The Four Agreements for Migraine: Be impeccable with your word

Years ago I really struggled with not wanting to let people know when I was getting a migraine. I didn’t want to be viewed as the one who spoiled the party or let down my co-workers by leaving them with my workload. I would try to hide my symptoms for as long as possible and discretely take medicine only when I had to. It never occurred to me to ask others to accommodate my needs.

About 15 years ago, I went through the most challenging headache struggle ever when I suddenly developed chronic cluster headaches, which triggered chronic migraine, too. Not wanting to see me suffer, a loved one shared some helpful insights with me. That was the beginning of my transformation from a helpless victim to an active participant in my own health care. One of the gifts from that time was the discovery of The Four Agreements – a small book, written by Don Miguel Ruiz. This book was just one of many treasures I encountered over a 3-year period of personal reflection and self-discovery. Now I’d like to share it with you.

The book is based on the simple premise that we make mental agreements that govern our behavior. It offers four new, practical agreements we can make to improve our mood, self-concept, and our relationships with others. These agreements can be applied to our experiences with migraine.  The pain of a migraine alone can make us vulnerable to negative thinking. Combine that with social isolation, job insecurity, and family stress and it can be nearly impossible to think positively.

Ruiz explains it best in his description of the book:

"Everything we do is based on agreements we have made – agreements with ourselves, with other people, with God, with life. But the most important agreements are the ones we make with ourselves. In these agreements we tell ourselves who we are, how to behave, what is possible, what is impossible. One single agreement is not such a problem, but we have many agreements that come from fear, deplete our energy, and diminish our self-worth.”

Each agreement will be covered in detail in a series of four articles. Each one will invite you to participate in the discussion with follow-up questions. Let’s start by taking a closer look at the first one, which involves how we use language to speak to and about ourselves and others.

Agreement #1: Be impeccable with your word.

Definition: im•pec•ca•ble –  in accordance with the highest standards of propriety; faultless:


What we say about ourselves matters. Whether it’s spoken aloud or just a passing thought, we must first treat ourselves with respect and love before we can expect others to respect us, too. By speaking gently and honestly to and about ourselves, we create an attitude of self-acceptance regardless of what we accomplish.

Instead of saying, “That storm is going to give me a migraine and ruin my weekend.“   Why not try, “I might get a migraine this weekend so let’s plan some low-key activities.” Do you notice the difference in how the latter makes you feel? Without the anticipation of a ruined weekend, you can embrace a change in plans much more readily.

I remember when I finally embraced this idea. It made such an improvement in my family’s acceptance of my disease. I used to make promises out of a sense of obligation because I wanted to be able to be there for them. My intentions were honorable, but my words were not impeccable. I needed to learn how to avoid self-blame and still acknowledge the truth.

Talking to others

How we communicate with others matters, too. We usually run into trouble when we let fear control us. When it comes to relationships, what are some of the things that migraineurs fear? I often hear people express the fear of losing friendships, loved ones, jobs, and the respect of others. This is a very real possibility. The key is in not letting fear be in charge. To get a balanced perspective, we must examine all the evidence in order to accurately assess our risk.  Even if we determine that speaking the truth will risk a relationship, that doesn’t mean we choose to lie. It might mean that we prepare ourselves for the eventual loss when we do speak honestly. Hopefully we have enough self-respect to be honest in the face of losing someone we care about.

Another theme also emerges when talking to migraineurs. It’s anger. We get angry at doctors, bosses, spouses, parents, best friends, and anyone who ever treated us badly because of migraine. We’ve all had the experience of being accused of faking a migraine to avoid an unpleasant activity. We’ve been called “slackers” and told we “sabotage ourselves”. The sentiment to “give someone a migraine” runs deep.

Anger has its place and can be completely justified – that’s a topic for another post. Speaking impeccably is in direct conflict with speaking in anger. It’s not that we shouldn’t be angry. It’s whether or not we let that anger consume us. By recognizing our anger in advance, we can better prepare to respond impeccably to situations that could trigger anger. Think about the kinds of things that incite the anger of migraineurs. Now think about how you might respond when faced with that situation. Can you be honest and say that you are angry? Can you communicate that anger in a way that avoids triggering a defensive response from others? How might you tell someone how offensive it is to be called a liar when your head feels like it might explode?

Start by planning your response out in your head. Then try it out on a trusted friend. If you jump in trying something new with the most difficult person you know on the worst migraine day of the week, you will likely get frustrated and fail. Don’t set yourself up for that kind of failure. Plan ahead. Stack the deck in favor of success. Each little success will build your confidence and increase your positive self-talk.

Remember: To be impeccable with your word means to be accurate, truthful, and loving in your speech and thought to yourself and others.

For discussion: How might being impeccable with your word help reduce stigma and suffering in your own life?

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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