The Gupta Program

The Gupta Program, also referred to as Amygdala and Insula Retraining (AIR), describes itself as a program incorporating “brain retraining, mindfulness, breathwork, and somatic practices” aimed at “calming the limbic system, strengthening inhibitory feedback from the prefrontal cortex, rebuilding emotional and physiological safety, and supporting the nervous and immune systems in rebalancing”, with the aim of supporting recovery from chronic conditions including ME/CFS, Fibromyalgia, and Long Covid.

The program is based on a hypothesis proposing that dysfunction in the amygdala and insula may contribute to chronic fatigue syndrome.

This hypothesis was first published in a peer-reviewed journal as a theoretical model and has subsequently informed clinical research into Amygdala and Insula Retraining. Seven peer-reviewed studies on the program and related approaches have been published, including five randomized controlled trials and two clinical audits. Studies have reported statistically significant improvements across outcomes including fatigue, energy, pain, physical functioning, sleep, cognitive functioning, psychological symptoms and quality of life. Some randomized controlled studies have reported large effect sizes and improvements significantly greater than comparison interventions.

The evidence base is still developing. Limitations include relatively small sample sizes in some studies, reliance on self-reported outcomes, and limited independent replication. There is also currently no direct evidence demonstrating that participation in the program changes amygdala or insula activity or confirming its proposed biological mechanisms.

In 2018, the Advertising Standards Authority (ASA) upheld a complaint that the Gupta Program made unproven advertising claims, including claims that it could treat conditions such as fibromyalgia, electromagnetic sensitivities, and ME/CFS.

As of 2026, the program’s website no longer describes the intervention as a treatment for these conditions, instead presenting it as a program intended to support recovery and symptom management.

Alternative names

• Amygdala Retraining Techniques (ART)
• Amygdala Retraining Program (ARP)
• Amygdala and Insula Retraining (AIR)
• Gupta Amygdala Retraining
• Gupta Programme

Theory

The hypothesis underlying the Gupta Program proposes that chronic conditions such as ME/CFS may involve a maladaptive “threat response” involving the amygdala and insula.

According to this model, an initial triggering event — such as infection, injury, or chronic psychological stress — may lead these brain regions to become persistently overactive, resulting in a state of heightened threat detection and physiological arousal.

The theory suggests that this sustained activation may dysregulate multiple bodily systems, including the stress response, immune function, and energy metabolism, contributing to physical symptoms such as fatigue, pain, and cognitive dysfunction. Over time, the brain is proposed to become conditioned to interpret normal bodily sensations as threats, creating a self-reinforcing feedback loop in which symptoms perpetuate further neural activation.

The model further posits that predisposing factors such as genetic sensitivity, prior stress, or trauma may increase susceptibility to this process, but are not sufficient to cause illness without a triggering event.

The theoretical model was first published in 2002 and draws on research into fear conditioning, stress responses, neuroendocrine and immune function, and interactions between the amygdala and other brain regions. It proposes that chronic sensitisation of the amygdala to internal bodily signals may contribute to a cycle of sympathetic activation, immune dysfunction and persistent symptoms.

The model has subsequently been developed to include the role of the insula and has informed clinical studies of AIR-based interventions. Although clinical research has produced evidence that interventions based on the model may improve symptoms and functioning, the proposed neurological mechanism itself has not yet been directly established.

Content of the Gupta Program

The Gupta Program is a brain retraining and mind-body program accessible through its website and mobile app. It combines Amygdala and Insula Retraining (AIR) with practices including mindfulness, meditation, breathwork, somatic techniques and lifestyle approaches.

The core program includes 15 video-based modules alongside guided exercises and supporting materials. Participants are introduced to a range of practices, including breathing exercises, meditation, mindset techniques, gentle yoga and stretching, somatic exercises, lifestyle guidance, laughter exercises, and the program’s seven-step brain retraining technique. Shorter versions of the brain retraining exercises are also provided so that participants can adapt the practice to their circumstances and energy levels.

Participants receive supporting materials including a workbook and floor chart designed to accompany the brain retraining exercises. The program also provides guidance for managing periods of increased symptoms, referred to as “dips” or setbacks, and encourages participants to adapt their practice according to their current capacity. Ashok Gupta describes this approach as “doing your best and leaving the rest” during a dip.

Lifestyle guidance within the program covers areas including pacing, sleep, diet and spending time in nature. Participants are encouraged to remain within their individual energy boundaries rather than pushing beyond their capacity, while gradually reconnecting with activities they enjoy rather than waiting until they feel completely well before engaging with life.

Some individuals have reported experiencing a “crash” or setback while applying the program. However, individual reports do not establish whether these experiences were caused by the program itself, and experiences may vary according to how the techniques and activity guidance are interpreted and applied.

The program also includes two modules focused on “parts” work. This approach proposes that people may develop different protective patterns or “parts”, such as the “achiever”, “perfectionist” or “protector”, which may contribute to stress or nervous system activation. Participants are encouraged to identify and engage compassionately with these parts, sometimes visualising them as beings, shapes or colours, with the aim of understanding their protective role and changing habitual responses.

Alongside its brain retraining techniques, the Gupta Program incorporates meditation, acceptance, mindfulness, pacing and sleep hygiene. It also introduces participants to other areas they may wish to explore as part of their wider wellbeing, including trauma-focused approaches.

Evidence

Seven peer-reviewed studies have examined the Gupta Program or related Amygdala and Insula Retraining approaches, including five randomized controlled trials and two clinical audits.

Across these studies, AIR-based interventions have been associated with improvements in a range of outcomes including fatigue, energy, pain, physical functioning, sleep, cognitive functioning, depression, anxiety and quality of life. Randomized controlled studies in fibromyalgia and Long COVID have reported statistically significant improvements compared with active controls or standard treatment, with some outcomes showing large effect sizes.

Taken together, the findings provide promising evidence that AIR-based interventions may benefit some people with chronic conditions. The evidence base nevertheless remains relatively small. Many outcomes are self-reported, some studies have relatively small samples, and further large-scale and independently replicated research is needed to establish the strength and generalisability of the findings.

Amygdala and Insula hypothesis

The Gupta Program is based on a hypothesis that chronic conditions such as ME/CFS and fibromyalgia may be associated with dysfunctional activity involving the amygdala and insula.

The original hypothesis proposes that following a combination of stressors — potentially including viral infection, psychological stress, or other physiological stress — the amygdala may become chronically sensitised to signals arising from the body. This is proposed to produce persistent sympathetic activation and contribute to immune dysfunction, fatigue and other symptoms.

Clinical research into interventions based on this model has reported improvements in symptoms and functioning. However, clinical efficacy does not itself establish the proposed neurological mechanism, which would require further direct investigation.

Neurobiological evidence

No studies to date have directly demonstrated that participation in the Gupta Program changes amygdala or insula activity.

However, brain imaging research in related fields has shown that psychological and behavioral interventions can influence neural activity in these regions.

Such research provides broader support for the principle that neural activity within these systems can be influenced through behavioral interventions, although this mechanism has not yet been specifically demonstrated for the Gupta Program.

Notable Studies

Two non-pharmacological interventions, amygdala and insula retraining (AIR) and physical activity, are both significantly more effective than standard medication in improving symptoms of Fibromyalgia (Apr 2025)

This randomized controlled study compared Amygdala and Insula Retraining (AIR), physical activity, and standard Pregabalin medication among women diagnosed with fibromyalgia. Outcomes included cognitive function, sleep disturbance, pain catastrophizing, depressive symptoms and overall fibromyalgia impact.

Both AIR and physical activity significantly improved all measured outcomes compared with baseline and the Pregabalin control group. AIR also produced significantly superior outcomes for pain catastrophizing, depressive symptoms and overall fibromyalgia impact, with large to extremely large effect sizes.

The authors concluded that AIR and physical activity were effective in improving cognitive function, sleep quality, pain catastrophizing, depression and fibromyalgia symptoms, and suggested that they may provide accessible and helpful resources for people with fibromyalgia.

The study had a relatively small sample and limited generalisability, and further larger studies would help establish the robustness of these findings.

Neuroplasticity Intervention, Amygdala and Insula Retraining (AIR), Significantly Improves Overall Health and Functioning Across Various Chronic Conditions (Dec 2023)

This international study evaluated outcomes among people using the Gupta Program for a range of chronic conditions. Of 315 respondents, 222 reported actively using the program for at least three months, with the primary analysis focusing on participants who had used AIR for this period.

Participants reported significant improvements in overall health and functioning following use of the program across a range of chronic conditions. The study concluded that the findings supported the potential of AIR to address overall health and functioning beyond the conditions in which it had previously been studied.

The study was observational rather than randomized and relied on participants retrospectively rating their health before and after using the program. Recruitment from the Gupta Program database may also have introduced self-selection and response bias. The findings therefore provide observational evidence of reported improvement rather than controlled evidence of efficacy.

Amygdala and Insula Retraining (AIR) Significantly Reduces Fatigue and Increases Energy in People with Long COVID (Jul 2023)

This randomized controlled trial evaluated Amygdala and Insula Retraining in people with Long COVID, comparing AIR with a structurally equivalent health and wellness intervention over three months.

Participants receiving AIR experienced a significant reduction in fatigue and increase in energy. The effect size for reduction in fatigue in the AIR group was more than four times that of the active control group, while the absolute reduction in mean fatigue scores was more than double that of the control group.

AIR participants also experienced a large increase in energy, with an effect size approximately twice that of the active control group and an absolute increase in mean energy scores almost twice that seen in controls.

The authors concluded that the findings suggest AIR is a viable means of reducing fatigue and increasing energy among people with Long COVID and noted its potential as a low-cost and widely available intervention.

The outcomes were based primarily on self-reported measures, and no biomarkers or neuroimaging outcomes were included to assess the proposed mechanism of action. Further research would help establish whether these results are replicated in larger populations.

Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia: A Pilot Randomized Controlled Trial (Oct 2020)

This randomized controlled pilot trial evaluated mindfulness plus Amygdala and Insula Retraining (MAIR) against a structurally equivalent active control intervention consisting of relaxation therapy. Both interventions were provided alongside treatment as usual.

MAIR produced significantly greater reductions in functional impairment, anxiety and depression than the active control, alongside greater improvements in mindfulness and self-compassion at post-treatment and follow-up. Effect sizes for these outcomes were moderate to large.

At follow-up, significant improvements were also reported in pain catastrophizing, psychological inflexibility, clinical severity and health-related quality of life, with large effect sizes.

The study reported a number needed to treat of three for achieving a reduction of at least 50% on the Fibromyalgia Impact Questionnaire at post-treatment.

Changes were also observed in brain-derived neurotrophic factor (BDNF), although significant changes were not found across the immune-inflammatory biomarkers studied.

The authors concluded that MAIR, as an addition to treatment as usual, appeared to be effective for the management of fibromyalgia symptoms. As the intervention combined mindfulness and AIR, however, the specific contribution of the AIR component cannot be determined from the study alone.

A Mind-Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue (Mar/Apr 2012)

This single-blind randomized controlled trial evaluated a mind-body intervention based on Amygdala Retraining in patients with fibromyalgia, chronic fatigue, or both.

Participants were randomly assigned to receive amygdala retraining alongside standard care or standard care alone. The intervention included a structured training course, a home-study video course and associated materials.

The study found statistically significant improvements in physical health, energy, pain, symptom distress and fatigue among participants receiving amygdala retraining compared with standard care.

Outcomes were assessed using validated self-report measures of health, wellbeing and symptoms.

Of 44 participants who completed baseline assessments, 21 completed the study, including seven in the amygdala retraining group. The high attrition and small final sample therefore limit the conclusions that can be drawn, but the results provided early randomized controlled evidence of improvements associated with the intervention.

Can amygdala retraining techniques improve the wellbeing of patients with chronic fatigue syndrome: A clinical audit of subjective outcomes in a small sample (Sep 2010)

This clinical audit examined Amygdala Retraining Techniques (ART), an early form of the Gupta Program, in 33 people with a confirmed diagnosis of chronic fatigue syndrome over approximately one year.

The audit reported that 93% of participants reported improvement. Two-thirds (67%) were reported to have made considerable recoveries, reaching 80–100% of their pre-illness level of functioning.

The authors reported that the rate of improvement was higher than natural remission rates reported in other intervention studies and recommended randomized controlled research to further investigate the efficacy of ART.

The audit did not include a randomized control group and relied on subjective self-assessments of functioning. Six participants dropped out. Its findings should therefore be interpreted as preliminary observational evidence rather than controlled evidence of efficacy.