Analysis Paralysis Conundrum of Autoimmune Management

In autoimmune disease, we often learn the hard way that the decisions we make—about what we put in our body, when to go to bed, which activities to participate in, you name it—have a direct impact on how we feel.

We can go years not giving a rip about any of these things, only to realize as we become aware of our disease that they’ve been playing a major role in how we feel. It’s a huge shift in perspective and it can be so empowering to know that we can make choices to make ourselves feel better.

I’ve noticed a common theme emerging among my clients, though, as a sort of “dark side” to this perspective shift: they get caught up in analyzing every single choice they’ve made and how it makes them feel, worrying that it was “right” or “wrong.” They’re looking for clear cut answers to the questions like:

“I’m experiencing diarrhea today, what did I eat to bring this on?”
“Ugh, I feel bloated. What’s that about?”
“My skin is itchy. Why???”

They get stuck in this obsession, and it can be really problematic. In addition to the Monday morning quarterbacking everything they ate, did, wore, or experienced yesterday, they become fearful of the choices they are making TODAY. They become terrified that eating or doing the “wrong” thing is going to have consequences, and they start keeping score.

“Well, I went out to see friends and didn’t get as much sleep as normal, that’s why I feel like crap today. What should I say about this party I’m invited to tonight?”
“I felt super lethargic this week, I wonder if it’s because I ate shellfish last week. Should I stay away from ALL seafood?”
“I haven’t worked out this week but I’m really tired. Should I go to the gym today, or keep resting?”

Multiply all these by 1,000 and you start to get the idea. Autoimmune message boards and groups online are full of this kind of hand wringing. And while it starts out in the wonderful intention of healing our bodies, this kind of obsession can be based in fear. It’s misleading to think that there is anything black and white about autoimmune disease, as is the idea that we can make 100% right or 100% wrong decisions for ourselves.

Fortunately, we can prevent ourselves from falling into this fear-based “analysis paralysis.” I’ve found a few strategies work really well to bring my clients back down to earth and get them rooted in confident decision-making again.

  1. Check the shame and self-aggression. When you notice problematic symptoms, take a deep breath before spiraling into self-flagellation. (“GAH! I knew I shouldn’t have had a drink after work—now I feel like shit. This is what I get for trying to have fun with my co-workers! I should have known better! I’m so stupid!”…Sound familiar?) My clients are so quick to judge themselves when they make certain choices. Many of them are high achievers who see perfection as the goal in most pursuits, and when they don’t reach that bar with their health (because how can you?) they spiral into guilt and fear. Build your self-awareness in these moments, and simply notice that you’re beating yourself up. Pause. Then:
  2. See your life as an experiment. File your crummy symptoms away as purely information, not some kind of verdict about your character. I encourage clients to take the, “How interesting!” approach when they notice a symptom. We’re all learning as we go, and this is simply another bit of information you can use to inform future decision making. If you see your healing process as a learning process, then you’re doing everything right by coloring outside the lines every once in a while.
  3. Take note of recurring themes and ask for support. Sometimes it’s consistently challenging to make a certain choice that supports healing. For example, every single day I have a hard time going to bed early enough to get adequate rest! It’s an opportunity for me to ask for support to help make the decision I want to make. My spouse can lovingly lend a hand with this, as can my friends. It’s always helpful for me to let others in on these sticky situations, so they understand why I might want to wind down earlier and help me stay accountable. And don’t hesitate to reach out for professional support as well—ask your medical providers, healers, and health coaches to help you make lifestyle changes that will help you reach your goals from a place of love, patience, and commitment.
  4. Trust yourself. My clients are often seeking any means to control their health because they’re coming from a place of having felt so confused and chaotic in their disease process. But there’s a lot to be said for just making a decision—“I’m going to enjoy just one helping of my grandma’s famous potato salad at the picnic, and fill the rest of my plate with foods that make me feel good”—and sticking with it. Don’t spend more time than necessary sitting in indecision. Embrace that you may not know the outcome of a certain choice, and that’s okay. You’ll feel better from making decisions in a place of peace and calm than hemming and hawing endlessly and making the choice from a place of stress.

Longtime readers in the Autoimmune Wellness community won’t be surprised to hear me draw connections between this process of decision-making stress and the healing power of the nervous system. When we approach our choices from a place of fear—instead of love and compassion for ourselves—we sabotage the body’s power to heal because we throw the autonomic nervous system into a sympathetic (stress) response. When we meet choices from a place of love, trust, acceptance, and abundance, we harness the healing power of the parasympathetic nervous state.

This provides powerful motivation to get clear in our decision-making process. When we don’t stress endlessly about our daily choices, we not only get to experience less stress, but we also promote our body’s ability to heal itself.

About Sarah Kolman

Sarah Kolman RN, MA, CHPN, INHC is an AIP Certified Coach, Registered Nurse, Integrative Nutrition Health Coach, and Contemplative Psychotherapist. Sarah’s unique one-on-one health coaching practice blends her nursing and psychotherapy experience with holistic and nutrition-based health concepts. A passionate student in the field of psychoneuroimmunology, she helps her clients heal by focusing on the brain-body connection and its profound impact on wellness. With Sarah’s support and guidance, clients learn to manage stubborn symptoms that have persisted through countless traditional treatments. Learn more about Sarah’s coaching services by visiting her website, Her book Full Plate: Nourishing Your Family’s Whole Health in a Busy World is available on Amazon. You can follow Sarah on Facebook.


  • Ardi says

    I think part of the problem is the way Reintroductions are being taught. We are told that our bodies can tell us when something is not working for us. Very specific symptoms are listed as possible signs of this. But because we can’t control all the variables in our daily lives, it is very hard to be sure that a certain symptom is really because we reintroduced eggs, or because we didn’t sleep well the previous night, or because we are coming down with cold or flu, or whatever. I have been on AIP for more than 2 years, and have never been quite sure that reintroductions have worked. Sometimes I have thought that I had a reaction to something, only to find out later that the food was not the cause. I have now taken the approach that AIP is my baseline, and I occasionally eat “reintro foods”, and then go back to AIP. I wish we could be more precise, but I don’t think it is possible.

  • Tim Guenther says

    Great information…just what i needed to hear today.

    • Karen says

      Ditto! I’m so scared to even start an AI protocol because I know I’ll screw it up! This is a great article and really helpful for me right now 🙂

      • That fear voice is strong, isn’t it? So many of us avoid “failure” at all cost, and look at what we miss out on along the way. What if you told yourself that there was no such thing as messing up or failure, but only information to be gathered? You don’t have to be “perfect” to have success on the AIP protocol. Reach out for support so you don’t feel like you are doing it alone. You will notice that it is a process and a learning opportunity for everyone on the journey. Watch out for that fear voice, and practice empowerment, courage, and grace (imperfection).

    • Glad it was helpful for you.

  • Linda says

    Hi Sarah, I am new to the Autoimmune Wellness community. I have only been on the Protocol for 2 1/2 weeks and have a million and one questions. For sure I am analyzing everything! Many of the things you wrote about pertain to me and when you get into the phase of analyzing everything it can totally cause Paralysis!

    I have been GF for several years and have been tested as gluten intolerant. How can I know for sure if I have Neurological Celiac or Hashimoto’s? I have most of the symptoms of both and after 55 years of symptoms I am getting desperate for some answers; but I don’t know where to turn.

    I listen to the Autoimmune Wellness podcast which has been awesome for me and I read the blogs on this site, but they raise more questions for me that have gone unanswered. I know where to start for the diet, but how do I find a reliable person who can test me? I have been to numerous doctors and have been told:

    “You have Epstein Barre! Sorry we don’t know how to treat it. Get some extra rest!”

    “You have Peripheral Neuropathy! Were so glad it’s not lupus or MS! But there is nothing you can do about it. Here take these pills for pain.”

    “Oh, you’re having seizures? Ghee… wish we knew where they were coming from. Here is 500 mg of Keppra. You will have to stay on it for life!”

    “You’re depressed, having anxiety attacks? Here try Lexapro!”

    What about my thyroid? “What about it, you have over 9 nodules on your thyroid, but your blood work is in normal range.”

    “Why am I so exhausted? What about my weight gain after eating healthfully and working out two hours a day with a trainer but not losing one pound! “Are you stressed? You need to watch your stress levels!”
    I’m having intense muscular pain at night in my legs and arms. “HUM…”

    Why do my bones hurt? When I wake up I walk like a duck and my neck is killing me!
    It’s either all in my head, a matter of stress (who doesn’t have stress! I have been hearing that all my life from doctors or neurologist!)

    Why do I have so much brain fog that I can’t think or concentrate? Why am I so motion sick? What is all this pressure in my face? Why am I passing out? Why do I get repeat bronchitis? It goes on and on and on.
    Constipation has been a big one. I have gone to the doctors for over thirty years because of my constipation.

    What about chemical reactions that leave me curled up on the floor board of the front seat of our car? (Just driving through petroleum district of St. Louis! Or gas fumes when we fill up for gas.)
    What about not being able to concentrate at school; continual brain fog. Extreme sugar and carb cravings that have taken me over 50 years to begin to escape from. Fatigue, exhaustion, tipping over and walking into doorways and counter tops, prolactinoma on my pituitary gland and now insomnia.

    I am sorry this is so long; but please, can someone lead me to someplace to get help!

    • Joy L Miller says

      Wow! Are we sisters? lol I’ve been working on many of the same issues as you for years. (I have SIBO and Leaky Gut) I have been using the AIP method for several years now and still don’t have it all figured out. But…I am ‘better’ and I’ll take that!
      So please rest assured you will get better if you work at it, but also take the advice to move forward slowly and don’t try to do it all at once. Or you will get ‘analysis paralysis’ for sure.
      A great D.O. or naturalist Dr. will be of great help as well.

      Best of luck!

    • Linda! Thank you for sharing. You have a lot going on, and I can imagine that it feels lonely, scary, and confusing when no one has answers and you don’t have a clear path toward wellness. I would imagine that you also feel out of control, helpless, and frustrated as your body continues to let you know it needs help but you don’t necessarily know what to do for it. I spend a lot of time working with my autoimmune clients on feeling empowered, strong, confident and even joyful, because autoimmune disease has a superpower way of making people feel helpless, out of control, and powerless. I wish I could answer your question about finding appropriate help in this short response, but I don’t have enough information. I’m happy to offer you a free consultation to learn more about what you have tried, what support you are wanting and what resources might be available to you. If you go to my website listed in my bio you can book an appointment online.

  • Izabela says

    This is spot on. Healing isn’t a linear path but we are often lead to believe it should be. When I’m feeling crummy, I often get people questioning my diet and lifestyle choices, saying “shouldn’t you be feeling better on this diet? Isnt that the whole point of this?” It’s as if I have to make progress each day in order to justify the Paleo Approach lifestyle I’ve chosen. The truth is, I have autoimmune disease and will always have it. Which means there will be bad days. Sometimes because of something I ate or a bad night of sleep and other times because of something I can’t even identify.

  • Rita Koll says

    Hi Linda. I am sorry your journey has held such frustration and pain. I share some of your physical symptoms, as well as prolactenemia and very elevated EBV antibodies. I have been to few doctor appts, as this seems like a bottomless hole. Rather, I research a good deal on my own and do my best to eat a whole foods, plant-based diet. When I stray, I put my wellbeing first and have compassion for myself…even when others don’t. Autoimmunity has taught me a whole new dimension of self-care and self-love! Besides trying to eat clean, I focus on movement (even when I have fatigue or joint pain) and connection to others. That’s it. I’ve learned to focus on enjoying my life as it is and mostly given up the day-to-day obsession with symptoms. I know, Linda, that’s WAY easier said than done. It helps to connect to this community! And I do hope you are blessed with supportive family and friends. One thing that did help me turn a corner was to give up grains. Look to Dr. Peter Osborne from The Gluten Free Society for data and inspiration. And when I chose to have a grain on very rare occasion, I tell myself it’s ok and I will start again tomorrow! My life and health are not perfect but they are MINE…and I’m determined to thrive!

    • Thank you for the thoughtful and insightful response Rita. I appreciate how you embrace imperfection, self-compassion, and courage on this journey. They are such important practices to focus on.

  • Charlene says

    Thanks Sarah for such an informative and well-written post about autoimmune disease. The above information mirrored my situation exactly. Autoimmune disease is so complex that it can only be approached on a case-by-case basis.There’s no cookie cutter solution. It feels as if you’re a dog chasing your tail because of the vicious cycle of eliminating foods you’re hypersensitive to and replacing them with healthier foods (ie., additive-free, non-cross-reactive) and after ingesting the so-called healthier alternative, you’re then blindsided with a myriad of debilitating symptoms. Frustrating? Yes. But as you stated it’s an “experiment.” It’s definitely a journey and hard work which requires tons of prayer, faith and patience. My husband is more frustrated than I an because he’s a chef and loves to cook. He’s puzzled when I’m reading ingredient info like it’s a book or that my food is bland without seasonings because I’m allergic to everything even my mouthwash and lotion. I’m sorry for rambling but I have no other outlet because neighbors, friends and family feel helpless and sorry for me and my doctor merely stated that I needed an antidepressant for my symptoms.

    • Prayer, faith, and patience! What powerful tools to support you in this journey. Practice those as often as possible.

      Thank you for sharing your experience.

  • Rita says

    Hi Linda. I left a long message but don’t see it posted. Perhaps I’ll wait a bit more?

  • Barbara says

    Wonderful article!!! I deal with that all the time..1 year Hashimoto’s, Gluten Sensitive, And Brain Injuries that were blamed for these ex as well..We are all a work in progress..

    • Thanks for sharing your voice. A work in progress! This statement gives us permission to experiment, stumble, learn, grow, and be gentle with ourselves.

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