Editor’s Note: This article was submitted to us by Tomáš Brabec, physiotherapist and consultant for pain and chronic conditions.
When pain persists, we naturally look for its cause and what needs to change. When we also consider our lives, we ask: What is still weighing on me? What remains unresolved? What do I still need to come to terms with?
For a long time, I approached my work with people experiencing chronic difficulties similarly. I explored what burdened them, what they experienced, and how this related to their physical symptoms. Gradually, however, I noticed situations that did not fit this perspective. Someone had resolved a problem, a difficult period had ended, and life had improved. Yet symptoms continued and often worsened. For some, symptoms appeared only when emotional relief arrived.
I began paying closer attention to what had changed, what had ended, and what remained.
These clinical observations led to the Adaptive Habit Framework (AHF). Its central idea is that a way of responding that was genuinely needed in the past may continue in the body as a learned habit after the original conditions have ended.
In this article, I do not present AHF as an explanation of the causes of rare, genetic, or other serious diseases. Its focus is on how learned responses may influence symptoms and how people experience them.
What Helped Us Endure
AHF distinguishes two concepts. An adaptive response is a way of adapting that fits current circumstances. An adaptive habit is the continuation of that response after its original purpose has ended.
By “habit,” I mean a learned response, rather than a bad habit or conscious decision. The distinction is between what was needed then and what is needed now.
A person usually already knows and genuinely feels that the difficult chapter is over.
Where does this habit originate? We all adapt to what life brings. During difficult periods, we learn to endure, fight, wait, stay alert, or keep things under control. These responses serve a purpose: they help us cope. Imagine someone who lives under pressure for years. They must manage everything, prevent things from going wrong, and put their own needs aside. In those circumstances, their need to endure has a place.
Later, circumstances change. They gain more space for themselves, responsibilities are shared, and they no longer have to manage everything alone. In my clinical experience, however, a learned response may continue and find expression in the body, for example as tension, pain, or other symptoms.
I have explored similar connections with several people living with high blood pressure. Together, we examined how long they had lived under pressure, how they had adapted, and which circumstances had ended. This was individual work alongside their usual medical care. These are individual clinical observations, rather than evidence of effectiveness, which would require systematic evaluation.
From Explanation to Individual Work
Education is the foundation of AHF: understanding that a situation and the learned way of coping with it may follow different paths. This provides a shared starting point. Naming a habit alone does not describe the whole therapeutic process.
Individual work means exploring these connections more deeply. Together with the client, I examine how a response developed, where it was needed, how it appeared at other times, and what changed when symptoms began or altered. Different situations may share a principle, such as enduring, waiting, controlling, or restricting oneself. We gradually connect experiences so that people can recognize a recurring response and understand its possible relationship to current physical difficulties. The same pain need not have the same personal connections for everyone.
“What did I once have to cope with that I no longer face?” can open a conversation. Deeper work explores what coping meant in that person’s life and where the learned response continues today. Throughout, we observe changes in symptoms, experience, and daily functioning.
In my clinical practice, I observe that this work brings people both psychological and physical relief and helps them understand themselves and their bodies differently. I am also developing AHF toward scientific evaluation so its benefits can be assessed systematically.
For people with rare or chronic conditions, it can offer individual support in managing symptoms alongside medical, psychological, and rehabilitation care. It does not replace that care.
About the Author: Tomáš Brabec is a physiotherapist and consultant for pain and chronic conditions based in the Czech Republic. He is developing the Adaptive Habit Framework from his clinical practice. He is the author of the Czech-language book Nemoc není bezmoc a bolest není trest (Illness Is Not Helplessness and Pain Is Not Punishment; Euromedia Group, 2026).
