{"id":2318,"date":"2026-08-25T21:58:24","date_gmt":"2026-08-25T19:58:24","guid":{"rendered":"https:\/\/equilibriumpsychotherapy.net\/?p=2318"},"modified":"2026-09-08T21:38:27","modified_gmt":"2026-09-08T19:38:27","slug":"hypermobility-and-the-nervous-system","status":"publish","type":"post","link":"https:\/\/equilibriumpsychotherapy.net\/hr\/hypermobility-and-the-nervous-system\/","title":{"rendered":"Hypermobility and the Nervous System"},"content":{"rendered":"\n<style>\n\/* The accent is a light-background device. Inside a reversed-out panel it stops\n   being emphasis and becomes unreadable - coral on the Matrix closing panel\n   measured 2.0:1 - so the mark falls back to the panel's own text colour and\n   lets weight alone carry it. gOpen tags those panels .eq-ondark. *\/\n.eqp .eq-ondark .eqb{color:inherit}\n\/* House rule: bold emphasis is set in the article accent colour, so a marked\n   phrase belongs to the piece it sits in. v2-emph.js inserts\n   <strong class=\"eqb\">. 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     setTimeout(function(){e.target.classList.add(\"in\");},d);      bo.unobserve(e.target);    });  },{threshold:0.3});  Array.prototype.forEach.call(bands,function(n){bo.observe(n);});}var links=[].slice.call(document.querySelectorAll(\"#eqp-parts a\"));var tops=links.map(function(a){return document.getElementById(a.getAttribute(\"href\").slice(1));});var btn=document.getElementById(\"eqp-top\");var last=-1;var sync=function(){  var y=window.scrollY+window.innerHeight*0.32, cur=-1;  for(var i=0;i<tops.length;i++){ if(tops[i]){ if(tops[i].offsetTop<=y) cur=i; } }  if(cur!==last){    links.forEach(function(a,i){a.classList.toggle(\"on\",i===cur);});    last=cur;  }  if(btn){    var h=document.documentElement.scrollHeight-window.innerHeight;    var far=false; if(h>0){far=window.scrollY\/h>0.35;}    btn.classList.toggle(\"on\",far);  }};addEventListener(\"scroll\",sync,{passive:true});addEventListener(\"resize\",sync);sync();if(btn)btn.addEventListener(\"click\",function(){  window.scrollTo({top:0,behavior:RM?\"auto\":\"smooth\"});});}if(document.readyState===\"loading\"){document.addEventListener(\"DOMContentLoaded\",init);}else{init();}})();<\/script>\n\n\n\n<div class=\"wp-block-group alignfull eqp has-global-padding is-layout-constrained wp-container-core-group-is-layout-69fa9525 wp-block-group-is-layout-constrained\" style=\"margin-top:0;margin-bottom:0;padding:0px 22px\">\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<div style=\"color:#8d9695;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:400;margin-top:54px;margin-bottom:0\" class=\"has-link-color wp-elements-1 wp-block-post-date has-text-color has-work-sans-regular-font-family\"><time datetime=\"2026-08-25T21:58:24+02:00\">25 kolovoza, 2026<\/time><\/div>\n\n<div style=\"color:#8d9695;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:700;text-transform:uppercase;margin-top:0;margin-bottom:0\" class=\"taxonomy-category has-link-color wp-elements-2 wp-block-post-terms has-text-color has-work-sans-regular-font-family\"><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/body-and-mind\/\" rel=\"tag\">Body and Mind<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/deep-dive\/\" rel=\"tag\">Deep Dive<\/a><\/div>\n\n\n<h1 class=\"wp-block-heading has-text-color has-playfair-display-font-family\" id=\"top\" style=\"color:#0b1f30;margin-top:12px;margin-bottom:18px;font-size:clamp(24.034px, 1.502rem + ((1vw - 3.2px) * 1.814), 40px);font-style:normal;font-weight:800;line-height:1.15\">Hypermobility and the nervous system<\/h1>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#5d6f6e;margin-top:0;margin-bottom:22px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.55\">What the research supports about hypermobility, pain, fatigue &amp; the nervous system, what it does not, and why knowing which is which changes what you do next.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.114), 15px);line-height:1.5\"><strong style=\"color:#00373e\">44 minute read<\/strong> &nbsp;&middot;&nbsp; 9,975 words<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"eq-short\"><p class=\"eyebrow\">The short version<\/p><p class=\"hook\">If you have been looking for answers about hypermobility, you have probably found explanations pulling in two directions: that it is nothing much to worry about, or that it explains almost everything. <b>What the research shows sits somewhere in between,<\/b> and it is more useful than either. Here are six things worth knowing.<\/p><ol><li><span class=\"n\">01<\/span><div><p class=\"c\">Being hypermobile is not a diagnosis.<\/p><p class=\"s\">Plenty of people are hypermobile and never think about it twice. The more useful question was never whether you are, but what it actually means for you.<\/p><\/div><\/li><li><span class=\"n\">02<\/span><div><p class=\"c\">It is rarely only about the joints.<\/p><p class=\"s\">When it does cause trouble, it often turns up somewhere nobody warned you about: fatigue, headaches, digestion, dizziness, and a body that is harder to feel your way around than it should be.<\/p><\/div><\/li><li><span class=\"n\">03<\/span><div><p class=\"c\">&ldquo;Nervous-system dysregulation&rdquo; is not a diagnosis.<\/p><p class=\"s\">Your nervous system really is part of this. But the phrase covers so much ground that it is hard to know what to do with on its own.<\/p><\/div><\/li><li><span class=\"n\">04<\/span><div><p class=\"c\">Pain your nervous system produces is still real pain.<\/p><p class=\"s\">Your brain and spinal cord are organs, and pain processing is biology. Working with something psychologically has never made it less real.<\/p><\/div><\/li><li><span class=\"n\">05<\/span><div><p class=\"c\">POTS and hypermobility overlap, and the size of that overlap is still open.<\/p><p class=\"s\">Across the studies the figure runs anywhere from 17.5% to 92.7%, depending on who was being studied and where. The overlap is real. How big it is has not been settled.<\/p><\/div><\/li><li><span class=\"n\">06<\/span><div><p class=\"c\">Therapy belongs alongside medical care, never instead of it.<\/p><p class=\"s\">And the evidence for specific psychological therapies here is still limited, which seems only fair to say before you spend your time and money on one.<\/p><\/div><\/li><\/ol><div class=\"close\"><svg viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M2 6h8M6.5 2.5 10 6l-3.5 3.5\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p>What follows is the long version: <b>where each of those comes from, and where it stops.<\/b> Both halves are worth having. The first tells you what is actually known. The second tells you which questions are still open, which can be a real relief if you have been trying to find one explanation that covers everything.<\/p><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-drop wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.642px, 0.915rem + ((1vw - 3.2px) * 0.836), 22px);line-height:1.62\">Hypermobility is often reduced to one simple idea: being unusually flexible. But for some people, flexibility is only the most visible part of a much more complex experience. A body that moves differently may also process movement differently. Pain can become persistent. Joints may feel unstable. The body\u2019s sense of position may be less precise. Standing upright may bring dizziness or a racing heart. Fatigue can become difficult to explain. And over time, these physical experiences can begin to influence how a person thinks about, pays attention to, and responds to their own body.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is where the nervous system becomes particularly interesting. The nervous system does not simply sit in the background, waiting for something to happen. It is constantly receiving information from the body, interpreting that information, predicting what might happen next, and adjusting the body\u2019s responses accordingly. So when the body is experiencing changes in joint stability, pain, <em>proprioception<\/em> or autonomic function, the nervous system is inevitably part of the picture.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But this does not mean that hypermobility is simply a problem of \u201cnervous-system dysregulation.\u201d And it certainly does not mean that physical symptoms are psychological. At the same time, <strong class=\"eqb\">it would be equally misleading to treat the body and psychological experience as completely separate<\/strong>. The relationship is much more interesting than that.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Research is increasingly pointing toward an interaction between connective tissue, biomechanics, proprioception, pain processing, autonomic regulation, <em>interoception<\/em>, fatigue, sleep and psychological wellbeing. Understanding these connections can help explain why some people with hypermobility experience symptoms far beyond flexibility itself, and why those symptoms can, in turn, profoundly affect the way they experience their bodies and their lives.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So, what exactly is happening between hypermobility and the nervous system?<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-66b53293 wp-block-group-is-layout-constrained\" style=\"border-color:#e3ecea;border-width:1.5px;border-style:solid;border-radius:22px;background-color:#f7faf9;margin-top:60px;margin-bottom:20px;padding:40px 44px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:22px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THIS ARTICLE COVERS &middot; EIGHT PARTS<\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\">\n<div class=\"eq-toc\"><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 1<\/span><span class=\"ttl\">What we are actually talking about<\/span><span class=\"cnt\"><span class=\"sec\">5 sections<\/span><span class=\"sep\"> &middot; <\/span>6 min<\/span><\/summary><ul><li><a href=\"#first-what-exactly-do-we-mean-by-hypermobility\">First, what exactly do we mean by hypermobility?<\/a><\/li><li><a href=\"#your-brain-needs-to-know-where-your-body-is\">Your brain needs to know where your body is<\/a><\/li><li><a href=\"#what-does-hypermobility-have-to-do-with-proprioception\">What does hypermobility have to do with proprioception?<\/a><\/li><li><a href=\"#when-stability-requires-more-work\">When stability requires more work<\/a><\/li><li><a href=\"#but-proprioception-isnt-the-whole-story\">But proprioception isn\u2019t the whole story<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 2<\/span><span class=\"ttl\">Why pain becomes central<\/span><span class=\"cnt\"><span class=\"sec\">3 sections<\/span><span class=\"sep\"> &middot; <\/span>2 min<\/span><\/summary><ul><li><a href=\"#why-does-pain-become-such-a-central-part-of-the-picture\">Why does pain become such a central part of the picture?<\/a><\/li><li><a href=\"#why-can-pain-continue-even-when-the-original-problem-chang\">Why can pain continue even when the original problem changes?<\/a><\/li><li><a href=\"#central-sensitization-does-not-mean-its-all-in-your-head\">Central sensitization does not mean \u201cit\u2019s all in your head\u201d<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 3<\/span><span class=\"ttl\">The autonomic nervous system<\/span><span class=\"cnt\"><span class=\"sec\">5 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><\/summary><ul><li><a href=\"#now-lets-talk-about-the-autonomic-nervous-system\">Now let\u2019s talk about the autonomic nervous system<\/a><\/li><li><a href=\"#why-can-simply-standing-up-make-someone-feel-unwell\">Why can simply standing up make someone feel unwell?<\/a><\/li><li><a href=\"#pots-and-hypermobility\">POTS and hypermobility<\/a><\/li><li><a href=\"#the-relationship-between-pots-and-hypermobility-is-real-bu\">The relationship between POTS and hypermobility is real &#45; but complicated<\/a><\/li><li><a href=\"#why-can-dysautonomia-feel-like-anxiety\">Why can dysautonomia feel like anxiety?<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 4<\/span><span class=\"ttl\">When the body teaches the brain what to fear<\/span><span class=\"cnt\"><span class=\"sec\">8 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><\/summary><ul><li><a href=\"#a-physical-symptom-can-become-an-anxiety-trigger\">A physical symptom can become an anxiety trigger<\/a><\/li><li><a href=\"#the-body-can-teach-the-brain-what-to-fear\">The body can teach the brain what to fear<\/a><\/li><li><a href=\"#hypervigilance-is-not-the-same-as-imagining-symptoms\">Hypervigilance is not the same as imagining symptoms<\/a><\/li><li><a href=\"#interoception-how-your-brain-experiences-the-inside-of-you\">Interoception: how your brain experiences the inside of your body<\/a><\/li><li><a href=\"#why-is-anxiety-associated-with-hypermobility\">Why is anxiety associated with hypermobility?<\/a><\/li><li><a href=\"#there-may-be-several-pathways-between-hypermobility-and-an\">There may be several pathways between hypermobility and anxiety<\/a><\/li><li><a href=\"#what-happens-when-your-body-becomes-unpredictable\">What happens when your body becomes unpredictable?<\/a><\/li><li><a href=\"#the-experience-of-having-to-prove-that-something-is-wrong\">The experience of having to prove that something is wrong<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 5<\/span><span class=\"ttl\">Fatigue, sleep, fog and gut<\/span><span class=\"cnt\"><span class=\"sec\">7 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><\/summary><ul><li><a href=\"#chronic-pain-changes-the-way-we-move-through-life\">Chronic pain changes the way we move through life<\/a><\/li><li><a href=\"#the-painavoidance-cycle\">The pain-avoidance cycle<\/a><\/li><li><a href=\"#fatigue-is-more-than-being-tired\">Fatigue is more than \u201cbeing tired\u201d<\/a><\/li><li><a href=\"#sleep-sits-in-the-middle-of-many-of-these-cycles\">Sleep sits in the middle of many of these cycles<\/a><\/li><li><a href=\"#what-about-brain-fog\">What about \u201cbrain fog\u201d?<\/a><\/li><li><a href=\"#headaches-and-migraine\">Headaches and migraine<\/a><\/li><li><a href=\"#and-then-there-are-gastrointestinal-symptoms\">And then there are gastrointestinal symptoms<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 6<\/span><span class=\"ttl\">Body and mind are not separate systems<\/span><span class=\"cnt\"><span class=\"sec\">9 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><\/summary><ul><li><a href=\"#the-body-and-mind-arent-separate-systems\">The body and mind aren\u2019t separate systems<\/a><\/li><li><a href=\"#but-this-does-not-mean-that-everything-is-psychological\">But this does not mean that everything is psychological<\/a><\/li><li><a href=\"#what-about-trauma\">What about trauma?<\/a><\/li><li><a href=\"#not-everyone-with-hypermobility-has-trauma-or-anxiety\">Not everyone with hypermobility has trauma or anxiety<\/a><\/li><li><a href=\"#so-what-exactly-does-nervous-system-dysregulation-mean\">So what exactly does \u201cnervous-system dysregulation\u201d mean?<\/a><\/li><li><a href=\"#what-about-the-vagus-nerve\">What about the vagus nerve?<\/a><\/li><li><a href=\"#you-dont-need-to-calm-your-nervous-system-every-time-you-f\">You don\u2019t need to \u201ccalm your nervous system\u201d every time you feel something<\/a><\/li><li><a href=\"#the-psychological-meaning-of-bodily-sensations\">The psychological meaning of bodily sensations<\/a><\/li><li><a href=\"#when-protection-becomes-restriction\">When protection becomes restriction<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 7<\/span><span class=\"ttl\">Where psychotherapy fits<\/span><span class=\"cnt\"><span class=\"sec\">5 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><\/summary><ul><li><a href=\"#this-is-where-psychotherapy-can-become-genuinely-useful\">This is where psychotherapy can become genuinely useful<\/a><\/li><li><a href=\"#what-does-the-research-actually-say-about-psychological-tr\">What does the research actually say about psychological treatment?<\/a><\/li><li><a href=\"#so-what-can-therapy-actually-work-on\">So what can therapy actually work on?<\/a><\/li><li><a href=\"#acceptance-is-not-giving-up\">Acceptance is not giving up<\/a><\/li><li><a href=\"#this-is-where-psychological-flexibility-becomes-important\">This is where psychological flexibility becomes important<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><span class=\"num\">PART 8<\/span><span class=\"ttl\">The whole picture<\/span><span class=\"cnt\"><span class=\"sec\">10 sections<\/span><span class=\"sep\"> &middot; <\/span>8 min<\/span><\/summary><ul><li><a href=\"#a-more-complete-model-of-hypermobility-and-the-nervous-sys\">A more complete model of hypermobility and the nervous system<\/a><\/li><li><a href=\"#the-same-symptom-can-have-several-contributors\">The same symptom can have several contributors<\/a><\/li><li><a href=\"#this-is-also-why-individualized-assessment-matters\">This is also why individualized assessment matters<\/a><\/li><li><a href=\"#what-we-know-with-reasonable-confidence\">What we know with reasonable confidence<\/a><\/li><li><a href=\"#what-we-still-dont-know\">What we still don\u2019t know<\/a><\/li><li><a href=\"#so-where-does-that-leave-us\">So where does that leave us?<\/a><\/li><li><a href=\"#your-nervous-system-is-not-your-enemy\">Your nervous system is not your enemy<\/a><\/li><li><a href=\"#you-can-believe-your-body-and-still-work-psychologically\">You can believe your body and still work psychologically<\/a><\/li><li><a href=\"#the-goal-isnt-to-eliminate-every-uncomfortable-sensation\">The goal isn\u2019t to eliminate every uncomfortable sensation<\/a><\/li><li><a href=\"#a-final-thought\">A final thought<\/a><\/li><\/ul><\/details><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART ONE OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-1\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">What we are actually talking about<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"first-what-exactly-do-we-mean-by-hypermobility\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">First, what exactly do we mean by hypermobility?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">Before we can talk about the nervous system, it helps to clarify what we\u2019re actually talking about when we use the word hypermobility. Joint hypermobility simply means that a joint can move through a greater range of motion than is typical. <strong class=\"eqb\">On its own, this is not necessarily a disorder<\/strong>. In fact, many people are naturally hypermobile and experience no significant problems because of it. The important distinction is therefore not simply:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cAre you hypermobile?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">but:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhat does that hypermobility mean for you?\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For some people, increased joint mobility is simply a physical characteristic. For others, it occurs alongside chronic pain, joint instability, recurrent injuries, fatigue, altered proprioception, autonomic symptoms or other difficulties affecting several areas of health. This is where terms such as hypermobility spectrum disorder (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) become relevant.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Although these terms are often used interchangeably online, they are not the same thing. HSD describes symptomatic joint hypermobility that does not meet the criteria for another specific disorder, while hEDS is a specific clinical diagnosis within the Ehlers-Danlos syndromes. The 2017 international classification of the Ehlers-Danlos syndromes also made an important distinction between generalized joint hypermobility as a physical finding and hypermobility-related disorders. hEDS remains a clinical diagnosis, and unlike several other EDS subtypes, there is currently no established genetic test that independently confirms it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And this distinction matters for our discussion because: being flexible is not the same thing as having a disease, and having a hypermobility-related condition is not the same thing as having a \u201cdysregulated nervous system.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Clinicians usually start by measuring how far a set of joints move, using a <strong class=\"eqb\">nine point check<\/strong> called the <strong class=\"eqb\">Beighton score<\/strong>. It is a screen rather than a diagnosis, and it only looks at a handful of joints.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:20px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can watch the assessment being carried out here:<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\" style=\"margin-top:0;margin-bottom:40px\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"The Beighton Score | Generalized Joint Hypermobility (Laxity)\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ZwWts_P-Xws?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-f8a037bb wp-block-group-is-layout-constrained\" style=\"background-color:#fbf6f1;border-color:#ecdcc9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:0;margin-bottom:56px;padding:36px 42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#b08d68;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A high Beighton score on its own is <strong class=\"eqb\">not a diagnosis<\/strong>, and plenty of people score highly and have no symptoms at all. It also misses hypermobility in joints it does not test, so a low score does not rule anything out. It is a starting point for a conversation with a clinician rather than a result.<\/p>\n\n\n<\/div>\n\n\n\n<style>\n\/* ---- the Beighton score ----\n   Placed after the video and after the author's caveat, so the reader has been\n   told what the test is, seen it done, and been told what it is not, before\n   they get a number. 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legend{font-size:11px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;\n  color:#7c8b8a;padding:0;float:left;width:100%;margin:0 0 9px}\n.eqp .bgt .seg{display:inline-flex;border:1.5px solid #dde8e7;border-radius:9px;overflow:hidden}\n.eqp .bgt .seg label{position:relative;display:inline-flex}\n.eqp .bgt .seg label span{display:inline-flex;align-items:center;font-family:\"Work Sans\",sans-serif;\n  font-size:14.5px;font-weight:600;color:#5d6f6e;padding:9px 17px;cursor:pointer;line-height:1.2;\n  background:#fff;transition:background .14s ease,color .14s ease}\n.eqp .bgt .seg label + label span{border-left:1.5px solid #dde8e7}\n.eqp .bgt .seg input{position:absolute;opacity:0;width:100%;height:100%;left:0;top:0;margin:0;cursor:pointer;z-index:1}\n.eqp .bgt .seg input:checked + span{background:#00373e;color:#fff}\n.eqp .bgt .seg input:focus-visible + span{outline:2px solid #00373e;outline-offset:-2px;z-index:1}\n.eqp .bgt .out{margin:24px 0 0;padding:20px 24px;background:#ebf6f7;border:1.5px solid #dde8e7;\n  border-left:3px solid #00373e;border-radius:10px;display:flex;gap:12px 26px;align-items:center;flex-wrap:wrap}\n.eqp .bgt .sc{font-family:\"Work Sans\",sans-serif;font-size:14px;letter-spacing:.1em;text-transform:uppercase;\n  font-weight:700;color:#7c8b8a;margin:0;flex:0 0 auto;text-align:center}\n.eqp .bgt .sc b{display:block;font-family:\"Playfair Display\",Georgia,serif;font-size:56px;line-height:1;\n  font-weight:700;color:#00373e;letter-spacing:0;margin:0 0 2px}\n.eqp .bgt .rd{font-family:\"Work Sans\",sans-serif;font-size:15.5px;line-height:1.6;color:#26302f;\n  margin:0;flex:1 1 280px}\n.eqp .bgt .foot{margin:18px 0 0}\n.eqp .bgt .clr{font-family:\"Work Sans\",sans-serif;font-size:13.5px;font-weight:600;cursor:pointer;\n  padding:8px 15px;border-radius:8px;border:1.5px solid #dde8e7;background:#fff;color:#5d6f6e}\n.eqp .bgt .clr:hover{border-color:#00373e;color:#00373e}\n.eqp .bgt .clr:focus-visible{outline:2px solid #00373e;outline-offset:2px}\n.eqp .bgt figcaption{margin:24px 0 0;padding:15px 0 0;border-top:1px solid #dde8e7;\n  font-family:\"Work Sans\",sans-serif;font-size:13px;line-height:1.62;color:#7c8b8a}\n@media(max-width:640px){\n  .eqp .bgt{padding:22px 20px 20px}\n  .eqp .bgt .mv li{align-items:flex-start}\n  .eqp .bgt .q{flex:1 1 100%}\n  .eqp .bgt .sd{width:100%}\n  .eqp .bgt .sd label{flex:1 1 0;min-width:0}\n  .eqp .bgt .sd label span{min-width:0}\n  .eqp .bgt .sc b{font-size:46px}\n}\n.eqp .bgt .foot{display:flex;gap:10px;flex-wrap:wrap}\n.eqp .bgt .pdf{font-family:\"Work Sans\",sans-serif;font-size:13.5px;font-weight:600;cursor:pointer;\n  padding:8px 15px;border-radius:8px;border:1.5px solid #00373e;background:#fff;color:#00373e}\n.eqp .bgt .pdf:hover{background:#00373e;color:#fff}\n.eqp .bgt .pdf:focus-visible{outline:2px solid #0b1f30;outline-offset:2px}\n@media print{.eqp .bgt .foot{display:none}}\n.bgt-sheet{display:none}\n@media print{\nhtml.bgt-printing body>*{display:none!important}\nhtml.bgt-printing .bgt-sheet{display:block!important;margin:0;padding:0;color:#17120f}\n.bgt-sheet h1{font-family:\"Playfair Display\",Georgia,serif;font-size:25px;font-weight:800;margin:0 0 3px}\n.bgt-sheet .dt{font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:#5d6f6e;margin:0 0 22px}\n.bgt-sheet .hd{display:flex;gap:14px;align-items:baseline;margin:0 0 12px}\n.bgt-sheet .big{font-family:\"Playfair Display\",Georgia,serif;font-size:52px;line-height:1;font-weight:700;\n  color:#00373e;margin:0}\n.bgt-sheet .of{font-size:11px;letter-spacing:.12em;text-transform:uppercase;font-weight:700;color:#7c8b8a;margin:0}\n.bgt-sheet .th{font-size:12.5px;color:#5d6f6e;margin:0 0 12px}\n.bgt-sheet .rd{font-size:13.5px;line-height:1.55;margin:0 0 22px;max-width:74ch}\n.bgt-sheet h2{font-family:\"Work Sans\",sans-serif;font-size:11px;letter-spacing:.14em;text-transform:uppercase;\n  font-weight:700;color:#5d6f6e;margin:0 0 8px}\n.bgt-sheet ul{margin:0 0 22px;padding:0 0 0 17px;font-size:12.5px;line-height:1.7}\n.bgt-sheet .none{font-size:12px;font-style:italic;color:#7c8b8a;margin:0 0 22px}\n.bgt-sheet .cv{font-size:11.5px;line-height:1.55;color:#3a4746;border-top:1px solid #b9c4c3;\n  padding:13px 0 0;margin:0 0 16px;max-width:80ch}\n.bgt-sheet .cv b{color:#00373e;font-weight:700}\n.bgt-sheet .ft{font-size:10px;color:#5d6f6e;margin:0}\n}\n<\/style>\n<div class=\"eq-rev\" style=\"margin-top:0;margin-bottom:56px\">\n<figure class=\"bgt\" id=\"bgt\" hidden>\n  <p class=\"lb\">Score it yourself<\/p>\n  <p class=\"hint\">Four of these are checked on each side, which is where the nine points come from. Everything except the forward bend is measured passively: the joint is taken to the end of its range rather than held there by its own muscles.<\/p>\n\n  <ol class=\"mv\">\n    <li>\n      <p class=\"q\">The little finger bends back to 90&deg; or more<\/p>\n      <div class=\"sd\">\n        <label><input type=\"checkbox\" data-p=\"f5l\" aria-label=\"Little finger, left\"><span>Left<\/span><\/label>\n        <label><input type=\"checkbox\" data-p=\"f5r\" aria-label=\"Little finger, right\"><span>Right<\/span><\/label>\n      <\/div>\n    <\/li>\n    <li>\n      <p class=\"q\">The thumb can be pressed back to touch the inner side of the same forearm<\/p>\n      <div class=\"sd\">\n        <label><input type=\"checkbox\" data-p=\"thl\" aria-label=\"Thumb, left\"><span>Left<\/span><\/label>\n        <label><input type=\"checkbox\" data-p=\"thr\" aria-label=\"Thumb, right\"><span>Right<\/span><\/label>\n      <\/div>\n    <\/li>\n    <li>\n      <p class=\"q\">The elbow bends back 10&deg; or more past straight<\/p>\n      <div class=\"sd\">\n        <label><input type=\"checkbox\" data-p=\"ell\" aria-label=\"Elbow, left\"><span>Left<\/span><\/label>\n        <label><input type=\"checkbox\" data-p=\"elr\" aria-label=\"Elbow, right\"><span>Right<\/span><\/label>\n      <\/div>\n    <\/li>\n    <li>\n      <p class=\"q\">The knee bends back 10&deg; or more past straight<\/p>\n      <div class=\"sd\">\n        <label><input type=\"checkbox\" data-p=\"knl\" aria-label=\"Knee, left\"><span>Left<\/span><\/label>\n        <label><input type=\"checkbox\" data-p=\"knr\" aria-label=\"Knee, right\"><span>Right<\/span><\/label>\n      <\/div>\n    <\/li>\n    <li>\n      <p class=\"q\">With the feet together and the knees straight, both palms rest flat on the floor<\/p>\n      <div class=\"sd\">\n        <label><input type=\"checkbox\" data-p=\"trk\" aria-label=\"Palms flat on the floor\"><span>Yes<\/span><\/label>\n      <\/div>\n    <\/li>\n  <\/ol>\n\n  <fieldset class=\"age\">\n    <legend>Age<\/legend>\n    <div class=\"seg\">\n      <label><input type=\"radio\" name=\"bgt-age\" value=\"child\"><span>Under 18<\/span><\/label>\n      <label><input type=\"radio\" name=\"bgt-age\" value=\"adult\"><span>18 to 50<\/span><\/label>\n      <label><input type=\"radio\" name=\"bgt-age\" value=\"older\"><span>Over 50<\/span><\/label>\n    <\/div>\n  <\/fieldset>\n\n  <div class=\"out\" role=\"status\" aria-live=\"polite\">\n    <p class=\"sc\"><b>0<\/b>of 9<\/p>\n    <p class=\"rd\">Choose an age band and this will say where the score sits.<\/p>\n  <\/div>\n\n  <div class=\"foot\">\n    <button type=\"button\" class=\"pdf\" hidden>Save as PDF<\/button>\n    <button type=\"button\" class=\"clr\">Clear the answers<\/button>\n  <\/div>\n\n  <figcaption>Nothing here is sent anywhere. The answers stay in this browser until you clear them. The thresholds are the ones in the 2017 international classification, which sets the bar higher before 18 and lower after 50, because how far a joint moves changes across a lifetime.<\/figcaption>\n<\/figure>\n<\/div>\n<script>\n(function(){\n  var root=document.getElementById('bgt');\n  if(!root){return;}\n  var KEY='eqp-bgt-2318';\n  var boxes=root.querySelectorAll('.sd input[type=\"checkbox\"]');\n  var ages=root.querySelectorAll('input[name=\"bgt-age\"]');\n  var scoreEl=root.querySelector('.sc b');\n  var readEl=root.querySelector('.rd');\n  var clr=root.querySelector('.clr');\n  var pdfBtn=root.querySelector('.pdf');\n  \/* The 2017 classification bands the cut off by age rather than using a flat\n     five, because range of movement falls across a lifetime and the same\n     number does not mean the same thing at 14 and at 60. *\/\n  var CUT={child:6,adult:5,older:4};\n  var LAB={child:'for anyone under 18',adult:'from 18 to 50',older:'after 50'};\n\n  function state(){\n    var s={p:{},age:''};\n    for(var i=0;i<boxes.length;i++){\n      if(boxes[i].checked){ s.p[boxes[i].dataset.p]=1; }\n    }\n    var a=root.querySelector('input[name=\"bgt-age\"]:checked');\n    if(a){ s.age=a.value; }\n    return s;\n  }\n  function save(){ try{ localStorage.setItem(KEY,JSON.stringify(state())); }catch(e){} }\n  function load(){\n    try{\n      var raw=localStorage.getItem(KEY);\n      if(!raw){ return; }\n      var o=JSON.parse(raw);\n      if(!o){ return; }\n      if(o.p){\n        for(var i=0;i<boxes.length;i++){\n          boxes[i].checked = o.p[boxes[i].dataset.p]===1;\n        }\n      }\n      if(o.age){\n        var a=root.querySelector('input[name=\"bgt-age\"][value=\"'+o.age+'\"]');\n        if(a){ a.checked=true; }\n      }\n    }catch(e){}\n  }\n  function render(){\n    var s=state(), n=0, k;\n    for(k in s.p){\n      if(s.p[k]===1){ n++; }\n    }\n    scoreEl.textContent=String(n);\n    pdfBtn.hidden = !s.age;\n    if(!s.age){\n      readEl.textContent='Choose an age band and this will say where the score sits.';\n      return;\n    }\n    var T=CUT[s.age];\n    if(n>=T){\n      readEl.textContent='That is at or above the '+T+' point threshold used '+LAB[s.age]+', which is what the 2017 classification calls generalized joint hypermobility. It is a physical finding rather than a condition, and the next step is a clinician rather than a conclusion.';\n    }\n    else{\n      readEl.textContent='That is below the '+T+' point threshold used '+LAB[s.age]+'. The score only asks about these nine movements, so it can miss hypermobility elsewhere in the body, and a low number does not rule anything out.';\n    }\n  }\n  root.addEventListener('change',function(){ save(); render(); });\n  clr.addEventListener('click',function(){\n    for(var i=0;i<boxes.length;i++){ boxes[i].checked=false; }\n    for(var j=0;j<ages.length;j++){ ages[j].checked=false; }\n    save(); render();\n  });\n\n\n  \/* The author's own words, from the callout directly above this tool. A sheet\n     that is printed and carried to an appointment is read without the article\n     around it, so the caveat has to travel with the number. *\/\n  var CAV1='A high Beighton score on its own is ';\n  var CAVB='not a diagnosis';\n  var CAV2=', and plenty of people score highly and have no symptoms at all. It also misses hypermobility in joints it does not test, so a low score does not rule anything out. It is a starting point for a conversation with a clinician rather than a result.';\n\n  function marked(){\n    var rows=root.querySelectorAll('.mv li'), list=[];\n    for(var i=0;i<rows.length;i++){\n      var labs=rows[i].querySelectorAll('.sd label'), sides=[];\n      for(var j=0;j<labs.length;j++){\n        var inp=labs[j].querySelector('input');\n        if(inp.checked){ sides.push(labs[j].querySelector('span').textContent.toLowerCase()); }\n      }\n      if(!sides.length){ continue; }\n      var txt=rows[i].querySelector('.q').textContent;\n      if(sides[0]!=='yes'){ txt=txt+' ('+sides.join(', ')+')'; }\n      list.push(txt);\n    }\n    return list;\n  }\n  function sheet(){\n    var s=state(), n=0, k;\n    for(k in s.p){\n      if(s.p[k]===1){ n++; }\n    }\n    var d=document.createElement('div');\n    d.className='bgt-sheet';\n    var h=document.createElement('h1');\n    h.textContent='Beighton score';\n    d.appendChild(h);\n    var dt=document.createElement('p');\n    dt.className='dt';\n    try{ dt.textContent=new Date().toLocaleDateString(undefined,{year:'numeric',month:'long',day:'numeric'}); }\n    catch(e){ dt.textContent=''; }\n    d.appendChild(dt);\n    var hd=document.createElement('div');\n    hd.className='hd';\n    var big=document.createElement('p');\n    big.className='big';\n    big.textContent=String(n);\n    var of=document.createElement('p');\n    of.className='of';\n    of.textContent='of 9';\n    hd.appendChild(big); hd.appendChild(of);\n    d.appendChild(hd);\n    var th=document.createElement('p');\n    th.className='th';\n    th.textContent='Threshold used '+LAB[s.age]+': '+CUT[s.age]+' of 9.';\n    d.appendChild(th);\n    var rd=document.createElement('p');\n    rd.className='rd';\n    rd.textContent=readEl.textContent;\n    d.appendChild(rd);\n    var h2=document.createElement('h2');\n    h2.textContent='What was marked';\n    d.appendChild(h2);\n    var list=marked();\n    if(list.length){\n      var ul=document.createElement('ul');\n      for(var m=0;m<list.length;m++){\n        var li=document.createElement('li');\n        li.textContent=list[m];\n        ul.appendChild(li);\n      }\n      d.appendChild(ul);\n    }\n    else{\n      var none=document.createElement('p');\n      none.className='none';\n      none.textContent='Nothing was marked.';\n      d.appendChild(none);\n    }\n    var cv=document.createElement('p');\n    cv.className='cv';\n    cv.appendChild(document.createTextNode(CAV1));\n    var cvb=document.createElement('b');\n    cvb.textContent=CAVB;\n    cv.appendChild(cvb);\n    cv.appendChild(document.createTextNode(CAV2));\n    d.appendChild(cv);\n    var ft=document.createElement('p');\n    ft.className='ft';\n    ft.textContent='equilibriumpsychotherapy.net';\n    d.appendChild(ft);\n    return d;\n  }\n  pdfBtn.addEventListener('click',function(){\n    var d=sheet();\n    document.body.appendChild(d);\n    document.documentElement.classList.add('bgt-printing');\n    var cleaned=false;\n    function done(){\n      if(cleaned){ return; }\n      cleaned=true;\n      document.documentElement.classList.remove('bgt-printing');\n      if(d.parentNode){ d.parentNode.removeChild(d); }\n      window.removeEventListener('afterprint',done);\n    }\n    window.addEventListener('afterprint',done);\n    setTimeout(function(){ window.print(); },40);\n    setTimeout(done,120000);\n  });\n\n  load();\n  root.hidden=false;\n  render();\n})();\n<\/script>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So why, then, does the nervous system come into the conversation at all? To understand that, we need to start with something surprisingly fundamental: How does your brain know where your body is?<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<style>\n.eqf{--t:#00373e;--m:#8d9695;--ln:#dfe6e5;--cr:#fbf6f1;--cre:#eddcc9;--am:#b08d68;--amw:#8a6a48;--bd:#3f5b5e;--soft:#9dbdbd;\n  font-family:\"Work Sans\",system-ui,sans-serif;color:var(--t);margin:0;padding:0}\n.eqf *{box-sizing:border-box}\n.eqf-eyebrow{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:var(--amw);margin:0 0 9px}\n.eqf-title{font-size:clamp(21px,2.3vw,27px);font-weight:700;line-height:1.22;margin:0 0 9px;color:var(--t)}\n.eqf-sub{font-size:16px;line-height:1.55;color:var(--m);max-width:760px;margin:0 0 30px}\n.eqf-foot{margin:30px 0 0;padding-top:19px;border-top:1px solid #e3e8e7;font-size:15.5px;line-height:1.6;color:var(--m)}\n.eqf-foot b{color:var(--t);font-weight:600}\n.eqf-foot i{font-style:italic}\n\n\/* ---- sets ----\n   Named eqf-set, NOT eqf-chips: that name was already taken by the convergence\n   diagram below, whose .eqf-chips is a fixed-pitch grid. A rule of mine at\n   .eqp .eqf-chips would have out-specified it and turned that diagram's grid\n   into a wrapping flex row. Caught by diffing the build against the live page.\n\n   Not scoped under .eqf, because these sit in the reading column beside body\n   prose rather than inside a figure. They are still prefixed eqf- so every\n   class this file owns can be found with one search.\n\n   Sized to sit UNDER the body text, not beside it: 15.5px against the 21px\n   body, so the set reads as an aside the eye can take in at once rather than\n   as eight sentences competing with the paragraph above. Wrapping is the whole\n   point, so no nowrap and no fixed columns.\n\n   The open variant is a set of questions. Dashed border, no fill, and the\n   colour steps back to the muted ink, so an open question does not look like\n   an established fact. *\/\n.eqp .eqf-set{display:flex;flex-wrap:wrap;gap:8px;margin:0;\n  font-family:\"Work Sans\",system-ui,sans-serif}\n.eqp .eqf-set span{font-size:15.5px;line-height:1.3;padding:7px 14px;border-radius:999px;\n  background:#f3f7f6;border:1px solid #dde8e7;color:#00373e;font-weight:600}\n.eqp .eqf-set.open span{background:transparent;border-style:dashed;border-color:#c3d3d2;\n  color:#4a5f5e;font-weight:500}\n@media(max-width:520px){\n  .eqp .eqf-set{gap:7px}\n  .eqp .eqf-set span{font-size:15px;padding:6px 12px}\n}\n@media print{\n  .eqp .eqf-set span{border-color:#999;background:transparent}\n}\n\n\/* A set sitting inside a deep dive panel is on a tint, not on white, and the\n   default chip is a MIST fill - a cool green-grey. On the warm stone of the\n   panel those two hues fought, which the author saw immediately: \"the colour\n   difference is not good with this thingy\". The relationship is inverted\n   instead of recoloured: on a white page the chip is tinted and the ground is\n   white; on a tinted panel the chip is white and the ground is tinted. Same\n   figure and ground, same amount of separation, no second hue introduced. *\/\n.eqp .eq-dive .eqf-set span{background:#fff;border-color:#e6ddd0}\n\n\/* ---- the chain line ----\n   One line of prose that is really a diagram. Sits in the reading column, so\n   it is scoped under .eqp like the sets rather than under .eqf.\n\n   The arrows are the emphasis: accent coloured, heavier than the terms, and\n   given breathing room on both sides so the line reads as four things joined\n   rather than as a run of words. <i> carries no italic here; it is a hook for\n   the colour and nothing else, and font-style is reset for that reason.\n\n   flex-wrap, not nowrap: on a 390px phone the four terms cannot sit on one\n   line, and a chain that scrolls sideways is worse than a chain that wraps. *\/\n.eqp .eqc{display:flex;flex-wrap:wrap;align-items:baseline;gap:2px 4px;\n  font-family:\"Work Sans\",system-ui,sans-serif;font-size:19px;line-height:1.5;\n  font-weight:600;color:#26302f;margin:0}\n.eqp .eqc .eqc-a{font-style:normal;font-weight:700;color:#00373e;padding:0 .28em}\n@media(max-width:520px){\n  .eqp .eqc{font-size:17px}\n}\n@media print{\n  .eqp .eqc .eqc-a{color:#000}\n}\n\n\/* d1 - three terms *\/\n.eqf-cards{display:grid;grid-template-columns:repeat(auto-fit,minmax(250px,1fr));gap:16px}\n.eqf-c{border:1.5px solid var(--ln);border-radius:14px;padding:24px 22px 26px;background:#fff}\n.eqf-c.mid{background:var(--cr);border-color:var(--cre)}\n\/* The third card is the top of a three-step ramp: white, cream, then this.\n   It used to be a solid teal block, and the fill was the wrong instrument.\n   Dark teal is not a special colour on this page - the short-version panel,\n   all eight part slabs and the closing panel are the same value - so a filled\n   card did not read as the end of a scale, it read as the page's heaviest\n   device turning up again inside a small figure. On a phone, where the three\n   cards stack, it became a full-width dark slab mid-article.\n\n   The escalation now lives in the border and in the gradient bar below, which\n   still runs to solid teal. Author's call, from a side-by-side preview. *\/\n.eqf-c.hi{background:#e6eeee;border-color:var(--t)}\n\/* 11.5px uppercase at var(--m) measures 3.03:1 on white and 2.85:1 on cream,\n   both under the 4.5:1 floor. The old dark card hid this, because #9dbdbd on\n   teal happens to measure 6.46:1 - so lightening that card WITHOUT darkening\n   these would have made the figure less readable, not more. Fixed together. *\/\n.eqf-tag{font-size:11.5px;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#5f6d6c;margin-bottom:11px}\n.eqf-c.hi .eqf-tag{color:#2c5f60}\n.eqf-c.mid .eqf-tag{color:var(--amw)}\n.eqf-nm{font-size:19px;font-weight:700;line-height:1.25;margin-bottom:3px}\n.eqf-c.hi .eqf-nm{color:var(--t)}\n.eqf-ab{font-size:13px;font-weight:600;color:var(--m);margin-bottom:12px}\n.eqf-c.hi .eqf-ab{color:#4a6f70}\n.eqf-dc{font-size:15px;line-height:1.6;color:var(--bd)}\n.eqf-c.hi .eqf-dc{color:#33565a}\n.eqf-bar{margin-top:24px;height:7px;border-radius:99px;\n  background:linear-gradient(90deg,#e3ebea 0%,#cfe0de 30%,#87b0ae 65%,#00373e 100%)}\n.eqf-ends{display:flex;justify-content:space-between;gap:18px;margin-top:9px;font-size:12.5px;font-weight:600;color:var(--m)}\n.eqf-ends span:last-child{text-align:right}\n\n\/* d2 - the loop.\n   Above 960px this is a true ring: one continuous ellipse with the five steps\n   sitting on it and arrowheads riding the curve, so the cycle is the drawing\n   rather than something a caption has to assert. 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What it buys is that the seven\n   strands stay individually legible right up to the point they converge. *\/\n.eqf-chip{position:relative;display:flex;align-items:center;gap:16px;padding:0 18px 0 21px;margin:0;\n  background:#fff;border:1.5px solid var(--ln);border-left:0;border-radius:9px;\n  font-size:15px;font-weight:500;line-height:1.3;color:var(--t);overflow:hidden}\n.eqf-chip .lb{flex:1 1 auto;min-width:0;position:relative;z-index:1}\n.eqf-chip .tg{flex:0 0 auto;position:relative;z-index:1;font-size:10.5px;font-weight:700;\n  letter-spacing:.13em;text-transform:uppercase;color:var(--c,#7fb0ad);opacity:.85}\n.eqf-chip::before{content:\"\";position:absolute;left:0;top:0;bottom:0;width:5px;\n  background:var(--c,#7fb0ad)}\n.eqf-chip::after{content:\"\";position:absolute;left:0;top:0;bottom:0;right:0;\n  background:linear-gradient(90deg,var(--c,#7fb0ad) 0%,transparent 42%);opacity:.10;pointer-events:none}\n.eqf-funnel{width:110px;height:390px;justify-self:center}\n.eqf-funnel svg{display:block;width:110px;height:390px;overflow:visible}\n.eqf-orb{position:relative;width:250px;height:250px;border-radius:50%;\n  background:radial-gradient(circle at 32% 26%,#0a4e55 0%,#00373e 62%);color:#fff;\n  display:flex;flex-direction:column;align-items:center;justify-content:center;text-align:center;padding:18px}\n.eqf-orb::before{content:\"\";position:absolute;inset:-13px;border-radius:50%;\n  border:1.5px solid #d6e6e4}\n.eqf-orb .ol{font-size:11.5px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:var(--soft);margin-bottom:6px}\n.eqf-orb .on{font-size:36px;font-weight:700;line-height:1;letter-spacing:-.01em}\n.eqf-orb .os{font-size:13px;color:var(--soft);margin-top:9px;max-width:190px}\n\n\/* d4 - interacting systems *\/\n.eqf-model{display:grid;grid-template-columns:1fr 252px;gap:34px;align-items:center}\n.eqf-spine{position:relative;padding-left:54px;margin:0;list-style:none}\n.eqf-spine::before{content:\"\";position:absolute;left:9px;top:9px;bottom:9px;width:2px;background:#d3e0df}\n.eqf-lvl{position:relative;margin:0 0 19px}\n.eqf-lvl:last-child{margin-bottom:0}\n.eqf-lvl::before{content:\"\";position:absolute;left:-52px;top:4px;width:15px;height:15px;border-radius:50%;\n  background:#fff;border:2.5px solid var(--t)}\n.eqf-lvl.soft::before{border-color:#c2a184}\n.eqf-lvl .rl{font-size:17px;font-weight:700;line-height:1.25;margin-bottom:3px}\n.eqf-lvl .rd{font-size:14.5px;line-height:1.55;color:#7c8b8a}\n.eqf-note{background:var(--cr);border:1.5px solid var(--cre);border-radius:12px;padding:17px 19px}\n.eqf-note .t{font-size:12px;font-weight:700;letter-spacing:.1em;text-transform:uppercase;color:var(--am);margin-bottom:9px}\n.eqf-note .d{font-size:14px;line-height:1.55;color:#5d6f6e}\n.eqf-note svg{display:block;width:30px;height:44px;margin:0 0 10px}\n\n@media(max-width:820px){\n  .eqf-conv{grid-template-columns:1fr;gap:22px;justify-items:center}\n  .eqf-chips{width:100%}\n  .eqf-funnel{display:none}\n  .eqf-model{grid-template-columns:1fr;gap:24px}\n  \/* The connectors are gone here, so the rows no longer have to hold a fixed\n     48px pitch. Release it: at 375px the longest label is wider than the chip,\n     and a fixed row plus overflow:hidden would silently crop the second line.\n     The type tag drops underneath the label rather than competing for width. *\/\n  .eqf-chips{grid-auto-rows:auto}\n  .eqf-chip{min-height:48px;flex-wrap:wrap;gap:3px 14px;padding:10px 16px 11px 21px}\n  .eqf-chip .lb{flex:1 1 100%}\n  .eqf-chip .tg{flex:0 0 auto;font-size:10px}\n}\n@media(max-width:520px){\n  .eqf-orb{width:196px;height:196px}\n  .eqf-orb .on{font-size:29px}\n  .eqf-ends{flex-direction:column;gap:2px}\n  .eqf-ends span:last-child{text-align:left}\n}\n<\/style><div style=\"margin:54px 0\"><figure class=\"eqf eq-rev\"><div class=\"eqf-eyebrow\">Terminology<\/div><div class=\"eqf-title\">Three different things, often used as if they were one<\/div><div class=\"eqf-sub\">These terms are frequently swapped for one another online. They describe genuinely different situations, and the distinction changes what, if anything, needs attention.<\/div><div class=\"eqf-cards\"><div class=\"eqf-c\"><div class=\"eqf-tag\">A physical characteristic<\/div><div class=\"eqf-nm\">Generalized joint hypermobility<\/div><div class=\"eqf-ab\">GJH<\/div><div class=\"eqf-dc\">Joints move through a greater range than typical. Common. Many people have it and experience no significant problems because of it. On its own, not a disorder.<\/div><\/div><div class=\"eqf-c mid\"><div class=\"eqf-tag\">A symptomatic condition<\/div><div class=\"eqf-nm\">Hypermobility spectrum disorder<\/div><div class=\"eqf-ab\">HSD<\/div><div class=\"eqf-dc\">Symptomatic joint hypermobility that does not meet the criteria for another specific disorder. Symptoms may extend well beyond the joints themselves.<\/div><\/div><div class=\"eqf-c hi\"><div class=\"eqf-tag\">A clinical diagnosis<\/div><div class=\"eqf-nm\">Hypermobile Ehlers-Danlos syndrome<\/div><div class=\"eqf-ab\">hEDS<\/div><div class=\"eqf-dc\">A specific diagnosis within the Ehlers-Danlos syndromes. Unlike several other EDS subtypes, there is currently no established genetic test that independently confirms it.<\/div><\/div><\/div><div class=\"eqf-bar\"><\/div><div class=\"eqf-ends\"><span>Flexibility alone<\/span><span>Symptoms across multiple systems<\/span><\/div><figcaption class=\"eqf-foot\"><b>Why the distinction matters:<\/b> being flexible is not the same thing as having a disease, and having a hypermobility-related condition is not the same thing as having a &ldquo;dysregulated nervous system.&rdquo; The useful question is not <i>are you hypermobile?<\/i> but <i>what does that hypermobility mean for you?<\/i><\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"your-brain-needs-to-know-where-your-body-is\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Your brain needs to know where your body is<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Close your eyes and lift your arm. You don\u2019t need to look at it to know where it is. You know whether your elbow is bent, whether your hand is moving, and roughly where your arm is in space. You can even touch your nose with your eyes closed. Your brain is constantly receiving information that allows it to construct an internal sense of where your body is and how it is moving. This is called proprioception.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Proprioception is one of the sensory systems that allows us to perceive the position and movement of our bodies. It is part of what allows you to walk without staring at your feet. It helps you maintain your posture. It helps your muscles coordinate movement. And it allows your nervous system to make constant adjustments without requiring conscious thought.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Much of this information comes from sensory receptors in muscles, tendons, joints and other tissues. Now consider what happens when the mechanical properties of those tissues are different. If a joint moves farther than expected, the nervous system has to control that movement. It needs information about where the joint is, how quickly it is moving, how much force is being applied and how stable it is. That makes proprioception particularly interesting in hypermobility.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-does-hypermobility-have-to-do-with-proprioception\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What does hypermobility have to do with proprioception?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Research suggests that proprioception can differ in people with symptomatic hypermobility. A systematic review and meta-analysis found evidence that people with benign joint hypermobility syndrome had poorer lower-limb joint-position sense and movement detection than control participants, although findings for the upper limbs were less consistent. That doesn\u2019t mean that every hypermobile person has impaired proprioception.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It also doesn\u2019t mean that proprioceptive differences explain every symptom. But it gives us one possible piece of the puzzle. Imagine that your ankle, knee or shoulder is capable of moving through a larger range than average. Your nervous system still needs to control it. And if the sensory information available to the nervous system is less precise, the body may compensate in various ways. Muscles may work harder. Movement may become more consciously controlled. Certain positions may feel less secure.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may rely more heavily on visual information. You may develop protective movement patterns. <strong class=\"eqb\">None of this necessarily happens consciously<\/strong>. Your nervous system is simply trying to solve a mechanical problem with the information available to it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-stability-requires-more-work\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When stability requires more work<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">We tend to think about physical effort in fairly obvious terms. You lift something heavy. You run. You climb stairs. You exercise. Those things require effort. But there is another kind of effort that is much less visible: the effort involved in maintaining stability. Think about standing on one leg. Your ankle, knee, hip and trunk are making tiny adjustments all the time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You don\u2019t consciously instruct each muscle to contract. Your nervous system coordinates the process automatically. Now imagine that maintaining a stable position requires your muscles to make more frequent or more substantial corrections. The activity may still look completely ordinary from the outside. But internally, it may require more work. This is one possible reason why some people with symptomatic hypermobility experience significant fatigue even when their daily activities do not appear particularly strenuous.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It is also one reason that fatigue should not automatically be interpreted as laziness, poor motivation or lack of fitness. There may be a physical cost to maintaining stability.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"but-proprioception-isnt-the-whole-story\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">But proprioception isn\u2019t the whole story<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It would be tempting to create a simple chain:<\/p>\n\n\n\n<div style=\"margin-top:6px;margin-bottom:30px\"><p class=\"eqc\">hypermobility<i class=\"eqc-a\">\u2192<\/i>poor proprioception<i class=\"eqc-a\">\u2192<\/i>pain<i class=\"eqc-a\">\u2192<\/i>fatigue<\/p><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But human physiology rarely works that neatly. Pain itself changes movement. Movement changes muscle activation. Muscle activation influences sensory feedback. Fatigue changes how we move. Pain can change attention. Attention changes what we notice. And all of these processes can influence one another. This is one reason researchers increasingly look at hypermobility as a multisystem condition in symptomatic individuals rather than treating it as a problem involving joints alone.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Recent systematic reviews continue to identify associations with musculoskeletal problems, autonomic symptoms, gastrointestinal problems, anxiety and other systemic manifestations, although the quality and consistency of evidence varies between symptoms. And that brings us to one of the most important parts of the story: pain.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART TWO OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-2\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">Why pain becomes central<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-does-pain-become-such-a-central-part-of-the-picture\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why does pain become such a central part of the picture?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">Pain in hypermobility is not necessarily produced by one mechanism. There may be pain associated with:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set\"><span>joint instability<\/span><span>recurrent injuries<\/span><span>muscle overuse<\/span><span>altered movement patterns<\/span><span>tissue irritation<\/span><span>nerve involvement<\/span><span>headaches<\/span><span>central changes in pain processing<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And several of these mechanisms can exist in the same person. This matters because we often imagine pain as a direct measurement of physical damage. More damage equals more pain. Less damage equals less pain. But the nervous system does not work like a simple damage meter. Pain is a complex biological experience produced through the interaction of incoming signals, the nervous system\u2019s processing of those signals, previous experience, attention, context and many other factors. This is not a way of saying:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cPain is psychological.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It is a way of saying: the nervous system is part of the biology of pain.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-can-pain-continue-even-when-the-original-problem-chang\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why can pain continue even when the original problem changes?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is where <em>central sensitization<\/em> becomes relevant. The term sounds complicated, but the underlying idea is relatively intuitive. Imagine a smoke alarm. Under normal circumstances, it responds when there is enough smoke to indicate a potential fire. Now imagine that the alarm becomes increasingly sensitive. It might start responding to very small amounts of smoke.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The alarm is not necessarily broken because there was never a fire. The original fire may have been very real. The problem is that the system has become more responsive. Something similar can happen within pain-processing systems. After persistent or repeated pain, the nervous system can become more responsive to incoming signals.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers have found evidence consistent with central sensitization in people with joint hypermobility syndrome and hypermobile EDS, including increased pain sensitivity and widespread alterations in pain processing. More recent research continues to investigate this relationship. A 2026 prospective study of people with hEDS\/HSD found that greater central-sensitization symptoms were associated with a greater multisystem symptom burden, with pain, fatigue and cardiac <span class=\"eq-term\" tabindex=\"0\" aria-describedby=\"gd-1\"><em>dysautonomia<\/em><span class=\"eq-def\" role=\"tooltip\" id=\"gd-1\"><b>dysautonomia<\/b>A general term for the autonomic nervous system not regulating the body as reliably as it should. It describes a pattern rather than a single condition, and POTS is one form of it.<\/span><\/span> emerging as important predictors in that sample. This is an important area of research.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But it should not become another overly simple explanation. Central sensitization does not mean that every symptom in hypermobility is caused by central sensitization. And it certainly does not mean that structural or mechanical problems are irrelevant.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-53f739e0 wp-block-group-is-layout-constrained\" style=\"background-color:#fbf6f1;border-color:#ecdcc9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:56px;margin-bottom:56px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#b08d68;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"central-sensitization-does-not-mean-its-all-in-your-head\" style=\"color:#00373e;margin-top:0;margin-bottom:16px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Central sensitization does not mean \u201cit\u2019s all in your head\u201d<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This distinction is so important that it deserves to be stated directly. If your nervous system is involved in producing your pain, that does not make the pain imaginary. Your nervous system is part of your physical body. Your brain is an organ. Your spinal cord is an organ. Pain processing is a biological process.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A person can have genuine joint instability, genuine tissue problems, genuine injuries and genuine pain while also developing changes in central pain processing. These things can coexist. In fact, understanding that they can coexist gives us a much more useful framework than forcing ourselves to choose between:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIt\u2019s physical.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">and<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIt\u2019s psychological.\u201d<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART THREE OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-3\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">The autonomic nervous system<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"now-lets-talk-about-the-autonomic-nervous-system\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Now let\u2019s talk about the autonomic nervous system<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">This is probably where you will encounter the strongest connection between hypermobility and the nervous system. The autonomic nervous system, or ANS, regulates many processes that happen largely outside conscious control. It helps regulate:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set\"><span>heart rate<\/span><span>blood pressure<\/span><span>blood-vessel tone<\/span><span>digestion<\/span><span>sweating<\/span><span>temperature regulation<\/span><span>bladder function<\/span><span>aspects of sexual function<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You do not consciously tell your blood vessels to constrict when you stand.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">You do not normally think:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMy heart should now increase its rate by this amount.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your autonomic nervous system coordinates these adjustments for you. And that becomes important when we talk about what happens when a person moves from lying down or sitting to standing.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-can-simply-standing-up-make-someone-feel-unwell\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why can simply standing up make someone feel unwell?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Standing seems almost too ordinary to think about. You get up from a chair. You walk across the room. You never give it a second thought. But physiologically, standing requires your body to make a series of rapid adjustments. Gravity pulls blood toward the lower part of your body. Your cardiovascular system needs to compensate. Blood vessels constrict. Heart rate changes. Blood pressure is adjusted. Blood flow is redistributed.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The autonomic nervous system is involved in coordinating much of this. For most people, the process happens so efficiently that they barely notice it. For someone with <em>orthostatic intolerance<\/em>, however, being upright can produce significant symptoms. These can include:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set\"><span>dizziness<\/span><span>lightheadedness<\/span><span>weakness<\/span><span>palpitations<\/span><span>racing heart<\/span><span>nausea<\/span><span>shakiness<\/span><span>visual disturbances<\/span><span>fatigue<\/span><span>difficulty concentrating<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And suddenly something as ordinary as standing in a queue can become physically demanding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"pots-and-hypermobility\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">POTS and hypermobility<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One form of orthostatic intolerance is postural orthostatic tachycardia syndrome, commonly known as POTS. POTS involves an excessive increase in heart rate when moving to an upright position, together with characteristic symptoms of orthostatic intolerance. It is a medical condition. And this is worth emphasizing because some of its symptoms overlap remarkably with anxiety. A racing heart. Trembling. Sweating. Shortness of breath. Dizziness. Feeling faint. A sense that something is wrong. Those sensations can occur during panic.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But they can also occur because of a physiological problem with orthostatic regulation. That distinction matters.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-relationship-between-pots-and-hypermobility-is-real-bu\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The relationship between POTS and hypermobility is real &#45; but complicated<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The relationship between POTS and EDS\/hypermobility has received increasing research attention. A 2026 systematic review examined 30 studies involving 8,421 people with EDS and 12,983 people with POTS. The proportion of people with POTS among EDS populations ranged from 17.5% to 92.7%, while the proportion of people with EDS among POTS populations ranged from 17.9% to 50%. The enormous variation reflects differences in the populations and clinical settings studied. That last point is particularly important. We can confidently say:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">POTS and EDS\/hypermobility frequently occur together. We cannot confidently say: Everyone with hypermobility has POTS. Nor can we say: Hypermobility always causes POTS. Researchers are investigating several possible explanations for the association, including vascular properties, blood pooling, autonomic regulation, blood-volume abnormalities and neuropathic mechanisms. There may not be one universal mechanism. Different people may arrive at similar symptoms through different physiological pathways.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin:54px 0\"><figure class=\"eqf eq-range eq-rev\"><div class=\"eqf-eyebrow\">What the studies actually found<\/div><div class=\"eqf-title\">The overlap is real. The size of it is not settled.<\/div><div class=\"eqf-sub\">Every bar below is a range across studies, not a margin of error. The bars are this wide because the studies disagree.<\/div><div class=\"plot\"><div class=\"row\"><p class=\"lbl\">How many people with EDS also have POTS<\/p><div class=\"track\"><div class=\"grid\"><i style=\"left:25%\"><\/i><i style=\"left:50%\"><\/i><i style=\"left:75%\"><\/i><\/div><div class=\"band\" data-d=\"0\" style=\"left:17.5%;width:75.2%\"><\/div><\/div><div class=\"ends\"><b style=\"left:17.5%\">17.5%<\/b><b style=\"left:92.7%\">92.7%<\/b><\/div><\/div><div class=\"row\"><p class=\"lbl\">How many people with POTS also have EDS<\/p><div class=\"track\"><div class=\"grid\"><i style=\"left:25%\"><\/i><i style=\"left:50%\"><\/i><i style=\"left:75%\"><\/i><\/div><div class=\"band\" data-d=\"90\" style=\"left:17.9%;width:32.1%\"><\/div><\/div><div class=\"ends\"><b style=\"left:17.9%\">17.9%<\/b><b style=\"left:50%\">50%<\/b><\/div><\/div><div class=\"axis\"><b style=\"left:0%\">0%<\/b><b style=\"left:25%\">25%<\/b><b style=\"left:50%\">50%<\/b><b style=\"left:75%\">75%<\/b><b style=\"left:100%\">100%<\/b><\/div><\/div><div class=\"note\"><b>Why this matters.<\/b> A figure anywhere between 17.5% and 92.7% can be quoted accurately from this literature. That is exactly why a confident single number, in either direction, should make you suspicious.<\/div><figcaption class=\"eqf-foot\"><b>Source:<\/b> 2026 systematic review of 30 studies, covering 8,421 people with EDS and 12,983 people with POTS. The spread reflects real differences in which populations and clinical settings were studied, not measurement error.<\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-can-dysautonomia-feel-like-anxiety\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why can dysautonomia feel like anxiety?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is where the relationship between physiology and psychology becomes particularly fascinating. Imagine that you stand up. Your heart suddenly starts racing. You feel lightheaded. Your chest feels strange. You become aware of your breathing. Your brain now has a problem to solve: What is happening? The brain is constantly trying to interpret bodily information.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If the sensation is unfamiliar or frightening, it may be interpreted as a threat. That interpretation can activate further physiological arousal. Your heart may beat faster. Your muscles may tense. Your breathing may change. Your attention becomes even more focused on your body. And now you notice even more sensations. You might think:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhy is my heart beating even faster?\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Which increases fear. Which increases monitoring. Which makes the sensations even more noticeable. A feedback loop can develop: bodily sensation \u2192 threat interpretation \u2192 increased arousal \u2192 stronger bodily sensation \u2192 increased monitoring \u2192 greater threat This is a genuine psychophysiological process. But notice what it does not mean. <strong class=\"eqb\">It does not mean that anxiety necessarily caused the original physiological symptom<\/strong>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin:54px 0\"><figure class=\"eqf eq-rev\"><div class=\"eqf-eyebrow\">A psychophysiological loop<\/div><div class=\"eqf-title\">How a physical symptom can become an anxiety trigger<\/div><div class=\"eqf-sub\">Every step here is an ordinary, well-functioning response. The difficulty is not that any single link is irrational. It is that the last one feeds the first, and the sequence closes into a circle.<\/div><div class=\"eqf-ring\"><svg viewBox=\"0 0 900 560\" aria-hidden=\"true\" focusable=\"false\"><ellipse cx=\"450\" cy=\"280\" rx=\"322\" ry=\"206\" fill=\"none\" stroke=\"#cfe0de\" stroke-width=\"2\"\/><path d=\"M-8,-6 L4,0 L-8,6 Z\" fill=\"#7fb0ad\" transform=\"translate(639.3,113.3) rotate(24.9)\"\/><path d=\"M-8,-6 L4,0 L-8,6 Z\" fill=\"#7fb0ad\" transform=\"translate(756.2,343.7) rotate(116.9)\"\/><path d=\"M-8,-6 L4,0 L-8,6 Z\" fill=\"#7fb0ad\" transform=\"translate(450,486) rotate(180)\"\/><path d=\"M-8,-6 L4,0 L-8,6 Z\" fill=\"#7fb0ad\" transform=\"translate(143.8,343.7) rotate(-116.9)\"\/><path d=\"M-8,-6 L4,0 L-8,6 Z\" fill=\"#7fb0ad\" transform=\"translate(260.7,113.3) rotate(-24.9)\"\/><\/svg><div class=\"eqf-node\" style=\"left:50%;top:13.2%\"><span class=\"n\">01<\/span><span class=\"t\">A bodily sensation<\/span><span class=\"d\">Your heart races. You feel lightheaded on standing.<\/span><\/div><div class=\"eqf-node\" style=\"left:84%;top:38.6%\"><span class=\"n\">02<\/span><span class=\"t\">The brain interprets it<\/span><span class=\"d\">&ldquo;What is happening? Is something wrong?&rdquo;<\/span><\/div><div class=\"eqf-node\" style=\"left:71%;top:79.8%\"><span class=\"n\">03<\/span><span class=\"t\">Arousal increases<\/span><span class=\"d\">Muscles tense. Breathing changes. The body responds to threat.<\/span><\/div><div class=\"eqf-node\" style=\"left:29%;top:79.8%\"><span class=\"n\">04<\/span><span class=\"t\">Sensations intensify<\/span><span class=\"d\">Now there is more to notice, and it feels more urgent.<\/span><\/div><div class=\"eqf-node\" style=\"left:16%;top:38.6%\"><span class=\"n\">05<\/span><span class=\"t\">Monitoring increases<\/span><span class=\"d\">Attention locks onto the body. Checking becomes constant.<\/span><\/div><div class=\"eqf-core\"><div class=\"hl\">The part that gets missed<\/div><div class=\"hq\">The original sensation can be entirely real. The loop is what builds around it.<\/div><\/div><\/div><div class=\"eqf-chain\"><ol><li><span class=\"n\">01<\/span><span class=\"t\">A bodily sensation<\/span><span class=\"d\">Your heart races. You feel lightheaded on standing.<\/span><\/li><li><span class=\"n\">02<\/span><span class=\"t\">The brain interprets it<\/span><span class=\"d\">&ldquo;What is happening? Is something wrong?&rdquo;<\/span><\/li><li><span class=\"n\">03<\/span><span class=\"t\">Arousal increases<\/span><span class=\"d\">Muscles tense. Breathing changes. The body responds to threat.<\/span><\/li><li><span class=\"n\">04<\/span><span class=\"t\">Sensations intensify<\/span><span class=\"d\">Now there is more to notice, and it feels more urgent.<\/span><\/li><li><span class=\"n\">05<\/span><span class=\"t\">Monitoring increases<\/span><span class=\"d\">Attention locks onto the body. Checking becomes constant.<\/span><\/li><\/ol><div class=\"eqf-back\"><svg viewBox=\"0 0 54 26\" aria-hidden=\"true\" focusable=\"false\"><defs><marker id=\"eqfLoopHead\" viewBox=\"0 0 10 10\" refX=\"8\" refY=\"5\" markerWidth=\"6\" markerHeight=\"6\" orient=\"auto\"><path d=\"M0,1 L9,5 L0,9 z\" fill=\"#b08d68\"\/><\/marker><\/defs><path d=\"M50,5 C50,20 34,22 22,22 C12,22 6,18 5,13\" fill=\"none\" stroke=\"#b08d68\" stroke-width=\"1.8\" stroke-linecap=\"round\" marker-end=\"url(#eqfLoopHead)\"\/><\/svg><p><b>And round again.<\/b> Step 05 feeds straight back into step 01: the more closely the body is monitored, the more sensation there is to notice.<\/p><\/div><\/div><figcaption class=\"eqf-foot\"><b>What this does not mean:<\/b> that anxiety caused the original physiological symptom. A racing heart on standing can have a genuine cardiovascular explanation. The loop describes what can form <i>around<\/i> a real symptom, which is also why it can be worked with psychologically without anyone claiming the symptom was imaginary.<\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART FOUR OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-4\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">When the body teaches the brain what to fear<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"a-physical-symptom-can-become-an-anxiety-trigger\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">A physical symptom can become an anxiety trigger<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">This distinction is especially important in therapy. Imagine someone whose heart repeatedly races when they stand. At first, they may simply find it strange. Then it happens while they are outside. They become dizzy. They become frightened.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Eventually they start thinking:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhat if I faint?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhat if it happens somewhere I can\u2019t sit down?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhat if I am alone?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And eventually:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMaybe I shouldn\u2019t go out.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The original physiological symptom may have been entirely real. But now there is a psychological layer built around it. The person may begin avoiding situations associated with the symptom. That avoidance can then reinforce the fear.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">The nervous system learns:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThat situation is dangerous.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And the person may gradually organize their life around avoiding it.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-dfba2422 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b08d68;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:48px;margin-bottom:48px;padding:6px 0px 6px 30px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-weight:600;line-height:1.45\">This is how a physical symptom can become psychologically disabling without ever being psychologically imaginary.<\/p>\n\n\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-body-can-teach-the-brain-what-to-fear\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The body can teach the brain what to fear<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Our brains are prediction machines. We learn from experience. If a particular situation repeatedly precedes pain, dizziness, instability or another frightening sensation, the brain begins anticipating what might happen next. Imagine repeatedly becoming dizzy in a supermarket. Eventually, simply entering the supermarket may make you anxious. You may begin scanning yourself: How do I feel?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Is my heart okay? Am I getting dizzy? Where is the nearest place to sit? The supermarket has become associated with danger. This is a very normal learning process. The difficulty is that the protective response can eventually become larger than the original problem. You may start avoiding the supermarket even on days when your body might actually tolerate it.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"hypervigilance-is-not-the-same-as-imagining-symptoms\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Hypervigilance is not the same as imagining symptoms<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There is an important distinction here. If your body has repeatedly surprised you with pain, dizziness, instability or other symptoms, it makes sense to pay attention. Your brain learns from experience. If a particular sensation has previously been followed by something frightening, noticing that sensation quickly may actually feel protective. The problem arises when monitoring becomes constant. Instead of:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI notice that my heart is beating faster.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">it becomes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMy heart is beating faster. Why? Is something wrong? What if I faint? What if this gets worse?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI need to keep checking.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And eventually:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI can\u2019t stop monitoring my body.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At that point, attention itself can become exhausting. This is one of the areas where psychological treatment can be useful. Not because the sensations are imaginary. But because the relationship with those sensations has become threatening.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-dive has-global-padding is-layout-constrained wp-container-core-group-is-layout-53f739e0 wp-block-group-is-layout-constrained\" style=\"background-color:#f3eee6;border-left-color:#0b1f30;border-left-width:4px;border-left-style:solid;border-radius:20px;margin-top:56px;margin-bottom:56px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#0b1f30;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">DEEP DIVE<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"interoception-how-your-brain-experiences-the-inside-of-you\" style=\"color:#0b1f30;margin-top:0;margin-bottom:16px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Interoception: how your brain experiences the inside of your body<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This brings us to another fascinating concept: interoception. Interoception refers broadly to the sensing, processing and interpretation of signals coming from inside your body. Your heartbeat. Your breathing. Hunger. Thirst. Temperature. Nausea. Muscle sensations. Changes in your internal organs. We don\u2019t experience emotions entirely through thoughts. We experience them physically too. Think about anxiety. It might involve:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set\"><span>a racing heart<\/span><span>a tight chest<\/span><span>butterflies in the stomach<\/span><span>muscle tension<\/span><span>changes in breathing<\/span><span>sweating<\/span><span>restlessness<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The body is part of the emotional experience. Research has found interesting associations between joint hypermobility, anxiety and interoceptive and emotional processing, including differences in neural regions involved in processing bodily information. But we need to be careful here. Interoception is not simply \u201cbody awareness.\u201d There are different aspects to it. You can be very aware of your heartbeat without accurately knowing why your heart is beating faster.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can notice bodily sensations intensely without accurately interpreting them. And you can have relatively little awareness of some bodily signals while still experiencing significant symptoms. So it is more useful to think about how bodily information is detected, interpreted and given meaning, rather than simply asking whether someone is \u201cin touch with their body.\u201d<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-is-anxiety-associated-with-hypermobility\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why is anxiety associated with hypermobility?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This relationship has been observed for decades. Earlier studies identified associations between joint hypermobility and anxiety, particularly panic disorder and <span class=\"eq-term\" tabindex=\"0\" aria-describedby=\"gd-2\"><em>agoraphobia<\/em><span class=\"eq-def\" role=\"tooltip\" id=\"gd-2\"><b>agoraphobia<\/b>Anxiety about being somewhere that would be hard to leave, or where help might be hard to reach. It is often described as a fear of open spaces, which is not quite it: the fear is about being unable to get out.<\/span><\/span>. More recent research continues to support an association. A 2025 systematic review examined 32 studies involving 12,116 people with generalized joint hypermobility. The authors found that anxiety was particularly elevated in symptomatic hypermobility, while people with asymptomatic generalized hypermobility showed smaller differences. Greater anxiety also appeared to be associated with greater hypermobility severity.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But this still leaves us with a very important question: Why? And the answer is probably not one thing.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"there-may-be-several-pathways-between-hypermobility-and-an\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">There may be several pathways between hypermobility and anxiety<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One possibility is biological. There may be shared mechanisms involving autonomic function, interoception, sensory processing or other aspects of neurobiology. Another possibility is physical. Chronic pain, dizziness, fatigue and unpredictable symptoms are inherently stressful. Another is behavioral. If movement repeatedly causes pain, people may become afraid of movement. If standing repeatedly causes dizziness, they may become afraid of standing.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If exercise repeatedly produces symptom flares, they may begin avoiding exercise. And another pathway is social. Living with a condition that is poorly understood can be incredibly frustrating. Repeatedly having to explain symptoms can be exhausting. Being told that symptoms are \u201cjust anxiety\u201d can make a person question their own perception. All of these factors can coexist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-happens-when-your-body-becomes-unpredictable\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What happens when your body becomes unpredictable?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This may be one of the most psychologically important aspects of living with symptomatic hypermobility. Most of us operate with an implicit assumption that our bodies are reasonably predictable. We don\u2019t normally wonder: Will my knee stay stable when I walk across the room? Will standing in line make me dizzy? Will carrying groceries cause pain later?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Will I have enough energy to get through the afternoon? If your body has repeatedly behaved unpredictably, that assumption can change. You may start asking: Can I trust my body? And that question can influence almost everything. You may become more cautious. You may monitor yourself more closely. You may stop making plans too far in advance. You may avoid activities. You may feel frustrated. You may feel grief. You may feel angry with your body. You may even feel betrayed by it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">These reactions are understandable. They are also psychologically important.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-experience-of-having-to-prove-that-something-is-wrong\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The experience of having to prove that something is wrong<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There is another dimension that deserves attention. People with complex multisystem symptoms can spend a long time trying to understand what is happening to them. Sometimes individual symptoms are treated separately. Sometimes there is no clear explanation. Sometimes tests are normal. Sometimes symptoms are attributed too quickly to stress or anxiety. And <strong class=\"eqb\">sometimes people genuinely do have anxiety alongside their physical symptoms<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The problem occurs when psychological explanations are used to replace appropriate physical investigation rather than complement it.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Being told:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIt\u2019s probably anxiety.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">when you are experiencing a genuine physiological problem can be profoundly invalidating. It can also create a difficult psychological consequence:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-dfba2422 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b08d68;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:48px;margin-bottom:48px;padding:6px 0px 6px 30px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-weight:600;line-height:1.45\">you stop trusting your own body.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">You may begin wondering:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cAm I imagining this?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cAm I exaggerating?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMaybe I really am just anxious.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That uncertainty can become its own source of distress.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART FIVE OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-5\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">Fatigue, sleep, fog and gut<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"chronic-pain-changes-the-way-we-move-through-life\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Chronic pain changes the way we move through life<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">Pain rarely stays confined to the moment when it hurts. It can influence behavior. Someone with chronic pain may move differently. They may sleep differently. They may exercise less. They may cancel plans. They may become more cautious. They may think more about their body. They may become frustrated when other people do not understand their limitations. Over time, pain can affect identity.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A person who used to think of themselves as active may begin thinking of themselves as \u201csomeone with a bad body.\u201d Someone who was spontaneous may become highly cautious. Someone who valued independence may become dependent on others. These changes can be psychologically significant even when the underlying physical condition is well understood.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-painavoidance-cycle\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The pain-avoidance cycle<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine someone experiences pain every time they perform a particular movement. Naturally, they avoid it. Avoidance reduces pain in the short term. That is important because the brain learns from consequences. If avoiding something makes you feel better immediately, avoidance becomes more likely in the future. But if the movement itself is safe and simply uncomfortable, long-term avoidance can gradually make the person\u2019s world smaller. They may lose confidence. Their activity level may decrease. Their physical conditioning may change.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The activity may become even more intimidating. And the cycle continues. <strong class=\"eqb\">This does not mean that people should simply push through pain<\/strong>. In hypermobility, some movements genuinely may be inappropriate or require modification. The important question is: What is actually unsafe, and what has become frightening because of what the body has experienced in the past?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That distinction should be made carefully and, where appropriate, collaboratively with medical and rehabilitation professionals.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"fatigue-is-more-than-being-tired\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Fatigue is more than \u201cbeing tired\u201d<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fatigue is another symptom that is easy to underestimate because it is largely invisible. Someone may look perfectly healthy. They may work. They may exercise occasionally. They may socialize. And still feel exhausted. Fatigue in symptomatic hypermobility can have multiple contributors. Pain is tiring. Maintaining joint stability can require physical effort. Autonomic dysfunction can make upright activity more demanding. Poor sleep reduces recovery. Migraine can be exhausting. Psychological distress consumes cognitive resources. And reduced activity can contribute to <span class=\"eq-term\" tabindex=\"0\" aria-describedby=\"gd-3\"><em>deconditioning<\/em><span class=\"eq-def\" role=\"tooltip\" id=\"gd-3\"><b>deconditioning<\/b>The loss of strength, stamina and tolerance for activity that follows a long stretch of reduced movement. It can be a consequence of symptoms and something that makes them harder to live with.<\/span><\/span>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Recent research continues to find fatigue among the common multisystem complaints associated with hEDS\/HSD. A 2026 meta-analysis of gastrointestinal manifestations and comorbidities, for example, identified chronic fatigue, migraine and orthostatic intolerance among frequently reported extraintestinal problems, while also emphasizing substantial heterogeneity and low certainty in parts of the evidence base. There is rarely one neat explanation.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin:54px 0\"><figure class=\"eqf eq-rev\"><div class=\"eqf-eyebrow\">One symptom, many contributors<\/div><div class=\"eqf-title\">Why fatigue is rarely one thing<\/div><div class=\"eqf-sub\">Fatigue in symptomatic hypermobility can have several contributors at once. Which is why looking for the single cause often fails, and why the honest answer to &ldquo;is it anxiety?&rdquo; is usually &ldquo;anxiety may be one part of it.&rdquo;<\/div><div class=\"eqf-conv\"><ul class=\"eqf-chips\"><li class=\"eqf-chip\" style=\"--c:#8ab5b1\"><span class=\"lb\">Pain, which is tiring in itself<\/span><span class=\"tg\">Pain<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#7aada9\"><span class=\"lb\">The muscular effort of staying stable<\/span><span class=\"tg\">Biomechanical<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#69a4a2\"><span class=\"lb\">Autonomic dysfunction when upright<\/span><span class=\"tg\">Autonomic<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#569a9a\"><span class=\"lb\">Poor sleep, reducing recovery<\/span><span class=\"tg\">Sleep<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#428c8f\"><span class=\"lb\">Migraine<\/span><span class=\"tg\">Neurological<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#2d7a80\"><span class=\"lb\">Psychological distress using cognitive resources<\/span><span class=\"tg\">Psychological<\/span><\/li><li class=\"eqf-chip\" style=\"--c:#1a6169\"><span class=\"lb\">Reduced activity and deconditioning<\/span><span class=\"tg\">Activity<\/span><\/li><\/ul><div class=\"eqf-funnel\"><svg viewBox=\"0 0 110 390\" width=\"110\" height=\"390\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M0,24 C57.2,24 52.8,195 110,195\" fill=\"none\" stroke=\"#8ab5b1\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"24\" r=\"3\" fill=\"#8ab5b1\"\/><path d=\"M0,81 C57.2,81 52.8,195 110,195\" fill=\"none\" stroke=\"#7aada9\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"81\" r=\"3\" fill=\"#7aada9\"\/><path d=\"M0,138 C57.2,138 52.8,195 110,195\" fill=\"none\" stroke=\"#69a4a2\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"138\" r=\"3\" fill=\"#69a4a2\"\/><path d=\"M0,195 C57.2,195 52.8,195 110,195\" fill=\"none\" stroke=\"#569a9a\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"195\" r=\"3\" fill=\"#569a9a\"\/><path d=\"M0,252 C57.2,252 52.8,195 110,195\" fill=\"none\" stroke=\"#428c8f\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"252\" r=\"3\" fill=\"#428c8f\"\/><path d=\"M0,309 C57.2,309 52.8,195 110,195\" fill=\"none\" stroke=\"#2d7a80\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"309\" r=\"3\" fill=\"#2d7a80\"\/><path d=\"M0,366 C57.2,366 52.8,195 110,195\" fill=\"none\" stroke=\"#1a6169\" stroke-width=\"1.9\" stroke-linecap=\"round\" opacity=\".9\"\/><circle cx=\"0.5\" cy=\"366\" r=\"3\" fill=\"#1a6169\"\/><\/svg><\/div><div class=\"eqf-orb\"><div class=\"ol\">The experience<\/div><div class=\"on\">Fatigue<\/div><div class=\"os\">and it is not &ldquo;being tired&rdquo;<\/div><\/div><\/div><figcaption class=\"eqf-foot\"><b>The same applies elsewhere.<\/b> Concentration, dizziness, gastrointestinal symptoms, sleep and pain can each have several contributors running at once. This is one reason people with multisystem conditions become frustrated with single-cause explanations, and why individualized assessment matters more than a general protocol.<\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"sleep-sits-in-the-middle-of-many-of-these-cycles\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Sleep sits in the middle of many of these cycles<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sleep is particularly interesting because it can influence almost everything else. Pain can make it harder to sleep. Poor sleep can increase pain sensitivity. Fatigue can reduce activity. Reduced activity can alter sleep. Anxiety can make it harder to fall asleep. And poor sleep can make emotional regulation more difficult. This means that asking:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIs your sleep causing your pain?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">may be less useful than asking:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cHow are your sleep, pain, fatigue and emotional state influencing one another?\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Complex symptoms often work in loops rather than straight lines.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-about-brain-fog\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What about \u201cbrain fog\u201d?<\/h2>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cBrain fog\u201d isn\u2019t a diagnosis.<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It is a description people use for experiences such as:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set\"><span>difficulty concentrating<\/span><span>forgetfulness<\/span><span>word-finding problems<\/span><span>slowed thinking<\/span><span>mental fatigue<\/span><span>difficulty multitasking<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">People with symptomatic hypermobility frequently report these experiences. And again, there may be several contributors. Pain demands attention. Fatigue reduces cognitive resources. Poor sleep affects concentration and memory. Anxiety can narrow attention toward perceived threats. Autonomic symptoms can make thinking more difficult, particularly when symptoms occur while upright. And constant body monitoring takes cognitive energy.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine trying to have a conversation while simultaneously wondering: Is my heart beating too fast? Am I getting dizzy? Does my knee feel unstable? How much energy do I have left? That\u2019s a lot of information competing for attention.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"headaches-and-migraine\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Headaches and migraine<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The nervous-system picture also extends beyond pain in the joints. Headaches and migraine are frequently reported in people with hypermobility-related conditions. A 2024 review of headache disorders in EDS and HSD found that migraine is common in symptomatic hypermobility populations, although estimates vary considerably between studies. The authors also emphasized the importance of considering different causes of headache rather than assuming that every headache in a hypermobile person has the same mechanism. Again, the appropriate conclusion is not:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cHypermobility causes migraine.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Migraine is a complex neurological disorder that also occurs very commonly in people without hypermobility. The more useful conclusion is: when several symptoms occur together, they deserve to be understood as part of the person\u2019s whole clinical picture rather than automatically being treated as unrelated problems.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"and-then-there-are-gastrointestinal-symptoms\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">And then there are gastrointestinal symptoms<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At first glance, digestion might seem unrelated to joints. But the gastrointestinal tract is heavily regulated by the nervous system. And gastrointestinal symptoms are increasingly recognized in hEDS\/HSD. A 2026 meta-analysis found that more than 60% of people with hEDS\/HSD in the included literature reported chronic gastrointestinal symptoms, with disorders of gut-brain interaction, reflux, chronic fatigue, migraine and orthostatic intolerance among commonly reported associated problems. The authors were careful to note that the evidence was highly heterogeneous and that causal conclusions cannot be drawn from these associations alone.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is another example of why the nervous system cannot be thought about as something that only controls thoughts, emotions and movement. It is involved throughout the body.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin:54px 0\"><div class=\"eq-stat eq-rev\"><div class=\"v\">60%<\/div><div class=\"b\"><p class=\"l\">of people with hEDS or HSD in the reviewed literature reported chronic gastrointestinal symptoms, alongside reflux, fatigue, migraine and orthostatic intolerance.<\/p><p class=\"s\">Source: 2026 meta-analysis. Reported as \"more than 60%\" across the included studies.<\/p><\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART SIX OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-6\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">Body and mind are not separate systems<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-body-and-mind-arent-separate-systems\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The body and mind aren\u2019t separate systems<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">This is perhaps the central idea of the entire article. We often talk about: physical health and mental health as though they are two separate categories. But biologically, the boundary is much less clear. Pain changes mood. Mood changes pain perception. Stress changes autonomic activity. Autonomic changes create bodily sensations. Bodily sensations influence emotion. Sleep affects pain. Pain affects sleep. Fear changes movement. Movement changes physical conditioning. Physical conditioning influences fatigue. Fatigue influences mood. These aren\u2019t abstract philosophical connections.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">They are physiological processes.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-53f739e0 wp-block-group-is-layout-constrained\" style=\"background-color:#fbf6f1;border-color:#ecdcc9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:56px;margin-bottom:56px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#b08d68;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"but-this-does-not-mean-that-everything-is-psychological\" style=\"color:#00373e;margin-top:0;margin-bottom:16px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">But this does not mean that everything is psychological<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is where a biopsychosocial approach can easily be misunderstood.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">A biopsychosocial model does not mean:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cEverything is partly psychological, therefore your physical illness is actually psychological.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It means that biological, psychological and social processes can all influence health outcomes. If someone has joint instability, that is a biological reality. If that instability causes fear of movement, that is a psychological response. If the fear causes avoidance, that is a behavioral consequence. If avoidance affects someone\u2019s work and social life, that becomes a social consequence.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And those social consequences can then influence psychological wellbeing.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">The model is not saying:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIt\u2019s all in your head.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">It is saying:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cLet\u2019s understand the whole person.\u201d<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-about-trauma\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What about trauma?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Trauma is another area where online discussions can become unnecessarily simplistic. Psychological trauma does not cause hEDS. It does not create the underlying connective-tissue differences responsible for a heritable connective-tissue disorder. At the same time, trauma can influence pain, sleep, <a href=\"\/your-brain-on-stress\/\" style=\"color:#00373e;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:2px;text-decoration-color:#00373e\">autonomic arousal<\/a>, threat perception, attention and emotional regulation. And living with chronic physical symptoms can itself be psychologically difficult. Repeated injuries. Medical procedures. Pain. Uncertainty. Loss of function. Invalidation. Changes in relationships. Changes in work.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fear of what the future will look like. Any of these experiences can contribute to psychological distress. So the relationship is better described as: physical illness and psychological experience can influence one another rather than: trauma caused the physical illness.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-53f739e0 wp-block-group-is-layout-constrained\" style=\"background-color:#fbf6f1;border-color:#ecdcc9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:56px;margin-bottom:56px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#b08d68;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"not-everyone-with-hypermobility-has-trauma-or-anxiety\" style=\"color:#00373e;margin-top:0;margin-bottom:16px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Not everyone with hypermobility has trauma or anxiety<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This deserves to be said explicitly. <strong class=\"eqb\">There is no single psychological profile of a hypermobile person<\/strong>. Some people with hypermobility have anxiety. Some don\u2019t. Some have trauma histories. Some don\u2019t. Some experience significant autonomic dysfunction. Some don\u2019t. Some have severe chronic pain. Some have little or no pain. The research shows associations and increased prevalence of certain difficulties in some populations.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It does not justify turning those associations into a personality type.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"so-what-exactly-does-nervous-system-dysregulation-mean\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">So what exactly does \u201cnervous-system dysregulation\u201d mean?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This phrase has become extremely popular. You will find it everywhere.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cYour nervous system is dysregulated.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cYour body doesn\u2019t feel safe.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cYour nervous system is stuck in fight-or-flight.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cRegulate your nervous system.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Some of the ideas underneath this language can be useful. But the terminology is often so broad that it becomes difficult to know what is actually being discussed. Are we talking about:<\/p>\n\n\n\n<div style=\"margin-top:4px;margin-bottom:30px\"><div class=\"eqf-set open\"><span>POTS?<\/span><span>orthostatic hypotension?<\/span><span>sympathetic activation?<\/span><span>anxiety?<\/span><span>hypervigilance?<\/span><span>chronic pain?<\/span><span>central sensitization?<\/span><span>sleep disturbance?<\/span><span>emotional overwhelm?<\/span><span>something else?<\/span><\/div><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">These are not interchangeable. <strong class=\"eqb\">There is no single medical diagnosis called nervous-system dysregulation<\/strong>. And there is no single exercise that \u201cregulates the nervous system\u201d in a way that resolves all of these conditions. This distinction becomes particularly important when talking about hypermobility because genuine autonomic disorders can require medical evaluation and treatment.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-dive has-global-padding is-layout-constrained wp-container-core-group-is-layout-53f739e0 wp-block-group-is-layout-constrained\" style=\"background-color:#f3eee6;border-left-color:#0b1f30;border-left-width:4px;border-left-style:solid;border-radius:20px;margin-top:56px;margin-bottom:56px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#0b1f30;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">DEEP DIVE<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-about-the-vagus-nerve\" style=\"color:#0b1f30;margin-top:0;margin-bottom:16px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What about the vagus nerve?<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The vagus nerve has become something of a celebrity in modern wellness culture. And to be fair, it is genuinely important. It is a major component of <span class=\"eq-term\" tabindex=\"0\" aria-describedby=\"gd-4\"><em>parasympathetic<\/em><span class=\"eq-def\" role=\"tooltip\" id=\"gd-4\"><b>parasympathetic<\/b>The branch of the autonomic nervous system associated with rest, digestion and recovery. It works alongside the sympathetic branch, which prepares the body for effort, rather than taking turns with it.<\/span><\/span> nervous-system function and participates in communication between the brain and organs including the heart and gastrointestinal tract. But online explanations often turn it into something much simpler than it actually is.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may have heard claims that the vagus nerve is essentially a switch between: safe and unsafe. Or that almost any symptom can be explained by an insufficiently \u201cactivated\u201d vagus nerve. The actual neurobiology is much more complicated. This is also why it is worth being cautious about treating Polyvagal Theory as established fact.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Polyvagal Theory has been influential in psychotherapy and trauma-informed practice, but several of its central claims remain scientifically disputed. Recent peer-reviewed publications have included substantial criticism of its neuroanatomical and evolutionary claims, alongside responses defending the theory. This doesn\u2019t mean that breathing, relaxation, social connection or mindfulness are useless. Quite the opposite. They can be helpful.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It simply means we don\u2019t need to explain their benefits using claims that go beyond the evidence.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"you-dont-need-to-calm-your-nervous-system-every-time-you-f\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">You don\u2019t need to \u201ccalm your nervous system\u201d every time you feel something<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is another subtle point. A nervous system that activates is not necessarily a nervous system that has malfunctioned. Your heart should beat faster when you exercise. You should become more alert when something requires attention. Fear is sometimes appropriate. Pain is protective. <span class=\"eq-term\" tabindex=\"0\" aria-describedby=\"gd-5\"><em>Sympathetic activation<\/em><span class=\"eq-def\" role=\"tooltip\" id=\"gd-5\"><b>Sympathetic activation<\/b>The branch of the autonomic nervous system preparing the body for effort or for something that needs attention: heart rate rises, breathing quickens, muscles ready themselves.<\/span><\/span> is normal.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-dfba2422 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b08d68;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:48px;margin-bottom:48px;padding:6px 0px 6px 30px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-weight:600;line-height:1.45\">The goal is not permanent physiological calm.<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">In fact, a system that never activates would be just as problematic as one that never settles. <strong class=\"eqb\">What matters is flexibility<\/strong>. Can the system respond when a demand appears? Can it adapt when the demand changes? Can it return toward baseline when appropriate? Can you experience a sensation without automatically interpreting it as catastrophe?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Can you respond to your body without becoming completely controlled by it? <strong class=\"eqb\">That is a much more useful way of thinking about regulation<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-psychological-meaning-of-bodily-sensations\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The psychological meaning of bodily sensations<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A sensation is not the same thing as the meaning we give it. Your heart beats faster. That is a sensation.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">You interpret it as:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019m exercising.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That creates one response.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">You interpret it as:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019m having a heart attack.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That creates another. The physical sensation may be identical. The meaning changes the emotional experience. This does not mean that interpretation creates all symptoms. It means that interpretation can influence what happens next. This is particularly relevant when someone has experienced unpredictable physical symptoms. Their brain has a history. It remembers what happened last time.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And that history influences what it predicts this time.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-protection-becomes-restriction\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When protection becomes restriction<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Many behaviors that become problematic in chronic illness begin as reasonable forms of protection. You avoid a movement because it once hurt. You sit down because standing made you dizzy. You check your heart because it has unexpectedly raced before. You cancel plans because you don\u2019t know how much energy you will have. Initially, these behaviors may be adaptive. But sometimes protection gradually becomes restriction. The question is therefore not:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cAre you avoiding things?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">but:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIs this avoidance still serving you?\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That is a very different question.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART SEVEN OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-7\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">Where psychotherapy fits<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"this-is-where-psychotherapy-can-become-genuinely-useful\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">This is where psychotherapy can become genuinely useful<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">Psychotherapy cannot stabilize an unstable joint. It cannot replace treatment for POTS. It cannot repair connective tissue. It cannot make a migraine disappear through positive thinking. And it should never be presented as a substitute for appropriate medical care. But therapy can work with the psychological processes that develop around a physical condition. It can help someone understand fear. It can help them recognize avoidance. It can help them challenge catastrophic interpretations. It can help them process grief.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It can help them develop a less adversarial relationship with their body. It can help them adapt to uncertainty. It can help them reconnect with activities and values that illness has pushed aside. And sometimes, perhaps most importantly, it can provide a space where the person does not have to prove that their symptoms are real before they are allowed to talk about how difficult they are.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-does-the-research-actually-say-about-psychological-tr\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What does the research actually say about psychological treatment?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is an area where we need to be honest. The research specifically examining psychotherapy for HSD and hEDS is still limited. A 2023 scoping review identified relatively few studies examining psychological interventions in this population, including approaches such as CBT, ACT, DBT, psychoeducation and interdisciplinary pain treatment. A 2024 systematic review found only six eligible studies. Most incorporated psychological interventions into broader multidisciplinary programs rather than testing psychotherapy on its own. The interventions generally focused on pain, pain-related fear and catastrophizing, while some also assessed anxiety, depression, fatigue and quality of life. The authors concluded that multidisciplinary interventions incorporating psychological treatment appeared promising, but that larger and better-designed trials are still needed.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That is important. We should not oversell the evidence. There is reason to think psychological treatment can help. But we do not yet have enough high-quality research to claim that one specific psychotherapy is the treatment for hypermobility.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"so-what-can-therapy-actually-work-on\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">So what can therapy actually work on?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Quite a lot.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"fear-of-movement\" style=\"color:#00373e;margin-top:50px;margin-bottom:13px;font-size:clamp(15.197px, 0.95rem + ((1vw - 3.2px) * 0.887), 23px);font-style:normal;font-weight:700;line-height:1.28\">Fear of movement<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If someone has been injured repeatedly, movement can become frightening. Therapy can help explore the difference between:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThis movement is medically unsafe.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">and:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThis movement has become associated with danger.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That distinction should be made carefully and, where necessary, in collaboration with physiotherapy or medical professionals.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"catastrophic-interpretations\" style=\"color:#00373e;margin-top:50px;margin-bottom:13px;font-size:clamp(15.197px, 0.95rem + ((1vw - 3.2px) * 0.887), 23px);font-style:normal;font-weight:700;line-height:1.28\">Catastrophic interpretations<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A symptom can quickly become a prediction about the future.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMy pain is worse today.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">becomes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019m getting worse.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">which becomes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThis is never going to improve.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">which becomes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMy life is going to become increasingly limited.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Therapy can help slow down that chain. Not by pretending that the future is guaranteed to be good. But by separating what is happening now from what the mind is predicting will happen next.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"hypervigilance\" style=\"color:#00373e;margin-top:50px;margin-bottom:13px;font-size:clamp(15.197px, 0.95rem + ((1vw - 3.2px) * 0.887), 23px);font-style:normal;font-weight:700;line-height:1.28\">Hypervigilance<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Constantly monitoring the body can become exhausting. Therapy can help someone notice when attention has become locked onto threat. The goal isn\u2019t to stop noticing the body. It is to make attention more flexible. You should be able to notice your body without having to monitor it every second.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"avoidance\" style=\"color:#00373e;margin-top:50px;margin-bottom:13px;font-size:clamp(15.197px, 0.95rem + ((1vw - 3.2px) * 0.887), 23px);font-style:normal;font-weight:700;line-height:1.28\">Avoidance<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If fear has gradually made someone\u2019s world smaller, therapy can help identify what they have stopped doing. Sometimes the goal is to return to an activity. Sometimes it is to find a modified version. Sometimes the activity genuinely needs to be abandoned.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">The therapeutic question is not:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cHow do we make you do everything?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">It is:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cHow do we make sure fear and symptoms don\u2019t unnecessarily decide the size of your life?\u201d<\/p>\n\n\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"acceptance-is-not-giving-up\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Acceptance is not giving up<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is particularly important in chronic illness.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Acceptance is sometimes misunderstood as:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThis is your life now. Just accept it.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That is not psychological acceptance. Acceptance is not approval. It is not resignation. It is not giving up on treatment. It is not deciding that symptoms don\u2019t matter. It is the willingness to acknowledge reality as it currently is without requiring reality to be different before you can begin living. Sometimes that means saying:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cMy body hurts today.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">without immediately adding:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cTherefore today is ruined.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Or:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI don\u2019t have enough energy for everything I wanted to do.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">without concluding:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cTherefore I can\u2019t have a meaningful life.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The question becomes: Given the body I have today, what still matters to me?<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"this-is-where-psychological-flexibility-becomes-important\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">This is where psychological flexibility becomes important<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A person living with chronic physical symptoms may have to make more adjustments than other people. Plans may change. Energy may fluctuate. Activities may need modification. Rest may become part of the schedule. Some days may be better than others. <em>Psychological flexibility<\/em> means being able to respond to those changes without becoming completely defined by them. It might mean:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI can\u2019t do this today, so what can I do instead?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">rather than:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI can\u2019t do this today, so everything is pointless.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">It might mean:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019m frightened, but I can decide what to do next.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">rather than:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019m frightened, so fear gets to make every decision.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">That is very different from pretending symptoms don\u2019t exist<\/strong>.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-9b925233 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:18px;margin-top:96px;margin-bottom:8px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:10px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">PART EIGHT OF EIGHT<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"part-8\" style=\"color:#ffffff;margin-top:0;margin-bottom:0;font-size:clamp(17.905px, 1.119rem + ((1vw - 3.2px) * 1.147), 28px);font-style:normal;font-weight:700;line-height:1.28\">The whole picture<\/h2>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"a-more-complete-model-of-hypermobility-and-the-nervous-sys\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">A more complete model of hypermobility and the nervous system<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#16292b;margin-top:0;margin-bottom:26px;font-size:clamp(14.92px, 0.933rem + ((1vw - 3.2px) * 0.861), 22.5px);line-height:1.62\">At this point, it may help to step back. Rather than imagining one single pathway, imagine several systems continuously influencing one another.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin:54px 0\"><figure class=\"eqf eq-rev\"><div class=\"eqf-eyebrow\">A more complete picture<\/div><div class=\"eqf-title\">Not one pathway, but several systems influencing one another<\/div><div class=\"eqf-sub\">Rather than a single chain of cause and effect, it helps to imagine continuous interaction. Each level shapes the next, and what happens further down can change what happens further up.<\/div><div class=\"eqf-model\"><ul class=\"eqf-spine\"><li class=\"eqf-lvl\"><div class=\"rl\">Connective tissue<\/div><div class=\"rd\">Differences in tissue properties, producing changes in joint mobility and tissue mechanics.<\/div><\/li><li class=\"eqf-lvl\"><div class=\"rl\">Biomechanics<\/div><div class=\"rd\">Joint stability, altered loading and muscular compensation.<\/div><\/li><li class=\"eqf-lvl\"><div class=\"rl\">Sensory information<\/div><div class=\"rd\">Proprioception and other signals telling the nervous system where the body is and how it is moving.<\/div><\/li><li class=\"eqf-lvl\"><div class=\"rl\">Pain processing<\/div><div class=\"rd\">Nociception, repeated pain, and potentially altered central pain processing.<\/div><\/li><li class=\"eqf-lvl\"><div class=\"rl\">Central nervous system<\/div><div class=\"rd\">Attention, prediction, pain sensitivity and threat processing.<\/div><\/li><li class=\"eqf-lvl\"><div class=\"rl\">Autonomic nervous system<\/div><div class=\"rd\">Heart rate, blood pressure, vascular regulation, digestion and temperature regulation.<\/div><\/li><li class=\"eqf-lvl soft\"><div class=\"rl\">Lived experience<\/div><div class=\"rd\">Pain, dizziness, fatigue, uncertainty and physical limitation.<\/div><\/li><li class=\"eqf-lvl soft\"><div class=\"rl\">Psychological responses<\/div><div class=\"rd\">Fear, anxiety, frustration, hypervigilance, avoidance and grief.<\/div><\/li><li class=\"eqf-lvl soft\"><div class=\"rl\">Behavior<\/div><div class=\"rd\">Changes in movement, activity, sleep and social participation.<\/div><\/li><\/ul><div class=\"eqf-note\"><svg viewBox=\"0 0 30 44\" aria-hidden=\"true\" focusable=\"false\"><defs><marker id=\"eqfUpHead\" viewBox=\"0 0 10 10\" refX=\"8\" refY=\"5\" markerWidth=\"7\" markerHeight=\"7\" orient=\"auto\"><path d=\"M0,1 L9,5 L0,9 z\" fill=\"#c2a184\"\/><\/marker><\/defs><path d=\"M15,42 C15,26 15,18 15,8\" fill=\"none\" stroke=\"#c2a184\" stroke-width=\"2\" stroke-dasharray=\"5 4\" marker-end=\"url(#eqfUpHead)\"\/><\/svg><div class=\"t\">And it feeds back<\/div><div class=\"d\">Behavior and psychological responses can influence pain, fatigue and autonomic symptoms, which changes the picture further up.<\/div><\/div><\/div><figcaption class=\"eqf-foot\"><b>Read this carefully:<\/b> this is not one proven causal pathway, and it is not a diagnosis of anybody. It is a way of picturing how interconnected these systems can become. Importantly, the arrows can point in both directions, which is why the same symptom can have several contributors, and why two people with the same diagnosis can need completely different things.<\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">This is not one proven causal pathway<\/strong>. It is a way of understanding how interconnected these systems can become. And importantly, the arrows can point in both directions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-same-symptom-can-have-several-contributors\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The same symptom can have several contributors<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Take fatigue. It might be influenced by pain. Or poor sleep. Or autonomic dysfunction. Or muscular effort. Or migraine. Or medication. Or depression. Or anxiety. Or several of these at once. The same applies to concentration. And dizziness. And gastrointestinal symptoms. And sleep. And pain. This is one of the reasons people with multisystem conditions can become frustrated with simplistic explanations. They may be asked:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cIs it anxiety?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">when the more accurate answer is:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cAnxiety may be one part of it.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"this-is-also-why-individualized-assessment-matters\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">This is also why individualized assessment matters<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Two people can have the same diagnosis and completely different symptom profiles. One person may primarily struggle with joint instability. Another may have severe chronic pain. Another may experience significant orthostatic intolerance. Another may have migraine and fatigue. Another may experience all of these. Their treatment priorities will therefore be different. There is no single \u201chypermobility protocol\u201d that makes sense for every person.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Medical assessment, physical rehabilitation, psychological support and symptom management may all have different roles depending on the individual.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-we-know-with-reasonable-confidence\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What we know with reasonable confidence<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The evidence supports several broad conclusions.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-ea472811 wp-block-group-is-layout-constrained\" style=\"background-color:#f3f7f6;border-color:#dde8e7;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:12px;margin-bottom:20px;padding:40px\">\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#26302f;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);line-height:1.7\">\n<li><strong style=\"color:#00373e\">First, hypermobility itself is not necessarily pathological.<\/strong> Many people are hypermobile without significant symptoms.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">Second, symptomatic hypermobility can involve much more than joints.<\/strong> Research describes associations with pain, fatigue, autonomic symptoms, gastrointestinal symptoms, headaches and psychological difficulties.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">Third, proprioception can differ in symptomatic hypermobility.<\/strong> This may affect how the nervous system receives information about movement and joint position.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">Fourth, pain in hypermobility is likely to have multiple mechanisms.<\/strong> Mechanical pain, neuropathic pain and altered central pain processing can coexist.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">Fifth, autonomic symptoms are an important part of the clinical picture for some people.<\/strong> POTS and other forms of orthostatic intolerance occur disproportionately in hypermobility-related populations.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">Sixth, anxiety and hypermobility are associated.<\/strong> Recent systematic-review evidence supports this relationship, particularly in symptomatic generalized joint hypermobility.<\/li>\n\n\n\n<li><strong style=\"color:#00373e\">And seventh, psychological wellbeing deserves attention.<\/strong> Not because the condition is psychological. Because living with a complex physical condition can have psychological consequences, and those consequences can themselves affect quality of life.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-we-still-dont-know\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What we still don\u2019t know<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There are also major unanswered questions. We still do not fully understand the biological basis of hEDS. We do not know why some hypermobile people remain completely asymptomatic while others develop significant multisystem problems. We do not fully understand why dysautonomia develops in some people. We do not know whether all presentations of POTS associated with hypermobility share the same underlying mechanism.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">We do not fully understand the relationship between connective tissue and sensory processing. We do not know exactly how central sensitization develops in individual patients. And we do not yet have a sufficiently strong evidence base to tell us exactly which psychological interventions work best for which people with HSD or hEDS. These aren\u2019t minor gaps. They are major research questions.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The fact that research is still evolving is precisely why we should be careful about turning interesting hypotheses into established facts.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"so-where-does-that-leave-us\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">So where does that leave us?<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Perhaps with a much more useful way of thinking about the relationship between hypermobility and the nervous system.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Not:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cYour joints are hypermobile, therefore your nervous system is dysregulated.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Not:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cYour symptoms are caused by anxiety.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And not:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cEverything is physical, so psychological factors are irrelevant.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Instead: Your body and nervous system are constantly communicating. Changes in connective tissue and biomechanics can influence the information the nervous system receives. The nervous system processes that information. Pain can change attention and behavior. Autonomic symptoms can create frightening bodily sensations. Those sensations can influence emotional responses. Repeated experiences can create predictions and fears. Fear can lead to avoidance.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Avoidance can change activity, confidence and quality of life. And all of those processes can influence one another. <strong class=\"eqb\">That is not a failure of the body<\/strong>. It is how interconnected biological systems work.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"your-nervous-system-is-not-your-enemy\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Your nervous system is not your enemy<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you live with hypermobility, you may have encountered a lot of language telling you that your nervous system is \u201cbroken,\u201d \u201cdysregulated,\u201d or stuck in fight-or-flight. I think there is a more compassionate and scientifically grounded way to look at it. Your nervous system is trying to make sense of what is happening.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sometimes it responds to a genuine physical threat. Sometimes it becomes protective because something painful or frightening has happened repeatedly. Sometimes it learns to pay very close attention to bodily sensations because those sensations have previously mattered. And sometimes those protective responses eventually become restrictive. <strong class=\"eqb\">The goal is not to fight your nervous system<\/strong>. It is to understand it. To understand what your body is communicating.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">To distinguish discomfort from danger where that distinction is appropriate. <strong class=\"eqb\">To recognize when something genuinely requires medical attention<\/strong>. To notice when fear has started making decisions for you. To learn when rest is necessary and when avoidance has taken over. And to develop a relationship with your body that is informed rather than fearful.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"you-can-believe-your-body-and-still-work-psychologically\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">You can believe your body and still work psychologically<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This may be the most important message of all. If you have spent years being told that your symptoms are \u201cjust anxiety,\u201d you may understandably be wary of anything that talks about psychology. But acknowledging the psychological consequences of a physical condition does not invalidate the physical condition. You can have genuine dysautonomia and anxiety.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can have genuine chronic pain and pain-related fear. You can have genuine joint instability and avoidance of movement. You can have genuine fatigue and depression. You can have a genuine connective-tissue disorder and still benefit from psychotherapy. These things do not cancel one another out. In fact, acknowledging both can be much more validating than insisting that only one explanation is allowed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-goal-isnt-to-eliminate-every-uncomfortable-sensation\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The goal isn\u2019t to eliminate every uncomfortable sensation<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A life completely free from uncomfortable sensations is not realistic. Even healthy bodies produce pain, fatigue, dizziness, tension, changes in heart rate, gastrointestinal sensations and countless other signals. <strong class=\"eqb\">The goal is not to become someone who never notices their body<\/strong>. It is to develop enough understanding and flexibility that bodily sensations do not automatically determine what you think, feel or do. Sometimes the appropriate response will be:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI need to stop and take care of my body.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Sometimes it will be:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cThis is uncomfortable, but I am safe.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Sometimes it will be:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI don\u2019t know what this symptom means yet, so I should get it checked.\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And sometimes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cI\u2019ve experienced this before. I know what it is, and I don\u2019t need to panic.\u201d<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Those are very different responses. Learning to distinguish between them is part of developing a healthier relationship with your body.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"a-final-thought\" style=\"color:#00373e;margin-top:86px;margin-bottom:20px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">A final thought<\/h2>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Perhaps the most useful way to understand the relationship between hypermobility and the nervous system is not as a battle between the body and the mind. It is a conversation. Your body is constantly sending information. Your nervous system is constantly interpreting it. Your brain is constantly making predictions. Your experiences shape those predictions. And your responses shape what happens next. Sometimes that system works beautifully.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sometimes illness, pain, autonomic dysfunction or repeated injury changes the conversation. Sometimes the nervous system becomes more protective than necessary. <strong class=\"eqb\">Sometimes the body genuinely needs protection<\/strong>. And sometimes it is difficult to know which is which. That uncertainty can be frightening. But it can also be approached with curiosity rather than blame.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You do not have to convince yourself that your symptoms aren\u2019t real. You do not have to blame yourself for having anxiety. You do not have to blame your body for being difficult. And you do not have to choose between medical care and psychological care.<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-dfba2422 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b08d68;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:48px;margin-bottom:48px;padding:6px 0px 6px 30px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-weight:600;line-height:1.45\">You can take your body seriously and still work on your relationship with it.<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can investigate what is happening physiologically while also exploring fear, uncertainty, avoidance, grief and identity. You can acknowledge your limitations without allowing them to define the entire shape of your life. And you can learn that listening to your body does not have to mean being afraid of it. Perhaps that is where the nervous system becomes most interesting.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Not because it is something we need to \u201chack,\u201d \u201creset,\u201d or permanently calm down. But because it is part of the system through which we experience being alive. And understanding that system a little better can help us move from:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#dcc3a6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhy is my body doing this to me?\u201d<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">toward a more useful question:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">\u201cWhat is my body telling me, what does it need, and how can I respond without letting fear take over the conversation?\u201d<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-767511e4 wp-block-group-is-layout-constrained\" style=\"background-color:#f3f7f6;border-color:#dde8e7;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:72px;margin-bottom:40px;padding:42px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#54706f;margin-top:0;margin-bottom:18px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">A NOTE ON THE EVIDENCE<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Research into HSD and hEDS is developing quickly, but it is still a relatively young and heterogeneous field. Studies do not always use the same diagnostic definitions. Clinical populations can differ substantially from community populations. Many studies have relatively small samples, and some findings are based on associations rather than longitudinal evidence.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This means we need to distinguish between what has been demonstrated, what is strongly associated, what is biologically plausible, and what remains hypothetical. That distinction is particularly important when discussing the nervous system. There is good reason to take the relationships between hypermobility, proprioception, pain processing and autonomic function seriously. There is also increasing evidence of an association between symptomatic hypermobility and anxiety.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#26302f;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At the same time, the evidence does not support reducing hypermobility to a generic concept of \u201cnervous-system dysregulation,\u201d nor does it support the idea that trauma causes hEDS or that a particular vagal exercise can correct the underlying connective-tissue condition. The science is more complicated than that. And, in many ways, that complexity is exactly what makes the subject worth understanding.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-3890a687 wp-block-group-is-layout-constrained\" style=\"background-color:#fafcfb;border-color:#e6eeed;border-width:1.5px;border-style:solid;border-radius:18px;margin-top:86px;margin-bottom:44px;padding:38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#7c8b8a;margin-top:0;margin-bottom:18px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">REFERENCES AND FURTHER READING<\/p>\n\n\n\n<ol class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#26302f;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.17), 15.5px);line-height:1.7\">\n<li><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31552\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 2017.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31539\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics Part C. 2017.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31543\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">De Wandele I, Rombaut L, Malfait F, et al. Cardiovascular autonomic dysfunction in Ehlers-Danlos syndrome-hypermobile type. American Journal of Medical Genetics Part C.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.autneu.2018.02.006\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">De Wandele I, Rombaut L, Malfait F, et al. Postural tachycardia syndrome and other forms of orthostatic intolerance in Ehlers-Danlos syndrome. Autonomic Neuroscience. 2018.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.autneu.2020.102637\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Miller AJ, Stiles LE, Sheehan T, et al. Prevalence of hypermobile Ehlers-Danlos syndrome in postural orthostatic tachycardia syndrome. Autonomic Neuroscience. 2020.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.autneu.2026.103453\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Kwok CS, Hagger G, Gillespie D, et al. The co-existence of Ehlers-Danlos syndrome and postural orthostatic tachycardia syndrome: a systematic review of the literature. Autonomic Neuroscience. 2026.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1007\/s00296-013-2790-4\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Smith TO, Jerman E, Easton V, et al. Do people with benign joint hypermobility syndrome have reduced joint proprioception? A systematic review and meta-analysis. Rheumatology International. 2013.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/ejp.856\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Di Stefano G, Celletti C, Baron R, et al. Central sensitization as the mechanism underlying pain in joint hypermobility syndrome\/Ehlers-Danlos syndrome, hypermobility type. European Journal of Pain. 2016.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31554\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Chopra P, Tinkle B, Hamonet C, et al. Pain management in the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C. 2017.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.3389\/fpsyg.2014.01162\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Eccles JA, et al. Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility. 2014.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1590\/s1516-44462012000500005\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Bianchi S, et al. Anxiety and joint hypermobility association: a systematic review. 2012.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1515\/jom-2021-0267\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Kennedy M, Loomba K, Ghani H, Riley B. The psychological burden associated with Ehlers-Danlos syndromes: a systematic review. Journal of Osteopathic Medicine. 2022.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1186\/s13023-023-02799-y\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Clark NL, et al. Psychological interventions for individuals with Ehlers-Danlos syndrome and hypermobility spectrum disorder: a scoping review. 2023.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1007\/s00296-023-05503-2\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Clark NL, Kainth GS, Johnson M, et al. Psychological interventions to improve pain, fatigue, anxiety, depression, and quality of life in children and adults with hypermobility spectrum disorders and Ehlers-Danlos syndrome: a systematic review. Rheumatology International. 2024.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.3389\/fneur.2024.1460352\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Mehta D, Simmonds L, Hakim AJ, Matharu M. Headache disorders in patients with Ehlers-Danlos syndromes and hypermobility spectrum disorders. Frontiers in Neurology. 2024.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.arrct.2025.100467\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">van Die-de Vries JE, Rameckers E, Calders P, et al. Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review. Archives of Rehabilitation Research and Clinical Translation. 2025.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.cgh.2025.02.015\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Aziz Q, Harris LA, Goodman BP, Simr\u00e9n M, Shin A. AGA Clinical Practice Update on GI Manifestations and Autonomic or Immune Dysfunction in Hypermobile Ehlers-Danlos Syndrome: Expert Review. Clinical Gastroenterology and Hepatology. 2025.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.3389\/fpain.2026.1799439\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Montemayor Zaraz\u00faa AP, et al. Linking central sensitization to multisystemic manifestations in hypermobile Ehlers-Danlos syndrome. Frontiers in Pain Research. 2026.<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/doi.org\/10.1016\/j.jbmt.2025.10.037\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Jari M, Alaei F. Prevalence, associated disorders and treatment of joint hypermobility syndrome: A systematic review. 2026.<\/a><\/li>\n\n\n\n<li>Grossman P, et al. Why The Polyvagal Theory Is Untenable: An international expert evaluation of the Polyvagal Theory. Clinical Neuropsychiatry. 2026.<\/li>\n\n\n\n<li>Porges SW. Polyvagal Theory: Current Status, Clinical Applications, and Future Directions. Clinical Neuropsychiatry. 2025.<\/li>\n<\/ol>\n\n\n\n<p class=\"eq-lastrev\" style=\"margin:34px 0 0;font-family:&quot;Work Sans&quot;,sans-serif;font-size:11.5px;font-weight:700;letter-spacing:.15em;text-transform:uppercase;line-height:1.5;color:#71655b\">Last reviewed September 2026<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-32086477 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b08d68;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:8px;margin-bottom:56px;padding:4px 0px 4px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#5d6f6e;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.7\"><strong style=\"color:#00373e\">This article is general information, not medical advice.<\/strong> It cannot diagnose or rule out any condition. Hypermobility-related symptoms &#45; particularly pain, dizziness, palpitations and fatigue &#45; deserve proper medical assessment. If any of this sounds like your experience, please speak to your doctor. Psychological support is intended to work alongside appropriate medical care, never to replace it.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"eq-rev\" style=\"margin-top:0px;margin-bottom:0px\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1708\" src=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg\" alt=\"A therapist taking notes on a clipboard during a session, with the other person&#39;s hands clasped in front of them\" class=\"wp-image-230\" style=\"width:100%;height:340px;object-fit:cover;object-position:center 40%;border-radius:22px 22px 0 0;display:block\" srcset=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg 2560w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-300x200.jpg 300w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1024x683.jpg 1024w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-768x512.jpg 768w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/div>\n\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-1960b768 wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:0px 0px 22px 22px;margin-top:0;margin-bottom:80px;padding:56px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#8fb3b3;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORKING WITH THIS<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"it-is-hard-to-live-in-a-body-that-nobody-has-been-able-to-\" style=\"color:#ffffff;margin-top:0;margin-bottom:18px;font-size:clamp(18.959px, 1.185rem + ((1vw - 3.2px) * 1.255), 30px);font-style:normal;font-weight:700;line-height:1.28\">It is hard to live in a body that nobody has been able to fully explain to you<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#cfe1e0;margin-top:0;margin-bottom:30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);line-height:1.7\">When hypermobility comes with uncertainty, exhaustion, fear, or the constant question of what is happening and why, it can become difficult to know what to do with all of that. Therapy can offer a place to make sense of that experience with someone. Not instead of medical care, and not as an explanation for everything medicine has not yet been able to explain, but alongside it. A place where you do not have to choose between understanding your body and taking care of your mind, and where the difficulty itself can be talked about.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-text-color has-background has-work-sans-regular-font-family wp-element-button\" href=\"\/book-now\/\" style=\"border-radius:9px;color:#00373e;background-color:#ffffff;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:700\">Book a discovery session<\/a><\/div>\n\n\n\n<div class=\"wp-block-button footer_b\"><a class=\"wp-block-button__link has-text-color has-work-sans-regular-font-family wp-element-button\" href=\"\/our-approach\/\" style=\"border-color:#43706f;border-width:1.5px;border-style:solid;border-radius:9px;color:#ffffff;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:600\">How we work<\/a><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Hypermobility is often reduced to being unusually flexible. For some people it involves far more &#8211; pain, fatigue, dizziness, altered proprioception and autonomic symptoms. What the research actually says about hypermobility, the nervous system and psychological wellbeing, and what it does not say.<\/p>","protected":false},"author":2,"featured_media":2627,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"iawp_total_views":132,"footnotes":""},"categories":[15,16],"tags":[],"class_list":["post-2318","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-body-and-mind","category-deep-dive"],"_links":{"self":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/comments?post=2318"}],"version-history":[{"count":20,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318\/revisions"}],"predecessor-version":[{"id":2729,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318\/revisions\/2729"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media\/2627"}],"wp:attachment":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media?parent=2318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/categories?post=2318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/tags?post=2318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}