If you're among the many women who have been diagnosed with an autoimmune disease or related condition (ARC), or if you know somebody who has, you might try to educate yourself as so many of us do these days; namely, by walking into a bookstore and searching through title after title on the subject. On the other hand, you could sit in the luxury of your home combing through the online bookstores that are proliferating daily. Of course, there are those of us who prefer the good old library, where we can look through the stacks and catalogs. Whether you try any or all of these approaches, you could become quite frustrated locating a book on ARCs. If you did locate some, you might become equally frustrated with their extremely technical presentations and high prices. This reflects the fact that, until recently, this topic was primarily under the purview of scientists and researchers. Even for these individuals, it has only been within recent decades that an improved understanding of the autoimmune system, ARCs, and their prevalence has developed. While science has gained important knowledge about these conditions, considerable mystery remains as to the underlying dynamics of the disorders. In addition, there has been little attention paid to one major fact: These disorders affect women in far greater numbers than men. When considered in light of other trends in our society and medicine in particular, this gap isn't surprising. Such trends and reasons are explained in this chapter and throughout the book.

...   I have a personal tie with the topic as I have several of the conditions described here. I've gone through (and continue to go through) many of the same very difficult experiences that both you and the women who generously offered to share their stories herein with us have had to contend. So, first off, I hope to help you feel you're not all alone in feeling picked on by the system, particularly doctors, insurance companies, and the like. Secondly, I'm hoping that by getting the word out about such harassment, we women can band together in effective ways, and thereby effect a change in the system. I've never agreed with the notion of treating people with less consideration because of their sex, race, health, social status, socioeconomic status, or any of the other labels our society loves to cut and paste. With regard to ARCs, as in general the effects of such differential treatment are incredibly harmful. While some medical professionals are experts in these conditions and wonderfully supportive of women dealing with these challenges, the majority continue to indulge in disbelief, stereotyping, and minimizing the seriousness of mind-body debilitation, fatigue, and pain. Women with ARCs often hear statements such as, "Say, I have someone great you should go talk to . . . ," from doctors who think, "Oh no ... another neurotic, probably depressed woman! She looks okay. Can't these women see I have really sick people who need my time and attention?" Such attitudes contribute to our painful debilitating conditions and worsen our mind-body health.

A third reason for my setting out on this challenging path involves my desire to disperse the knowledge I've gained from the many women I've worked with, whether as individual clients or members of workshops and seminars. I've also learned much from and felt great empathy for the many women I've chatted with for hours as we've duly waited to be called in by our doctors. With the women with whom I work in particular, I've noted the undeniable efficacy of applying the notions of holistic healing and mind-body intervention in beating the odds against these tricky illnesses, which don't play by the rules and lure our bodies into working against us. The more female clients I was referred with these physical conditions, and the more I researched and learned as a result, the more disgusted I became with the shocking dearth of information about these complex conditions. Particularly lacking is the type of information that women need to improve the quality of their mind-body health. My goal is to provide sufficient data and suggestions to help in this quest so women like you and I can learn, make changes, improve our mind-body health, derive new meanings for our lives, and thus thrive rather than just survive.

There are two more reasons I believe you'll derive benefits from this book. One is that when people learn and understand more about their particular conditions, they derive a sense of control and involvement-both of which improve recovery and healing. Secondly, from my varied roles in working with women with ARCs, whether as therapist, lecturer, e-mail correspondent, interviewer, and comrade, I've seen one noticeable trait that can't be ignored. These women are among the most ardent pursuers of knowledge regarding their conditions I have ever seen. Perhaps we're motivated by frustration brought on by the denial from the medical system as to the reality and pain of our conditions, as well as the insulting comments we've received, ranging from "It's all in your head" (known by the inner circles of patients as IAIYH) and "You look too good to be sick" to "Insurance doesn't cover that." I believe this book will help in our dedicated quest for knowledge and tools that can reduce our cycle of pain, illness, guilt, depression and the resulting further dampening of our immune systems.

I've included stories from women like us, hoping the information helps create a sense of sharing that will mitigate the aloneness and hopelessness many of us feel. Also, I asked each thriving woman for techniques and tools that helped her mind-body healing and her ability to cope with her new life. Each woman also shared what she had learned from her illness and how she had changed and grown. Talking about their experiences helped these women more clearly see their progress in the face of adversity, their strength, and their continued hope. The point is that no matter how ill you are, there are things you can do to assume control over improving your mind-body health. Too many women have experienced intense distress and pain from their illnesses and then have had to endure negative forecasts or demeaning comments from doctors or loved ones. Feelings of hopelessness and worthlessness are easily comprehensible in this light. I recall finally receiving my diagnosis after having made the typical exhaustive rounds of doctors. The doctor who gave me the news was right on with the diagnosis but completely off with the delivery: "You have fibromyalgia and chronic fatigue syndrome. They're chronic-you'll have 'em for the rest of your life ... pain and fatigue. There's really nothing you can do about it." This is worse than poor practice, given that there is much evidence that negative, disheartening messages like these can worsen mind-body health.

I received encouragement to write this book from others based on my experience with women and health psychology, as well as the knowledge and understanding I gained in writing my previous book, High on Stress: A Woman's Guide to Optimizing Stress in Her Life. It's my hope that this knowledge and understanding, as well as some shared experiences, will help you develop a sense of trust and willingness to work with me, particularly in the sections entitled What You Can Do. These are composed of alternative and conventional, allopathic techniques and recommendations to reduce symptoms and pain, to heal, and to go beyond enduring to actually thriving in the face of real obstacles and difficulties. Please try to use a notebook or journal during your healing process. Actually writing down thoughts, feelings, memories, images, dreams, plans, assumptions, realizations, progress, letters to people in your life (whether or not they're sent), lists of goals and priorities, schedules, and charts showing your pain in conjunction with stress, diet, exercise, and medications, are among the most effective tools you can use as you journey along your self- and health-optimization course (SHOC). At this point, I would like to explain two other reasons I took on such a technically and emotionally challenging topic. I suggest you write them down in the very beginning of your personal notebook.

• I want this book to empower you by helping you understand what is going on within your mind-body system. The greater your understanding, the more informed your decision making. You'll also feel a greater sense of control (over your symptoms, responses to your ARC, and the whole medical system-self interaction), and won't be so overwhelmed by fears of the unknown. Each of these three elements (greater understanding, a sense of control, less distress regarding the unknown) directly reduce negative stress (distress).

• The less distress you experience, the less immune-system suppression you'll experience, and the more energy you'll have available for positive purposes such as extinguishing your negative, irrational thinking and replacing it with positive, rational thinking; designing and leading a balanced, harmonious lifestyle; getting in touch with the priority goals for your life and ensuring you follow those that are consistent with your values, enhance your sense of self, and allow you to grow in the direction you choose rather than in the ways you believe you "should"; educating yourself about your ARC and the most effective conventional and alternative techniques (the combined whole yields results greater than the sum of its parts); participating in activities involving social support and human interaction; finding or rewriting the purpose and meaning of your illness and your life in ways that are relevant and motivating to you; including essential, appropriate prostress activities for you whether these are skydiving, mountain climbing, learning a new language or hobby, writing, or getting involved in a volunteer program.

One of the positive consequences of taking personal responsibility and assuming control of your life is reduced distress and suppression of your immune system. The healthful suggestions above complete the picture as they involve and generate positive emotions and power and can enhance your immune system functioning, enjoyment, and life growth. Amidst the tears of the women I interviewed came the ring of beautiful, healing laughter. May this book also help you on your journey toward healing.

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