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2009 Chalder slides for Medically Unexplained Symptoms Talk.

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
Examples of beliefs that can act as vulnerability factors:

4) If I put my own needs before those of others that
would mean Im not a good person

yet, these patients are given personality assessments designed for physiologically healthy and fit people, and if they indicate they don't put others' needs first, everyone is told these patients have a personality disorder (i.e. they are not good people)

warped!
 

ixchelkali

Senior Member
Messages
1,107
Location
Long Beach, CA
Immoral and egotistical. Anything which is unexplained, idiopathic, of unknown origin, must be emotionally caused. Egotistical to suggest that there are no physical illnesses with unknown pathology in the 21st century, like we know all there is to know about how the body works. The only thing left is the mind: how convenient for the psychiatrists. It reminds me of overly ambitious tomcats spraying everywhere in an attempt to claim their territory.

Immoral because it's people's lives they're messing with, sick people whom they are causing greater harm. Stifling real research, denying them treatment and care, and doing it for profit. I wonder what kind of special circle of hell Dante would design for these folks?
 

oceanblue

Guest
Messages
1,383
Location
UK
Couple of quotes jumped out at me:

example of 'aberrant' thoughts about CFS -
This fatigue is so severe, there must be something seriously wrong with my body
we patients are a very strange lot.

Recovery defined in terms of concrete behaviour, not necessarily symptom free or returning to previous lifestyle
So Trude has form when it come to novel ways of defining recovery
 
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13,774
I might pull out a couple of bits that bugged me too:

Maintaining factors - examples
Behaviours
Repeated investigations (NHS, privately or
alternative practitioners)
Repeatedly seeking external cure
Reading about symptoms e.g. medical
textbooks, internet

I'm particularly angered by this one because, for a long time, I followed it. I couldn't be bothered to spend my time reading up on stuff on my own, when I thought that, if there was any well researched and evidence based work relevant to my case, I would be informed of it by the 'experts'. Since realising that's not the case and putting some independent work in my friend's been diagnosed a separate condition and is free of the CFS label, (I've sldo found some useful information for myself) ... etc. That's a decade of their lives lost because they didn't realise the extent to which the psychosocial approach to CFS led to clinician's active disinterest in relevant medical investigations and evidence, rather than just placing quackery in the void where there was no good evidence to be used.

If we could trust those working at CFS centres in the UK to do their jobs properly then we wouldn't need to spend our time looking in to this stuff ourselves. Thanks to the pragmatic quackery promoted by Chalder etc, in which psychosocial factors can be presumed to be the cause of fatigue without the need for any good positive evidence that this is the case for a particular individual patient - we've got no choice but to be our own doctors.

If I cant keep up with my usual standards at
work, other people will think Im a failure
If I tell people I need help, theyll think Im not
up to the job
If people think Im not coping then theyll reject
me
(Such beliefs may also occur in people with other
types of unexplained physical symptoms)

Such beliefs may also occur in people with other types of explained physical symptoms... because they're often true! It really pisses me off that reasonable beliefs and responses can be so casually classed as dysfunctional or pathological by psychosocial CFS researchers. I think it's a really disgusting way to view the developments of beliefs, that totally undercuts the sort of respectful dialogue that's meant to underpin liberal democracies. I was just speaking to someone whose MUS have now been explained, and they were talking about being rejected and viewed as inferior after getting ill and being diagnosed with CFS. This isn't just some demented paranoia we've just imagined Trudie! - it's something which occurs in no small part as a result of your work.

Chalder doesn't seem to realise the extent to which her own work has meant that people with CFS are much more likely to be rejected, or seen as just 'not up to the job'. For all her twittering about an expansive and sophisticated psychosocial approach, she seems to have the most reductionist and simplistic approach to understanding how her actions have affected CFS patients.

It is a bit silly to rant like this over slides when we don't even have access to a transcript... but better out than in. Otherwise it would be claimed I'm incapable of expressing a healthy disdain for her.
 
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Messages
15,786
I read over the slides and was laughing out loud a few times. Some of it really is that ridiculous! I'm a lawyer by training, and the approach Chalder takes toward logic is the logic we learn in law school, not the logic learned in science classes - in other words, it looks like she started with a conclusion, then worked backwards to try to justify that conclusion.

I did a quick search online, and aside from some sites referring to her as "Dr Chalder", there was no indication she had earned an MD, and was mostly referred to as "Professor Chalder". One site that looked like a CV/resume only mentioned normal and mental nursing certifications. Anyone know if she's really a doctor?

I'm thinking probably not. Her general mindset seems to be that physical problems can cause mental illness, and cognitive problems can cause physical symptoms, ergo there should be no delineation between mental and physical illness. Instead of addressing mental illness with physical causes as a physical illness, her solution seems to be that physical illness with any potential mental or neurological component (as the cause OR as the effect of the physical illness) can only be addressed psychologically. Ergo making making her own "profession" more important.
 
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13,774
Hi Valentijn.

She's a nurse with a phd, not an md.

Pleased to hear you got a laugh out of it... It's the best medicine we'll get from Chalder!
 
Messages
22
Did anyone else notice how most of her references are actually authored by ... her?

The part that pissed me off more than anything is that they recommend that therapists avoid using the term "psychological" because they know it will piss patients off.
I didn't know whether to laugh or cry, but I'm glad I'm not in the UK. I really feel for those of you who have to fight the whole medical system on top of your own symptoms :( Must make living with this so much harder when the experts don't believe... how do they seriously expect anyone with this NOT to get depressed? Seriously?
 
Messages
13,774
This is off-line now. I thought I'd saved a copy, but can't find the file.

Anyone else save a copy that can be put up as an attachment? I should always attach stuff to posts as well as linking to avoid things disappearing.
 
Messages
15,786
This is off-line now. I thought I'd saved a copy, but can't find the file.

Anyone else save a copy that can be put up as an attachment? I should always attach stuff to posts as well as linking to avoid things disappearing.
I can't find one from 2009, but there's one from 2011 that has at least some of the same text.
 
Messages
13,774
Could you post that up Val? I don't think that this is a particularly valuable thread, but it's good to try to keep track of things a bit.
 

peggy-sue

Senior Member
Messages
2,623
Location
Scotland
Chalder is qualified as a nurse. She may have been given an opportunity to do a PhD., pushed froward by her superiors because her face fitted so well with what they wanted, but she didn't do a relevant degree first. The professorship is just another cooked-up honorary qualification - a chair was (convieniently) created for her.
 

N.A.Wright

Guest
Messages
106
Chalder is qualified as a nurse. She may have been given an opportunity to do a PhD., pushed froward by her superiors because her face fitted so well with what they wanted, but she didn't do a relevant degree first. The professorship is just another cooked-up honorary qualification - a chair was (convieniently) created for her.
I hope you don't mean to attack the Nursing Doctorate and allied Phds (or any doctorate awarded on course completion to a vocationally qualified Phd programme entrant) in principle. Nursing has been massively undervalued in the NHS and the development of Nursing Doctorates and also Nurse Practitioner roles are really important in terms of offering some of the most competent people in the NHS the chance to develop their careers as equal to the 'white coats'.

The awarding of professorships in UK medical schools is not exactly an open process but Chalder is as qualified as as any of her white coat peers, and the role probably demands more administrative ability than medical competence so 'honorary' probably isn't a fair description. In the end it'd be a choice between one or other psychiatrist - no reason why it shouldn't go the one with nursing background.

As SRN/SEN level nursing qualifications are now degree awarded the issue of vocational versus graduate will presumably cease to be a dichotamy in the NHS and nurses will have well defined paths into advanced learning. In general though vocational qualification as a gateway to Advanced education should be valued, insisting that everyone who does a Phd must have a lower degree before they engage with the higher degree process, can ossify research by unnecessarily narrowing the intake.
 

peggy-sue

Senior Member
Messages
2,623
Location
Scotland
No, not in the slightest am I attacking or in any way denigrating very proper qualifications.
My suspicions are with regard to nurse Chalder only.


I've worked in academia - I've seen how one student, with the right sorts of connections, face and background, can suddenly have everything fall into their laps. A technician looses their job or leaves - suddenly the student has the job, but they're not doing the job. They're getting a salary to continue their studies, and the other technicians have to take up the slack of the job loss. Grants appear from nowhere, for the right folk, with the right faces.

While it may be beneficial in some cases for somebody to be elevated to a PhD without doing a relevant degree first, I am still of the opinion that it only happens in terms of wheels within wheels, and promoting the views of a biased body.