Research Paper Towards a schema level understanding of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A grounded theory approach

Abstract

BackgroundCore beliefs or schemas have been proposed as a possible predisposing factor in the cognitive behavioural model of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) (Surawy et al., 1995). Additionally, in clinical practice, characteristics of early maladaptive schemas have been recognised in people with this debilitating illness (Kinsella, 2007), although research in this area is limited.AimsThe aim of the study was to develop an understanding of the relationship between early maladaptive schemas as described by Young, Klosko and Weishaar (2003) and ME/CFS.MethodThe study involved 13 people with ME/CFS who endorsed early maladaptive schemas; they were interviewed using a range of media (face-to-face, email and phone). The study adopted a mainly classical grounded theory approach.ResultsThe core category generated from the data termed ‘obscuring’ conceptualised the manner in which early maladaptive schemas and the coping style ‘surrender to the schema’ obscured the needs of individuals with ME/CFS. The theory proposed a subtle cycle of ‘obscuring’ within the illness context potentially exacerbating the illness, increasing fatigue.ConclusionThis study progresses knowledge in this area by providing a schema-level understanding of ME/CFS, offering insights into the behavioural process from schema to illness. Recommendations are made for clinical practice.