Ester, the whole argument around the 'psychosocial' aka psychotic approach to ME revolves around several technically inaccurate and naive premises. Firstly the assumption that most people with ME become de-conditioned due to inactivity is soundly wrong. Most people with ME spend many years fighting valiantly to do as much as they possible can, those of us who are not very severely affected often retain a surprising amount of strength for our level of activity. The issue is one of stamina, however further exercise decreases that stamina - soundly debunking the 'de-conditioning model'. Secondly there is an assumption that people with ME have 'given in' or 'maintained illness belief' my personal experience of people with ME is that more than half are 'very determined to get well' Speaking personally for the first 6 years of my illness I was quite determined that I needed to 'shake myself out of this' and tried relentlessly to get myself fit and stay active. It was only when I became too ill to function and was forced to rest that I began some degree of improvement. The two founding premises of the Psychosocial approach are in short dogma and completely without scientific or technical foundation. They also show a profound lack of medical ability since the individuals presenting this claptrap are clearly NOT listening to their patients. Effective communication is the single most important medical skill - no test can match the massive volume of qualitative information available to the patient's own brain. Treating patients as though they are stupid or delusional and failing to listen them is an act of negligence that precludes correct diagnosis. The approach also confuses trivial fatigue (as caused by hard work) with the exhaustive energy deficit that occurs in ME. This model also fails to provide any solid explanation for the biochemistry behind post exertional malaise with delayed onset. It also fails to explain aspects of the disease such as Insulin resistance (in severe cases) over which the brain has no control. Further it fails to explain why this approach causes severe and sometimes permanent increases in disability. In time the psychotics stopped running the nut house and admitted they are wrong.