I really agree that testing interventions like CBT is nothing like testing a chemical in a lab.
Anything based on mental states and social interactions is inherently difficult to draw conclusions from, because the statistics assumption of a "homogeneous population" is clearly not satisfied (and samples are seldom truly random anyway!).
But what you wrote sounds like a possible misunderstanding of CBT as being the same as "talk therapy" so I thought I would add my 2 cents about it.
I have NO expertise other than a good Psych 101 course back in college, and especially reading "Feeling Good: The New Mood Therapy" by David D. Burns (I consider it my "bible" on CBT as self-help), but I understand it as helping a person identify the mental/logical errors that are making them feel depressed, anxious, stressed, etc. (there are approximately 10 common ones) and addressing each one by finding rational responses to the negative automatic thoughts.
I think it can help people to LIVE with their CFS/FMS etc. but since they are real, *physical* illnesses / handicaps with no known cure (or at least no widely accepted or universally applicable one) -- cognitive therapy can at best help people function a little better while living with it.
That can which actually be a huge benefit. But the therapist and patient have to both understand and accept that the condition and symptoms themselves are "real" and not curable, UNLIKE the way that physical symptoms that go with textbook depression can disappear with a change in thought patterns (or sometimes with a pill).
Otherwise, I would imagine people get *worse* if they're repeated told that their symptoms are *caused* by their own psychology, and if they only thought differently and maybe went out for a good run (!) they would get over it.
I think that's why there is so much controversy about CBT and graded exercise therapy: if applied incorrectly, patients are encouraged to push themselves way too hard and they simply crash, sometimes over and over - getting worse each time!
On the other hand, if applied correctly, they can in many cases improve quality of life...to a degree.
Over time, hopefully professionals everywhere will come to accept the limits of what is and can be known about these chronic conditions experienced by unique individuals who are probably the best experts on our OWN minds and bodies, and treat us with the dignity and respect we deserve - as well as a huge dose of humility about what their area of speciality can and cannot reliably accomplish.
Someday maybe we'll crack a code and medicine will be a science. It's still very much an art, whether most doctors and therapists believe it or not.
I hope I'm not just stating the obvious or repeating what many already know.
I've been reading posts here (mainly on methylation and the "Freddd protocol") for years without posting and recently decided to jump in and see what happens.
Cheers!
No signature yet: I'm diagnosed with CFS and fibromyalgia, anxiety, depression, hypothyroidism, low-functioning adrenals (not Addisons -- diagnosed by an "enlightened" integrative/holistic physician), IBS-D, low-normal testosterone, occasional "brain fog"...and many other bothersome symptoms that keep me at home most of the time. Many of these things have improved with various supplements and medications. High-dose vitamins geared toward supporting methylation seem to have helped the most. CBT performed on my self also helps me get through the bad days and take advantage of the occasional good days (more like "good few hours")--while pacing myself is key to avoiding too much post-exertional malaise and "crashes" the next day.