Am probably out of my depth here but the authors of CBT in ME have also looked and published CBT in MS for example, haven't they? Was that the same approach? I only did a short google but came up with a few 'hits' and this one looked at 'fatigue' in MS using CBT and Chalder was an author: http://www.ncbi.nlm.nih.gov/pubmed/18256342 2008 'The results from this RCT suggest that CBT was a more effective treatment for MS fatigue than RT, but that both treatments resulted in significant improvements in fatigue which were maintained over the 6-month follow-up period.' All right the above example is a little 'old' and CBT here is applied differently I suppose (haven't read the whole thing) and it was compared to Relaxation Therapy - but it would be interesting to discover if this type of CBT uses similar language to that used in the ME studies and applications I think. I guess my point is that CBT is used to 'treat' and overcome 'fatigue' in MS and I am wondering if it can be compared? Here's the beginning of the introduction from the above paper: 'Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. There is substantial variability in the symptoms experienced by patients, but between 76% and 97% of patients complain of fatigue (14). The pathophysiological mechanisms of this fatigue are still poorly understood (5), but for many, fatigue is one of their more debilitating symptoms, having a substantial impact on their quality of life and ability to carry out day-to-day tasks (2,6,7)....' Ok so far with the language? And then later: '...This model proposes that primary disease factors trigger the initial symptom of fatigue in MS, and the fatigue is perpetuated or worsened depending on how people react to the fatigue cognitively, emotionally, behaviorally, and physiologically...' Here they seem to suggest that the 'fatigue' is largely based on one's 'reaction' i.e. that a patient has some control of this debilitating symptom. Sound familiar?