terms of natural health and so on, and basically, nothing had improved but a lot of things had gotten worse. And one of the things that had got worse was my psychological and emotional states had become more and more desperate really. And it was not that I was severely fatigued because I was anxious and depressed, I was anxious and depressed because I was severely fatigued and I could not do any of the things I wanted to do, I lived in pain, I could be exhausted all day then I could not sleep at night, I would struggle to do an hour or two of schoolwork a day, and then it would be all the things that would have brought me joy I could not do because the tiny bit of energy I was using to do that schoolwork. 

And I basically had a conversation with my uncle which helped me realize that if I wanted the circumstances of my life to be different then I could spend the rest of my life waiting for the doctors and the scientists to find the answers. And I think 25 years later I would still be waiting or I could make it my life’s mission and purpose to find a way to recover. And of course, I had all kinds of narratives. I was 18 at the time, who was I to find the answers, this was pre-mass use of the internet, so you actually had to go to a library and order books, it is difficult, it was kind of the opposite problem of today where there is almost too much information, there was no information ready that was out there. But that enormous rage and frustration at having my life taken away from me was then channeled into this very proactive path of recovery, of reading books, doing meditation, yoga, in time doing psychology work. And there was no one answer but there were many different answers like pieces of a jigsaw. And over a five-year period, I was then able to find my pathway back to recovery. And along the way really the commitment I made was that if I found a way out of this situation I would then dedicate my life to helping others to do the same.

Aimie Apigian, MD, MS, MPH

Wow. I can only imagine being at 16. And thank goodness that they did not tell you that it would be seven years without being able to cope with that and even fathom what that would look like. But in the process, you have developed two maps for fatigue. Tell us about those.

Alex Howard

Yeah. Well, those maps came later. And I went on to set up the clinic that I would want to exist in the years that I’ve been ill which was and is called the Optimum Health Clinic. And along the way, I mean, we have worked with tens of thousands of people over the last 20 or so years of people with complex chronic illnesses,  a lot of them were fatigue as a primary symptom. And the realization, a little bit like it had been on my journey, there is no one answer, there are many different answers that then you need maps to figure out how and why, and where, and when different things will work for different people. In fact, a few years ago, I wrote a book about the work that we do with fatigue which was called “Decode Your Fatigue” because to me before you can map someone’s path to recovery you have to decode what is actually going on. And of these two maps, the first map is a map of decoding and the second map is then a map of a path to recovery. And that first map in terms of decoding fatigue, the first thing is, I think often people think, well, is not it just genetics? Isn’t it just that I was born to be this way? 

And the research on genetics and complex chronic fatigue conditions is that, yes, there is a modest impact of genetics. And there have been twin studies that show that if one is an identical twin of one that has a fatigue condition there is a slight increase in probability. But it is small in the scheme of things statistically and it certainly does not explain it. And more importantly, as I am sure you have had others speaking about as part of the summit, we have to look at epigenetics and the fact that one might have a genetic predisposition towards something, but that says nothing about how likely they are actually to manifest that based upon lifestyle and behaviors and life experiences and so on. There is a small genetic piece but then we have to look at the different ways that one responds to themselves and to their lives. And this is an important psychology piece. 

And I want to just caveat this by saying, I am not saying that fatigue and related conditions are caused by psychological conditions. I am saying that psychological conditions have a factor, they are a piece of a jigsaw, but they are also determined, partly are epigenetics. But they also determine how we respond to other things that happen which I will talk about in a moment. There are certain, what I call energy-depleting psychology, ways of relating to ourselves, relating to other people, and relating to the wider world which are inherently draining and depleting things like being a helper, placing everyone else’s needs as more important than our own, well-being and achiever. Self-worth is defined by what we do and what we achieve, body says stop rest, personality pattern says keep going. Now, I know that Aimie, you, and I would never be guilty of any of these things nor would any other people watching our interview.

Aimie Apigian, MD, MS, MPH

I have no personal experience with that.

Alex Howard

Exactly. There are five of these different personality patterns to help achieve anxiety, perfectionism, and control. But then there are the loads that happen to our system, these can be environmental loads, things like toxins, things like viruses, Epstein-Barr virus being an example, COVID-19 being another example, they could be viral loads or environmental loads. They can be trauma loads, adverse childhood experiences a good example of this. And our genetics, our personality patterns determine often how those loads do and do not impact us, example might be that somebody gets Epstein-Barr virus or glandular fever and they recognize that the body is sick and it needs rest and so they do the sensible thing and they rest and it might take six months for their body to recover from that. And if that person was born in a world of financial privilege 30, 40, 50 years ago, they probably went somewhere like Switzerland and they lifted up a mountain and they just waited until that body recovered. Somebody else who maybe has learned to define their self-worth by what they do and what they achieve and achieve a pattern, body says rest, they say, screw you, I have got to hit this deadline, I have got to achieve this thing and they just keep on pushing through it. I think one of the misunderstandings sometimes is we can overly fixate on the loads and not look at the internal and external environment within which those loads happen. 

We have the genetics, we have the personality patterns, and we have those various loads that then result in an impact on our bodily systems and the separation of the systems. Well, medicine overly separates, mainstream medicine focuses on one. But we also need to recognize that you can have three people with fatigue in the actual system which is the origin of that fatigue, is different. Particularly we talk about the immune system, the endocrine system, and the digestive system and you can have one person where the impact on the bodily systems is that they have developed small intestinal bacterial overgrowth or SIBO and they are not breaking down the nutrients in their food effectively and that is the primary source of their fatigue. Somebody else, it may be that their adrenals have consistently overworked and they have ended up with low cortisol, testosterone, whatever it may be and that is the source. Somebody else, it may be their immune system has become overactive and oversensitive and they now have reactions to lots of things that are not real threats to their system and that is what is depleting them. 

Just to summarize this first map, I know I have just talked to you for the last couple more minutes, that there is a genetic piece, there are the personality patterns, there are the loads that hit us, and then there are the systems that impact us. And also, of course, those systems are interconnected. And that SIBO example could affect our hormone balance which could then affect our capacity of our immune system to respond effectively, for example. It is really important to not just look at something like fatigue from the point of view of a symptom which is what fatigue is. A diagnosis of chronic fatigue syndrome is not a diagnosis, it is a label for symptoms. We have to then go a number of steps further to use this map. And there are other maps out there as well to really figure out what is actually happening for that individual.

Aimie Apigian, MD, MS, MPH

Which is, what brings a lot of the help because then we can look at what are the true root causes. And so much of functional medicine is looking at root causes but this is like going to the root of the root of the causes and being able to look at. And what I am hearing you say, without having said the word yet, is what affects our regulation of our nervous system and all of these different loads are going to be impacting the regulation of our autonomic nervous system. And that is what kind of runs the operating system for our body, putting one person more at risk for developing fatigue because of the downstream effects on those systems from that dysregulation.

Alex Howard

Yeah. Well, one of the ways that I think a lot about this is that you need to decode what is happening physiologically and psycho-emotionally in someone’s experience. But a given of what is also happening is when you suffer from a condition where you do not know what is wrong, why it is wrong, should you rest, should you push through, will you ever recover, is this treatment going to work, the kind of normal response to that is for our nervous system to start to amp up. Because we are in a physiological threat, it is not a perceived threat like an actual threat that we do not know if we are going to get through the day without feeling horrendous, or without crashing, or without doing too much. And our nervous system is designed to respond to acute stress like well, you and I thousands of years ago walking down the path and a sabertooth tiger jumps out at or you and I walking down the street in London and the big red London electric busses coming towards us, we do not see it, we suddenly see it, we get an immediate adrenaline call and that is a healthy stress response. But when it is like the bus is chasing us all of the time that stress response becomes maladaptive and then a nervous system becomes trained to be in a state of constantly being on. 

Apart from the fact that that is inherently depleting and draining in of itself, it also blocks a natural capacity towards healing. It’s like if you and I want us to get a cut, why would you keep that cut clean? You might have stitched the skin together, but the body will heal that. Same when you break a bone as long as you set the bone and it does not heal crooked, like that thing set properly, it heals crooked. And we have that natural capacity to heal. But when we are in a state of maladaptive stress response that healing capacity is not there because of all of the resources going on to perpetuate the cycle of being in that stress response. In fact, Dr. Robert Naviaux has done some fascinating research on cell danger response. And looking at that, our mitochondria which are like the powerhouses of our cells in terms of metabolizing and making energy. They have two functions. They have the function of making energy and they have the function of danger signaling, spreading internally within the system there is a threat and we need to respond to that threat. 

And when we are under danger, appropriately our cells will prioritize the danger signaling over the energy production. When you live an amount of that stress response apart from the fact that you just have not got energy available for healing, you don’t even make energy in the way that you should be making it. The final thing I will say is a maladaptive stress response is that a little bit like, we, for many years, must be 20 or so years ago now, there is a series of bombings in London and prior to that, people would leave their gym bag on the London Underground and sort of no one would really notice that someone left their gym bag, whatever, or their suitcase, whatever it might be, and post the bombings, of course, everyone was hyper-aroused at the threat that it may be a bomb. So someone would leave their gym bag and the whole of the London Underground would shut down because there was a bomb threat, so that was a disproportionate response to danger. Same thing happens with the immune system when we are in a state of maladaptive stress response. We start to react to supplements, foods, and chemicals that are not actually dangerous but our system is misreading the cues and it is seeing things as dangerous that are not. This dysregulated nervous system, this maladaptive stress response has an enormous impact on all kinds of functions within our system which directly then impacts our capacity towards making energy, our capacity towards healing, and just our general well-being in day-to-day life.

Aimie Apigian, MD, MS, MPH

With this maladaptive stress response, is this the trauma response, Alex, or are you seeing this maladaptive stress response as different than trauma? How are you defining trauma in everything that you are describing today here with fatigue?

Alex Howard

Trauma has a number of different roles and crossovers within fatigue. Maladaptive stress response is a response to trauma. Taking fatigue out of the picture, when we go through trauma our nervous system becomes over-activated or dysregulated in response to that. But living in a maladaptive stress response is also traumatic because you are living in a state of unsafety, you are living in a nervous system which is fundamentally dysregulated. And also these personality patterns that we spoke briefly about earlier are often in of themselves coping strategies in response to trauma. For example, that achiever pattern that we touched on a couple of times, maybe what we learned as a child is love came when you achieved or state you felt safe when you helped and cared for other people you then felt safe. And we have this kind of core emotional needs and we develop these patterns to help us ensure that we meet those needs. And trauma has all kinds of crossovers and places within fatigue. And you do not need to heal all of your traumas to recover from fatigue. Because by the way, there are lots of people without fatigue that have lots of unhealed traumas. But you do need to address the ones that are in the way of your healing. And if they assess unhealed or unresolved traumas that are driving, for example, a maladaptive stress response then you need to work with those for your nervous system then to be able to rewrite your leads and to come back into a healing state.

Aimie Apigian, MD, MS, MPH

And I know that so much of your work that you tell people they have to do in order to work with this is this mind-body connection, why is that important here? How is that going to be helping fatigue to do mind-body work?

Alex Howard

Well, I think I should probably back up first and say that when I was suffering from fatigue one of the few things that would give me temporary energy was someone telling me it was all in my head because I wanted to fight them because it felt so much like I was not being seen and validated in the lived physical experience that I was having. But then along my healing journey recognition was I could not leave any stone unturned and that meant that I could not deny the reality that that was also what happened. Psycho-emotionally also impacted what happened physically and what happened physically impacted what happened psycho-emotionally. And for the reasons we have just been talking about in terms of the maladaptive stress response and I then opened to this idea that learning to regulate, not that we were using these kinds of words 25 years ago, but learning to regulate my nervous system started to have impacts on my healing process. And over the years, having worked with tens of thousands of people through the autism health clinic, for some people reassessing their nervous system is a piece of the jigsaw, for other people it is most of the jigsaw, and for some people, it is a piece or a step on the journey that until they do it they can not do the other pieces. And I am very careful not to infer that you need to do all of this work on your nervous system to recover from fatigue and at the same time the vast majority of people need to do at least some of this work to be able to recover from fatigue.

Aimie Apigian, MD, MS, MPH

And when I look at your story, Alex, 16 is a pretty young age to have that severe fatigue. I think that a lot of people start to have their fatigue a decade or two decades later than what you did. Your system had a lot of loads. Knowing you, knowing how you were able to decode all of this. And that has been so much of the value that you bring to the world. And thank you again for that. What were the specific loads that you identified in your system? What was that process for you? What were the pieces that you needed to start to feel better so that we can give people some type of an idea of how this process was for you in the healing process? Because I know that it did not recover overnight but as you put pieces together, as you started to figure things out a little bit would get better and then a little more. What were the specific loads for you, if you do not mind sharing that? And what was your process to finding the puzzle pieces for yourself?

Alex Howard

Well, it is much easier for me to make sense of my own healing journey 25 years later, having worked with lots of other people. I have already talked about it with a level of insight that I would have loved to have had at the time. But part of it was physiological. I had irritable bowel syndrome a number of years before I had chronic fatigue, digestive elements were part of it. It is likely, although it was unproven that I had some kind of viral load which was a tipping point at the time that I got sick. And I had significant where, it is all relative but relatively significant childhood trauma in terms of the father which left soon after I was born, and a system of severe mental health issues and kind of complex family dynamics. And I then had a significant maladaptive stress response in response to being seriously unwell with no understanding, no clarity of pathway forward from that. And along the way, things like working with foods, nutrition, balancing blood sugar, working with things like adrenals, and hormones, meditation, practice, and techniques to learn to calm the nervous system, and sometimes it was very targeted, it was like there is this piece and there is this intervention and other times it was more broad of working on issues around asking for help, for example, or working on issues around emotional healing, or working on issues around calming of the nervous system. And I think it is really important to have that clarity in decoding one’s fatigue to be able to map that effective path to recovery. And there are certain general principles which are generally helpful for many people anyway.

Aimie Apigian, MD, MS, MPH

If you could share one hope, what would be that one piece of wisdom that you would share with others who may be struggling with fatigue and have not found that map and their puzzle pieces yet?

Alex Howard

Well, I think really the heart of this is the recognition that recovery is possible. I certainly would not be as arrogant as to say that full recovery is possible for every single person because I do not, I do not know the exact quote but it is something on the lines the more someone knows about something the more they realize how much they do not know about something. And I think if they are really cautious that people that talk in absolutes or talk in oversimplification around complex things because all that normally tells you is that they have got a simplistic view of a complex situation. And my observation is the vast majority of people can make meaningful progress on their healing journey and no one has all the answers. And the more certainty someone speaks of they have all the answers the more uncertainty you should have they have all the answers. And the reality is that there are many stories of people that suffer sometimes for long periods of time with complex chronic illnesses that have decoded what is happening and then they found effective interventions to address that, and then they found pathways forwards. 

And there are a kind of bizarre two mainstream medical narratives. One of which has historically been we do not know what is wrong with you therefore, there is nothing wrong with you or there is something wrong with you but we do not have the answer therefore, no one has the answer. And you just break down the level of arrogance in both of those statements. It is like that they know everything there is to know and therefore if they do not have the answer or can not see it there is none. Whereas the reality is these things are complex and there are many people these days doing amazing work, working with them that have found pieces of the jigsaw and ways to support people moving forwards and progress. And indeed recovery is possible.

Aimie Apigian, MD, MS, MPH

You can see why I have such great respect for Alex and his work, his story, his experience, and what he has done with his experience. I know that you have been enjoying the summit. This interview, I highly recommend that you share it with your friends. And I also recommend that you consider purchasing these interviews so that you can have access to them at any time. You can come back and rewatch them, you can watch the ones that you missed. This is a lot of information but I want you to have all the tools, I want you to have all the resources. Because like we talked about in this interview there are many different puzzle pieces and I do not want you to miss a major puzzle piece for your healing journey. Resource yourself. As Alex talked about in this interview we do need to be the ones to find those answers for ourselves. We can have guides and mentors along the way. I am happy to be one of those guides for you and I welcome you here. But we need to make sure that we are resourcing ourselves, so resource yourself. This is one resource that you can have purchasing the recording so that you can come back and revisit these at any time. Thank you for attending this interview on the Biology of Trauma Summit 3.0. I am your host, Dr. Aimie. And I will see you in the next interview.