When we put too much emphasis on food to heal instead of utilizing a truly holistic plan that includes physical, emotional, and spiritual components of our wellness, we are missing the whole picture. Eating “clean,” fad diet protocols, and obsessing about food planning or the relative healthiness of ingredients can promote physically and emotionally disconnected relationships with food. This can lead to disordered eating and orthorexia, which is an unhealthy obsession with eating healthy food, says Jessica Flanigan, holistic nutritionist and founder of Transformational Eating.

We commonly hear phrases such as: “Follow this diet. Get this lab work done. Monitor these antibodies. Eliminate these items from your environment. Practice these modalities to support your healing.” While these methods are integral parts of chronic illness treatments, deeper healing may continue to be out of reach if emotional health, both past and present, is not addressed. Further, because chronic illness is heavily impacted by lifestyle, there is often guilt associated with what the individual did wrong either in developing the disease or in not getting better. This distinction is crucial: taking responsibility for your health doesn’t mean shouldering blame.

The High Cost of Chronic Illness

Dealing with chronic illness can feel like a Sisyphean task; an enormous amount of time, energy, and resources are dedicated to feeling better and trying to get answers, sometimes with little gain.

Besides the tremendous expense of treatments, there are many other costs associated with chronic illness: recurring flare-ups can strain friendships and/or marriages, put pressure on maintaining a career, and fuel anxiety about what else could go wrong. Adding shame to this litany of stresses likely thwarts any progress in tackling the illness.

As Flanigan says, “The biggest emotional toll for people with chronic illness is being told the lie that they need to fix their disease.”

Flanigan doesn’t suggest that individuals dealing with chronic illness should ignore the physical healing process but rather that they use their diagnosis as a discovery process. She points out, “Often when individuals stop assuming they are healing wrong, stop giving in to the view that they are not trying hard enough or haven’t found the ‘missing key’ to healing, their bodies start healing rapidly.”

Past Trauma and Autoimmunity

A study carried out by the Centers for Disease Control and Prevention examined the relationship between adverse childhood events (ACEs) and the development of autoimmune diseases in adulthood. Examples of ACEs included childhood physical, emotional, or sexual abuse; witnessing domestic violence; and growing up with substance abuse, mental illness, parental divorce, or an incarcerated household member. The data revealed that trauma (ACEs) in childhood increased the likelihood of hospitalization in adulthood due to autoimmune disease.

Not everyone with an autoimmune disease will have a traumatic past, but it is certainly a factor to be considered in understanding the layered history of chronic illness. And it further illustrates that addressing only the current physical concerns of chronic disease may address only a portion of the problem, which could include past trauma, thereby limiting the results that might be obtained.

Restrictive Diets and Orthorexia

Following a supportive, individualized diet plan can transform your health, especially if you have a chronic illness. There are countless studies that support the therapeutic benefit of diet in diseases such as irritable bowel, cardiovascular issues, autoimmune conditions, and Alzheimer’s. Yet, if you have a chronic illness, you could find yourself on lifelong, highly restrictive elimination diets. Many patients either haven’t been told or fail to understand that these intense diets are not intended to be carried on indefinitely. In addition, many patients feel unsure about what they “can” or “should” eat outside of these restrictive protocols.

This is where nutrition guidelines can become detrimental—both physically and emotionally. As Flanigan says, people often become hypervigilant about food because if they can’t reintroduce foods, they think they are doing something wrong and need to try harder. Unfortunately, this message is often reinforced in online autoimmune protocol diet (AIP) support groups. For some patients, continuing the AIP diet for longer than the commonly recommended six weeks can cause them to develop orthorexia.

Relationship to Illness

The incessant search for the next supplement, latest food plan, or newly discovered environmental factor is incredibly taxing if you have a chronic illness. Rather than jumping from one protocol to the next, it may be important to explore discontentment due to the trials of chronic illness. It may seem undesirable to approach an illness in this way because it has the potential to awaken deep emotional pain. However, according to Flanigan, this approach assumes that even though emotional suffering may be present through this process, it can be the answer to unlocking the emotional issues that cause and/or keep someone ill. “That small shift can be profound for hopeless clients,” Flanigan says.

Chris Kresser, co-founder of the California Center for Functional Medicine, uses his own experience of accepting his chronic illness as an example of the power emotional work can provide. “Accepting that I was ill did not make the illness go away. Nor did it stop me from continuing to pursue treatment in the hopes of improving my health. What it did do is remove an entirely unnecessary layer of suffering that came from continuously struggling against what was true in each moment.”

Thomas R. Egnew, clinical professor emeritus at the University of Washington Department of Family Medicine, has treated patients individually and studied behavioral science for decades. He advocates a treatment model for those with chronic illness that includes what he calls the “narrative approach.” This approach encourages patients to tell their stories as a means to understand their experience and derive meaning from it. Egnew says that through uncovering conflicts in a patient’s narrative, acceptance and meaning can be discovered and suffering transcended.

Radical Compassion

Leaning into your emotional pain—both past and present—requires deep self-honesty and radical compassion for yourself. Yes, it’s important for you to take ownership of your actions, but it is just as crucial to be forgiving and patient with yourself. While chronic illness may feel all-encompassing, it doesn’t represent your entire identity. Your body is not failing, bad, or broken; it is trying to communicate its need for support. Self-compassion and acknowledgement of those issues are ways to provide your body with the help it needs. Kresser asserts, “to accept something means to let in all of the feelings and sensations that go along with that something. In the case of illness, it means feeling the grief associated with the lost dreams, the fear that we may never get well or that we won’t survive, and the isolation that comes from living with chronic illness.”

Using Egnew’s research as a guide, it is suggested that chronically ill patients look for healthcare professionals who help them work through suffering and are willing to accompany them through pain rather than trying to solve their problems external changes only. According to Egnew, it’s crucial that patients find practitioners that don’t inflict expectations on their patients, including expectations for physical healing. Patients should avoid any practitioner whose methods may result in shaming or embarrassing them for falling short of their goals. Patients and practitioners are a team, and the patient should not have to try to win their practitioner’s approval or adulation.

Flanigan reminds patients that there really is no way to heal wrong. Each step taken can yield valuable information even if it appears to be a misstep initially. What’s more, when treatment includes overly restrictive diets, patients can feel shame if they aren’t strong enough to do whatever it takes to heal. These feelings can result in massive, negative emotional tolls that may prevent the patient from healing.

Flanigan suggests that chronically ill patients ask themselves the following questions to understand their emotional perceptions of their illness:

• Do you think there is a right\/wrong way to heal?
• How do you find and experience safety in your body?
• Do you think you are getting punished by your physical illness?
• What is your relationship to your illness and physical body?

According to Kresser, not accepting something doesn’t make it go away. It just distances the patient from themselves and reality. “When we accept what is, we are free,” Kresser says. “Free to act in accordance with reality. Free to be at peace with the circumstances of our lives, no matter how undesirable or difficult they are. And free to continue to do everything in our power to improve the conditions of our lives (or of life in general) in the next moment.”