Body Reprogramming: Reframing the Fibromyalgia narrative and providing an integrative therapeutic model

Abstract

We propose a theory known as the Hyland model to help conceptualise Fibromyalgia within a complex adaptive control system. A fundamental assumption is that symptom generating mechanisms are causally connected, forming a network that has emergent properties. An illness narrative has been developed which has a ‘goodness of fit’ with the lived experience of those with Fibromyalgia. The theory guides management within the clinical setting and incorporates current evidence-based therapeutic strategies, within a multi-modal intervention described as ‘Body Reprogramming’. This intervention focuses on non-pharmacological and lifestyle-based considerations. The theoretical framework also helps explain why modest therapeutic effects are gained from current pharmacological options.

UK healthcare services for people with fibromyalgia: results from two web-based national surveys (the PACFiND study)

“…The diagnostic turbulence ( [33], p2) evident in the accounts above, offers some insight into the number of healthcare professionals referring to other healthcare professionals to make or confirm a diagnosis of fibromyalgia, notably rheumatologists. In a few localities, rheumatology services diagnosed fibromyalgia routinely, in line with local pathways and or individual clinician referral behaviours: one general practitioner stated that fibromyalgia should only be diagnosed in secondary care as it could be "a devastating diagnosis of a severe chronic condition" (A-1351; GP Wales).…”

Explanation for symptoms and biographical repair in a clinic for persistent physical symptoms

“…In this paper we propose that providing scientifically plausible ( Van Den Bergh et al, 2017 ) and acceptable ( Davies et al, 2020 ; Salmon, 2007 ) explanations for symptoms in the context of an especially designed clinical intervention can be a catalyst for biographical repair. Offering and negotiating explanations for symptoms opens a communicative space in which epistemic incongruence in the clinic can be resolved ( Den Boeft et al, 2017 ; Hyland et al, 2016 ).…”

Body reprogramming for fibromyalgia and central sensitivity syndrome: A preliminary evaluation

“…A layered, metaphorical narrative has been constructed from this adaptive network theory incorporating the analogy of a sophisticated computer. 33 The body reprogramming (BR) therapeutic approach for fibromyalgia is designed primarily from the Hyland model. 33 It is multi-faceted, developed in partnership with patients and consistent with non-pharmacological evidence-based guidelines.…”

“…33 The body reprogramming (BR) therapeutic approach for fibromyalgia is designed primarily from the Hyland model. 33 It is multi-faceted, developed in partnership with patients and consistent with non-pharmacological evidence-based guidelines. 34 There are parallels to the recovery model with the focus on greater patient understanding of the condition and facilitating patients to take control of their own recovery rather than awaiting 'hardware medical fixes'.…”

“…A layered, metaphorical narrative has been constructed from this adaptive network theory incorporating the analogy of a sophisticated computer. 33 …”