Invest in ME Conference 12: First Class in Every Way
OverTheHills wraps up our series of articles on this year's 12th Invest in ME International Conference (IIMEC12) in London with some reflections on her experience as a patient attending the conference for the first time.
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"The biopsychosocial approach: a note of caution" George Davey Smith (2005/2006)

Discussion in 'Other Health News and Research' started by Dolphin, Jun 26, 2015.

  1. Dolphin

    Dolphin Senior Member

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    I post this on another thread http://forums.phoenixrising.me/inde...ewcastle-13th-14th-october.36515/#post-610609 but thought it deserved highlighting in its own thread:

    George Davey Smith gave a talk at a meeting of biopsychosocialists, but it looks like what he said wasn't popular with some/many/most there.

    Maxhead (presumably the same @Maxhead that's on Twitter) posted the full chapter of Davey Smith's talk online:
    http://issuu.com/maxhead/docs/bps_caution_davey_smith

    Here's a sample summary to help use decide if you want to read it: http://www.meactionuk.org.uk/PROOF_POSITIVE.htm

     
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  2. Kati

    Kati Patient in training

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    Thank you @Dolphin it is very important as programs develop around the world.
    A 'biopsychosocial' approach to ME and related illness is just a polite way to say no testing and no medical treatment for you. Instead we will send you on an everending goose chase on how to cope, how to live, how to think and definitely how to behave. It is definitely more cost efficient for health care systems to do it this way. They introduce the concept of sustainable health care. Because they could not handle another HIV/AIDS epidemic.

    If you think I am exaggerating, I'm not. It's happening right now.

    In my opinion there is no 'good' CBT. Give patients medical treatments. As they get better, their lives will improve all by itself.
     
    Last edited: Jun 26, 2015
  3. Sasha

    Sasha Fine, thank you

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    George Davey Smith is giving a talk at the upcoming UK CMRC conference on ME in October.

    He's a leading figure in British (and international) epidemiology.
     
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  4. Sean

    Sean Senior Member

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    :)
     
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  5. duncan

    duncan Senior Member

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    I'd be curious to examine that trend list Wessely alludes to, i.e., once considered real diseases being revealed as psychiatric. Or am I simply misunderstanding his insinuation? I notice he didn't say "pantheon" or "list" when he talked about it; rather, he used "trend", which suggests (to me at least) something ongoing, as opposed to static.

    I suspect he is talking about myths and wives' tales pertaining to illnesses that have been proven - in his mind at least - to be of psychiatric origin. I wonder though, even so, how many are really psychiatric vs. simply upended superstitions.

    That's a list I'd like to see.
     
    Last edited: Jun 27, 2015
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  6. A.B.

    A.B. Senior Member

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    That diseases are mistakenly framed as psychosomatic over and over again is a sign of a systematic error. Until that error is corrected, the same mistakes will continue to be made. And I think that error is uncritically accepting the claims of psychosomatic illness, even if today we know that the initial case reports of successful treating psychosomatic disease were lies and fraud (Freud).
     
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  7. alex3619

    alex3619 Senior Member

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  8. jimells

    jimells Senior Member

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    :thumbsup:
     
  9. Bob

    Bob

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    But they're very good at observing what they want to see.
     
  10. jimells

    jimells Senior Member

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    It helps to have magic glasses to see what no one else can.
     
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  11. Snow Leopard

    Snow Leopard Hibernating

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    I broke my glasses, where can I get another pair?
     
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  12. jimells

    jimells Senior Member

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    Here we see the unholy alliance of the psychobabblers, academia, government, and insurers in the UK. I am convinced the same unholy alliance also exists in the US, with some of the same players, including psychobabblers exported from the UK (Hey! We don't want them either!) I hope to live long enough to see these connections exposed. Americans love a good scandal. There are still good investigative journalists around - I wish they'd go after this.
     
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  13. SOC

    SOC

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    Not sure I can entirely agree with this. Certainly CBT is not a treatment that will improve ME/CFS somatic symptoms, whether it is 'good' CBT or 'bad' CBT. To improve our health we need medical treatment, not psychology.

    However, some people with ME/CFS don't naturally develop the coping skills they need in order to function with a disabling chronic disease. Those people might benefit from the type of CBT that helps the patient learn to live with extremely difficult situations. There are (sometimes) ways to deal with tragedy that can help you get through it. Good CBT can help you face reality and move on with life.

    CBT makes not one iota of difference to somatic symptoms, nor does every patient need it. Plenty of patients manage to cope without therapy, just like some people cope with divorce without therapy, but others benefit from some counseling. CBT should never be considered a treatment for ME/CFS, nor should it be recommended for all patients any more than it is recommended for every cancer or MS patient.

    That said, I wouldn't put a penny of donated or government money towards 'good' CBT until we have reliable, well-accepted medical treatments available to all patients. It's a matter of priorities.

    As for BPS theories -- total BS. They have no solid evidence to support them and should be tossed into the pseudoscience trash bin.
     
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  14. jimells

    jimells Senior Member

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    I just realized the psychobabblers have built a perpetual motion machine. They are brilliant and devious:

    1. Convince public that patients are fakers.
    2. Public treats patients badly, causing much damage, including psychological.
    3. Offer patients talk therapy to cure damage caused in Step 2.
    4. Invest profits and publicity into more Step 1.
     
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  15. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Here is the exact quote:
    "You should remember that there is an opposite trend as well, which you didn't mention. You ignored the history of visceral proptosis, floating kidney, autointoxication, or focal sepsis, for example"

    This list, of course, doesn't prove his point at all.
    In order for it to be an "opposite trend", these would have to be distinct diseases presumed to be of somatic origin, which with the advance of knowledge were proved to be distinct diseases of psychosomatic origins.

    In fact these were more theories that were popular (presumed) aetiological explanations for symptoms.

    Focal sepsis might be he closest to almost fitting this model. Ironically (for Wesseley), it was psychiatrists who were pushing the theory that this was the cause of bipolar disorder and schizophrenia. Leading to some rather nasty experimenting on psychiatric patients. From Wikipedia:

    "the director of the psychiatric asylum at Trenton State Hospital since 1907 was Henry Cotton.[51] Drawing influence from the medical popularity of focal infection theory,[20]Cotton identified focal infections as the main causes of dementia praecox (now schizophrenia) and manic depression (now bipolar disorder).[51] Cotton routinely prescribed surgery to clean the nasal sinuses and to extract the tonsils and dentition.[51] Yet, seeking to clean the entire body of focal infections, Cotton frequently prescribed surgical removal of the appendix, gall bladder, spleen, stomach, colon, cervix, ovaries, testicles, and thereby claimed up to 85% cure rate.[51]"

    What makes this an especially bizarre comparison is that I don't believe ANYONE (even Wesseley?) would condone calling bipolar or schizophrenia a psychosomatic disorder. And, in fact, I would say these are the psychiatric illnesses where there is the CLEAREST evidence of an underlying biological / biochemical basis.
    So really no one was mistaking a psychosomatic disorder for a somatic one. They were just wrong about the aetiology. (Very, very wrong).

    In any case. His list holds no water. It is (at best) an illogical and intellectually dishonest argument.
     
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  16. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Last edited: Jun 29, 2015
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  17. Snow Leopard

    Snow Leopard Hibernating

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  18. Kyla

    Kyla ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ

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    Edited the post. It should work now.
     
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  19. Woolie

    Woolie Senior Member

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    I also got interested in Wessely's comment on this presentation, where he mentioned four diseases he believes were formerly thought to be "organic" and are now thought to be psychiatric (he rather cleverly uses the word psychiatric, not psychological, but he uses the example in a way that claims these illnesses are indeed now thought to be psychological in origin).

    They are:

    visceral proptosis, floating kidneys, autointoxication, focal sepsis.

    The point he was trying to make is that its not always the case that illnesses once believed to be psychological turn out to have a biological basis. The opposite can occur too.

    I did a little research into these conditions, to see what their presenting features are and what current views on them are. There is little information to be found in scientific journals on the first condition (visceral proptosis). The only places I found reference to it was when it was being listed to support arguments of Wessley himself or his coauthors (where the diseases above are often listed in the same order, almost as if copied and pasted from one article to the next).

    But I had a bit more luck on floating kidneys, where it appears the "psychological" interpretation is still in dispute:

    Barber, N. J., & Thompson, P. M. (2004). Nephroptosis and nephropexy—hung up on the past?. European urology, 46(4), 428-433. http://www.sciencedirect.com/science/article/pii/S0302283804001794

    So this example is incorrect.


    Autointoxication is not a disease in its own right, but rather an early explanation for a condition we now would probably call schizophrenia. While the autointoxication theory has gone out, most current theories of schizophrenia focus on genetics and neurobiology as the primary causal factors, not psychology at all. Schizophrenia is not generally believed to be psychogenic in origin, nor is it considered to be a psychosomatic disease.

    So this example is incorrect
    .

    Focal sepsis is also an explanation rather than a disease in its own right, and its not true to say that diseases once thought to be due to this cause are now considered to have a psychological cause. One of the diseases where focal sepsis was thought to play a causal role is in fact rheumatoid arthritis:
    http://www.sciencedirect.com/science/article/pii/0277953682901356

    So this example is incorrect.
     
    Last edited: Jul 4, 2015
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  20. Snow Leopard

    Snow Leopard Hibernating

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    Thanks for digging past the rhetoric!
     
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