ME/CFS, Long Covid, and Disconnection From the Self
Could the ways you meet the world make you vulnerable to chronic fatigue?
Posted June 11, 2025 | Reviewed by Monica Vilhauer Ph.D.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long Covid are complex and often disabling health conditions. They are multifactorial, with research demonstrating that common triggers for these overlapping illnesses include different forms of biological and psychosocial stressors: infections, major life events, and exposure to toxins.
Physical symptoms are undeniably real. Meanwhile, clinicians and researchers have observed a cluster of personality traits that are present in many people living with these illnesses. A striking number of people affected by these conditions have traits such as perfectionism , people pleasing, hyper-responsibility, self-sacrifice, a high drive to achieve, and a strong aversion to letting other people down.
Related to these traits, research also suggests that people living with ME/CFS may be more likely to suppress emotions.
This has led some to hypothesise that personality traits may themselves contribute to a person’s vulnerability to becoming ill. The current research on this question is ambiguous. A group of Dutch researchers reviewing 16 studies concluded that:
“Although personality seems to play a role in CFS, it is difficult to draw general conclusions on the relation between personality and CFS”.
Understanding, not blame
At this point, you may well feel uncomfortable with the idea that our personality traits could somehow contribute to something as life-altering and devastating as becoming unwell with a chronic illness . It may feel blaming and stigmatising. I fully understand and respect this concern.
So let me be clear: I am not suggesting that personality traits constitute a singular cause for these illnesses. However, as someone who has historically identified with all the traits listed above, and who has recovered from ME/CFS and long Covid, and now works with other people living with these conditions — I have learned to be curious about this connection. As Gabor Maté has written on this subject:
"Asserting that features of the personality contribute to the onset of illness and, more generally, perceiving connections between traits, emotions, developmental histories, and disease is not to lay blame. It is to understand the bigger picture for the purposes of prevention and healing – and ultimately for the sake of self-acceptance and self-forgiveness .”
It is also worth noting that researchers have identified similar personality traits as vulnerability factors in many other, less contested, physical illnesses, from cancer to multiple sclerosis. Back in 1987, psychologist Lydia Temoshok proposed the “ type C ” personality, in response to interviews with 150 people with melanoma. She identified people in this group as consistently being: “excessively nice, pleasant to a fault, uncomplaining and unassertive”.
Ways of meeting the world
Whereas the language of “personality trait" may give the impression of immutability, I have come to understand self-sacrificing, people pleasing, and so forth, not as psychic pillars firmly set in stone, but rather as learned patterns of behaviour.
Why would anyone learn to ignore their emotions, to default to self-suppression, and to rigidly meet the needs of others before oneself? For Gabor Maté, "nobody is born with such traits. They invariably stem from coping mechanisms to developmental trauma , beginning with self-abnegation in early childhood .”
Whether or not we feel that the language of “trauma” applies to us, many of us learn early in our lives that, on some level, who we are is not okay. We may come to internalise a view that in order to get our needs met, we must be untroubled, good, helpful and responsible. Psychoanalyst Donald Winnicott called this the “false self”.
In many cases, the tendency to disconnect from one’s own core needs does appear to result from messages received, even if inadvertently, from our caregivers. In childhood, there is never really a choice between attachment with our caregivers and living authentically; attachment wins by default, since our survival depends on it.
Disconnecting from one’s true self can, of course, also be reinforced by wider influences. Modern capitalist culture places our productivity above almost anything else. We persistently valorise pushing through adversity without paying too much attention to our needs or feelings, as codified by aphorisms and slogans: don’t dwell on it, keep calm and carry on, no pain no gain, and just do it.
Undermining the brain’s search for balance
How is it, then, that a tendency to disconnect from your authentic self may predispose you to a fatigue related illness? On a superficial level, we can all intuit that being a self-sacrificing, perfectionist, high-achiever is likely to be potentially exhausting, and to expose us to burn out . It doesn't take a neuroscientist to see that.
A little more empirically, one study found that people with ME/CFS were not only more prone to suppressing their emotions than people without a health condition, but that when they did, this led to greater nervous system activation. In other words, habitually bottling up emotions is significantly more demanding and therefore draining for your body.
From an evolutionary biological perspective, we can consider how important it is for our survival to be attuned to our own core needs. As Maté describes:
"Imagine our African ancestor on the Savannah, sensing the presence of some natural predator: just how long will she survive if her gut feelings warning of danger are suppressed?”
Meanwhile, neuroscientist, Lisa Feldman Barrett offers some food for thought on how certain ways of meeting the world can serve to undermine the brain in its attempts to keep the body in balance:
“The brain’s most important function is running a budget for your body …to regulate the systems of your body in the world, to make sure you stay healthy and alive and well …But when a brain is running on ideology, that is dangerous for your health.”
The language of “running on ideology” may not feel the most compassionate way to think about your patterns of behaviour. But still, it makes sense that when we are living our lives according to rigid expectations of ourselves — for example that we must never let other people down —we are effectively undermining our brain as it seeks to prioritise our body’s metabolic needs.
Of course, many people live their entire lives in self-sacrificing ways and don’t have a chronic illness. However, when we live in this way and then encounter a perfect storm of threatening life events — say a global pandemic, a bereavement , a job loss, and a viral infection — the brain may come to doubt its ability to maintain balance. This has been described by researchers as a loss of allostatic self efficacy .
In the face of this overwhelming picture, the brain may send signals of danger and overwhelm to different bodily systems, including the immune system, the gut, and the endocrine system. The result may be a state of increasing dysregulation, or dyshomeostasis, in the entire organism, and a number of unpleasant persistent physical symptoms.
Rebalancing your life
In my view, looking at the ways that we meet the world is likely to be part of the puzzle for many people living with long Covid and ME/CFS. I fully accept that it may not be for others. If this does feel at least partly relevant for you, it offers you some important cues for areas you may want to focus on in the service of recovery and improved health.
Reconnecting to long suppressed emotions is difficult, but potentially healing. Meanwhile, befriending the parts of you that have learned to meet the world in sometimes extreme ways can allow them to soften.
These shifts can send a powerful message back to the brain: things are going to be different moving forward. Since the brain is a predictive machine , this information can be incredibly important as the brain gradually comes to regain its confidence in its ability to rebalance the body, which in turn may contribute to a reduction in symptoms.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.