Post-viral illness has received increased attention lately due to the Covid pandemic. People are experiencing persistent symptoms long after their initial Covid infection. You might hear this called “long Covid,” “long-haul Covid,” “post-acute Covid,” or “chronic Covid.” Maybe a family member or a coworker—or even you, yourself—has been dealing with this ailment.

Yet chronic infection has been silently and steadily sidelining sufferers even prior to Covid-19. In recent decades, a wide swath of the population has been grappling with vaguely-defined conditions like chronic fatigue syndrome (ME/CFS) and fibromyalgia. They feel perpetually ill and they don’t know why.

Chronic infection is frequently at the root of these conditions. Whether it’s tick-borne pathogens (which can cause illnesses like Lyme Disease, anaplasmosis, and babesiosis) or Epstein-Barr or cytomegalovirus or a coronavirus or any of the other countless invisible invaders—these “bugs” bury their way deep into our inner terrain, disrupting our physiology and derailing our lives.

Traditional East Asian Medicine offers a useful framework for understanding and treating chronic infection. It’s known as “Gu Syndrome.”

In Chinese, the character for Gu depicts a cauldron filled with worms: 蠱. Indeed, in chronic infection, the “vessel” of the body has been overrun by little critters. A vulnerability in the person’s physiology created a vacuum, and we know that “nature abhors a vacuum.” That space gets filled by opportunistic parasites.

Gu evokes the idea of “possession.” The person is possessed by a foreign entity. An invader has, to some extent, hijacked the system. Our “inner throne” has been usurped.

And while the pathogen delights in the consumption of our resources, we experience chaos: fatigue, malaise, brain fog, pain, poor sleep, digestive disturbances, cognitive problems, mood dysregulation, cardiovascular irregularities, and respiratory issues are some of the many possible symptoms. We might just perpetually feel run-down, crummy. We might have a good stretch, which makes us think we’re “over it,” only to be toppled again by a new wave of debility.

The inner turmoil caused by pathogenic invasion carries the potential to:
• impair our relationships with others, including our families (since our up-and-down health can make us withdrawn and unpredictable)
• hamper our capacity to make a living (since our bodies and minds might not be up to tasks that we could easily accomplish before)
• disturb our mental-emotional well-being (since infections can dysregulate our neuro-endocrine rhythms…and since being chronically ill can simply wear away at a positive outlook)

So, we understand the problem: the invasion of our inner terrain is disrupting our lives. Then, it must follow that the answer is to kill off the bugs, right? Let’s nuke ‘em!

Well, it’s not so simple. In chronic infection, the pathogens have often embedded themselves deeply into our inner ecosystem. Heiner Fruehauf, who unearthed and popularized the concept of Gu over the last two decades (see here and here), likens pathogenic possession to oil seeping into flour. Once they’re together, they’re quite difficult to separate!

So, how can we reclaim our inner terrain?

When we’re possessed, our body has been turned against us. Our various bodily systems (immune, endocrine, etc.) stop working together coherently. There’s disorganization, fragmentation, chaos. The bugs “feed” on this chaos.

We need to “remind” our systems how to communicate and collaborate with coherence, to serve us instead of the pathogen. When our physiological networks are working together harmoniously, they will naturally dispatch the invaders. There’s simply no space for the bugs. At that point, we will be able to climb back on our inner throne.

So, it’s about the terrain—our resources, the capacity for our various systems to work together efficiently and effectively—more than the pathogen itself. Western biomedicine tends to get trapped by concentrating on the bug; but we would benefit more by focusing on supporting our inner ecosystem to regain harmony.

We can do this in three ways:
1) Take medicinal herbs daily
2) Get bodywork regularly
3) Make appropriate lifestyle adjustments

Plants have spent millennia evolving sophisticated responses to pathogens. When we take herbs, we borrow plants’ intelligence and power. Furthermore, herbs are quite safe. Whereas pharmaceuticals often have harsh side effects and addictive properties, herbs are gentler and more holistic. This is very important in a body that’s already off-balance due to infection.

Herbs teach the body how to have proper flow. They remind its components how to work together efficiently and effectively, so that eventually the herbs themselves are no longer needed.

There is a wide variety of herbal traditions to choose from: Traditional Chinese herbalism, Western clinical herbalism, Western folk herbalism, Native American herbalism, Ayurvedic herbalism, and more. I encourage you to be curious: seek out local herbalists and start testing out their herbal prescriptions. Listen to how your body is receiving them, and, with your herbalist or on your own (if you’re trained), make adjustments.

While supporting yourself by taking herbs internally, you can also seek external support in the form of bodywork. It can be quite useful to have someone outside of your “operating system” assessing how things are working and providing supportive touch-based therapies. One benefit is that it places you in the position of receiving, being taken care of, nurtured, touched. This is so important in cases where chronic infection might leave us feeling alienated. Being heard, seen, touched, and understood can really soothe our mammalian cravings.

Like herbalism, there are a whole range of bodywork options, from massage to acupuncture, craniosacral to chiropractic. No matter what type of bodywork you pursue, I highly recommend that you find someone who is able to “titrate” their approach based on your needs.

Let me elaborate on this point for a moment: When we’re chronically ill, we might feel desperate for help, and it can be tempting to seek out extreme therapies and practices. We might assume that nothing’s happening unless we’re feeling pain or ecstasy, unless we’re streaming sweat or pooping our guts out. Such experiences can feel cathartic in the moment. They can make us feel like something is fundamentally changing for the better.

However, chronic infection tends to require a gradual, titrated approach. Less is more. With each treatment session, the aspiration is to incrementally improve. The goal is to slowly and steadily strengthen your inner resources.

“Over-treatment” is unfortunately a common occurrence in the healing profession. Intense treatment approaches can actually deplete patients in the longterm. They can create significant setbacks for those dealing with chronic illness. So, I encourage folks to find a practitioner who abides by the maxim of “less is more.”

This logic also applies to my third area of focus: lifestyle adjustments. With chronic infection, it’s essential to try to simplify. Your system is already under intense stress from the pathogenic invasion. So, keep things as simple and un-stressful as you can.

Try to keep your meals basic (avoiding sugar and alcohol and processed foods) without getting wrapped up in unnecessary diets (which can often cause more anxiety than they’re worth).

As much as is possible, try to keep your mind healthy. Provide yourself with creative outlets. Spend time in nature, away from devices. Try to keep a meditation practice, even if it’s small. Pursue therapy if needed.

There are many members in our “mental committee”—the mind is made up of many voices, each representing a strategy for achieving happiness. When we’re chronically ill, our harsh, harmful voices can often get louder: self-critical voices, voices promoting hopelessness and despair, blame and resentment.

But our fears and hatreds only serve as food for pathogens; our psychic anguish can prolong our sickness. Chronic illness presents an opportunity to promote the beneficial members of our mental committee that might have been silenced in the past—qualities like patience, kindness, and discipline.

If, for instance, we’re used to ignoring our bodily signals and “pushing through” our fatigue, now’s the time to start listening to what the body is telling us and wisely responding. That might mean slowing down; resting; saying “no” to events or people that might leave us drained. It might mean soothing ourselves like we would a crying baby; offering ourselves kind words and gestures; letting go of our obsessions and compulsions.

Our mental health can also benefit from consistent—yet moderate—exercise. Find some regular movement practice that doesn’t leave you exhausted afterward (might I suggest Qigong?). Some folks battling chronic infection find that they get easily depleted by aerobic exercise (such as walking, jogging, or cycling), but they do well with anaerobic exercise, like weight-lifting. Also, much like physical movement, dry-brushing your skin can help to keep the lymph flowing and the immune system healthy.

Chronically ill folks tend to already feel overwhelmed by basic tasks, so, again, keep it simple: Take herbs. Get bodywork. And implement regular self-care practices.

The path back from chronic infection is sometimes long and winding. The medical community still knows so little about illnesses like chronic Covid. It can be frustrating and dispiriting for sufferers to not have any answers.

Start by taking the above steps. One foot in front of the other. Keep a broader view, and celebrate incremental success. And know that I’m here as a resource! Offering gentle four-needle acupuncture treatments, Chinese herbalism, and guidance in Qigong and meditation, my goal is to help promote harmony among the various organ systems. When our systems are relating harmoniously, we have the best chance for regulation and resilience. We have a real opportunity to regain our inner sovereignty.