Long COVID is Biological
One of the greatest misconceptions surrounding Long COVID and other complex chronic illnesses is the assumption that if a condition is brain-based, it is somehow not biological. In reality, a condition can be both brain-based and profoundly biological. Direct effects of a virus, including tissue and organ injury, are biological. Likewise, a brain and nervous system that remain in a prolonged state of survival can also drive biological changes throughout the body. These are not competing explanations. They are biological processes that can co-exist.
The brain and nervous system are biological organs. Every thought, emotion, memory, stress response, immune signal, and autonomic reflex is mediated through physical structures, electrical activity, neurotransmitters, hormones, immune messengers, and genetic regulation.
Modern neuroscience has demonstrated that the brain is not merely responding to the body: it is continuously regulating it. Through neural pathways, endocrine signaling, and the autonomic nervous system, changes in brain and nervous system function can influence immune activity, cardiovascular regulation, hormone production, digestion, pain perception, inflammation, metabolism, sleep, and tissue repair. In other words, biological changes in the brain and nervous system can produce biological changes throughout the body.
DNRS is built upon this principle.
It does not suggest that illness is "imaginary." Rather, it recognizes that the nervous system itself can become dysregulated following infections, toxic exposures, trauma, injury, surgery, or prolonged stress. Once these protective networks become chronically activated, they can continue driving very real physiological symptoms, even after the original trigger has diminished or resolved.
Why Politics Can Prevent Healing
The politics surrounding chronic illness developed for understandable reasons.
For decades, patients with conditions such as ME/CFS, fibromyalgia, POTS, chronic Lyme disease, and now Long COVID experienced dismissal, disbelief, and inadequate medical care. Many were told their symptoms were "just anxiety" or "all in their head."
In response, advocacy organizations fought tirelessly to establish an essential truth:
These illnesses are biologically real.
That advocacy has been enormously important. It has helped secure research funding, increase physician awareness, expand disability recognition, and improve public understanding.
However, over time, an unintended consequence has emerged.
For some, protecting the legitimacy of the illness has become intertwined with rejecting any discussion of the brain or nervous system as a contributor to recovery.
Yet these ideas are not mutually exclusive.
An illness can be biologically real while the brain and nervous system also play a central role in maintaining (and recovering from) that illness.
Those two statements can both be true.
Why Recovery Stories Matter
Recovery stories are not scientific proof, but they are often the beginning of scientific discovery.
Recovery stories generate hypotheses.
They identify patterns.
They point researchers toward questions worth investigating, and interest in treatments when patients begin recovering in unexpected ways.
When recovery stories are discouraged, dismissed, or removed from public discussion simply because they involve neuroplasticity-based approaches, fewer patients become aware that these approaches even exist. Fewer clinicians become curious. Fewer researchers pursue formal studies.
Suppressing recovery stories does not strengthen science. Carefully examining them does.
Why Advocacy Groups Are Fearful
The fears within many advocacy communities are understandable.
Patients have fought extraordinarily hard to have their illnesses recognized as legitimate biological conditions.
Many worry that if neuroplasticity-based treatments become widely accepted, insurers, governments, or physicians could misuse that information by claiming that patients no longer require biomedical care or that recovery is simply a matter of mindset.
History gives them reason for caution. Those concerns deserve respect.
However, acknowledging a role for the nervous system does not require abandoning the biological reality of chronic illness.
In fact, the nervous system is itself one of the body's most powerful biological regulators.
What Would Have to Change?
Many people assume that insurers would only support nervous system-based treatments if there were "proof that the brain is involved."
The proof already exists.
Modern neuroscience has extensively demonstrated that the brain regulates immune activity, autonomic function, pain processing, endocrine signaling, inflammation, and stress physiology.
The real question is different.
Can a specific intervention reliably improve outcomes?
Insurance companies generally require high-quality evidence demonstrating that a particular treatment is safe, effective, reproducible, and cost-effective. That typically means randomized controlled trials, replication by independent researchers, and evidence that the treatment provides measurable benefit beyond existing standards of care.
The path toward broader acceptance of neuroplasticity-based interventions is therefore not simply proving that the brain is involved—it is building stronger evidence that particular therapeutic approaches consistently help patients.
Separating Advocacy from Politics While Maintaining Hope
Patients should never have to choose between validating the seriousness of their illness and remaining open to recovery. These goals can co-exist.
Advocacy can continue demanding biomedical research, better physician resources, disability protections, and compassionate care while also supporting rigorous investigation into neuroplasticity, nervous system regulation, autonomic rehabilitation, and brain-based therapies.
Curiosity is not betrayal.
Hope is not denial.
Scientific openness does not diminish patient advocacy; it strengthens it.
The strongest advocacy welcomes evidence wherever it leads.
Where DNRS Differs from Older Psychosomatic Models
One of the greatest misunderstandings surrounding DNRS is that it is often grouped with older psychosomatic theories.
Historically, many psychosomatic models implied that symptoms arose primarily from unconscious conflict, personality traits, repressed emotions, or faulty thinking. Too often, patients were left feeling blamed for illnesses they did not choose.
DNRS is fundamentally different.
It is grounded in modern concepts of neuroplasticity, central sensitization, predictive processing, autonomic regulation, and the brain's capacity to learn and unlearn protective survival responses.
The model does not suggest that patients consciously created their illness.
It proposes that the nervous system can become involuntarily stuck in patterns of heightened protection after significant biological or psychological stressors. These patterns are protective responses that developed over time. Because the brain is capable of change, they may also change through structured neuroplasticity training.
This distinction removes blame while preserving hope.
The Paradox
Perhaps the greatest paradox in today's chronic illness conversation is this:
Patients have spent decades fighting to prove that their illnesses are biological.
At the same time, many have become understandably wary of any discussion involving the brain because similar language was once used to dismiss them.
Yet the brain is itself a biological organ.
Its cells are biological.
Its neural circuits are biological.
Its chemistry is biological.
Its electrical signaling is biological.
Its regulation of the immune, endocrine, autonomic, and cardiovascular systems is biological.
Recognizing the brain's role does not make an illness less real.
It expands our understanding of how biology works.
The very organ that can contribute to chronic dysregulation may also possess the remarkable capacity to support recovery.
What This Means for DNRS
For DNRS, this conversation represents an opportunity to bridge a divide that has often polarized the chronic illness community.
DNRS does not ask people to choose between biology and neuroplasticity.
It recognizes that neuroplasticity is biology.
It acknowledges that chronic illnesses can begin with genuine biological triggers—viral infections, toxic exposures, injury, surgery, or trauma—while also recognizing that the nervous system can become locked in protective patterns that continue influencing physiology long after the initial trigger.
The future of chronic illness care does not need to be either biomedical treatment or nervous system regulation.
Increasingly, it may be both.
As research advances, the most comprehensive model is likely to integrate immunology, neurology, autonomic science, endocrinology, psychology, and neuroplasticity into a unified understanding of recovery.
DNRS is best understood not as an alternative to biology, but as an application of biology, one that seeks to harness the brain's innate capacity for adaptation and regulation. As research continues to advance, the science of neuroplasticity provides increasing reason for hope, underscoring the brain's remarkable capacity to adapt, form new pathways, and support lasting change.
