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ME/CFS: A disease at war with itself
We can all agree that ME/CFS is a nasty disease, particularly in its severe form, but there are abundant nasty diseases in the world. What is unique and particularly confounding about our disease is that so much controversy surrounds it, and not only surrounds it, but invades it too.
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Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Populat

Discussion in 'Latest ME/CFS Research' started by V99, Jul 28, 2010.

  1. IamME

    IamME Too sick for an identity

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    "Pioneering help"?! If you're being sarcastic you need to make it clearer.

    "I think that psychological and social factors often will affect the way allmost all illnesses develop, disable and are treated."

    You can read here about what the BPS model seems to think these factors are;

    http://en.wikipedia.org/wiki/Biopsychosocial

    (I've yet to see the supposed "social" component used in ME/CFIDS as anything other than criticism of carers "enabling" disability etc.)

    "The biopsychosocial model of health is based in part on social cognitive theory."

    "This is in contrast to the traditional, reductionist biomedical model of medicine that suggests every disease process can be explained in terms of an underlying deviation from normal function such as a pathogen, genetic or developmental abnormality, or injury"

    Funny that's just what's censured and what we need more of, in contrast to the abysmal failure of CBT/GET. All the helpful social and psychological helpful stuff oddly enough flows on from that, but it would be "validation" which is why Peter White et al don't want it. If cancerous cells were unknown in cancer the priority would be to find them, otherwise cancer would be as subject to abuse as with us.

    "The biopsychosocial model presumes that it is important to handle the three together as a growing body of empirical literature suggests that patient perceptions of health and threat of disease, as well as barriers in a patient's social or cultural environment, appear to influence the likelihood that a patient will engage in health-promoting or treatment behaviors, such as medication taking, proper diet or nutrition, and engaging in physical activity.[6"

    Small wonder the psychobabblers aren't willing to scrutinise this "model" very closely, it makes for a nice comfortable polysyllabilic velvet glove to compel your average "chronic fruitcake shirker" or "CFS" as the CDC misdiagnosed us ("unexplained fatigue" = mental illness), into popping some antidepressents, shutting up and ignoring their serious exertional limitations, while at the same time on a grand social-engineering scale generally, conveniently blur the boundaries between disease and irresponsibility.

    "Since the collapse of the 19th century models (psychoanalysis, biologism and behaviourism), psychiatrists have been in search of a model that integrates the psyche and the soma. So keen has been their search that they embraced the so-called 'biopsychosocial model' without ever bothering to check its details. If, at any time over the last three decades, they had done so, they would have found it had none. This would have forced them into the embarrassing position of having to acknowledge that modern psychiatry is operating in a theoretical vacuum" (Niall McLaren)

    It's our bad luck to get sick in an age where apparently huge swathes of the population are eating/drinking/lazing/thinking themselves sick, if public health arbiters are to be believed. Still, on most sites where BPS examples are listed they tend towards traditional psychosomatic/lifestyle illnesses than something you'd get a non-psychotropic drug for, which is a bit of a give away.
    PhoenixDown likes this.
  2. urbantravels

    urbantravels disjecta membra

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    I thought the sarcasm in Esther12's use of the phrase "pioneering help" was more than abundantly clear.
  3. Esther12

    Esther12 Senior Member

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    ... phew.
    ahimsa likes this.
  4. Dolphin

    Dolphin Senior Member

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    (OT?) link for some critiques of biopsychosocial model

    (If people want a detailed discussion of the biopsychosocial model it might be better to move it to another thread)

    If one Googles:
    one gets articles and critiques of relevance to people with ME to the biopsychosocial model

    http://www.meactionuk.org.uk/PROOF_POSITIVE.htm

    http://www.meactionuk.org.uk/The_Model_of_the_Myth.htm
  5. Sean

    Sean Senior Member

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    This, IMHO, is right on the money. It is what really drives people like Wessely, Shape, White, Chalder, Prins, Reeves, Jones, etc. Nasty psycho-drama, morality play thuggery, with more than a sprinkling of political ideology, all dressed up in pseudo-scientific, pseudo-compassionate rhetoric.

    Their real skill is not in science or medicine, let alone constructive compassion. Their real skill is in political manoeuvring, public relations, and sales. They know how to work the system, how to tell the powerful (and, to some extent, the general public) what they want to hear and win their support. They know how to build empires.

    And they are very, very good at it. Wessely, in particular, has this skill in lavish abundance, he is a master at the political game, and without doubt has (thus far, at least) comprehensively outplayed his critics and opponents. As we patients know all too well.
    Enid and PhoenixDown like this.
  6. biophile

    biophile Places I'd rather be.

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    McLaren's views on ME/CFS

    McLaren offers interesting criticism of the biopsychosocial model in general. Unfortunately, his beliefs regarding ME/CFS (as expressed in pages 192-194 of his book, "Humanizing Madness: Psychiatry and the Cognitive Neurosciences") are perhaps even worse than those ascribed to "Wessely School psychiatrists".

    He does not believe ME/CFS and other supposedly similar illnesses exist as valid clinical entities, but instead are examples of an obsessive hypochondriacal response (cycle of self-reinforcing fear / abnormal illness beliefs) to the typical but non-descript symptoms of anxiety and depression. So I wouldn't expect McLaren to be supporting our team any time soon. However, what if XMRV/MLV turns out to be significant? Who knows.
  7. Dolphin

    Dolphin Senior Member

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    Thanks for that biophile. I tend to distrust psychiatrists on ME/CFS unless I see good stuff on them specifically.

    Also, he's very critical of antidepressants. There can be value in that. But psychiatrists sceptical of antidepressants are presumably into talk therapy more than most. So may be less into the biological side of conditions. Which made me cautious about his views on ME/CFS until I saw them given somewhere.
  8. biophile

    biophile Places I'd rather be.

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    Your instincts are accurate here Dolphin. McLaren rejects biological reductionism, is very skeptical about biological factors in mental illness, has even stated that further biological research in psychiatry is a waste of money, and thinks the treatment should target "thought content".

    He acknowledges that the mind is dependent on organic hardware, but emerges with its own set of software-like rules, with mental illness (almost always or by default) being maladaptive rules operating within a perfectly healthy brain. I still have to read more of his work, but as far as I know he offers no obvious breakthroughs in treatment protocols, and is instead trying to establish a theoretical framework for psychiatry to proceed, because the profession lacks one and is currently a cluster**** of eclecticism. I think his work is intriguing but too black and white on the subject of biological factors in mental illness.

    The topic of this thread is personality in CFS patients, with the CDC reporting that 29% of Reeves-criteria CFS patients had at least 1 "personality disorder" and then apparently adding the caveat that it is not specific to CFS but may be general to serious and chronic disease. As far as I know about his views on personality as the sum of mental rules which affect behaviour, McLaren would probably view 100% of CFS patients as having a personality disorder simply because he views CFS as being the result of chronic anxiety (depression is attributed to chronic anxiety as well), which itself is the result of maladaptive personality factors/beliefs/rules.
  9. Snow Leopard

    Snow Leopard Senior Member

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    Sounds like a classic case of "Retreat to commitment". (ie retreat towards faith in Psychiatry)
  10. Angela Kennedy

    Angela Kennedy *****

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    Hi Snow Leopard,

    Thanks for this. Have you read Bartley's book? If so, what did you think of it?
  11. Snow Leopard

    Snow Leopard Senior Member

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    Yes, I personally found it the most rewarding book on philosophy that I have read (though I haven't read that much). Some people may find it deeply unsettling though.
    There is a review here: http://www.the-rathouse.com/bartagree.html
  12. Dolphin

    Dolphin Senior Member

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    I know of 4 letters that have gone in (or are just about to go in) complaining about this. Fingers crossed they publish one or more.
  13. Enid

    Enid Senior Member

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    Hasn't the whole psycho babble lobby learned yet this has nothing to do "types" - better they direct energies to solid scientific biomedical pathology findings as all respected researchers do - discovering/revealing/unravelling the complexity of viral behaviour not only for ME but a vast arrange of human disease.
  14. Dolphin

    Dolphin Senior Member

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    I know three went in (not sure if the fourth person ever sent there's in). Two that went in in recent weeks have been rejected. The third one went in in November. There was no mention of another letter on the subject being accepted in the two latest rejections (one referred to the Heins et al. letter and the Van Houdenhouve letter which weren't on the same topic) so I imagine it [November letter] has been rejected also. :(
  15. Snow Leopard

    Snow Leopard Senior Member

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    Do you know for what sorts of reasons are the letters being rejected?
  16. Angela Kennedy

    Angela Kennedy *****

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    Hi Snow Leopard

    I'm ploughing through this at the moment- I hven't got to the denouement yet - where he shows us how to outsmart the tu quoque of the irrationalist position like he promised ; )

    Don't tell me what happens!!
  17. Esther12

    Esther12 Senior Member

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    I've seen some of the stuff circulated about. It seemed like they weren't interested in posting more stuff criticising their CFS work. They'd recently carried a letter from Tom K about a different CFS piece, and felt that meant no more was needed. Who knows... there was that ABC mainstream media piece critical of the paper, some of the CFS charitites had been critical... they didn't want to draw any more attention to it? It's a shame that this means no criticism of the piece will be published though.
  18. Esther12

    Esther12 Senior Member

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    That reminds me... I read that review Snow Leopard posted a while back, and it alone is worth reading for those of us too lazy to read a whole philosophy book. It laid out a position I already held, but helped clarify and explain my own instinctive thoughts on the matter. Recommended.
  19. Angela Kennedy

    Angela Kennedy *****

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    Yeah - it doesn't quite for me - though on reflection I might be prone to say it's my own position - but I see problems in the review (or at least it feels incomplete) so I'm ploughing through, for my sins.
  20. Dolphin

    Dolphin Senior Member

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