Psychiatrists -- People with authority and PACE.

[eafw]

Maybe we should discuss CBT and brainwashing. Both have the same goal, that is changing what someone thinks about something.

"Brainwashing" is not so much the changing of thoughts (eg learning something new is not brainwashing) as the attempt to alter someone's perception of reality. It is the manipulation of people's sense of the world, and themselves, so that they end up believing whatever set of untruths is being presented to them.

CBT can be used as a tool for this, as can various other things - social pressure, cultural norms of compliance, media stories, threats, witholding of resources, the promise of a miracle cure: "It's your fault you are ill ... try harder .... do more exercise ... think positive thoughts ... this (one special unproven technique) will make you better ... you are choosing to be unwell".

Where CBT is moving in the UK, as a mandatory doctrine under certain conditions, is medical abuse. Brainwashing tends to be political. Oh, wait, the drive for it in the UK is political.

The BPS school and CBT is a blight on mental health services and more within the UK. And the way it is practised, particularly for ME, is especially manipulative. It is an exercise in denying reality and victim blaming, while witholding proper treatment. Very abusive.

 

[alex3619]

"Brainwashing" is not so much the changing of thoughts (eg learning something new is not brainwashing) as the attempt to alter someone's perception of reality.

To me that is simply creating a compelling interlocking system of thoughts. Its a matter of degree and purpose, and some difference in technique, but its not really different in purpose or what is done. CBT also fits this by the way.

Learning can indeed fit this profile. In some ways teaching is brainwashing, and vice versa. The goal and the interpersonal relationships are different. The agenda is often different.

Even self directed learning can fit this broad idea, though being self directed it has many mitigating factors. Yet the information you learn, what is available, is important. Suppose I wanted to learn about CFS and knew nothing about it. I then find a whole lot of BPS and CBT/GET material, and read it first. On that advice and understanding I might take a dim view of the biomedical literature. I might also be convinced CFS and ME are the same. I might then go out and start exercising, with or without CBT. That is information-driven changing of my views to fit someone else's agenda. It might also severely harm me.

Here is the issue. Brainwashing is ubiquitous, its a social and cultural thing. The difference in what is considered brainwashing is a matter of scope, agenda, coercion, and specific techniques. Its a playing with definitions, whereas these issues blur into each other and have no clear demarcation.

 

[TiredSam]

In some ways teaching is brainwashing, and vice versa.

Very well spotted. About 20 years ago I was teaching English to hundreds of employees of multi-national companies using the so-called "Superlearning" method (accelerated learning / Lozanov method in the UK I think), which became very popular in the eighties and remained so for a couple of decades.

One day (can't remember why) I went to the Cult Information Centre's website, and at the time they had a list of 20 mind-control techniques used by cults (they don't any more, they may have realised it could be used as a guide on how to do it?). I recognised that I was using about half the techniques in my teaching, can't remember them all now but it was things like use of music, chanting etc.

It became an in-joke at the company and one colleague took to calling me "Elron" after L. Ron. Hubbard, whose biography we had both recently read. I always joked that after being a teacher I was going to set up a cult as a natural next step. The superlearning method was the most effective way of teaching beginners I have ever come across, about 2-3 times more effective than other methods. I've since come to the opinion that it's based on junk science and an outdated model of the brain (at the time I read a book about it and was a believer), but it was still very effective.

EDIT: Thinking back to that time, I now remember that the courses came to an end after running well for 7 years because a new personnel manager arrived, who didn't like the course because he considered it had cult-like practices.

 

[eafw]

The difference in what is considered brainwashing is a matter of scope, agenda, coercion, and specific techniques. Its a playing with definitions, whereas these issues blur into each other and have no clear demarcation.

If it means everything then it means nothing and we're back in Humpty-Dumpty land. For the word to be useful then there needs to be a workable definition and in both common and political use it is about manipulating or coercing someone into believing an altered reality. Those two aspects are why it is given a specific (and pejorative) label.

I recognised that I was using about half the techniques in my teaching, can't remember them all now but it was things like use of music, chanting etc.

These techniques can work, which is why cults use them, but I'd make a distinction between accelerated learning of some objective "truth" eg a language, and taking on the idea that guru whoever is the messenger of a holy alien race etc.

 

[TiredSam]

These techniques can work, which is why cults use them, but I'd make a distinction between accelerated learning of some objective "truth" eg a language, and taking on the idea that guru whoever is the messenger of a holy alien race etc.

Fair enough. I'd say I was trying to create optimum conditions for students' brains to accept and retain new information. To engrave it as deeply as possible in their brains by engaging as many senses and learning styles as possible.

I just noticed that some of the same techniques that I was using were also being used for nefarious purposes by cults.

 

[Skippa]

I think we're missing a major point here...

Just who is being brainwashed?

All the therapists I've met (the actual practitioners) really ARE nice people.

There are many things they can help with, but I fear it is THEY who have been brainwashed into thinking they can help with CFS/ME (by the likes of PACE etc).

 

[alex3619]

There are many things they can help with, but I fear it is THEY who have been brainwashed into thinking they can help with CFS/ME (by the likes of PACE etc).

Which is in part my point. If most of the information you have leads you into fairyland, then you are vulnerable to become some version of deluded.

It is not possible to guarantee that you cannot be led into false belief systems. Most people will have plenty. This however seems rife in some professions rather than others, such as psychogenic psychiatry. The last holdouts of Freudian psychiatry probably have the same issue, though since I have not investigated modern Freudian thinking I cannot say the have this issue with certainty.

Lots of words we use, every day concepts, have no clear definition with clear demarcations. Concepts like love and justice are included in that. We try to cleave reality into neat packets, but its not so simple. Which is one of the reasons I am uncomfortable calling something science when its not based on objective evidence. It can be rigorous academic research, but its not science, not even bad science. Mind you, rigorous nonscientific research is often better than poor scientific research. Especially when it recognizes its limitations ... which is also critical in science.

 

[Cheshire]

It is not possible to guarantee that you cannot be led into false belief systems.

The problem lies in the definition of the "false belief system". If I'm correct, this kind of "reconfiguration of thoughts" has been used first for depression. It was aimed at helping people see the positive side of a situation, or cope differently with a difficult situation. If done fairly, with the therapists not imposing their view, I don't see any distrurbing thing here. Whether it's effective or not is a different question.

The situation with the "false belief system" in CFS (and every "MUS") is very different. The "false belief" here is that there is no disease. The patient is delusional in believing this. But this is the view of the BPS crew, it's not an established truth. It implies that all the scientific who think CFS is a real disease are delutional too. Whereas it's not a matter of delusion, it's a scientific disagreement.

 

[alex3619]

The problem lies in the definition of the "false belief system"

Yes, its a huge issue. Its one reason you cannot medicalize a false belief system by itself. You catch everyone if you go looking for false belief systems.

False belief systems with MUS for example, are far bigger and wider than just believing ME is not a disease. Its about all the background beliefs, including Freudian and post-Freudian nonscience. They tolerate dodgy claims because they match their overall belief system in psychiatry. Evidence, reason and science somehow do not compete with this.

I dispute its a scientific disagreement. The MUS arguments are not only not scientific, they are not even rational, and lack sound evidence. It might be valid to call it an academic disagreement though.

 

[Cheshire]

I dispute its a scientific disagreement. The MUS arguments are not only not scientific, they are not even rational, and lack sound evidence.

Yes I agree, the MUS argument is just plain nonsense. But as the BPS crew is supposed to do science (and seen by most outside of the field as doing science), I'd say theoritically "scientific disagreement" could describe it.

 

[Valentijn]

All the therapists I've met (the actual practitioners) really ARE nice people.

Of the four I saw at a clinic, 3 were nice, and one (the psychologist) got pretty nasty. The guy running the clinic was definitely of the "nasty" variety as well, though he never spoke to me directly, just to my fiance on the phone or in email (he insisted I speak Dutch, which I can't do well enough for the relevant subject matters.)

When I was upset about a bad neurologist visit and wanted to vent, the trusted psychologist responded by insisting that doctors could not help me. She then told me to imagine my symptoms never improving (unless I magically made them go away, presumably). Considering I had little real treatment at the time, that was very upsetting, and I started crying. She then kept repeating that, and I spent most of the appointment sobbing.

I'm not a crier, especially around other people, and that is the one time in my life that I have felt suicidal. I recovered after a couple days, partly due to low-key emotional support from the physiotherapist in the the appointment immediately after seeing the psychologist. We didn't say anything when I went into his office, but it was obvious I'd been crying, and he got a bit pissed-off looking and left the room for a while to have a chat with the psychologist.

My fiance was also very supportive of me, and I was able to rechannel that very painful experience into a quest for vengeance. I found the source for some of the weird things she'd said before, basically the Dutch manual for illness-denial CBT in ME/CFS. The avoidance of mobility aids struck me as particularly outrageous, so at the next appointment we started "innocently" talking about mobility scooters as much as possible just to annoy her. It worked rather well

But if I had been ignorant enough to believe the psychologist, or hadn't had the support I had, or had been prone to mood disorders or impulsive actions, I can easily see how such a betrayal and the deliberate infliction of hopelessness could lead to a suicide attempt.

I know most therapists aren't like that. But some are pretty bad people. And I would never risk making myself vulnerable to one again - it's a matter of survival.

 

[jimells]

If it means everything then it means nothing and we're back in Humpty-Dumpty land. For the word to be useful then there needs to be a workable definition and in both common and political use it is about manipulating or coercing someone into believing an altered reality. Those two aspects are why it is given a specific (and pejorative) label.

It's all a matter of perspective. One person's "brainwasher" is another person's "educator". So the word is probably only useful as an insult.

 

[jimells]

When I was upset about a bad neurologist visit and wanted to vent, the trusted psychologist responded by insisting that doctors could not help me. She then told me to imagine my symptoms never improving (unless I magically made them go away, presumably). Considering I had little real treatment at the time, that was very upsetting, and I started crying. She then kept repeating that, and I spend most of the appointment sobbing.

Sounds like a real sadist.

 

[Aviva3]

I just terminated a six-months course of CBT. No brainwashing at all....I had a flexible and intelligent therapist. The basic notion was to track activities and my feelings about them on an hourly basis, and to build upon those that feel good.

My problem (which is a criticism of this approach) is that it would have worked great before I got sick....to better deal with my work and other relationships, but it is just too difficult to set goals now. My life is too circumscribed to even have enough activities/relationships to examine and expand upon. As reported in critiques, I felt a sense of dismay and failure at being so unable to "get better," by increasing activities.

I do rely on 1X/wk. therapy with a psychologist. I also see a psychiatrist/neurologist 2X/month. I have a neurological disorder...dysautonomia, as well as sensory neuropathy. I am on this site because I have "sickness behavior:" profound fatigue. I now know that a good percentage of people with ME also have dysautonomia. Both disorders come with a myriad of odd symptoms and are hard to diagnose and treat. Yet because I have visible nerve damage (seen through skin biopsies) I see how some physician s take me much more seriously than before.

Basically I am saying there is no need to demonize CBT; it may be helpful, but the key point is that it is not in any way curative of ME. It is good to refute the notion that a devastating illness like ME is psychosomatic. Yet psychological therapy is a lifeline for me amid all the losses I've suffered in just two years.

 

[digital dog]

If we had scientific research, treatments and knowledgeable doctors and we were all treated with respect and compassion then I'm sure that we would all be quite open to CBT as an add-on therapy.

I bet if we were hooked up to the latest ground-breaking medicine, or waiting for our next round of immune boosting drugs we wouldn't mind a little CBT to help us through the whole palaver.

I'm sure if the medical profession actually gave a shit about us then we would quite happily accept some CBT. In fact, some of us might actually welcome it.

 

[Esther12]

it may be helpful

Almost anything may be helpful. The trouble with CBT for CFS is that a lot of people are being misled by a small number of researchers about what the evidence shows for the helpfulness of CBT as a treatment for CFS. Lots of patients would not have spent their time, effort and money on CBT is they'd been properly informed about it.

Also, 'CBT' can include a wide range of different approaches. The form for CFS that has been assessed in trials in one founded upon a fear-anxiety model of CFS which assumes that patient's dysfunctional illness beliefs play an important role in perpetuating their illness.

 

[Aviva3]

I agree with you Esther. I need to look more closely the studied model.

It is hard to maintain a sense of agency while sick, and we forced to do so if we are to find sympathetic and knowledgeable care-givers of any sort.

 

[alex3619]

I'm sure if the medical profession actually gave a shit about us then we would quite happily accept some CBT. In fact, some of us might actually welcome it.

I have done classic CBT and I was happy with it. The problem with CBT is that most of the claims being made with specific diseases appear to be hype. The methodology used results in biased data, and over time this disappears.

I do not question that CBT has some capacity to assist people cope. If the discussion is about quality of life then I see no reason why CBT is any worse than most (not all) other therapies, and for some patients its probably superior, especially versus the over-use of dangerous drugs.

Comparing CBT with brainwashing has some negative connotations. Yet the technology has similarities. Its the purpose and methods used that, if used appropriately, make CBT a viable therapy. Misused is in some ways worse than brainwashing.

When you read about CBT you should really be asking ... which CBT? Its no longer one structured therapy. Its who knows how many therapies under a broad umbrella. They all use the same basic idea of challenging thoughts with words, and inducing patients to incorporate different word choices and thoughts as a kind of homework. Yet the choice of thoughts to target is not some uniform process.

CBT for quality of life, in general, is fine. This includes sick people.

CBT as promoted by therapists for specific diseases, with implication of cure or remission or recovery, is hype. Sometimes dangerous hype. CBT when combined with other unproven restorative therapies is problematic. When combined with GET, graded exercise, for either ME or CFS, it looks to be dangerous, not just problematic. It is very dangerous when weak implications of this therapy are taken as gospel by government, medical authorities, bureaucrats and insurance companies. How many hundreds of thousands are suffering, directly or indirectly, because of this? We know of specific cases of ME patients whose deaths were probably due to forced CBT/GET and other psychiatric therapies.

This is also part of a wider issues, the biopsychosocial movement. Currently the UK is being investigated by the UN for basic violations of rights of the disabled, due to its work and pensions policy and how that was enacted, which uses as its justification arguments developed by BPS proponents. The evidence shows, the governments own published data, that over 30,000 extra disabled are dying per year in the UK via this policy. That implies that the death total is probably over 100,000.

When a small number of people are killed by terrorists the world reacts. In most cases the world should be reacting as it is, though there are hyperbolic or excessive exceptions. Somehow a hundred thousand dead in the UK is no big deal. This might in part be because, and I am somewhat speculating, that other countries would not fare much better in this regard. Or because they kill with rules and regulations and not poison gas, explosives or bullets.

To reiterate, CBT is many different therapies. More and more its being claimed as restorative. Many of the claims are now in serious doubt due to the evolving scientific results.

I think that CBT claims not based on objective evidence need to be looked at very closely, and never regarded as gold standard evidence.

PS What @Esther12 said.

 

[jimells]

The evidence shows, the governments own published data, that over 30,000 extra disabled are dying per year in the UK via this policy. That implies that the death total is probably over 100,000.

...they kill with rules and regulations and not poison gas, explosives or bullets.

Every year it becomes harder for me to avoid the conclusion that these deaths are considered to be desirable outcomes of official policies. All "they" have to do is sit on their hands in order to get rid of us Useless Eaters. So much easier and cleaner than the Eugenics policies of the recent past.

 

[Jeckylberry]

This is sad to hear. It's data fudging at its lowest and dirtiest.

In my experience and from what I read of others like @Valentijn the difference lies between doing CBT to 'get better' and seeing a practitioner for your mental health for whatever reason. It's like witnesses for the prosecution or defence are told to be impartial but end up leaning towards the one who has enlisted their help. I've seen therapists who have been very helpful and given me real help in finding peace of mind. The one neuropsychologist I saw was part of a team treating FND. Now if you're on that side, the patient who doesn't accept the diagnosis is not going sit comfortably with you because they will sense you are not fully on their side. THAT is the problem. They will hold back and you will interpret their behaviour from an FND standpoint, not even realising you have drawn a line in the sand. Every illness belief they have you will make it a false illness belief, because that is the lens through which you will observe them. You will always be at loggerheads, waiting for the patient to crack. I've seen this in cults - brainwashing. It's dirty but it's sanctioned by the group. And on capitulating the relief is enormous, the welcome and sense of belonging are warm rewards. The police can break an innocent person into confessing, so can a psychologist.