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NHS IAPT Medically Unexplained Symptoms/Functional Symptoms Postive Practice Guide

Discussion in 'General ME/CFS News' started by Firestormm, Jul 22, 2014.

  1. Firestormm

    Firestormm Guest

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    Tweeted by with thanks to @dxrevisionwatch

     
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  2. Sidereal

    Sidereal Senior Member

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    Horrifying.
     
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  3. SilverbladeTE

    SilverbladeTE Senior Member

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    BASTARDS!
    after IBS has been PROVEN to be physical and if folk think that's "Oh noes supports the mad mental patient" crap, too damn bad

    you can't change the minds of those who are perverting the entire system towards horror and already to abuse...No point trying to play them at their own game.
     
    Last edited by a moderator: Jul 22, 2014
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  4. Cheshire

    Cheshire Senior Member

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    How simplistic the BPS model is when compared to the complex biological discoveries recently found.

    And the usual blame of the victim...

    "The common response to an acute illness is to rest."
    "Another simpler approach is to encourage a gradual return to previous activities, to reverse the changes secondary to inactivity. "
    Whatever we do, it is wrong, when we try to be active it is too much, when we rest, inactivity perpetuates our symptoms...

    And how hypocritical
     
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  5. Snowdrop

    Snowdrop Senior Member

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    :( :mad: :eek: :cry: :thumbdown: :aghhh: :bang-head:

    I'm conflicted. Experiencing various emotional responses. Maybe I should just :vomit:.
    Of course, because medicine can't explain the reason for a symptom it makes perfect sense to 'talk the patient down'.

    NOT.

    I notice that they are listening though. They seem to more and more use language that we would use, only with an evil twist :devil:.
    An example would be how we often talk here of how we have pushed through or continue to push through trying to function when experiencing this illness (although we know this is a bad thing)

    'a combination of excessive stress and an acute illness or injury, their initial reaction is to press on and keep coping. This behaviour leads to the experience of ongoing symptoms which may be more closely related to pushing too hard than to the initial insult or injury. However, in making sense of the situation, patients attribute the ongoing symptoms to the original trigger.'

    Always we are to blame. If but for our behaviour we wouldn't be sick. I would like to see ME advocacy organisations speak out against this abuse. Who will stand up for us when most of us can't stand.
     
  6. SilverbladeTE

    SilverbladeTE Senior Member

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    As I've said before, it's like the Witch hunts: you are damned if you do, damned if you don't

    That a lot of this crap is down to psychologists/psychiatrists isn't mere coincidence, fact is they know how to manipulate how people think about things, how to write good PR....
     
    Last edited: Jul 23, 2014
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  7. Snowdrop

    Snowdrop Senior Member

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    From the Guide:

    2. Issues of terminology


    2.1 Although the term MUS is commonly used in healthcare practice and academic articles it is unsatisfactory for a number of reasons. Foremost, it fails to engage patients in treatments as patients feel it invalidates their symptom experience and infers that their symptoms are 'all in the mind'6. In order to increase access to psychological therapies for this patient group it is crucial that our terminology is both accurate and acceptable to potential patients.

    2.2 Other reasons cited for why we should not use the term MUS summarised in Creed et al.7 include:

    2.2.1 It reinforces dualistic thinking and the idea that illness is either biological or psychological.

    2.2.2 The term defines the illness by what it is not: i.e. it implies no organic cause which is not necessarily accurate and affords no treatment utility.

    2.2.3 Research has shown that most patients want a positive description of symptoms i.e. an explanation of what it is rather than what is isn’t.

    2.2.4 The term may appear dismissive and provides the message that nothing can be done. This is inaccurate as there are evidenced based approaches which show that methods such as CBT and graded exercise are effective treatments for these conditions.

    2.2.5 Similar approaches also assist patients with well recognised medical conditions reduce the severity of symptoms and disability associated with the symptoms. Therefore the fact that psychological treatments works does not mean that the illness is psychological.

    2.3 The IAPT MUS Task and Finish group strongly advises that when engaging or treating patients, the term MUS is not used. The experience of experts working in this field is that where possible patients should be given a specific diagnosis of a syndrome which describes their central symptom(s) without inferring that the aetiology is psychological. Common syndromes include:

    - - -

    Fibromyalgia
    Irritable Bowel Syndrome
    Chronic Fatigue Syndrome
    Tempromandibular Joint (TMJ) dysfunction -
    Atypical facial pain -
    Non-Cardiac l chest pain -
    Hyperventilation

    Chronic Cough -
    Loin Pain haematuria syndrome -
    Functional Weakness / Movement Disorder -
    Dissociative (Non-epileptic) Attacks -
    Chronic pelvic pain/ Dysmenorrhoea

    2.4 Many of these conditions have published diagnostic criteria which can be used in diagnosis.

    2.5 Other terms in use which appear more acceptable to patients include persistent physical symptoms or functional syndromes/symptoms (FS)8. The term “functional” here is used because it is assumed that the disorder is one of function, which may be physical and/or psychosocial function, rather than anatomical structure. Sharpe likens this distinction to a car that needs tuning rather than a car which has mechanical damage. More recently, physiologically explained symptoms have also proposed as an alternative. For the rest of this paper we will refer to functional symptoms or syndromes (FS) rather than MUS.

    This is not good. They have thrown people in the garbage by creating this. Dr's are/will be trained with only this in mind.
     
  8. Scarecrow

    Scarecrow Senior Member

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    Are we paying for the NHS to send these people on creative writing courses or is this something they do in their spare time?
     
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  9. Scarecrow

    Scarecrow Senior Member

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    You know you're a high achiever when.........................

    you have three or more of the following:

    Fibromyalgia
    Irritable Bowel Syndrome
    Chronic Fatigue Syndrome
    Tempromandibular Joint (TMJ) dysfunction -
    Atypical facial pain -
    Non-Cardiac l chest pain -
    Hyperventilation
    Chronic Cough -
    Loin Pain haematuria syndrome -
    Functional Weakness / Movement Disorder -
    Dissociative (Non-epileptic) Attacks -
    Chronic pelvic pain/ Dysmenorrhoea

    Nice to see dysmenorrhea making another MUS appearance. But wait, don't period pains usually disappear around about the time that menses cease?

    Medically unexplained? Really?

    Sharp as dog biscuits, the lot of them.
     
  10. OverTheHills

    OverTheHills

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    :rofl:(your post) :mad::vomit::bang-head:(their 'paper').
     
  11. Esther12

    Esther12 Senior Member

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    Moss-Morris was the chair... oh-oh.
     
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  12. Scarecrow

    Scarecrow Senior Member

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    And the other usual suspects made an appearance.
     
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  13. Leopardtail

    Leopardtail Senior Member

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    The title says it all. This is little more than gratuitous self promotion.
     
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  14. Sean

    Sean Senior Member

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    Indeed. Unfortunately it is from people who currently have the upper hand politically, and can do real damage in the meantime, until they are defanged.
     
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  15. daisybell

    daisybell Senior Member

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    Members of the fibromyalgia association must be delighted that their Chair contributed to this .....
     
  16. zzz

    zzz Senior Member

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    So in other words, it's fine for doctors to believe in this crap - they just shouldn't let their patients know.

    This, unfortunately, is my doctor's philosophy. :bang-head:

    It's a complete violation of the Autonomy section of medical ethics, which emphasizes the importance of keeping the patient honestly informed of their condition, as well as their doctor's evaluation of it. This is considered important so that patients can make informed decisions regarding their health.
    In other words, they're hijacking it. That way, if we use this language, they can claim that we're agreeing with them, and this confirms their diagnosis.
    A swipe against women is mandatory in pseudo-psychiatry (hey, even Freud did it). Paying attention to the facts is not (again, see Freud).

    This is just a slightly more refined version of Epidemic of apathetic and tired women.
     
    Last edited: Jul 23, 2014
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  17. Sean

    Sean Senior Member

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    How much difference three sobering words could make:

    But making it a conditional claim (as it should be) would expose their whole act. So it has to be made as an absolute claim ("…cannot be explained by…" ).
     
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  18. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Medically unexplained because they don't allow the appropriate tests and if something is abnormal it's explained by saying it's nothing to worry about.

    I'm starting to think there is a conspiracy on nk function testing. If gp's could test for this imagine how many they would find and this would help explain different infections and possibly then have to have better infection testing. But the health system don't want to pay for this or the antivirals some may need. It's cheaper to prescribe Zoloft and prozac.

    how come other doctors and researchers can find and explain abnormalities in cfsme. It's not unexplained, it's just that they have no idea or the psychobabblers have a conflict of interest.
     
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  19. Scarecrow

    Scarecrow Senior Member

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    This reads like a Just So story to me, only not quite so diverting. It doesn't resonate with me at all because my own experience of falling ill and how I responded was so different. But I'm curious. Is there any pwMe or pwCFS out there who recognises this pattern in themselves?
     
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  20. Leopardtail

    Leopardtail Senior Member

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    I was and still am achievement oriented, and I have had to respect the illness and learn my new limits. The fact the few people with the illness surrender to it and many actively seek information on how to regain their health and get medical help partially fits their paradigm. What they forget is threefold:
    1. people are less driven and have ME are more likely to recognise their capacity and avoid making themselves very ill. A driven personality plus ME is a very bad combination.
    2. the people are who driven are more likely to be seen by medics, one has to fight hard to shake of the depression diagnosis and getting proper action.
    3. people who have psychiatric mis-diagnoses or who are depressed due to their ME are more likely to accept psych referrals than those with dominantly physical symptoms.
    I suspect they both forget what subset of ME patients they see due to the above, forget the impact personality on the ME (fighting against it) and focus on the symptoms they understand and know how to manage.
     

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