May have accidentally stumbled upon the true intentions of the "Pacing-Up" Approach

[Elara Grey]

I accidentally came across a post on social media that may explain the aim of the 'CFS Recovery' and BACME-style version of pacing aka "pacing up".

The post read to me as yet another programme being sold for financial gain, and isn't my cup of tea.

However, it explains a lot. The words from the post are below (AI compilation from screenshots):

----- Start quotation:

BASELINE? PACING? NOT PACING?​

​

How seemingly conflicting advice sent me into a confusion spiral — and what I learned​

In 2026, after 7 years of chronic illness, I committed to one thing: stop the push-crash cycle, find my baseline, build slowly. But the crashes kept coming.​

​

A friend (Sue, recovered after 20+ years with ME/CFS) reminded me: the thing that helped most was baseline — having that structure.​

What baseline means: Reaching stability where you're not pushing and crashing. Learning what you can do without worsening symptoms. Stabilise for a few weeks, then increase activity by 5–10% at a time, each new activity at only 50% of capacity. Stabilise. Increase again.​

​

I thought that's what I was doing — until a Heal programme co-founder said they don't recommend pacing. I spiralled. Then I contacted him directly and discovered his definition of pacing was different to mine. What he recommended was essentially what I was already doing and calling pacing.​

​

The research rabbit hole led to a reframe:​

"Pacing" has historically meant stopping any activity that causes symptoms — which can lead to getting stuck, bedbound, and regressing. Avoiding symptomatic activity can reinforce the body's fear response and worsen symptoms over time.​

​

The reframe: It's not about pacing activity. It's about pacing the nervous system. Teaching the body it is safe again. Dr Naviaux's Cell Danger Response research describes how the autonomic nervous system, under sustained threat, can lock into a protective metabolic state long after the original danger has passed.​

​

So what now?​

The approach is the same — but the understanding is deeper. It's not about doing less or more. It's about how the nervous system feels while doing it. Building at a pace where the body feels safe, not pushed past its limits.​

"It's not back to square one. It's on to square one — with more tools, awareness, self-compassion, and acceptance than ever before."​

----- End quotation.

Bolding and underscoring mine for emphasis.
Source: @mind.body.heal on Instagram, publically available. Accessed 11th May 2026.
Link here if you don't mind messing your algorithm up.

Ahhh. So there you have it, folks. Perhaps this explains the same premise of the likes of the BACME approach? Or a similar premise? A premise that hasn't been explicitly written into their therapy guide or documents. But maybe this is it? Plausible deniability that "pacing up is not based on deconditioning".... If they have reframed pacing as "slowly teaching the nervous system it's safe".

There's the ick we all knew was there!

I still call it BS, and it's still a psychological approach at the end of the day, no matter how much it (BACME approach) is dressed up in borrowed biomedical language. It's still trying to train the 'nervous system' that the smoke alarm is a false alarm without having addressed the fire burning the building down.

 

[Alinda]

Its just the same as what I was teached in CBT and GET, like 0 difference. It's so dangerous.

 

[Elara Grey]

Its just the same as what I was teached in CBT and GET, like 0 difference. It's so dangerous.

Precisely.

 

[Trish]

That sounds like a variation on the BACME dysregulation model that is based on misapplying poor quality unreplicated research. They don't say their pacing up is based on deconditioning, but on desensitising and regulating various body systems by stabilising then increasing.

Initially the focus is on consistency and regulating, to support stability beforeincreasing the level of demand. This should be done gradually allowing developmentof tolerance and adaption prior to any further increases in demand, to enable thebody to rebalance.Therapy programmes should work on different phases of stabilisation and thenbuilding tolerance.

It's all nonsense. It sucks people in because the initial advice to reduce activity and stabilise symptoms feels good and gives a sense of control, so pwME believe the therapist that the next stage of increasing activity will improve their health, instead of which they keep crashing, and blame themselves for doing it wrongly.

 

[Jonathan Edwards]

I still call it BS, and it's still a psychological approach at the end of the day, no matter how much it (BACME approach) is dressed up in borrowed biomedical language. It's still trying to train the 'nervous system' that the smoke alarm is a false alarm without having addressed the fire burning the building down.

I agree that this is the BACME nonsense. However, it may well be that we will end up seeing ME/CFS as a false alarm problem. So far we have no evidence of anything burning down. It all seems in order. What is BS is the idea that if the nervous system is set to fire off alarms when it shouldn't that you can change that by keeping quiet and then sneaking up on it. There is zero reason to think that would work.

And if there is a false alarm it is not at a 'psychological' level but at a chemical level probably much further down the central nervous system than where anything is 'felt'. Maybe in the dorsal root ganglia cells or hypothalamus. Maybe in the vagus nerve.

We know of diseases where that sort of thing happens - familial Mediterranean fever, where the alarm signals are even further down in body tissues and familial episodic pain syndromes where I guess the alarm is in the sensory nerves. If there is a small fibre neuropathy in fibromyalgia that may well be where false alarm signals arise. And so on.

 

[Elara Grey]

That sounds like a variation on the BACME dysregulation model that is based on misapplying poor quality unreplicated research. They don't say their pacing up is based on deconditioning, but on desensitising and regulating various body systems by stabilising then increasing.

My thoughts exactly. I was wondering if BACME haven't written in precisely that it's based on "making the nervous system feel safe" on purpose. Writing it like that into their literature would be a dead giveaway that they're still following a BPS approach. However, writing it as 'regulating body systems to stabilise and then building tolerance' and going on about "dysregulation" is the same thing... But gives them plausible deniability through word choice.

But their clinics are full of talk about the nervous system...

So yeah, I think I was more trying to say that perhaps the whole dysregulation model approach is just specifically chosen words for "building nervous system safety". Linking with other discussions, the concept of the "dysregulation model" is basically unfalsifiable. No doubt that's on purpose.

I wonder whether they are really using that language as a cover for the above definition of pacing as "building nervous system safety"? Language matters, and had they written it differently, defining it like the above, then there may have been a way of establishing their premise as false.
Both are essentially the exact same thing... At least in my experience. And the same as CBT and GET.
All just cleverly worded in the dysregulation model so that it's difficult to falsify.

It's all nonsense.

Quite. Just nonsense that's difficult to dismantle the way BACME have chosen their language.

 

[Elara Grey]

However, it may well be that we will end up seeing ME/CFS as a false alarm problem

Sure, I understand that perspective from the way you're describing it and that may turn out to be a possibility one day. Perhaps not my best analogy using smoke alarms and fires... But yes, I get what you're saying.

What is BS is the idea that if the nervous system is set to fire off alarms when it shouldn't that you can change that by keeping quiet and then sneaking up on it.

Absolutely!

 

[Jonathan Edwards]

I wonder whether they are really using that language as a cover for the above definition of pacing as "building nervous system safety"?

I think you may be attributing a higher level of analysis than is needed. I think they have picked up on some nice sounding words. I am not sure there is more to it than that.

The error is to use the psychologists' assumption that once you have identified something wrong you can magically put it right by telling it how to go away. Telling TRPM3 how to go away isn't much good because TRPM3 doesn't speak English! And it probably doesn't take much notice of psychologists, or indeed a bit a gentle 'up pacing', anyway.

 

[BrokenBeaktheBrave]

So far we have no evidence of anything burning down. It all seems in order.

Wouldn't people dying from starvation because they can't swallow be evidence that something is going wrong? Do we know why very very severe MECFS lose their ability to swallow?