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Simon Wessely and "all in the mind"

Dolphin

Senior Member
Messages
17,567
Publishing a lot implies a great deal of influence/networking in the field. An investigator can only conduct so many experiments at one time and so more papers can only result from more networking/collaboration.

I know a few people (in other scientific fields) that publish 10-20 papers per year and they're all stressed/anxious workaholics. Make of that what you will.
And also in the ME/CFS field, it should be remembered that the total number of papers in any one year is relatively small compared to lots of areas so 10 papers is a few percent of the total output.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
He was an odd and complex man, shame he went so odd at the end, may have disagreed with him a lot but he was sure interesting! :)
Loved the over-the-top mickey take they pulled of his stuff in "Starship Troopers" :p

IIRC, he was the first to envision using a mass driver as a weapon on the Moon, something which the building tensions/space race MKII (very lopsided this time) has brought up.
ie for those not familiar with such, you can hurl lumps of metal from the moon at hypersonic speed using magnetic propulsion, and gravity will turn 'em into "Hiroshimas"
Potentially though it has good applications however, launching spacecraft, processed material, or even destroying (or more likely nudging them with very small impact) dangerous asteroids, etc

classic skit on this, hehe
[video=youtube;hLpgxry542M]http://www.youtube.com/watch?v=hLpgxry542M[/video]
 
Messages
13,774
I've just added some Wesselt papers to my annotation of his personal story (Simon Wessely's Personal Story (Annotated)), but thought I'd post them here, at the end of the thread too.



edit: I'm adding a random handful of Wessely papers in addition to what has been pasted so far, just to provide a taster for people. I think that it's quite difficult to understand his approach, particularly if one has only read a few papers, so do not think that reading only these papers would be sufficient to allow one to make much of a judgement upon his work and impact. I didn't try to pick particularly 'bad' papers, but did avoid papers that were just negative findings, or didn't seem to say much, and tried to post more papers about how patients should be treated (although couldn't find the full paper for this one: http://www.sciencedirect.com/science/article/pii/S0163834397803155 )

Management of chronic (post-viral) fatigue syndrome: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1711569/

Wessely Slater speech notes from 1994: http://www.meactionuk.org.uk/wessely_speech_120594.htm

ATTRIBUTIONS AND SELF-ESTEEM IN DEPRESSION AND CHRONIC FATIGUE SYNDROMES: http://simonwessely.com/Downloads/Publications/CFS/12.pdf

Symptoms of low blood pressure: a population study: http://simonwessely.com/Downloads/Publications/CFS/13.pdf

History of postviral fatigue syndrome: http://simonwessely.com/Downloads/Publications/CFS/20.pdf

VIRUSES, NEUROSIS AND FATIGUE: http://simonwessely.com/Downloads/Publications/CFS/45.pdf

Chapter from a book (the amount available on google seems to vary): http://books.google.co.uk/books?id=...he provision of negative information"&f=false

There is only one functional somatic syndrome: http://bjp.rcpsych.org/content/185/2/95

Health for me: a sociocultural analysis of healthism in the middle classes: http://bmb.oxfordjournals.org/content/69/1/197.full
 

user9876

Senior Member
Messages
4,556
However, seeing as the only specific example of a 'threat' we've had in the recent media coverage was Esther Crawley being sent an e-mail that said "You will pay", I'm not sure how significant a problem this is.

Given the comment below I wouldn't be surprised if some paediatricians receive threats. Its one thing to push a particular treatment with poor science its another thing to start care proceedings or given the lack of information that social services will provide be thought of as having started them. I believe schools have a huge reputation for starting child protection proceedings where children have ME.

I think the belief in treatment is currently the single biggest problem. Lots of these centres have set up. And local champions - whether its a local paediatrician, a therapist or whatever - seem to believe in their own treatment too much. Whether its CBT or graded exercise, pacing, colouring things in, whatever it is, they seem to believe in it. Then it really upsets them if someone gets worse despite their best efforts. Sometimes they get worse because of their efforts,it. Ive seen care proceedings initiated just for that reason. The paediatrician had allegedly guaranteed the family a hundred per cent cure rate, which she said was following NICE Guidelines.
http://tymestrust.org/pdfs/vision2010-3.pdf
 
Messages
13,774
'Threats' as expressions of anger and hatred wouldn't surprise me at all - threats to CFS patients from doctors wouldn't surprise me either; Wessely et al. have helped create a rather heated psychosocial setting arround CFS. I don't know if there's likely to be anything more than that. I've certainly never been invited to join any secret paramilitary CFS organisation!!

If these articles were simply about patients feeling mistreated and angry, it would have been nice if just one of the reporters had tried to see if they had any legitimate reason for doing so, and for holding Wessely responsible for some of the problems that they face.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
From the thread title...
Wow, finally I've found out what's in Simon Wessely's mind, and the true source of all our woes!!

Makes sense, as Simon's new book is:
UnAmazon book review said:
Satan, my part in his downfall!
By Simon Wessely: Procto, ENT, Dr, Eng, Jr, Omnicyclist

"The true tale of a demonic, mutant, gerbil psychiatrist in Hades!
Read how one evil little rodent schemed his way out of the Pit, and into our world, where he now works as a psychiatrist, laywer, and lobbyist during the week, and Mandy the Hamster at the weekends."

SEE? IT ALL MAKES SENSE, NOW!!
We are being ass pounded by Lucifer's Hamster!!
:D :D

36029-cc1686-530-508.jpg


(link in case site prevents direct linking http://piccsy.com/2010/11/mutant-gerbil)


(there's also a bunch of gags in my post too, hehe)
 
Messages
13,774
2009 Simon Wessely interview with New Scientist:

It's behind a paywall there, but available here:

http://www.healthcare-today.co.uk/content.php?contentId=10612


Can people think themselves sick?
16th March 2009

In the New Scientist psychiatrist Simon Wessely, adviser to the Home Office and Ministry of Defence, looks into the idea that people can "think themselves sick".

manindespairQ

Dr Wessely has researched how illnesses such as chronic fatigue syndrome and Gulf war syndrome are caused. This has led to controversy and he has received angry letters from people who believe he has dismissed their conditions.

However Dr Wessely has devoted himself to the finding ways of treating these conditions. Speaking to Claire Wilson, Dr Wessley explains how a person's brain can affect their health.

How does a person's mindset affect their physical health?

On a weekly basis one would experience many manifestations of "how what's going on around you affects your subjective health". When unpleasant experiences occur, they affect a person physically. One might suffer a number of reactions including insomnia, anxiety and other symptoms.

At what point does that make someone ill?

The physical reactions "only become a problem when people get trapped in excessively narrow explanations for illness". Going online to diagnose ourselves can potentially be harmful.

How does chronic fatigue syndrome (CFS) relate to this?

In many cases, it is caused by an illness such as glandular fever. After a few weeks or months most people will have recovered from it. Unfortunately some people decide to monitor their symptoms and can "get trapped in vicious circles...so that what started it all off is no longer what is keeping it going".

We still do not understand why some infections and not others trigger CFS, or why depressed people have double the risk of developing it. It is important to consider both the "infective trigger" and the mental factors in order to understand the condition.

How is CFS treated?

The first step is to make people engage with their treatment. I speak with them for 2 hours and let them know I want to understand their problems.

Although I may not know why many of the patients I see are unwell, the most important thing "is what happens next". I encourage cognitive behavioural therapy and for the patient to become more active.

Is your method of treating CFS a success?

About one third of people improve, one third "completely recover" and the remaining third do not.

You have claimed that CFS, irritable bowel syndrome and fibromyalgia "are all the same illness".

Many of these conditions share overlapping symptoms - people with IBS say they are tired and people with CFS report intestinal problems.

So the "syndrome labels" are too random?

You find that countries around the world have "different syndromes". For example, in France CFS does not exist and in Germany low blood pressure is not good.

What about Gulf war syndrome?

I asked the question: "What are the rates of illness in those we sent to the Gulf compared with those we haven't?" Our research found that being sent to the Gulf had caused a definite effect to the health of some of those serving there.

How has your work affected military policy?

Our research has gathered data about psychiatric disorders in soldiers. We discoverd that alcohol is more of an issue than post-traumatic stress disorder (PTSD).

You have recently been exploring the claims of people who say their mobile phones have made them unwell. What's this about?

My co-worker James Rubin and I found that people who say they are affected by mobile phones could not "tell the difference between sham and real phone signals". These people are not inventing the problem - they have put themselves in a trap where a mobile phone is the trigger for their problems.

What does it feel like to be sent hate mail?

It has been "pretty unpleasant" in some cases, but my work covers a controversial area.

My patients do not send me hate mail and I would be concerned if my colleagues or patients thought I was not a good person. What is important is producing "good quality" research.
 
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13,774
I was just reading this little Wessely book review, and was unsure whether it was worth saving, but then remembered this thread, and decided to add it here. I found it interesting in light of the casual manner in which the cognitions of those with CFS are treated as abnormal or dysfunctional.

How shyness became social phobia
Simon Wessely Email Address
Shyness: How Normal Behavior Became a Sickness
Christopher Lane
Yale University Press, 2008
Pp 272. US$2750 (1999). ISBN-0-300-12446-5

In 1917, the American Psychiatric Association (APA) recognised 59 psychiatric disorders. With the introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM), often called the psychiatrist's bible, in 1952, this rose to 128 disorders. By 1968 it was 159, 227 in 1980, and 253 in 1987. Currently DSM-IV has 347 categories, and it would be a brave person who would anticipate anything other than a further increase in the next edition.

In his splendid book, Shyness: How Normal Behavior Became a Sickness, Christopher Lane concentrates on just one of the many newcomers to the diagnostic canon. Drawing on documents exchanged behind the scenes during the creation of DSM-III, he focuses on how, with the help of psychiatrists, journalists, and drug companies, shynessonce seen as a normal variation of character or personalitybecame incorporated into the DSM as social phobia or avoidant personality disorder. His critique sits alongside Allan Horwitz and Jerome Wakefield's dissection of the gradual extension of the boundaries of depression in The Loss of Sadness.

All psychiatrists are familiar with those whose crippling phobias and panic attacks prevent them from engaging in any form of social interaction, whilst major depression remains a worldwide scourge. Lane accepts this, but what concerns him is how one draws the line between the normal and abnormal. In a previous generation, says Lane, shy people were seen as introverted, but not mentally ill. Now embarrassment about eating alone in restaurants, or concern about interacting with figures in authority is part of the definition of social anxiety disorder. How, then, have we redefined the shy individuals of his parents' generation into a new army of people with mental health problems?

It is a well worn path. At first only a few cases will be known to the mental health servicesthe tip of the iceberg. Next comes large-scale studies, with the inevitable conclusion that the new condition is a hidden public-health problem, after which it can be called the disorder of the decade, as social anxiety disorder was, indeed, labelled in the 1990s. Finally, a sustained campaign to educate the public can be launched. Lane gives a compelling description of this process for social phobia, but it is a story that could also apply to several other conditions.

Lane and other critics, such as David Healy, accuse the drug companies of medicalising problems like shyness and unhappiness. The drug industry develops compounds such as diazepam, fluoxetine, or paroxetine, and then promotes the creation of disorders for which these new drugs are the apparent answer. Lane quotes Isaac Marks, a pioneer of research into the anxiety disorders but opposed to the construction of social anxiety as an independent diagnosis, who described the promotion of social anxiety disorder as an advertising ploy to exaggerate the plight of the socially anxious.

There is truth in these arguments, but it would be naive to lay the blame for these expansionist tendencies solely at the feet of Big Pharma. The psychiatric profession has had a key role in hyping vaguely defined ailments without much scientific research or credibility. This is partly the result of the reimbursement system that governs American psychiatry. Treat someone for shyness, and the insurance companies will laugh at you. Treat someone with social phobia, with its DSM seal of approval as disorder 30023, and the bill will be paid. Indeed, it could have been worse. Lane's research in the archives of the APA shows that months of protracted discussion were necessary before other conditions such as chronic complaint disorder or chronic undifferentiated unhappiness were dropped.

Once a new disorder has sprung Athena-like from the head of the APA, the product still needs to be marketed. One technique is the celebrity disease endorsement. American football star Ricky Williams, for example, chose the Oprah Winfrey Show to come out with his social phobia. Lane hints that his real shyness lay in not disclosing the fee he received from the public relations agency acting on GlaxoSmithKline's behalf. The marketing impact of this epitome of masculinity admitting to a mental health problem then cured by an anxiolytic must have been immense. Unfortunately, Williams's benefit to the drug company, like his career, came to a halt when it turned out he was also taking rather different drugs banned by the National Football Leaguedrugs he later publicly said were more effective in building his confidence.

Some of this is no surprise. The Ivan Illich inspired sociology that I was taught as a medical student showed that the medical profession was always seeking to extend its boundaries at the expense of the public. But Illich never anticipated the social revolution of self-help, therapy, and self-improvement that means the public is now part of the process. But the unstoppable growth of another hidden public health problem, attention deficit hyperactivity disorder (ADHD) shows other actors at work, not just the APA and the drug companies.

One psychiatrist quoted by Lane remarked that we used to have a word for sufferers of ADHD. We called them boys, and few can doubt that the label is now getting applied to many children who misbehave. But the attempts by child psychiatrists to restrict the label to a narrowly defined small group of children are often opposed by teachers and parents. How much easier is it at the dinner table to announce that Johnny has ADHD and is receiving medication for his problems, rather than admitting he is a nightmare to teach and not much better at home?

What remains unknown is the consequence of these shifting boundaries and new labels. I recently saw the child of prosperous parents, who was a problem at home and school. By the age of 13 years he had eight diagnoses and nine mental health professionals involved in his care and education. His family doctor, however, felt that the real problem was that the boy was lucky if he saw his parents for more than 1 hour each week, and was sceptical that throwing therapists, diagnoses, and stimulant medication at him was going to help.

How will children like this grow up? And what does it mean to think that your behaviour is not your own responsibility, but is because of your brain being wired differently than the rest of your class? Might these children come to believe that they are indeed differentset apart and endlessly in need of support and treatment even as they enter adulthood?

There is another reason for concern. A genuine debate about the limits of psychiatry is being hijacked by some, like the Scientologists, to attack the entire enterprise of psychiatry. Yet severe mental disorders remain a scourge. In the developing world, most of those with major depression, mania, or schizophrenia languish unnoticed and untreated. Lane quotes with approval the warning of psychiatrist Arthur Kleinman that including mild forms of anxiety and depression under an ever widening umbrella of mental disorders will divert attention and resources from diseases like schizophrenia and major depression which remain under treated and stigmatized across much of the world.

And even in affluent societies anyone who has a child with schizophrenia or a severely depressed husband knows all too well that our current treatments and services are inadequate. It is now over half a century since the last genuine breakthrough, the discovery of chlorpromazine. Like it or not, the next major leap forward in the treatment of major mental disorders will come from neuroscience, and will be funded by the pharmaceutical industry. Pathologising shyness, eccentricity, or sadness does few any favoursneither those who receive unhelpful labels, nor those with major mental disorders who need all the resources and research we can muster.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)60470-5/fulltext
 

Enid

Senior Member
Messages
3,309
Location
UK
Isn't it about time he and his ilk (it's me Scots forebears) took a very long sabbitical to continue studying the very simple - not the brains for more.

Silverblade - much enjoyed the delightful hampster - any chance the wierdoes (like psyches will leave alone).
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Enid
well, yes, a logn sabbatical "At Her Majesty's Pleasure", prefferably, muhaha! ;)

Note on hamsters and the internet:
ever since a game called "Baldurs gate" came out, there's been a internet meme/fondness for hamsters, because of "Boo", the "miniature giant space hamster", the pet of one character in the game, lol. (And is sitll carried on in the "Mass Effect" games)
Minsc said:
Boo does not trust this Weasel. See how his nose twitches? Something smells about this, and it is not stinky clouds from Boo's furry backside!
:p
 
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When I stumble upon some Wessely-ish thing, I now just post it in here, in case others are interested.

A debate on PTSD Wessely was speaking in, against the motion: http://www.iop.kcl.ac.uk/podcast/rs...Psychiatry-Post_Traumatic_Stress_Disorder.mp3

"PTSD - THIS HOUSE BELIEVES THAT THE TRAUMA INDUSTRY INAPPROPRIATELY MEDICALISES NORMAL SUFFERING

It touches on some abstract issues which are vaguely related to CFS... but no-one seeming terribly interested in the views of patients.

It's funny how so many of these sorts of London events have the same sort of atmosphere. It makes me sympathise with the desire of Scots for independence.
 

SOC

Senior Member
Messages
7,849
"PTSD - THIS HOUSE BELIEVES THAT THE TRAUMA INDUSTRY INAPPROPRIATELY MEDICALISES NORMAL SUFFERING

In my experience, these kind of nonsense statements come from people who have never really suffered and are therefore empathy-deficient. Very few people who have really suffered -- for any reason -- can make such flat and absolute statements about suffering.
 
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13,774
In my experience, these kind of nonsense statements come from people who have never really suffered and are therefore empathy-deficient. Very few people who have really suffered -- for any reason -- can make such flat and absolute statements about suffering.

I don't think that they would have thought of it in that way.

These sorts of silly debate titles, and the manner in which discussion occurs does irritate me though, and seems part of a the culture of sections of British society which enjoys turning important issues into reassuring play-time debates.
 

SOC

Senior Member
Messages
7,849
I don't think that they would have thought of it in that way.

These sorts of silly debate titles, and the manner in which discussion occurs does irritate me though, and seems part of a the culture of sections of British society which enjoys turning important issues into reassuring play-time debates.

I see what you mean. I've encountered some pseudo-intellectual groups who think they are being clever with discussion topics like "Eugenics -- Destruction of Society or Economic Wisdom?" To me, they sound juvenile, not clever. I guess they're everywhere. **sigh**
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
I see what you mean. I've encountered some pseudo-intellectual groups who think they are being clever with discussion topics like "Eugenics -- Destruction of Society or Economic Wisdom?" To me, they sound juvenile, not clever. I guess they're everywhere. **sigh**

Jack the Ripper was a monster
But he pales in comparison to the death toll of the likes of Robespierre of the French "Terror" (arguably the first of the "Intellectual agents of mass murder")

In other words, generally it's the cold, callous, calculating sons of b*tches who do the most harm and are often not recognized for what they are, or the even carnage they cause.
Like I keep saying, 100 million died by tobacco by 2000AD, by 2100AD, it will be 1 billion,and people knew that would happen, calculated it, sold it as part of their plans to developing nations, a silent cull of those who'd then be retired, economic "negatives", wastes of space....
Gimmie an old fashioned axe murderer, anyday! :p
 
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13,774
I see what you mean. I've encountered some pseudo-intellectual groups who think they are being clever with discussion topics like "Eugenics -- Destruction of Society or Economic Wisdom?" To me, they sound juvenile, not clever. I guess they're everywhere. **sigh**


Yeah. I've been listening to a few Norman Finkelstein debates recently, and while I don't agree with everything he says, I like how he keeps a sense of moral seriousness to the discussions. He seems really focused on attacking his opponents arguments, and this allows for a more interesting discussion to take place. I think that the easiest way to win a debate is to convince people that they always agreed with your position, but they just hadn't quite realised it - these sorts of games really restrict the range of ideas and arguments that can be put forward though.