Font Size

Chronic Fatigue Syndrome: Using Cognitive-Behavioral Therapy

What is an Actionset?

Cognitive-behavioral therapy is good news for people who have chronic fatigue syndrome (CFS). Studies show that this type of therapy can help you feel better.1

Return to topic:

Cognitive-behavioral therapy teaches you how to change your thinking and fears that prevent you from planning and managing your activities realistically. Research shows that people who have chronic fatigue syndrome (CFS) can improve when they learn about their ability to control their health and then take steps to do so.1

Some facts about cognitive-behavioral therapy:

  • It is not psychoanalysis. You will not be asked to lie on a couch and delve into your subconscious and your dreams.
  • It's more like coaching or counseling. You and your therapist will talk about what your goals are and ways to reach them.
  • It's not about fooling yourself into thinking positively. It's about learning how to think accurately about your situation instead of letting fear guide your feelings and your behavior.
  • Therapists teach self-help strategies, such as gentle exercise, improving sleep habits, learning to pace daily activities, getting support from others, and daily meditation and relaxation exercises.

Test Your Knowledge

Cognitive-behavioral therapy helps people who have CFS by:

Analyzing dreams to determine the subconscious causes of the illness.
Identifying incorrect thoughts and beliefs to help the person learn to cope realistically with his or her illness.

The people with chronic fatigue syndrome (CFS) who have the best chance of improvement are those who remain as active as possible and who seek to have some control over their illness. A therapist can help you do that. For example, you may believe that any activity that causes fatigue will make your illness worse. You may be afraid to expend energy for fear of having a relapse.

Because a cognitive-behavioral therapist helps you work on your thinking patterns and on the way you react to problems, you can learn to let go of beliefs and fears about CFS that may be contributing to inactivity and despair. With therapy, you can learn how to calm your mind and your body so that you can feel better, think more clearly, and make better decisions.

Test Your Knowledge

Any activity that makes you tired should be avoided because it will only make your illness worse.


For most people, therapy usually consists of weekly 1-hour visits over the course of just a few weeks or months. Longer-term and/or more frequent therapy is available for those who need it. Here are some of the techniques a cognitive-behavioral therapist may teach you:

  • Keeping an energy diary. This can serve as a guide for what limits you should set on your activities and how to plan your day according to how your energy level changes throughout the day.
  • Confronting discouraging thoughts. This will help you move from the idea that "I'm not strong enough" to the idea that "I will find evidence to show that I can control this disease."
  • Learning to be flexible. This can help you adapt when your energy levels vary from their usual pattern.
  • Setting limits. Many people who have CFS need to learn how to pace themselves to avoid overexercising and bringing back their fatigue.
  • Prioritizing and delegating tasks. You can identify jobs or activities that are more important for you to perform and assign family and friends to perform others.
  • Accepting relapses. It's easy to do too much too soon. And it's important to accept what happens when you do that—and then move on.

Therapy can be expensive and may not be covered by insurance. But the fact that it is usually short-term helps keep the cost down.

Test Your Knowledge

Cognitive-behavioral therapists use self-help techniques to teach people who have CFS how to manage their lives more effectively by setting goals, prioritizing tasks, and learning to be flexible.


Talk with your doctor

If you're wondering whether cognitive-behavioral therapy is for you, take this information with you when you visit your doctor and talk about it.


  1. Reid S, et al. (2011). Chronic fatigue syndrome, search date March 2010. BMJ Clinical Evidence. Available online:

Other Works Consulted

  • White PD, et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. Lancet, 377(9768): 823–826.

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerNancy Greenwald, MD - Physical Medicine and Rehabilitation
Last RevisedJanuary 18, 2013

eMedicineHealth Medical Reference from Healthwise

This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

To learn more visit

© 1995-2014 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Medical Dictionary