I would word this differently. I don't think any 'psychological component' in the way that most will understand this phrase, is part of ME/CFS. If someone develops any e.g. psychological distress as a result of living with a misunderstood chronic painful illness with little support from society etc., this is NOT part of the said chronic illness - this is a separate issue on top of the original illness that should be addressed separately (but within the context of the chronic illness). E.g. if someone develops depression or anxiety *as a result of* of living with ME/CFS, these are *not* part of ME/CFS. This does not make it *part of* ME/CFS and should not be presented as such.
I think this is very important for patients to differentiate. And patients need to understand this so as not to mislead others about their illness. If a depression/anxiety etc develops as a result of ME/CFS, then it's not part of ME/CFS. Yes, it's part of the person - the continuum etc - but a separate issue from ME/CFS.
I think that for this condition where we are faced with often competing opinions from 'experts' as to it's aetiology and possible route to treatment and testing; it is all too easy to see that any progress could be held up by our confusion (which could stem from a belief in any number of the opinions advanced).
That is to say, that for those who say we might be 'hung up' on a physical cause and a persistent 'viral' infection for example; any treatment that does not feature a drug targeting a specific physical cause will not even be tried let alone considered by the patient - and this belief will curtail any hope of improvement.
Personally, I do struggle when trying to believe that my facing and overcoming any fears I might have (and I do have them be in do doubt about that), that this will in some way lead to an overall improvement.
What I believe to be true is that my quality of life can/does improve through - basically - being able to talk with someone about my struggles and concerns and learning how better to manage my overall state of health.
I have no doubt that someone with let's say, MS, who was similarly able to do this might also benefit in terms of mental health from being able to e.g. engage in activities and take 'risks' that they had previously feared would be too much.
What is different about our condition is that nobody with MS is likely to 'recover' solely from either of these interventions.
Yes they might improve their quality of life. Feel better able to maintain a balanced existence. But until such time as our condition can be linked to a purely 'physical' origin - nobody can say that these therapies are
not capable of returning a person to a better state of health.
We cannot (generally) say that GET or CBT are unable to fix our deteriorating myelin sheath and nerve damage. Or that GET and CBT have failed to cure us of an autoimmune disease. As we legitimately might if we had MS.
That is not to say that either therapy is not used in the treatment of people with MS. It is. And similarly, were ME to be found to be an autoimmune condition - both therapies would be deemed to have a place for those that wanted to try them.
Because we are where we are and no answers have been forthcoming, these therapies remain the only recommended treatments outside of drugs prescribed for help with symptom management.