What are 'Psychological Processes"?

[alex3619]

Nobody doubts that our disease experience, and what we think about it, can have an impact. That was the point of the original focus of psychosomatic medicine before it got hijacked. Its an open question - we still do not know the limits of this, only that there must be limits. We have known since the 70s I think that pain medication can assist the healing of broken bones, because pain can inhibit recovery. Yet we don't know what percentage of this is basic neurobiology and what is due to how we think.

A much stronger case can be made for therapies like CBT when its on the basis of improving quality of life, and not cure. I think this absurd focus on a cure from thought modification is as much a problem for genuine CBT research as it is for research into ME.

Psychiatry needs to finally decide if it wants to be mysticism or science. This hybrid of the two is doing nobody any good.

 

[Cheesus]

Nobody doubts that our disease experience, and what we think about it, can have an impact. That was the point of the original focus of psychosomatic medicine before it got hijacked. Its an open question - we still do not know the limits of this, only that there must be limits. We have known since the 70s I think that pain medication can assist the healing of broken bones, because pain can inhibit recovery. Yet we don't know what percentage of this is basic neurobiology and what is due to how we think.

A much stronger case can be made for therapies like CBT when its on the basis of improving quality of life, and not cure. I think this absurd focus on a cure from thought modification is as much a problem for genuine CBT research as it is for research into ME.

Psychiatry needs to finally decide if it wants to be mysticism or science. This hybrid of the two is doing nobody any good.

Okay, I am down with that. I think psychology really needs to evolve into something more resembling neuropsychology. That is where the future lies.

I have always maintained that psychological interventions are an invaluable part of treatment approaches, and I have recognised in my own journey that they are very important to me personally. Time and again I see a correlation between emotional stress and symptoms. The worse the stress, the worse the symptoms. The more I am centred, the more my functional capabilities increase.

My treatment is about reducing stress inputs into the body, whether those stressors be nutritional, a result of activity, biological (viruses etc.), structural (I am thinking of Dr Perrin's work with the spine) or psychological, etc. When I reduce the stress inputs, the output is, over time, improved functioning. I suspect different stressors are important for different individuals and is largely related to the truck that initially ran you over. The truck that ran me over was my degree, an intense anxiety disorder, a suicidal girlfriend, a virus and 'candida die-off'.

I woul like to stress the distinction between this and just throwing CBT at the issue. Taking what I say here and assuming that I support the idea that ME is generated by the mind or that we shouldn't be investing heavily in biomedical research would be entirely false. We need research, we need a discipline to take ownership (preferably neurology or immunology) and we need to be taken seriously. All I am saying is that - working under the assumption that brain and mind are not seperate entities - one of my routes to treating neurological dysfunction is to treat my own faulty thought processes.

 

[lansbergen]

Nicotine can be used medicinally for some conditions.

I still need nicotine from smoking and the a7nAchR modulator. I am beginning to understand why I need both,

 

[xchocoholic]

Thanks. It's good to see an open discussion about this.

I went through natural childbirth so I can relate to how what we think or do can help us control our experiences to an extent. I never researched this to understand why it works tho.

And of course there was still pain but the feeling of having some control during this experience made it 100 times easier for me.

And my doctors since my baby was on her way out while we were headed to the delivery room. I believe the type breathing I was instructed to do to slow the birth was candle something.

I still use these breathing techniques if my pain is a 10. But they only work for a short time. Having level 10 pain for any length of time exhausts me mentally and emotionally.

Tc .. x

 

[xchocoholic]

Thanks @cmt12

So I understood your panic attack analogy. Btw more paragraphs would reduce my anxiety when trying to read this. All the letters run together if they're too close. Many of us have this visual problem.

What would suggest this person do to stop their panic attack ? In this case drugs of any kind seem like a good idea. Whatever is behind the fear of heights is ingrained.

So why not just accept your limitations in this situation and take something ?
Different situations require different approaches.

Tx .. x

 

[xchocoholic]

Hi @Cheesus

I've seen a therapist off and on since becoming ill and only recently recognized some of the coping techniques that I was taught.

Praising myself for the little accomplishments such keeping up with life, grocery shopping, etc is one of the lessons I learned.

Not beating myself up for being an airhead at times was an important lesson too. Lol.

Actively looking for fun distractions that I can do helps. Like watching movies when supine, etc.

@Gingergrrl43 may want to reply here since she's had experience with providing appropriate cbt.

I was never told to ignore my symptoms. But I think it's because my cognitive impairment is obvious to anyone trained to look for it. Stoners probably think I'm a fellow stoner. Lol.

In 2005 I was given info on food intolerances and related symptoms and instructed to listen to my body. I was surprised at how comprehensive the list of symptoms was.

Tc .. x

 

[cmt12]

Most of the validity of these approaches are, in my view, about improving disease coping. CBT used for this purpose has some grounding. When however the argument is used to try to justify disease causation, as they have done with many diseases, its complete psychobabble.

I believe all of us agree that there is a physical cause; we might just differ on where that physical cause is located or originates. It's unfortunate that there are still so many pushing a psychosomatic viewpoint.

My treatment is about reducing stress inputs into the body, whether those stressors be nutritional, a result of activity, biological (viruses etc.), structural (I am thinking of Dr Perrin's work with the spine) or psychological, etc.

Right, it's about reducing stress inputs. Well said. Self awareness techniques are just another tool to have for this purpose.

From what I know about CBT, it seems to focus mainly on thought processes but I think it's more effective to focus on feeling. Like I said before, there is a tendency with ME patients to sort of recoil in their body since we have so many symptoms.

This reaction can be subtle and it's not done intentionally, but it can cause an increased fear response, worsening symptoms, and decreased functionality over time.

I would encourage people to try to be aware of how they are reacting to stress inputs and instead focus on feeling their entire body - to not be afraid of feeling their symptoms. This will allow for a tolerance to develop.

Much like in the panic attack example, in which to reduce the fear response you have to expose yourself in a safe, grounded way - by allowing yourself to stand your ground instead of recoiling from your symptoms, they will have less of an effect on you over time.

Self awareness is the key. You have to become your own coach.

 

[xchocoholic]

Being couchbound, housebound, bedridden or supine often is an area where we might be over reacting to our symptoms. It's a tough call tho.

I've gone back and forth on this. Sure due to OI being supine feels best but I can't say that it's improved my physical or mental health. My OI never improved permanently by being supine. Just temporarily.

And being supine is boring and depressing if I'm supine too often.
I'd rather be upright, dizzy, busy and feeling like crap. Lol.

Lack of coordination would prompt the urge to stop what we're doing too but sometimes pushing thru can force our mind and body to reconnect. But if you're injuring yourself, like when using a kitchen knife, it's time to stop.

Whether to push or not is individual based on known reactions. As in I refuse to push myself if I'm feeling pre seizure. My 2 hour seizure scared the crap out of me. I always have Klonopin on hand now.

But I'll push myself to walk even if I start having back pain from walking. Walking actually relieves the pain some of the time after a few minutes.

I'll be quiet now. Tc .. x

 

[Cheesus]

My 2 hour seizure scared the crap out of me.

Wow! I can't say that I am surprised! That sounds scary as hell.

I've had what I think was a seizure. The world started flashing by in still images and I collapsed (fortunately onto my bed). I couldn't move for a while. I rang my GP's office afterwards and I could virtually hear the doctor I spoke to shrugging his shoulders.

From what I know about CBT, it seems to focus mainly on thought processes but I think it's more effective to focus on feeling. Like I said before, there is a tendency with ME patients to sort of recoil in their body since we have so many symptoms.

I've never done CBT for my ME, just for my previous anxiety disorder. The therapist I speak to sometimes now is a mindfulness based psychotherapist, so a lot of what we do is about how I relate to my emotional and physical experiences.

Also what I do with my physiotherapist is about maintaining awareness of my symptoms so I can more effectively read what my body is telling me. Symptoms = messages, and generally the message is 'stop what you're doing'.

 

[cmt12]

One more thing:

I mentioned in another thread that there are natural fluctuations with our symptoms beyond our control. So, just because we may feel worse one day, that doesn't mean it's due to the way we are reacting.

There are three things that can make us worse: these fluctuations from our condition, too much stress, and our reaction to our symptoms (which can also be classified as too much stress)

The fluctuations complicate things so much further by causing us to attribute the changes in how we feel to something we did.

 

[Cheesus]

I just posted this in another thread but I thought it might be relevant here too:

http://www.cortjohnson.org/blog/201...ain-hypersensitives-chronic-fatigue-syndrome/

 

[Gingergrrl]

Hi @@[USER=15021]Gingergrrl43 may want to reply here since she's had experience with providing appropriate cbt. [/USER]

@[USER=245]xchocoholic I have not had a chance to read this thread but can tell you my experience as a social worker/therapist using CBT techniques for patients with anxiety, depression, OCD, eating disorders, etc (again I have never used it in relation to ME/CFS and the way we practiced it in my former career before I became ill with CFS bears absolutely no similarity to what is being used in the U.K. for political reasons to deny real medical care.)

What we practiced in a group therapy setting was teaching about thought distortions and using thought records to look for evidence to track the possible distortions and replace them with more affirming thoughts to reduce feelings of distress. I will give a quick example. Let's say a person in the group feels very anxious but cannot identify the reason. In trying to identify the thought connected to the anxiety they realized that when a peer left the room, they had the thought, "She left the room b/c she does not like me." This spun into the thought, "No one likes me... and I am never going to get better and it is my fault I am sick."

When later examined it turned out the peer left the room only b/c she had to go to the bathroom and that when the person understood this, they felt relieved, and was able to identify several friends who did like them. Some of the distortions in this example are called "mind reading" "catastrophizing" "overgeneralization" etc. We all do them, every human being and they are totally normal.

However, if someone felt anxious and it was for a medical reason (they have OI or POTS and stood up too quickly and couldn't breathe) then this is NOT a distortion and not something in which CBT would have any relevance unless it helped to use a calming statement such as "I have been through this before, I stood up too fast, I can rest and re-gain my breath again, etc."

CBT as we used it in my program in the US bears no resemblance to what is used in the UK and is just one technique of many, many others. It is not for everyone and some patients loved it and others did not and it was always optional and never forced on anyone. I am not sure if this addresses @xchocoholic's question as I apologize I did not have time to read this thread yet.[/user]

 

[alex3619]

Let me give an alternative view of stress. Its not fact, its an explanatory hypothesis, like so much of this kind of thing.

We have severe energy deficits. One of the issues we have is that if we push our energy demands then we can get worse.

Stressful things can focus our attention and biologically increase our energy usage. Our brains in particular will increase energy use. This is particularly the case with adrenaline.

Calming the brain is not substantially different from pacing, which is calming the body and brain. Cognitive, physical, emotional, any kind of activity can push us too hard. In terms of recovery this might slow down repair mechanisms. Its less clear it can have any impact on the actual cause, mostly because we still do not understand the cause.

Its also about quality of life. Being calmer will assist with coping with one of the most disabling diseases around.

Stress is not magical. It still comes down to biology in the end.

 

[xchocoholic]

We're just not biologically designed to cope with the chronic psychological stressors we are typically faced with in this day and age. In treating biological illnsess - particularly something that is so closely related to the limbic system, of all things - neutralising toxic thought patterns can surely play an important role?

Hi @Cheesus

When you say toxic thought patterns are you talking about self loathing ? Or fear of pushing ourselves ? Or ?

Adjusting to being chronically ill is quite a shock for most people. But because of all the controversy and misinformation, imho adjusting to having me/cfs is even harder. Not to mention how frustrating having all these symptoms can be.

I've been disabled with ME since 1990. Back before info was available on the web. I would hope adjusting is easier now.

I briefly checked out the limbic kindling article on Cort's site and noticed that along with possible physical reasons, the author considers being an over achiever or being too helpful a problem. That pretty much describes the successful people we hear about everyday. Lol.

Fwiw my body calmed down after I eliminated toxins from my diet back in 2005. Esp gluten and stimulants. I'm experimenting with stimulants nowadays.

Tx ... x

 

[Cheesus]

Let me give an alternative view of stress. Its not fact, its an explanatory hypothesis, like so much of this kind of thing.

We have severe energy deficits. One of the issues we have is that if we push our energy demands then we can get worse.

Stressful things can focus our attention and biologically increase our energy usage. Our brains in particular will increase energy use. This is particularly the case with adrenaline.

Calming the brain is not substantially different from pacing, which is calming the body and brain. Cognitive, physical, emotional, any kind of activity can push us too hard. In terms of recovery this might slow down repair mechanisms. Its less clear it can have any impact on the actual cause, mostly because we still do not understand the cause.

Its also about quality of life. Being calmer will assist with coping with one of the most disabling diseases around.

Stress is not magical. It still comes down to biology in the end.

I would say it is relatively similar to pacing. The fact is you're very unlikely to get better if you're not pacing properly.

But I also think it could be more influential than that. If we have 'limbic encaphalitis', we must consider that the limbic system is essentially, amongst other things, the stress centre of the brain. I've no doubt that poor pacing can cause an increase in inflammation, but I would be supremely surprised if poor stress management, anxiety and negative thoughts in general did not also contribute significantly to limbic inflammation.

There is a lot of anecdotal evidence that people can get better by addressing their psychological demons. Often the retort is "well they didn't have 'real ME'". This seems like a bit of a convenient and easy means to explain away the fact that someone who was previously very sick has gotten better. It seems like an easy way to distance oneself from the potential reality of the situation. People don't like to hear that what they think can perpetuate their illness.

 

[Cheesus]

Hi @Cheesus

When you say toxic thought patterns are you talking about self loathing ? Or fear of pushing ourselves ? Or ?

Adjusting to being chronically ill is quite a shock for most people. But because of all the controversy and misinformation, imho adjusting to having me/cfs is even harder. Not to mention how frustrating having all these symptoms can be.

I've been disabled with ME since 1990. Back before info was available on the web. I would hope adjusting is easier now.

I briefly checked out the limbic kindling article on Cort's site and noticed that along with possible physical reasons, the author considers being an over achiever or being too helpful a problem. That pretty much describes the successful people we hear about everyday. Lol.

Fwiw my body calmed down after I eliminated toxins from my diet back in 2005. Esp gluten and stimulants. I'm experimenting with stimulants nowadays.

Tx ... x

Just many things that come with being human, and especially a human with a horrible chronic illness. Being self-critical; worrying about if you've overdone; worrying about whether you'll get better; worrying about whether or not you are doing the right treatments; that cruel thing you did when you were 9 years old; if you said something stupid last week. The circles the mind can run in are endless.

 

[A.B.]

Thinking can't cure or cause illness. And this all comes from observing a correlation between negative thinking and illness, and then ignoring the obvious common sense interpretation in favour of the magical interpretation. Psychobabble is the great superstition of our time. Sorry for being blunt.

 

[Cheesus]

This is where I find it fascinating. If we take it that they are equal to each other - two sides of the same coin - then is it not possible, in some instances, that thought processes which burden our neurological and thus physiological processes could theoretically prevent the body from staging its own recovery?

Did I say here that thoughts would cure physical illness? No.

I explicitly stated that it is the body doing the healing. We're suffering from a physical illness, and to recover the body would need to be healed. The only thing that can heal the body is the body. We just need to figure out what is in the way.

 

[alex3619]

There are multiple interpretations on head trauma in particular. Under the microglial theory head trauma might trigger microglial priming. However, its still physical damage causing yet more physical damage, under this model.

I know people who got neuroimmune issues after head trauma. It had nothing to do with stress.

When you go looking for substantive evidence of causation, things backed up by studies, stress appears to be largely absent, except in studies that fish for vague confirmatory correlations. Pathogens dominate. Head trauma is very much present. Organophosphate poisoning is also a big issue.

Now I do think there is some argument that stressful life events may predispose to increased risk for developing ME to a slight extent, though there are counter-arguments as well. This requires a lot more study to verify, so far its mostly speculation, but its possible. Alterations in stress hormones, the HPA axis etc., may yet turn out to play a part. Yet what is not clear is how much of this is about thoughts, and how much about biology.

Models of alternatives are only that, models. We need hard evidence, testable theories, and concrete claims. So far many of the stress claims that were made are now debunked, and by this I mean generally in medicine, not ME. Stress is important, but its been far too overhyped, and there has been too much emphasis on psychology instead of biology. We can do better. We need to do better.

 

[Cheesus]

Alex, I have no problem with what you're saying. It is rational and grounded. I would say, however, that the car accident example was only an example. I don't think it meant to impy that it was stress only arising from physical injury. You're right, more research is needed.