The Role of Fear and Self-Abandonment in Chronic Symptoms

A popular concept in the field of mind-body medicine is that fear fuels chronic symptoms.

I find this concept helpful for understanding and healing from chronic pain and other stress-related symptoms, but I want to propose an additional layer of nuance.

Fear, like pain, is something that we need for survival. Without fear, we wouldn’t run for cover when a tornado is coming. Without pain, we wouldn’t pull our hand away from the stove when we get burned.

So, it wouldn’t be accurate to say that all fear is undesirable or that all fear leads to chronic pain. And it’s certainly impossible to get rid of fear or to never feel afraid again.

But there’s one type of fear in particular that I find most often in clients who struggle with chronic symptoms, and that is the fear of social rejection. This fear can trigger self-abandoning thoughts and behaviors, and habitual self-abandonment leaves us feeling helpless and hopeless. It can put our nervous system into a state of chronic stress that manifests in chronic symptoms.

Here are some anecdotal examples:

I’ve seen folks who are afraid to sit, stand or walk because it hurts, and the more they fear these activities, the more the pain persists. But what really escalates their pain levels is the fear that they will be rejected by their family, their job, their partner and friends for not being able to “keep up.” This social fear preoccupies them so greatly that they spend most of their energy trying to please others rather than prioritizing their own feelings, needs, desires and pleasures. And this habit of self-abandonment puts them in a chronic state of stress.

I’ve seen folks who are afraid to go out for a night on the town for fear that it will trigger a migraine attack. And the more they fear and predict pain, the more the pain persists. But what really escalates their attacks is the fear that friends and loved ones will see them as weak or pathetic or uncool for not being able to “keep up.” And again, it’s that social pressure that triggers self-abandoning habits which in turn leads their body to feel like it can’t trust them. And when our body feels like it can’t trust us, it freaks out and pulls the emergency alarm: symptoms.

If any of this is resonating with you, you might be wondering: OK now what? Now that I’ve recognized this pattern of fear of rejection and self-abandonment that exacerbates my stress levels and symptoms, what the heck can I do about it?

And my answer might not be what you want to hear, because when we’re feeling fearful, we want quick solutions and certainty. And as far as I know, the antidote to self-abandonment is something far more complex than that: it’s the gradual journey of developing self-compassion.

Developing self-compassion is slow work. It’s gentle work. It’s asking ourse in each moment, “what is the simplest, easiest, most doable step I can take right now to be just a little bit gentler and kinder toward myself?”

We can’t develop self-compassion with harsh expectations or by pressuring ourselves to transform our self-relationship overnight. We have to give ourselves the grace to do it one baby step at a time.

So, keep it simple and ask yourself, “what is the simplest, easiest doable step I can take — from exactly where I am right now — to bring just a tiny bit more kindness and gentleness into the way I treat myself?”

I’d love to hear what you come up with!

➡️ If you need support with chronic pain and anxiety, take my FREE QUIZ called “Why the *bleep* am I still in pain?!” so I can help you get some clarity.

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Anna Holtzman
Anna Holtzman
Anna Holtzman is a chronic pain recovery therapist and coach based in New York City.
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