Would this help anyone with media responses to Dr White?

[Tilney]

Ciba Foundation Symposium 173 Chronic Fatigue Syndrome 12-14 May 1992

ISBN 0-471-93618-9

Page 310 Discussion – Non-pharmacological treatment

White: On this theme of treating the physical and the psychological factors together, Silas Weil Mitchell was probably the most successful doctor ever in treating this condition (Mitchell 1904). Apart from dietary requirements, that Norma Ware has mentioned, he was also very keen on massage; and his masseurs, if you read his work, were also very interested in talking to the patients. I wonder if Michael Sharpe believes that what he is doing is dealing with one part of the multidimensional problem, the psychological aspect, but missing out the on the physical aspects? Do you think a successful treatment would be one that combined the physical and the psychological sides together? It might include graded exercise therapy from David McCluskey, plus cognitive or dynamic psychotherapy at the same time.

Sharpe: I tend to agree with you on this. The model of illness we employ includes physiological, psychological and interpersonal dimensions; while we aim to change all of these, we focus our intervention on individual psychotherapy. The patients do carry out their own programme of physical therapy and we often see them with their partner. However, I think there would be a case for evaluating a programme that explicitly intervened simultaneously in physiological, psychological and interpersonal realms, although the results may be more difficult to interpret.

-reference page 317
Mitchell SW 1904 The evolution of the rest treatment. J Ment Dis 31:368-373


P. D. White Department of Psychological Medicine, Bartholomew’s Hospital, London EC1A 7EB, UK


M. C. Sharpe Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX UK

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A couple of points Tilney would like to include in this post-

When White refers to David McCluskey I believe he should have said Michael Sharpe as -

I cannot see any reference to David McCluskey saying or recommending graded exercise therapy. David McCluskey was talking about Pharmacological approaches to the therapy of chronic fatigue syndrome (drugs) pages 280- 287 Discussion pages 287-297

– I believe he is be referring to Michael Sharpe talking about Non-pharmacological approaches to treatment (this is all about CBT) pages 298-308 Discussion pages 308-317

To the best of my knowledge the chap Dr White refers to as "probably the most successful doctor ever in treating this condition" was

Silas Weir Mitchell (February 15, 1829 – January 4, 1914)

 

[trishrhymes]

I'm not sure what we can do with something written over 20 years ago. Though it does indicate they were making it up as they went along, and assuming even then that all 'fatigue' could be lumped together and treated by psychiatrists.

I've just looked up Silas Weir Mitchell - the treatment White seems to be referring to is Mitchell's prescription of 6 months bed rest without any stimulus - the rest cure - for 'neurasthenia' in women 100 years ago.

Interesting I guess that White seems to be saying this rest cure was the most successful treatment he knew of, then he went on and recommended the opposite - graded exercise! And even then he was assuming CFS and neurasthenia are the same thing.

It is kind of fascinating in a car crash sort of way to see how White and Sharpe thought it appropriate to build their theories together without any scientific foundation, just what sounded good to them. These are not scientists.

They were making it up as he went along, preferring to pick the bits they liked from an untested 100 year old treatment, and other people's psychiatric treatments they'd heard about, to learning anything about the clear medical evidence available at the time, for example Melvin Ramsay's book on the Royal Free Outbreak which refuted the psychiatric theory.

So they've learned nothing in 20 years. How very unsurprising.

 

[trishrhymes]

I've been pondering the 'neurasthenia' diagnosis of 100 and more years ago, and guessing it was a catch-all for any condition, particularly in women, that caused them to feel fatigued and unwell. This could include physical illnesses that weren't diagnosable at the time, like autoimmune, neurological and endocrine disorders, eg, ME, MS, Lupus etc, as well as anaemia, frequent pregnancies, depression, stress, anxiety, the need to retreat from abusive husbands etc.

There is no excuse now for the dreadful incompetence of psychiatrists continuing to lump together the remaining physical illnesses like ME that as yet have no bio-marker into their umbrella diagnoses like MUS (medically unexplained symptoms), PPS (persistent physical symptoms), Oxford criteria CFS, etc.

How can we make them understand that lack of evidence (of a bio-marker proving physical disease) is not the same as evidence of lack (of physical disease).

Sorry, you're the wrong audience for this - you know it all already. Just venting. 3 hours sleep last night.

 

[trishrhymes]

Interesting I guess that White seems to be saying this rest cure was the most successful treatment he knew of, then he went on and recommended the opposite - graded exercise!

The more I think about it, the more I find it not just interesting but astonishing! How stupid can he be - in one breath saying the man who recommended extended bed rest as developing the most successful treatment he knows of, and in the next he's suggesting graded exercise therapy.

Perhaps he was suffering from brain fog.

Or perhaps I am. Time to stop rambling. Apologies.

 

[Asa]

"Apart from dietary requirements, that Norma Ware has mentioned, he was also very keen on massage; and his masseurs, if you read his work, were also very interested in talking to the patients."

Recalled the following post on the success of physician-administered, orgasm-inducing "pelvic massage." Is this what White is referring too?? Orgasm(s) and talking afterwards? LOL.

http://forums.phoenixrising.me/inde...ychological-medicine.41828/page-4#post-676633

 

[JohnCB]

There is a sample where you can read the first 37 pages of this book. This includes a list of the papers presented, the list of participants, the introduction and the first paper and prt of the second. Even this limited sample would be interesting as part of the history of our illness.

http://samples.sainsburysebooks.co.uk/9780470514399_sample_384738.pdf