Chronic Fatigue Syndrome (CFS)
Case History & Analysis #1

1. Disease Progression
   
   In the Summer of 1990, after Beth finished her Junior year in High School, she began to experience her first symptoms that were related to the eventual development of CFS. She had regular episodes of hunger no matter how much was eaten. It is as if she wasn't absorbing the food she was eating. In addition, Beth experienced a back injury that happened while running.
   
   Intense Premenstrual Syndrome (PMS) runs in her family. Beth started to have PMS symptoms, but after taking a homeopathic remedy in 1990 which was intended to treat hives, the PMS went away and has never returned. It is also of note that Beth experienced amenorrhea (absense of menstruation) for 1-1/2 years during the time that she was a runner in High School.
   
   During the Summer of 1991 Beth began to experience debilitating chronic fatigue which led to her sleeping for long periods of time and quite often throughout parts of the day. Later that year, Beth was put on antibacterial and antiprotozoal drug Flagyl for the treatment of a suspected case of Giardiasis (an infection of the small intestined caused by an intestinal protozoan). After the treatment by the drug Flagyl, Beth suffered from severe insomnia such that it regularly took 3-5 hours or more to fall asleep at night. Even though Beth suffered debilitating fatigue, she could not easily fall asleep.
   
   

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2. Food & Nutrition
   
   Beth was formula-fed (not breast-fed) as an infant. In that period of time, the baby formulas still had the excitotoxin, monosodium glutamate (MSG) and probably a number of other artificial and unhealthy ingredients. As everyone now knows, breast feeding is very important for passing immunity on from the mother to the child and for assuring that the infant obtains a proper amount and balance of nutrients. In addition to the formula feedings, Beth was given solid foods starting at only six days of age.
   
   During childhood, Beth's diet focused heavily on fruit, milk (averaging 6 glasses per day), steak/chicken, prepared foods (e.g., macaroni & cheese) and some fresh and frozen vegetables. There was very little candy or sugar-containing foods eaten. As far as Standard American Diets (S.A.D.s) go, it wasn't bad in that there was not a constant intake of sugary foods. But a lack of whole grains and the very large amounts of dairy and fruit is clearly not healthy from a holistic perspective.
   
   Fortunately, it appears that Beth obtained an adequate level of key nutrients such as protein and calcium so that severe deficiency did not likely contribute to health problems. Although a moderate deficiency in key nutrients may have limited the detoxification that Beth was capable of during toxic exposures (to be discussed below).
   
   Beth was told to drink alot of dairy after being diagnosed with hypoglycemia. This is a very unhealthy practice not only because of the hormones and traces of pesticides in milk and the homogenization of milk, but it is generally unhealthy for most people to eat more than small amounts dairy. As it turns out, Beth was unaware that she was allergic to dairy foods. She also had difficulty with digestion of foods.
   
   In 1988, after reading the cookbook, "The Book of Whole Meals" by Annamarie Colbin, Beth and her mother experimented with the dishes in the cookbook and went on a modified Macrobiotic diet as expoused by Colbin. By 1990, Beth completely stopped dairy intake and focused on vegetarian dishes. However, in 1991 at college she ate quite a bit of chicken. In 1992, Beth studied Japanese-style Macrobiotics at the Kushi Institute in Boston.
   
   Her current diet is primarily a Japanese-style Macrobiotic diet consisting of:
   
   
   • Whole grain dishes approximately 2 times per day
   • Legume dishes approximately 1 time per day
   • Alot of vegetables including leafy greens vegetables
   • Fish approximately 1/4 pound 1 time every 2-3 weeks
   • Beverages -- a small amount of spring water and occasionally banch tea or mugwort tea.
   • No artificial sweeteners, flavors, colorings, MSG, preservatives, etc.
   • Approximately 75% of foods are organic
   • Beth eats 2-3 meals per day.
   
   Current supplements include:
   
   
   • Liquid minerals concentrated from sea water
   • Choline supplement
   • Three grams of chorella mixed with 1/2-inch in a cup of aloe gel and sometimes mixed with Swedish Bitters (Taken since April 1997.)
   • Occasional B-complex
   
   It is important to note that Beth's diet is not static. She uses her intuition and research to make changes from time to time in her nutrition plan and supplement intake. She appears to be reasonably adept at judging what her body needs.
   
   

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3. Toxic Substance Exposure
   
   Aside from the toxic and unhealthy substances Beth ingested as part of food (e.g., MSG), there were several ongoing toxic and unhealthy exposures which likely contributed to developing health problems:
   
   
   • The house she lived in as a child was treated with Chlordane. Chlordane is an organochlorine insecticide that poisons the nervous system and damages the immune system. Most uses were banned in 1988 although traces can be found in some milk, for example, where it is used for cattle breeder pest infestations.
     
     
   • There was shag carpeting put into the house when she was a child. It was put into her bedroom and playroom and she was likely exposed to common carpet neurotoxic and immunotoxic chemicals such as formaldehyde and toulene for many years. Please see the Toxic Carpeting Web Page for more information.
     
     
   • There was a severe problem with mold in Beth's playroom. Even after it was cleaned up to some extent, there was a mold problem. Beth was allergic to mold.
     
     
   • The lawn that Beth played on had been dosed with toxic chemical fertilizers.
     
     
   • Fluoride treatments were given regularly in school. Recent research shows fluoride to be neurotoxic, block the action of key enzymes as it builds up in the body and cause lowered IQ in some children. Please see the Fluoride Web Page for more information. Beth uses Toms brand fluoride toothpaste.
     
     
   • Beth has had only one cavity which was filled with a composite filling. She has not needed any crowns, bridges or root canals.
     
     
   • As a teenager, Beth was exposed to a large number of x-rays due to numerous running-related injuries.
     
     
   • Beth does not use perfumes or toxic personal care products.
     
     
   • Beth does not spend long periods of time in sitting or standing positions that tend to throw her structural alignment off. For example, she does not work long hours at a computer desk in a slouched posture which would could limit the movement of the diaphram for long periods of time. As another example, Beth does not wear high heeled shoes regularly which could affect the alignment and health of the spine.
     
     
   • It appears that Beth wears clothes primarily with natural fibers. It is unknown if the bedding has been treated with formaldehyde although it is probably not the biggest concern at this point in time.
     
     
   • Beth uses gas stoves for cooking. When heat is needed in the colder months, the heating mechanism is natural gas.
     
     
   • The living situation appears to be relatively toxic chemical-free.
     
   
   It is important to keep in mind that the human body usually has an amazing ability to detoxify from toxic chemical exposure. However, continuous exposure or large, short exposures can begin to overwhelm the detoxification channels and damage the immune system and neurological system. Even in these cases, though, reversal of the effects and healing can gradually occur.
   
   

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4. Stress Issues
   
   Beth experienced a regular and large amount stress in Junior High School due to working at and worrying about getting her school work completed. She spent several hours every day working on her homework.
   
   In High School, Beth continued to push herself in school and pushed very hard in training for running races (Track & Field and Cross Country running). She would not feel satisfied with anything but a very strong effort in training. She continued to perform training runs even while recovering from numerous injuries such as shin splints, hip and back disorders, etc. In High School, Beth was busy with other extracurricular activities including music and skiing. She suffered with extreme stress during the period of time that she filled out college applications because she put alot of pressure on herself to do it perfectly.
   
   In college, Beth understandably became very worried and felt stress related to the severe health problems she way experiencing. She stopped worrying about school work. She took steps to lighten her workload during this period of time.
   
   During childhood and through Junior High School, the stress that Beth felt was primarily related to school and schoolwork. But after getting sick she would always be able to find something to be worried about and generate stress. It is quite common nowadays for persons to develop habits of worry and stress in their lives.
   
   Not long ago, Beth left her job thereby reducing her workload and stress significantly. She still appears to feel some stress related to difficulty accomplishing day-to-day tasks, but this is perfectly understandable.
   
   

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5. Psychological Issues
   
   Beth's mother did not have a cesarean section performed during Beth's birth. Beth is fairly certain that no forceps were used during the birth. There was anesthesia given to Beth's mother during the birth process and it was a difficult birth. Beth was often crying for food as an infant probably due to being formula-fed and having difficulty digesting food and absorbing nutrients.
   
   Beth has an impressive memory of childhood events including those which happened when she was an infant. It does not appear that she suffered any regular or serious neglect or abuse as a young child. It is possible, however, that there may have been very subtle and ongoing neglect or abuse during these years. It probably should not be automatically assumed or discounted.
   
   Since Beth didn't have any brothers or sisters she received alot of attention from her mother during the day. Her father would play with her after work. By the time Beth was born, it seemed that her mother and father were no longer in love, but were civil with each other. The parents were never affectionate, but there was not any violence or regular yelling.
   
   Beth's father moved out when she was eight years old. She visited him twice per week. Beth felt that her mother was extremely over-protective and smothering. On the other hand, her mother encouraged her quite a bit. There was a lack of emotional boundaries between Beth and her mother. After Beth's father left, Beth felt responsible for making her mother feel good about herself.
   
   Throughout Junior High School, Beth was regularly treated in a vicious way by many of the children in her class. People in the class talked about her behind her back and isolated her.
   
   In High School, Beth found many friends who understood the importance of being respectful and caring. She was not into partying, drugs or alcohol. She and her friends were just into being themselves.
   
   During her Junior year in High School, Beth's father remarried. The remarriage created emotional distance between Beth and her father, but she feels somewhat closer to him now. Also during that period of time, there was a very difficult and emotional breakup with a boyfriend.
   
   By the end of High School, Beth developed CFS. She lived with her mother for a year. Her mother had a difficult time dealing with Beth being sick. Even though Beth's mother tried to be helpful, Beth felt smothered and felt that there were still not enough safe emotional boundaries between her and her mother. This caused significant psychological distress which culminated with Beth moving out and eliminating most contact with her mother.
   
   For the past seven (7) years, up until approximately one year ago, Beth was somewhat emotionally numb such that instead of feeling an emotion when appropriate, she would simply experience a numb no-feeling state. This state is sometimes due to the feelings being too painful or unfamiliar to handle. Sometimes she would feel anxiety. Any anger she felt was turned inwards at herself. Recently, she started to be able to feel anger at others if the situation warranted it. Sometimes she goes running to deal with the anger that comes up.
   
   

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6. Sleep
   
   Beth slept reasonably well during Junior High School despite the stress she experienced. After the breakup with her boyfriend in High School, she suffered from some insomnia. By the Summer of 1991, Beth had debilitating Chronic Fatigue Syndrome and was sleeping much of the day. But she did not have any trouble falling asleep. At that time Beth was given a treatment regimen of the drug Flagyl to treat a suspected case of protozoan infestation, Giardia. Since taking Flagyl, Beth has suffered from severe insomnia such that it would take 3 to 5 hours or more to fall asleep. It may be of significance that the course of Flagyl was taken immediately after Beth started college and moved into a crowded and noisy dormatory.
   
   Currently, Beth is practicing a short qigong exercise before bedtime which is a significant help to her in falling asleep. When the qigong exercises do not work, she takes a Chinese herbal remedy prescribed by her acupuncturist, "Root the Spirit". This herbal remedy helps considerably and she finds that it works much better than valarian root. Beth finds that the qigong and the herbal remedy help induce a much better quality sleep than she gets by taking Melatonin.
   
   Beth goes to bed between 10pm and 11pm and usually wakes between 6:30am and 7:30am.
   
   

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7. Creative Expression
   
   Beth enjoys a variety of creative activities including making jewelry (which she sometimes sells to clients), woodworking and a little bit of sewing and drawing. For health reasons, Beth chose to cut back on her work schedule at the craft store, but she still works there occasionally and takes on some creative projects.
   
   

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8. Friendship & Support
   
   Beth has a number of close friends who are available to talk to about various personal issues. However, there is still a feeling of isolation in that her friends do not have a deep understanding of what Beth has experienced in living with the CFS. Although sometimes it is difficult due to lack of energy, Beth does make an effort to reach out and keep in regular contact with her friends.
   
   

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9. Exercise
   
   In High School, Beth ran for the Track & Field and Cross Country teams. She enjoyed running emensly. She experienced numerous running-related injuries during High School, but often continued running while she had the injuries. She tended to push herself to train very hard. As she began to experience CFS, Beth was forced to stop running competatively.
   
   Currently, Beth does some walking and short commutes by bicycle. She is swimming in a local pond a few times per month. In addition, because she loves it so much, Beth does do some running on occasion (~3 miles). She may run three time a week for a while and then stop running altogether for several months. She feels better for a few hours after running, but the she often feels low in energy for the next one or two days. It is important to note that Beth's exercise activities vary considerably depending upon how she feels (as they should).
   
   

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10. Spiritual Connection
    
    Beth grew up a Catholic, but she chose not to join the Catholic church. She feels that she is in touch with her intuition and does feel a connection to her "Higher Self."
    
    

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11. Other
    
    Beth experiences a chronically tight diaphram which may be partially due to the significantly emotional and physical stressful situations that she experienced regularly during parts of childhood. This tends to create a situation known as "body armouring" where there is chronic and deep tightness in certain areas of the body. Chronic tightness around the parts of the body related to breathing are quite common in body armouring cases. Body armouring is commonly seen in persons who have suffered from various forms of abuse or who have had traumas or long periods of high stress. Beth also experiences tightness on the back at the base of her neck and in the lower section of the spine. I noticed a significant lack of chi (energy) movement from the upper body into the pelvis and down through the legs and into the ground. This lack of grounding seemed to be due to structural and breathing issues. Finally, I sensed a possibility that there was tightness in the throat and upper chest that contributed to the lack of full, deep breaths during the course of the day. Beth is noticably slender.
    
    

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12. Use of Holistic Healing Treatments/Practices
    
    
    • Qigong
      
      At night, before sleep, Beth often practices a short qigong energy movement exercise which has helped to reduce the severe insomnia she was experiencing. She has been practicing this exercise for approximately 6 months.
      
      
    • Acupuncture
      
      Beth has acupuncture treatments once or twice per month (sometimes less) and takes two prescribed Chinese Herbal Formulas which have been helping her considerably. One is helping her with sleep and the other is helping to reduce her hypoglycemia (chronic low blood sugar).
      
      
    • Bodywork
      
      Occasionally, Beth will get CranioSacral Therapy treatment or a shiatsu massage. She has to be careful not to get a treatment that lasts too long or is too intense so that she doesn't feel adverse effects afterwards.
      
      
    • Yoga
      
      Her yoga practice varies considerably depending on how she feels. She has practiced very little in the last month. Sometimes, however, she practices for 1/2 hours to an hour, five times per week. Sometimes she practices twice per week. Her yoga practice does include a final relaxation pose. She does not use pranayama (yogic breathwork) as part of her yoga routine.
      
      
    • Breathwork
      
      For the last two years Beth has been part of an ongoing Holotropic Breathwork group. She has participated in a total of 11 breathwork sessions.
      
      For the first two sesesions, Beth was still taking two college courses and experiencing slight stress about getting things done. During the first year of the breathwork group, Beth felt somewhat shy, but once she spoke up, she shared quite a bit about herself.
      
      In the first year, Beth was hypervigilent during the breathwork sessions and felt that she had no "altered state" experiences. (Altered states often occur and can promote healing during the Holotropic Breathwork process). She did cry towards the end of several sessions out of a feeling of desparation. She was somewhat disappointed about her lack of experiences and healing progress during the first year.
      
      During the second year, she also felt that she had no altered state experiences. She had fewer emotional experiences. However, she feels that the qigong helped increase her ability to look inside herself. In order to experience the breathwork process more deeply, it is necessary to feel safe to be with and look inside oneself. Beth experienced more subtle changes during the second year of breathwork, but she is not certain how much of those changes are related to the breathwork.
      
      During the breathwork, Beth's nasal passages sometimes close up making it difficult to breath through her nose. Beth felt that she often "drifted off" away from the breathwork process even though she often made some effort to use the suggested breathing techniques. When she made herself keep up the effort of using the suggested breathing techniques, she sometimes felt as though she was just going through the motions. She also felt tightness in her neck and cranial base during the breathwork sessions.
      
      Currently, Beth is not sure if her body is ready for breathwork. She wants a cathartic experience but her body closes up during the sessions. She fees that the sessions may be too long for her and that she wonders if she may do better in a one-on-one session.
      
      
    • Other
      
      Beth sees a wonderful psychotherapist/counsellor once or twice per month.
      

1. Difficulty absorbing nutrients during childhood.
2. Excessive intake of dairy and fruit during childhood.
3. Stress throughout childhood varying in intensity.
4. Very difficult psychological issues including significant difficulty in relationship with mother and father at times. Understandably, some body armouring seems to have developed because of this -- in the diaphram (effecting breathing depth), base of neck, lower back, and possibly the throat.
5. The running may have been helpful, but excessive amounts of running and running through injuries may have contributed to chi (energy) blockages in the hips and legs. In addition, running did not provide much upper body movement and exercise.
6. The toxic exposures of chlordane, toxic carpeting chemicals, mold, fluoride, and possibly other poisons likely contributed to the development of CFS.
7. Other things that may have played a part include the anesthesia given to Beth's mother during the birth process and the Flagyl that was taken by Beth.
8. Severe insomnia after the CFS developed.

• Inappropriate nutrition plan for this particular condition.
• Shallow breathing and diaphramatic tension
• Energetic (chi) blockages due primarily to structure and tension problems
• Unreleased and unintegrated trauma (birth, childhood, etc.) or stress
• Poor digestion (causing nutrient deficiency, absorption of intact proteins, etc.)
• Undetected allergy or intolerence (gluten, for example)
• Reactive hypoglycemia
• Leaky gut syndrome
• Candidiasis
• Enzyme inhibition (for various reasons) (e.g., blocking protein synthesis or brain chemical production, etc.)
• Hypothyroidism
• Other endocrine disorders (e.g., infant excitotoxic damage from MSG, etc.)
• Undetected toxic metal or other chemical exposure (e.g., lead from hair dyes, etc.)
• Etc.

Phase 1

1. Holistic Practices/Treatments
   
   A series of Integrated Awareness Table Sessions with an experienced teacher may prove extremely helpful, especially when it comes to energy and digestion ability in Beth's case. Eventually, Beth may choose to consider a full Integrated Awareness Training/Healing Program. This may allow, over time, the ability to make some of the suggested Food & Nutrition changes below. Other holistic treatments (Acupuncture, qigong, etc.) can be continued as desired.
   
   
2. Food & Nutrition
   
   Beth has made enormous positive changes to her food and nutrition plan since 1988. She began these changes when she was still in High School. To being to take control of her own health at this young an age is quite admirable!
   
   There are several significant changes to the current food and nutrition that could be considered. Some of these changes involve moving towards what has worked well in the long run for many persons with CFS. Below are a few of the key ideas that could be used to adjust Beth's current Japanese-style Macrobiotic diet.
   
   
   • More protein. There appears to be a significant lack of protein in the diet for what I would consider proper for the treatment of CFS. Over the short-run, this might not present a problem, but over the long-run it will often delay healing of CFS. A significant number of people with CFS have found that getting plenty of protein in the diet to be helpful. Beth should strongly consider adding small, regular amounts (~2-6 ounces) of fish especially cold-water fish such as salmon and mackerel and occasionally a little bit of chicken or turkey at least four times per week if not more often. (Fresh salmon and mackerel contain important healthful derivatives of essential fatty acids.) Extra protein can also be obtained by combining easily-digestible beans such as mung beans with grain dishes. Obviously, it is not necessary or desirable to ingest these high-protein foods in large quantities, but it can be helpful for many with CFS to ingest them regularly.
     
     If Beth was allergic to fish, she could use a very small amount of chicken or turkey instead. An important key is to let go of theoretical rules to find the balance of macronutrients which suits one's current condition. Meat consumption may be reduced later on as health changes.
     
     Ingesting meat with cooked greens, ginger, lemon, or traditionally used spices can help make the meat more easily digestible. The cookbooks listed in the Resources section of the Food & Nutrition article can be useful for recipies.
     
     
   • Reduce whole grain consumption somewhat. After reducing the grain consumption somewhat (to offset the increase in fish/protein consumption and an increase in vegetable consumption, be sure to add variety to the grains that are currently ingested. For example, the use of slow-cooking oatmeal and soba noodles can add variety and important nutrients.
     
     
   • Be sure to get plenty of essential fatty acids (EFAs) -- linoleic acid (LA) and alpha-linoleic acid (LNA). The interview did not discuss EFA intake in detail, but over the last several years there appears to have been a significant lack of LNA (and LNA derivatives) and possibly a lack of LA in Beth's diet.
     
     More information and product resources related to Essential Fatty Acids can be found in the presentation by Dr. Udo Erasmus at: http://www.holisticmed.com/add/erasmus.html.
     
   • Get plenty of fluids. This is very important for persons with CFS. There is a short-term positive health gain that some people experience when limiting liquid intake and eating a more "contracting" diet (from a Macrobiotic perspective). But in the long run I believe that the intake of plenty of fluids to be very important, especially for those with CFS.
     
     In Beth's case, she appears to have digestive ("Spleen") weakness and "Dampness" from a Chinese Medicine perspective. In such a case, it is helpful to avoid overdoing the consumption of liquids during meals. Between meals a slightly lower than normal liquid consumption might be warrented, but probably significantly more than is current being ingested. I would consider erring of the side of slightly too much rather than too little liquid intake.
     
     In addition, it may be useful to add a little spice and variety by gradually incorporating non-Macrobiotic beverages into the diet. Consider a little bit of herbal tea on occasion if it does not cause any problems. Or try some freshly-made vegetable juice, coffee substitute, etc.
     
     
   • Keep the salt (sodium) consumption at a small to a moderate level. This is usually somewhat less than is common in Japanese-style Macrobiotic cooking.
     
     
   • The use of mineral supplementation is a good idea. It might be beneficial to focus on supplementation and/or sources for magnesium, calcium, and zinc. B vitamin supplements may be necessary in some cases, but I would try to go without it for now. The above-mentioned minerals and vitamins are important co-factors in the metabolism of EFAs. I would not recommend taking amino acid supplements in this case.
     
     
   • Try to add food treats from time to time and keep a relaxed and fun-loving attitude (to the extent possible) while working with the food and nutrition plan.
     
     
   • Be very careful when using aloe internally for any length of time. It is very Cooling (from a Chinese Medicine perspective) and, on a medium-term or long-term basis, can lead to the worsening of digestive problems (and other health problems that grow out of a weakened digestive system). Some people mix it with some ginger root (grated with juice squeezed out) to help add more energetic balance to the mixture. Unless the intuition is demanding the use of aloe, I would think it is best avoided by persons with a weak digestion and/or Cold conditions (from a Chinese Medicine perspective).
     
     
   • Since certain aspects of Chinese Medicine seem to be helpful (qigong and Chinese Herbalism), it might be useful to read about Chinese Nutrition theory in:
     
     
     
     • Arisal of the Clear: A Simple Guide to Healthy Eating According to Traditional Chinese Medicine
       by Bob Flaws
       Blue Poppy Press (1775 Linden Ave. Boulder, CO 80304, 303-447-8372, 102151.1614@CompuServe.COM )
       ISBN 0-936185-27-9
       
   
   
3. Breath & Movement Routine
   
   The occasional yoga routine helps to reduce built-up stress and tension. But in order to loosen chronically tight areas of the body related to body armouring and to help promote energy movement though the body, a more customized routine is necessary.
   
   Before we get to the details of the routine, a short explaination is warranted. Running can strengthen leg muscles. However, it is more important for the leg muscles to be flexible and the joints loose and relaxed so that chi (energy) can flow through them -- from the body into the ground and from the ground into the body. It appears that legs and especially diaphram are chronically tight so that the chi flow from the upper body through the lower body and legs and into the ground is not sufficient.
   
   Chi movement in the neck and upper back caused by stretching or massaging these tense areas might, under normal circumstances, be beneficial. However, in Beth's case, excess released chi has nowhere to go because of chronic mid- and lower-body tension and overheats certain organ systems (from a energetic perspective). Looking at the cause and treatment of significant energetic blockages from a structural/body armouring and breathing perspective is different than might be done by a Chinese Medicine practitioner (for example). An acupuncture treatment may lead to temporary benefits, but structural/body armouring and breathing tension issues will likely cause the chi imbalances to return after a short period of time. In these types of cases, other types of treatments are warranted in my opinion.
   
   In order to handle chronic tension in the neck and upper back that is causing significant discomfort for Beth, it is very important to focus heavily on 1) loosening the legs muscles and joints, hips, pelvis and diaphram, and 2) developing the ability to send the released energy down through the legs and into the ground. The simple Phase 1 routine will also include exercises which will begin to address the body armouring in the diaphram which is limiting breathing potential.
   
   Transformational techniques such as Breathwork may be one way for Beth to make deeper and more permanent changes to chronic body tension, but for now, the exercises detailed below are an important start. The short routine presented below combined with the regular use of an active meditation such as qigong can also continue to reduce emotional numbness and prepare the body and deeper healing and transformation.
   
   While this routine may not be a perfect fit for Beth's current needs, it is the routine I would start with if I were in her situation. Changes can be made if needed. All exercises should be performed slowly, gently and in a playful way.
   
   
   • Ankles, knees and hips loosening exercises as taught in Bioenergetics classes. It is basically a simple exercise to move and loosen the ankle, knee and hip joints. This will help the chi (energy) flow through the lower part of the body. (Note: A full Bioenergetics class of 1-1/2 hours may be too exhausting for Beth at this point.)
     
     
   • Daily Breathing Routine from "At the Speed of Life" by Gay & Kathlyn Hendricks. Learn the "Bouncing Ball" exercise so that it is performed in a gentle, relaxed, fun way. (It is much easier to learn the "Bouncing Ball" exercise with an experienced Hendricks Institute teacher than from a book. Also learn to bounce the ball diagnally. These exercises will help loosen the diaphram and pelvis and help coordinate the movement of the pelvis and spine with the breath.
     
     
   • Use a blanket roll under the hips (on the upper part of the sacrum) and very gently roll the pelvis around it. A blanket roll is a roll of old, taped newspapers with a folded blanked rolled around it into the shape of a cylinder (~2-8 inches in diameter). Inhale as the pelvis slowly and gently rolls down around the blanket roll and exhale as it comes up. Bouncing the pelvis up and down in this position may be too much at this time. This exercise will help loosen the pelvis so that it can move easily with the breath.
     
     
   • Four minutes of various Bioenergetic grounding exercises. Two minutes performed after loosening the ankles, knees and hips and two minutes before the Alternate Nostril Breathing. A teacher of Bioenergetics can be helpful in learning to perform this exercise correctly. Theses exercises will help move the chi (energy) released from previous exercises through the body and into the ground.
     
     
   • Alternate nostril breathing exercise for five minutes as described by Gay & Kathlyn Hendricks in "Conscious Breathing." Or use the simplier, but still powerful version as taught in Issue #35 of Yoga International Magazine (717-253-4929). This exercise will help balance the activity of the different hemispheres of the brain and help gradually heal the nervous system.
     
   
   After becoming adept at the exercises, this routine should take approximately 20 minutes. It is important to create a short routine so that is easy to practice daily. There should be flexibility in the routine such that other simple exercises can be added depending upon how one feels. For example, if the neck is tight, gentle stretching of the neck from shoulder to shoulder and moving the neck in circles can done. Shoulder shrugs and rolling of the shoulders can be performed. Loosening of the jaw, face, arms, etc. can be done as long as the routine doesn't become so long that regular practice is difficult.
   
   If Beth is experiencing extreme fatigue or extremely busy during a particular day, the routine can be skipped. A bioenergetic grounding exercise can be performed while lying down with the feet against the wall if desired.
   
   Finally, it is important that Beth allow herself to sigh, vocalize, grunt, etc. during the exercises to keep the chi (energy) from getting stuck in the throat. In fact, it is often helpful to practice grunting and sighing during some of the exercises so that one gets used to giving oneself permission to vocalize and be expressive.
   
   One thing to keep in mind is that when one has a tendency to be emotionally numb, the regular practice of these exercises can very gradually change one's breathing patterns and open the person up to fully experiencing life and feelings. Sometimes the feelings that come up during the process of opening up can be happy and joyous, but at other times there can be sadness, anger or fear. These changes usually do not happen overnight, but tend to come gradually.
   
   
4. Toxic Chemical Removal
   
   Beth has done a wonderful job removing toxic chemicals from her immediate environment. The only change that would be warrented for Phase 1 would be to replace the toothpaste which has toxic fluoride compounds and sodium lauryl sulfate with a safer toothpaste.
   
   
5. Inspiration
   
   If she has not done so, Beth should take the time over the next few months to read: "The Rebellious Body: Reclaim Your Life from Environmental Illness or Chronic Fatigue Syndrome" by Janice Strubbe Wittenberg, R.N. This book is useful, inspirational and discusses cases of people using natural healing techniques to recover from Environmental Illness and Chronic Fatigue Syndrome.
   
   
6. Self-Acceptance and Self-Love
   
   Beth deserves to give herself regular pats on the back for having done so many wonderful things for herself, for inspiring others who are in a similar situation to use Holistic Healing techniques for health improvement and for putting up with a moderately long interview!
   

1. Holistic Medicine treatments
2. Adjustments to nutrition plan
3. Short daily breathing and movement routine
4. Switching toothpastes
5. Reading a book
6. Regular self-love

Phase 2