chipmunk1
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@Jonathan Edwards
...and this is the "treatment" protocol for the clinic this doctor @Kati mentioned works at (and the only ME/CFS clinic in all of Canada ):
http://www.bcwomens.ca/Professional-Resources-site/Documents/Clinical Protocal-ME-CFS 1.4.pdf
It gives GET and CBT a "level A" evidence rating
Patient handout:
http://med-fom-tcmp.sites.olt.ubc.ca/files/2015/10/Central-Sensitivity-Syndromes-CSS.pdf
I will try to translate from psychobabble speak:
What predispose someone to Central Sensi.vity Syndromes? The syndromes can run in families (parents, siblings, children). Also abuse or trauma in childhood also seems to play a role (as it does in many other condi,ons). Many with these syndromes have neither of These.
So the known causes are classical freudian childhood traumas and the other causes are not known.
Conversion disorders are supposed to be caused by repressed emotions. A way for the psyche to deal with traumatic events using the body to communicate emotional distress.
.What are triggers (precipitants) for Central Sensi.vity Syndromes? In predisposed individuals, there is oJen a trigger (precipitant) in the form of a stressor
What triggers them is a stressful event. I believe this is exactly what Charcot said. He believed that hysteria was partially hereditary and triggered by a traumatic event like a railway accident.
http://courses.washington.edu/freudlit/Hysteria.Notes.html
Freud's teacher, the famous French neurologist Jean Martin Charcot (1825-1893), spent a great deal of energy studying hysteria and concluded that it derives from a particular hereditary disposition. (To view an 1885 painting of Charcot demonstrating a hysteric patient--a drawing that Freud hung, moreover, in his office--click here.) In other words, certain people are genetically pre-programmed, as it were, to develop hysteria, just as today we know that the predisposition to other diseases (e.g. cancer, alcoholism) can be genetically based.
a. Charcot believed that real events could serve as the Trigger that released the hysterical symptoms. Hysteria, in short, can lie "dormant" in one until its symptoms are stimulated by some real-life event. Charcot called such events "provoking agents"; they serve to actualize the hereditary potential for hysteria, to transform it from latent possibility to concrete reality.
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From Charcot Freud borrows the notion of the "trigger" or the "provoking agent" that unleashes the hysterical symptoms. The theory here is that the event that stimulates the symptoms is not itself the cause, but merely areference to a deeper cause. It serves to invoke that cause. It is possible that Charcot's theory of the "provoking agent" of hysteria influenced Freud's later notion of the "day residue" or "trigger" in dreams. The structural mechanism, at any rate, is identical. a. For Freud, however, what this "trigger" activates is not a hereditary predisposition, as for Charcot, but rather:infantile experience.
2. Freud searches in these 18 cases for a single cause that all of them have in common: this would be their uniform basis and would hence point to the general aetiology of hysteria. What is this shared element?A traumatic experience in childhood that is uniformly of aSEXUALnature
Are they doing a bit of Freud and Charcot here?
This includes infec,ons (for example aJer a flu), physical trauma (for example aJer a car accident), or psychological stress or trauma (for example “burn out” or even a single trauma,c event).
Note how they mention car accident and infection. Symptoms from whiplash injuries following car accidents are supposed to be somatisation disorders. Symptoms following infections are of course CFS which is believed to be a somatisation disorder in many circles.
What else goes wrong with Central Sensi.vity Syndromes? Central sensi,za,on is the result of problems with the endocrine (hormone) system, the immune system, and inflamma,on. There are also problems with the cell’s mitochondria (the energy power houses of the cell).
Very vague.
Are there any other factors that come into play in Central Sensi.vity Syndromes? Yes. Poor sleep, overexer,on, reduced ac,vity, stress, depression and anxiety can all turn up the dial of sensi,vity and make symptoms worse.
Depression,Anxiety can make things worse. Worse to the point that they make symptoms that are otherwise not significant, disabling?
They mention "biopsychosocial mechanisms". Now we know we have a BPS model here.
What about pharmacological treatments?
The recognition of the mutual association among the CS conditions is helpful in their diagnosis and in avoiding costly and unnecessary investigations. Also, these conditions usually respond to the same treatments. Drugs that are known to attenuate CS are the NMDA receptor antagonists including amitriptyline and gabapentin, among others.
Psychiatric medications.
The treatment plan.
In addition to medication management, patients can participate in groups including the core group, “Living with Complex Chronic Diseases,” comprising 10 weekly sessions on self-management with a focus on pacing and the energy envelope, mindfulness, and cognitive behaviour therapy. Other program components can include one-on-one or group visits with members of the interdisciplinary team: occupational therapist, physiotherapist, dietitian, social worker, counselor, naturopath, nurses, nurse practioner, family physicians, and specialists. Patients also have access to interventions offered by the program as indicated: acupuncture and trigger point injection. T
pacing and the energy envelope, mindfulness, and cognitive behaviour therapy
to sum it up:
The only known causes are childhood traumas and treatment is mostly behavioural therapy.
If we are lucky we might qualify for antidepressant medication.
Add a lot of random stuff and some neurobabble to the mix and we have the theory of central sensitivity syndromes.. I would say central sensitisation is the new politically correct way of saying Hysteria. New name, same old canard.
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