ABSTRACT
This chapter discusses how to help patients work with other potential maintenance factors such as sleep problems, physical illness and viruses, iatrogenic factors, and disadvantages of recovering. It describes the elements of cognitive behavioural therapy for sleep problems. If chronic fatigue syndrome (CFS) patients are obese, this may be a contributory factor towards their symptoms, through the possible mechanisms of poor nutrition or having to carry about extra weight. This can be addressed in terms of helping the patient lose weight. One of the many unpleasant experiences that CFS patients have to suffer is that of frequent viruses. One can advise patients to avoid people and situations where they are likely to pick up viruses. Somatisation is a psychiatric concept that describes the patient who has multiple physical symptoms without a clear cause, and the significance of the word is that emotional distress is turned (‘somatised’) into physical distress.
