@Woolie thanks for your contribution. I've generally taken the position that whatever people in PACE had, CBT or GET didn't work. Yet the possibility that it might work for a portion of patients still has to be considered. I think it adds to the credibility of our criticism if we're also honestly able to consider views that differ from our own. Why did the PACE authors expect good improvement from CBT/GET? Maybe they have been fooling themselves with poor methodology all these years and that clearly happened to some degree, but another possibility is that maybe there really is a subgroup out there where this approach is somewhat helpful. Maybe some form of depression, maybe graded exercise can speed up recovery when the patient is already in remission. I'm perfectly comfortable with the idea that it's all just nonsense too though.
Personally, I don't rule out the option that CFS = physical problem + central sensitization.
CBT/GET creates a strict daily schedule, which reduces the focus on symptoms.
But if that would be the case, then the PACE style CBT/GET would be the wrong treatment.
If someone tells me I'm deconditioned, have false illness beliefs, and 20 more factually wrong claims, it will only leave me confused. I will then start paying MORE attention to my symptoms, to check if the symptoms aren't indeed just normal body signals.
This could explain why CBT/GET helps some patients, harms others, but no one fully recovers.
(Because it only affects the symptom sensitivity, not the actual the problem.)