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Article on psychological therapies and the "placebo effect"

Messages
724
Location
Yorkshire, England
The useful CBT I had for my phobia was what I would class as mostly common-sense, and what most people would try anyway. I had a sort of pick and mix attitude to most of it, and one of the therapists had ME anyway, so she taught me pacing, and was mostly ok.

I guess I got lucky with the less dogmatic approach, and the thing that strikes me the most, is that the 'Fear Avoidance Behaviour' is/was the opposite of what most people with ME have. Part of the struggle was that some of the fear was irrational, and some of it was rational, and it didn't seem, if applied dogmatically, to help the part of the fear that was rational.

As you can imagine, when you have something like a phobia, you do not in anyway fantasize about doing the activity that you fear and you act in ways to avoid it. In ME, most people would happily do the act(s) if they physically could, and I would guess that most at some point mourn the loss of the ability to do so.

It should be pretty easy to do an experiment to test the fear by measuring some basic bodily functions, and in ME there must be people with phobias who would could be tested.

In my case, a simple visualization exercise would be enough to test the theory, and I was also, a few years before ME, deconditioned, and the symptoms then were nothing like the symptoms I have now either.

It would be interesting to see the differences between the success rates for phobia treatment and CBT for ME, because I can't see them being the same at all.
 

user9876

Senior Member
Messages
4,556
Interesting thoughts, @A.B. I suppose there's a literature out there somewhere about what people show the most improvement on self-report measures. Maybe I might look some day.

Obviously, CBT for CFS is in its own special class. But I suppose all CBT requires a certain sort of unquestioning faith in the methods. If you question the details too much, you're not going to be fully on board.

I assumed that CBT gives a measurable result because it tries to change peoples beliefs about symptoms and then basically tries to measure the effect with a questionnaire where answers will be a function of someones beliefs about their symptoms (along with other factors). So it could be an effect based on wanting to please a doctor but I've tended to think it is a little more subtle where spending a long time trying to change beliefs leads to different descriptions of the same symptoms (and hence different answers).
 

A.B.

Senior Member
Messages
3,780
Speaking of CBT. Hans Eysenck played an important role in establishing CBT in the UK. According to Coyne, there will soon be an article about fraud he played a part in:

Tony renews charges that Hans Eysenck was a fraudster, abused editorial privilege, and had huge, corrupting undisclosed conflicts of interest – payments not only from American tobacco companies but from their lawyers desperately trying to muster evidence that smoking did not cause cancer. Evidence that Hans Eysenck cooked up for them.

https://jcoynester.wordpress.com/20...-shoved-a-hans-eysenck-scandal-under-the-rug/

Reading Eysenck's work on personality traits as risk factor for cancer reads a lot like the psychosocial garbage written on CFS.

He worked at King's College.

Yet another psychologist fraudster exposed.
 
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chipmunk1

Senior Member
Messages
765
He was paid millions to push crap like this.

http://pms.sagepub.com/content/71/1/216.full.pdf

Perceptualand MoforSkills, 1990, 71, 216-218. O Perceptual and Motor Skills 1990 THE PREDICTION OF DEATH FROM CANCER BY MEANS OF PERSONALITY/STRESS QUESTIONNAIRE: TOO GOOD TO BE TRUE? ' H. J. EYSENCK University of London Summary.-Recent work by Grossarth-Maticek and Eysenck has suggested that there are personality traits which in combination can predict cancer in healthy probands with 81% accuracy. Many critics have considered this result "too good to be [rue" It is shown that earlier studies have given results not very differenc Ln accuracy, suggesting that such a criticism is unwarranted.

http://www.independent.co.uk/news/eysenck-took-pounds-800000-tobacco-funds-1361007.html
 
Messages
3,263
Haha. This journal, Perceptual and Motor Skills, was a pay-to-publish journal long before the era of open access. Its always been considered similar to "placing an ad" about your research (no real peer review, just the appearance of it).

Eysenck's famous for publishing his own stuff in the journals he edits, so I wonder why he had to pay to do it here
 
Messages
724
Location
Yorkshire, England
Latest from Perceptual and Motor Skills Journal;
medical-automobile_repair-car-auto-mechanic-auto_mechanic-shrn210_low.jpg
 
Messages
3,263
Breaking the flow a bit, and going back to the decline of CBT, I just read a huffpost article that raises another possibility: it could be due to increased use of psychological diagnoses for normal reactions to bad stuff in life like with grief, sadness, frustration.

http://www.huffingtonpost.com/allen-frances/antidepressants-work-but-_b_9849478.html

It could be that CBT is most useful for those people with severe problems that have a marked psychological component (e.g., phobia, OCD). Where the person's psychological state or reaction goes well beyond what most people would experience when dealing with life's problems. Trying to apply it to ever smaller "disorders" (I feel bad because I lost by job, I'm sad because my partner died, or I'm pissed off and frustrated cos I have an illness/disabilty), may be the cause of reduced effectiveness. Its normal to feel sad, angry, frustrated in these situations, so probably unhelpful to reframe these reactions as pathological and needing treatment.
 
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Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
I assumed that CBT gives a measurable result because it tries to change peoples beliefs about symptoms and then basically tries to measure the effect with a questionnaire where answers will be a function of someones beliefs about their symptoms (along with other factors). So it could be an effect based on wanting to please a doctor but I've tended to think it is a little more subtle where spending a long time trying to change beliefs leads to different descriptions of the same symptoms (and hence different answers).

Yes.

Sometimes when we've spent a lot of time and emotions invested in something (doesn't matter whether what it is - CBT - alt med, a bad relationship)... We are likely to report that it was more beneficial than it actually was. This is of course the whole point about double blinded trials - the emotional investment is supposed to be the same, hence an equal amount of bias on the questionnaires - it doesn't always work out that way though, when you have a drug that has obvious side effects though.
 
Messages
724
Location
Yorkshire, England
Breaking the flow a bit, and going back to the decline of CBT, I just read a huffpost article that raises another possibility: it could be due to increased use of psychological diagnoses for normal reactions to bad stuff in life like with grief, sadness, frustration.

http://www.huffingtonpost.com/allen-frances/antidepressants-work-but-_b_9849478.html

It could be that CBT is most useful for those people with severe problems that have a marked psychological component (e.g., phobia, OCD). Where the person's psychological state or reaction goes well beyond what most people would experience when dealing with life's problems. Trying to apply it to ever smaller problems (I feel bad because I lost by job, I'm sad because my partner died, or I'm pissed off and frustrated cos I have an illness/disabilty), may be the cause of reduced effectiveness. Its normal to feel sad, angry, frustrated in these situations, so probably unhelpful to reframe these reactions as pathological and needing treatment.
Very good points Woolie,

It's only in the last year or so, but the government in the UK has been trying to put mental health workers in Jobcentres, and at the same time trying to imply that unemployment is a psychological deficit. It doesn't help people, but seems very convenient to place the emphasis on the person instead of the wider social environment.

It's seems part of a wider movement to create 'diseases' out of normal variations in emotions and thoughts, and using them as a form of control.

CBT probably only works (if at all) when the patient knows that some thought is irrational, is badly impacting their life in some way, and also wants to change in the first place.
 

Skippa

Anti-BS
Messages
841
Always bear (bare? I never know...) in mind that what is considered a character flaw (and thus a personality condition) in one country can sometimes be seen as a virtue in another country. What is desired here is feared over there and vice versa.

So some CBT can be appropriate and helpful, but just as much CBT is simply messing with human nature and fitting yet more square pegs into round holes.
 

chipmunk1

Senior Member
Messages
765
The psychs are experts when it comes to irrational thinking.

Do we even know if any illness physical/mental is due to irrational thoughts?

What if distorted thoughts are caused by something else and are the consequence of something not the cause?

I don't doubt that behaviour and attitude can be changed, at least temporarily, if a person wants to change but are we even addressing the cause here?
 
Messages
5,238
Location
Sofa, UK
Always bear (bare? I never know...) in mind that what is considered a character flaw (and thus a personality condition) in one country can sometimes be seen as a virtue in another country. What is desired here is feared over there and vice versa.

So some CBT can be appropriate and helpful, but just as much CBT is simply messing with human nature and fitting yet more square pegs into round holes.
Bear.