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Academic GPs will hear this biopsychosocial talk tomorrow....

jimells

Senior Member
Messages
2,009
Location
northern Maine
I just realized that this talk is aimed at people who are training the next generation of physicians. It is truly horrifying that in spite of the overwhelming biochemical evidence the psychobabblers are still stamping out new doctors trained to abuse us, and will continue to do so for a very long time...
 

Asa

Senior Member
Messages
179
... in spite of the overwhelming biochemical evidence the psychobabblers are still stamping out new doctors trained to abuse us, and will continue to do so for a very long time...

“The most brilliant propagandist technique will yield no success unless one fundamental principle is borne in mind constantly - it must confine itself to a few points and repeat them over and over.” (Joseph Goebbels)
 

Cheshire

Senior Member
Messages
1,129
The talk is now online

Nothing new here, but a 34min concentrated version of the BPS model, with the usual inaccuracies and false correlations...

The worst is that is you don't dig deep in this sort of speech, I'm sure it can seem articulate and coherent with the avalanche of data that "back up" the theory.
 

Scarecrow

Revolting Peasant
Messages
1,904
Location
Scotland
Some very brief notes of the first half. This is based on one viewing. I'm not wasting my time watching it twice. Throughout she refers to 'chronic fatigue'.

That was a promising start. She wants to dispel myths. [We'll see.]

The Model: We are emotional and perfectionist. Our behaviour is erratic, we do too much, all or nothing, then start to do less and less.

Also mentioned precipitating viral infections.

Study in NZ looked at people with glandular fever who had not previously had CFS. Did they go on to develop it? Found that anxiety and depression scores were risk factors but scores were not that high and would not be considered as depression - they were more indicative of high levels of stress. An 'all or nothing' pattern was important as were negative illness beliefs (a belief that illness was severe). Also a high unrealistic personal expectation.

CBT is not giving advice (telling you what to do) but it gets people to change their thinking and behaviour by the therapist asking questions. It starts by getting the patient to complete a diary of daily activity and then the assess it together and set goals based on what the patient can do on a bad day not a good day.

A good sleep routine is important (didn't elaborate).

Then tackle unhelpful thoughts: expecting too much, the patient feeling that symptoms are out of their control.

She looked at the evidence for the effectiveness of four CBT trials : slides are not shown so can't comment.

She then went on to talk about GET. To give her due, she talked about VO2max (recommends starting at a lower point (40%) rather than higher (70%) and the use of heart rate monitors so that the patient can get immediate feedback.

I found it hard to concentrate after this point so my notes are incomplete. I may come back and finish later but if anyone else wants to take it on, be my guest.
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
I just realized that this talk is aimed at people who are training the next generation of physicians. It is truly horrifying that in spite of the overwhelming biochemical evidence the psychobabblers are still stamping out new doctors trained to abuse us, and will continue to do so for a very long time...

I wonder how people get authorised to 'train' UK doctors like this.

There have been previous horrific UK GP training videos about ME, although these were not based on talks.

Here they are for those who can stomach them and haven't seen them before. I was only able to watch a little...
 

worldbackwards

Senior Member
Messages
2,051
I wonder how they get their authorisation?
Entitlement and back scratching, at a guess and knowing who's involved.
A few choice quotes:
2. Patient and Public Involvement
This work stream recognises the important role that people with this condition and their carers play in the development of services. Patient Executive Members and representatives of patient organisations input into the work of the network, ensuring that developments are focused on patients’ needs.
Chortle
3. Clinical Outcomes
This workstream looks at outcomes measurement, capture and evaluation considering the practical tools required for clinicians and services. It has close links to the National Outcomes Database.
Given how poor those real world outcomes are, I was intrigued by the reference to the National Outcomes Database. It turned out to be a link to an old AfME website (nice to know who your friends are).

Couldn't have people looking for the truth or anything.
 
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Cheshire

Senior Member
Messages
1,129
A few points about her talk

She’s trying to achieve a “false normalisation” of CFS, by comparing it to diseases with a clear biological basis, where she takes for granted that psychological factors play a role, like heart diseases, referring to the old type A personality literature.

Apart from the fact that the relevance of psychological factors is not a proven fact (http://issuu.com/maxhead/docs/bps_caution_davey_smith), this makes little sense because she does not recognise a neat biological basis fo ME.

On the contrary, she clearly dismisses the search for biological factor throughout her whole talk.

There’s a lobby from patients to do more biomedical research, saying so much money is going into psychological. But I would actually dispute this. I’m not saying we shouldn’t fund other things but I wouldn’t say all the money is going to psychological research. If you look at the seventy studies in the systematic review, 13 of these were CBT or GET studies. It’s actually a really small minority. The others were immunological, pharmacological, complementary therapies or nutritional supplements. And the only consistent evidence was for the behavioural interventions.
It’s not to say that other things won’t work but what I would make a real plea for is not to go to the MRC and ask for more biomedical funding, but to go to the MRC and ask for funding that actually funds biopsychosocial research because until we do that we won’t get enough answers in terms of understanding the complexities of the condition.
cc 25mn

Would she dismiss in such a crude way biological research about heart disease? So why does she make that hypocritical comparison with "real diseases"? Why doesn't she say openly what all her talk implicitely states: it's a psychological illness. (shh, beware of the patients lobbies)

I also like her way to trick patients:
This is a way that you can engage patients quite easily. Often some of the words in psychiatry and psychology are partly to blame with the kind of strong reaction we get from patients. You say to some patients you’re high in neuroticism. That actually sounds quite offensive. Where if you actually say to somebody are you somebody who expects a lot from yourself, do you think that if you fail people will cease to respect you, there’s a lot less judgement in that. It’s a more nice way to look at it.
 
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Aurator

Senior Member
Messages
625
"Where if you actually say to somebody are you somebody who expects a lot from yourself, do you think that if you fail people will cease to respect you."
It's difficult not to conclude from this that Moss-Morris is advocating taking the opposite approach. And the evidence of her talk suggests that this is an approach that she herself has taken, i.e. that of not expecting a lot from herself and failing miserably as a scientist and even as a rational thinking being. She has certainly done a thorough job of the remaining bit: ensuring that people cease to respect her.
 

JamBob

Senior Member
Messages
191
The talk is now online

I think that youtube talk is from a 2008 RSM conference, but it sounds similar (judging by the twitter response) to what RM-M presented to GPs yesterday in Oxford.

My concern is that GPs just imbibe this psycho-B***S*** uncritically and don't think to go to the biomedical literature to see for themselves.

It's no wonder there's no care available (eg. GPs could be encouraged to refer for autonomic testing and treatment but instead they are presented with this psycho-nonsense and told to refer for CBT).
 

MeSci

ME/CFS since 1995; activity level 6?
Messages
8,231
Location
Cornwall, UK
My concern is that GPs just imbibe this psycho-B***S*** uncritically and don't think to go to the biomedical literature to see for themselves.

I suspect that many - perhaps most - GPs will not understand scientific papers. They certainly don't seem to have the skills to critically analyse them, so won't be able to recognise what is quality research and what is BS.

This came as rather a shock to me after I gained my own medical science MSc, having thought that this would now enable me to discuss medical science on an equal footing with doctors. What I found was that I was now talking way over their heads, and was greeted with blank looks.

I have tried giving them printed sheets of summaries of relevant research, sometimes my own easy-to-read analyses and collations, but have never gained the impression that they have read them. There has never been any discussion about it. One doctor even refused to look at what I gave her.

Combining this with some (many?) doctors' obvious inability to understand the relevance of test results, I have been left feeling as though my health is in the hands of people who understand my illnesses less well than I do, and it is incredibly frustrating.

They do have some knowledge that I don't, and I had hoped that we could collaborate, using our different skills and knowledge to manage my health, but have just come up against brick walls most of the time.
 

duncan

Senior Member
Messages
2,240
Culturally-rewarded arrogance on their part, along, I suspect, with a sense of insulation from real-world consequences of ignoring patients with formal learning of their own - and the 'insolence' to bring that education to the clinicians' attention.
 

Asa

Senior Member
Messages
179
Are you somebody who expects a lot from yourself?

The Barnum effect, also called the Forer effect, is the observation that individuals will give high accuracy ratings to descriptions of their personality that supposedly are tailored specifically for them, but are in fact vague and general enough to apply to a wide range of people. This effect can provide a partial explanation for the widespread acceptance of some beliefs and practices, such as astrology, fortune telling, graphology, aura reading, and some types of personality tests...
https://en.wikipedia.org/wiki/Barnum_effect

Applicable??
 

Aurator

Senior Member
Messages
625
I wonder whether Moss-Morris has seen this video yet.
Would she be prepared to say to Ron Davis' family that Whitney Dafoe is ill and continues to deteriorate because he hasn't yet understood the biopsychosocial basis of his illness?