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Simon Wessely and "all in the mind"

Enid

Senior Member
Messages
3,309
Location
UK
Wasn't it Harry Truman who said - if you can't convince people confuse them.

Decades of science have not moved this pathetic "profession" ? anywhere.
 
Messages
13,774
I was just reading some rapid responses here: http://www.bmj.com/content/319/7221/1376?tab=responses

There were a couple of response to the article and Wessely's reply which I thought were worth posting, and decided to add them to this thread.


Confrontational TV Programme Harms Children
19 November 1999


Sir

I congratulate Harvey Marcovitch on his exposition of the methods
used by some activists to hound those paediatricians who are prepared to
consider that parents do not always act invariably in the best interests
of their children.

Marcovitch draws attention to the Panorama Programme last Monday on
the equally contentious subject of chronic fatigue syndrome (CFS) in
children. This was a particularly biased and pernicious account of an area
where balance and reason are needed, not polemic and distortion.

Contrary to the message of the programme, the management of CFS in
children is in practice not contentious. Programmes of rehabilitation
rather similar to those now shown to be effective in adults, including
some form of support, encouragement, behavioural management and
activation, are now the mainstay of treatment in virtually all centres
helping such children and their families. Indeed, it is hard to find
dissenting voices in the professional literature.

Such programmes, including the one we run at King's College Hospital,
necessarily involve collaboration, not confrontation, with both the child
and family. We will shortly be presenting the results of an uncontrolled
case series, adding to the literature demonstrating both the effectiveness
and acceptability of such approachs, and have just commenced a randomised
controlled trial as part of the normal process of demonstrating efficacy
in the most scientific fashion.

Any parent who watched the one sided Panorama Programme might be
forgiven for thinking that the management of CFS in children involves
coercion and the Courts, and be discouraged from seeking help. Of course
cases of parents harming their children, even occasionally with good
intentions, do exist. Some appear nowadays under the guise of CFS or
bizarre allergic disorders (1), and when a doctor believes this is
happening, he or she has Statuatory duties to fulfil. But such cases are
fortunately extremely rare - we have not yet encountered such a problem
here at King's - and tell us little or nothing about the general
management of CFS.

(1). Taylor D. Outlandish Factitious Illness. In: David T, ed. Recent
Advances in Paediatrics. Edinburgh: Churchill Livingstone, 1992: 63-76.

Simon Wessely, Professor of Liaison and Epidemiological Psychiatry

King's College Hospital



Children with ME and Doctors
4 December 1999


There is a strange illogicality permeating much of the argument put
forward by Harvey Marcovitch (1) on the question of the treatment of CFS
or ME in children, and in some of the subsequent responses. He writes of
the hatchet job performed by Panorama (8th. November), and, in this
context, refers to the Washington Posts policy that news requires
corroboration. One of the responses to his review states contrary to the
message of the programme, the management of CFS in children is in practice
not contentious (2). Yet there was an omission in Dr. Marcovitchs
reference to a case reported by Panorama in which, he states, ...
parents views and those of the local medical team were in conflict. The
programme made it clear that the dispute was between the parents supported
by their own medical advisers and the local medical team, so perhaps there
is more divergence of view in this area than has been asserted.

Dr. Marcovitch discussed at length Munchausen syndrome by proxy,
which is relevant because one of the cases of ME reported by Panorama was
labelled as such. Neither doctors nor anyone else like being on the
receiving end of emotional, intemperate outbursts, even from people who
think they have been wrongly accused. But what is sauce for the goose is
surely also sauce for the gander. Nobody is infallible, and even doctors
make mistakes at times, yet there is no recognition in Dr. Marcovitchs
review that this is even a remote possibility. He gives no credence to the
possibility that some of those accused, knowing themselves to be innocent
of the allegations, may feel themselves to have been in receipt of exactly
the same type of vituperative attack that he objects to strongly when
doctors are on the receiving end. Allegations of this nature turn on
questions of historical fact, rather than simply being matters of clinical
opinion, so should be subject to Dr. Marcovitchs own Washington Post
test of corroboration.

It is hardly surprising that innocent people feel very angry when
accusations are levelled at them that, if made without justification in
any other context, could end in an action in defamation in the High Court.
It is also not surprising that innocent people will react vigorously to
such accusations, in order to give paramount importance to the interests
of their children, which means, in this context, fighting to preserve the
integrity of their families. The fact is that clinical opinion may at
times be highly speculative in nature, and does not enjoy the same status
as fact. Yet alone of all professionals, some doctors seem to think that
their opinions should be treated as paramount, even when they fly in the
face of the facts. Lawyers, for example, may form professional opinions
about cases, but expect to see them challenged adversarially by other
lawyers in the course of legal proceedings. Journalists, as Dr. Marcovitch
himself has suggested, should be subject to a stringent test of
corroboration in the views they express. As far as doctors are concerned,
much of the heat could be taken out of the situation if some doctors would
approach the care of children with ME with greater humility and
understanding, and attempt to build the type of partnership between
professionals and parents that is clearly best practice, and in line with
the intentions of the current child care legislation.

1)Marcovitch, H. Diagnose and be damned. BMJ (1999): 319 1376.

2)Wesseley, S. Confrontational TV programme harms children. e-BMJ,
19th. November 1999.

Competing interests: None declared

Derek Pheby, Director, Unit of Applied Epidemiology,

University of the West of England, Coldharbour Lane, Bristol, BS16 1QY.

Where was the BMJ's peer review process
20 December 1999


Dear Sir or Madam,

I write to suggest that the thoughtful response of Dr.
Derek Pheby which I have read on the eBMJ should be
published in the paper journal.

The British record of paediatricians in the field of child
abuse is not above scrutiny. There are clear examples of
doctors having done more harm than good, despite what may
well have been good intentions as illustrated by the
excesses of the "rectal tone" paediatricians in Cleveland in
1987.

The BMJ should be seeking more balance before publishing
articles like the one from Harvey Marcovitch

sincerely

Douglas Newberry, Consultant Physician

Ashford & St. Peter's Hospital, UK
 
Messages
13,774

Some Wessely comments about Breivik, where he says:

"In psychiatry you judge people by what their beliefs are, rather than their behaviour"

He also talks about people preferring prison to a psychiatric hospital because in that later they 'try to do your head in'.

What beliefs of CFS patients justify lumping them together, and medicalising their cognitions and behaviour? He's putting forward a much more sensible view of psychiatry here than has been imposed upon patients as a result of his work. I was really surprised by him making this claim, and do not see how it can be understood in relation to his work on CFS, and thought that I'd post it here as I reminder to myself of it.

It was only a tiny clip, so he didn't really have time to say what he meant, but it seems to present a very different view of psychiatry to his norm (and rather a dualist, non-biopsychosocial one at that).
 

Desdinova

Senior Member
Messages
276
Location
USA
Wessely is a gifted orator, salesman and marketer. Thus he has learned over the years how to speak to people to convey just the message he wants them to get. As far as him presenting a professional opinion that doesn't sound bad and / or that you agree with, if you roll the dice enough times eventually it's going to come up snake-eyes/
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Just because he doesn't eat livers with faava beans,doesn't mean he's NOT an evil, skilled manipulator :alien:
They turned Lector into a raving kook in later works but in first novel/film he was far more "dangerous" because he was so calm and well mannered....
To paraphrase from an old film
"The Devil is most dangerous, when he's being the most charming" ;)
 
Messages
13,774
It could be that he see things like the belief that one has suffered from a loss of capacity which is not the result of cognitive or behavioural changes as dysfunctional. Or more important - the belief that one has suffered a loss of capacity which legitimises support from private health insurance, or social insurance systems.

When so little is known about causes of CFS, it seems that placing people in positions of authority for assessing the beliefs of patients will inevitably lead to quackery, and the imposition of the prejudices of those in positions of medical/psychiatric authority.

I get the impression that Wessely starts from really different moral assumptions to myself - and I'm deeply unhappy about the impact his assumptions have had upon my life.
 

Enid

Senior Member
Messages
3,309
Location
UK
I did appreciate your SW video Esther - the visuals and voice being out of sync - just the way I like ! Contrary to his beliefs most ME sufferers if able pursue all possibilties to try and restore health - scientific findings, treatments being used and found effective and following Internet sites like Poenix Rising where treatment regimes are shared by members. As the UK advertisement here says "he should have gone to spec savers".
 

Tito

Senior Member
Messages
300
In conclusion, the weasle is lecturing his expert opinion on a man he never talked to based on what he read in the DailyMail. Sounds like the same approach he's been using with severe ME sufferers...
 

Enid

Senior Member
Messages
3,309
Location
UK
Looks like he is dabbling with his own uncertainties - some theoretical definition of insanity. And the psychos can't agree apparently.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
He does seem like an attention seeker
I also think his ilk are at the moment trying to move away from ME/CFS and covering their arses because they know the evidence is against them and they are gonna get called up on it one day, maybe even by the Law.
ergo,they are trying to build a defence of saying:
"But oh look, we did all this other stuff too! We care! We are proffessionals with SCIENCE!"

Suuuuure they do, and I'm the pink tooth fairy named Fiona! :alien:
(or would that be "green" tooth fairy? *he says thinking of Shrek* :p)
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Hi Fiona, how are you doing? :) Its refreshing to meet someone I can believe in, after trying to come to grips with psychobabble. I see more evidence of toothfairies than most of psychobabble, so I am happy to say hello to you. I wonder if the psychobabblers even acknowledge the existence of tooth fairies? The babble they give credence to is far more outlandish. Have a nice tooth hunt, Alex
 
Messages
13,774
Has anyone read much of Wessely's brain injury stuff? It often sounds similar to his CFS stuff, but brain injury seems to get more interest and respect than CFS.

I've not read enough of Wessely's stuff in this area to say, but it does seem to have some familiar themes:

Imaginary Wessely said:
Certainly, having a brain injury is bad, but how people respond to it is the most important thing. It's really important that we stop people from seeing themselves as victims who deserve compensation from powerful people - we should be carefully managing them to adopt a more positive approach, in which they take control of their own problems.*

* My research is funded by powerful people who are responsible for the brain injury of people and don't want to pay out compensation - but they've been very good at just letting me get on with my work without interference... No, I don't know why they decided that I should lead their research in this area - perhaps because of the great success I've had with CFS, Gulf War Syndrome, etc?

I mention this because there's a new brain injury study out "Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model": http://stm.sciencemag.org/content/4/134/134ra60

Weesely commented on it with the SMC:


Simon Wessely, Professor of Epidemiological and Liaison Psychiatry at the Institute of Psychiatry, King’s College London, said:

"This study adds significantly to our knowledge about what serious or repeated concussion does to the brain. The animal work is impressive, particularly showing the importance of accelerating/decelerating injury.

"However, we need to remember that this is not the same as mild concussion. Nor is this the same as post-traumatic stress disorder, with which mild traumatic brain injury is sometimes confused.

"Finally, it cannot explain why mild traumatic brain injury/concussion seems to be more common in US than UK Forces, despite fighting the same enemy on the same terrain and, at least in recent years, sustaining the same rate of casualties."
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Because US forces aren't routinely shat on by the likes of Wessely to keep costs to the bureaucrat scum down?

Because UK military has far too much of a culture of "booze and pretend hard ass" than larger social outlets etc the US has that reinforces aspect of them still being people rather than only allow machismo stupidity
(ie UK forces will have lower tendency to report problems, because of a poor cultural system in the our miltiary than US)

US forces has better integrated veterans disability system (When it works that is!) and education system. (UK gov really regards troops as "human sandbags who cost too much money", grrr)

and,UK tends to be much more cautious, after much longer experience of dirty back alley fighting etc. (so our troops are less likely to get injured because less gung ho and more thought/experience...US is learning too, hard way, alas)

So more US folk will be seen/treated for these problems where as more UK veterans will be denied/hide it, but US will also have higher rates
 

Enid

Senior Member
Messages
3,309
Location
UK
I have reactive osteoarthritis/porosis (my Neurologist) What is this pathetic bunch of mumbo- jumbos still hovering in the wings.But the Wessley sort of hey here's our pathetic contribution still hovering around real pathology we don't understand yet. Crap, tiny minds as Freud (not scientific) and in the Uk absolutely incapable of seeing scientific findings - what is it in the established medical here in the Uk. 4 Docs in my family who would like to know too of much misleading/ignorance here in rhe UK.
 

Enid

Senior Member
Messages
3,309
Location
UK
I really do hope he finds HIMSELF stuck in the limbo for years - all his sort - gosh it is not too difficult to loathe their ignorance.
 
Messages
13,774
Just saw a new debate with Wessely:
Smart drugs: magic bullet or cheating ourselves?

http://www.worldbytes.org/smart-drugs-magic-bullet-or-cheating-ourselves/

It wasn't very good, but I thought Wessely was okay in this (although I hate the way he uses humour to ingratiate himself with an audience).

None of the speakers considered the possibility the increasing our ability to adapt our mind to our desires would increase the power of those who are already in positions of social authority, and who are able to shape the systems and structures which determine what sorts of behaviour is to be rewarded, and what preferences lauded: currently some people are compelled by their biology to behave in a stubborn and dysfunctional way, and I think that's a good thing. Increasing our ability to subvert our nature could serve to undermine the impulses which lead some to fight for social progress and change.

If we'd been able to drug black slaves in a way which left them absorbed and contented in their work, would that have been a good thing? If we have more effective drugs to help ensure that those at the bottom of society cause fewer problems for themselves and those at the top (and some psychoactive medication already seems to be used in this way) doesn't that serve to undermine some of the impetus for social justice? What if some people want to escape their distracting concerns about their own selfishness, and willingness to prioritise their desire for holidays over the needs of others for basic nutrition and shelter? I'd have been more interested if those sorts of political concerns had been considered... but these debates are normally based on a foundation of pragmatism, so wasn't expecting much.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Esther

Illuminati.jpg


while the "illuminati" is moslty a joke, you give the folk in power the ability to directly "push people's buttons" and oh boy, Stalin would have creamed his pants at such ability as "drugs to adjust attitudes", never mind our butthole leaders ;)