Academic GPs will hear this biopsychosocial talk tomorrow....

[JamBob]

Just saw this on twitter - academic GPs are having a big conference in Oxford and tomorrow they will get a talk on MUS - the presenter writes a blog about the talk using CFS/ME as an example of MUS.

http://cmajblogs.com/supporting-people-with-medically-unexplained-syndromes/

I posted a comment citing the Rituximab trials and asking if she will mention Rituximab in her talk but it is in moderation and I bet it won't be allowed.

 

[Scarecrow]

Moss-Morris

 

[A.B.]

"Supporting people with medically unexplained symptoms" is an euphemism for "how to pretend to help patients while acting against their interests".

ie. explaining the symptoms as psychosomatic disease: a way to get the patient to stop looking for answers.

The idea that medical investigation makes the imaginary disease worse: a convenient justification to deny lab tests and referrals to patients.

CBT as treatment: a convenient way to put the responsibility for getting better entirely on the patient (and not the healthcare system), and to then stop offering any further help when the patient fails to get better (citing presumed lack of motivation on the part of the patient).

Framing it as mental disorder: a way to limit payments for the insurance industry (many will cut off payments to patients after 2 years if the patient's problem is considered a mental disorder).

Getting the patient to stop thinking about the disease and pretending that everything is just fine: of course they don't want anyone to think that there any problems with the current system.

PS: doctors might not even realize what's going on and are misled into believing that they're doing the best for their patients by following BPS advice.

 

[Valentijn]

I like how the central concern is the amount of money that patients with "unexplained" illnesses cost society. Naturally the solution is to find a nice hole to bury us in.

 

[Scarecrow]

A thread from last July:

http://forums.phoenixrising.me/inde...tional-symptoms-postive-practice-guide.31581/

 

[Cheshire]

Supporting People with Medically Unexplained Syndromes
This title is just a bad joke.


I'm getting more and more upset and angry at these people supposedly helping us from the deep of their heart, for our own good who in reality just undermines what is so important when dealing with such a disease: self-confidence.


Just left a comment (I'm pretty sure it will never be published, what can be learnt from a self-deceiving psychiatric case?)

Is Ms Moss-Morris aware of the Rituximab trials held in Norway?

These trials suggest that ME/CFS is a not yet fully explained organic disease, as once were MS, peptic ulcers and numerous others.

Did Ms Moss-Morris read the IOM report that clearly states that ME/CFS is a severe organic disease, whose major objectivable symptom is post exertional malaise?

I would be really pleased if Ms Moss-Morris addressed these issues during her talk.

If ME/CFS turns to be the organic disease that more and more think it is, the "treatment" recommended by Ms Moss-Morris (convince people to think they are not sick, that they should ignore their symptoms, that they have a responsibility in their illness) will appear in its crude brutality.

(hope my grammar is not too awful...)

These people need to start answering some questions.

 

[Valentijn]

The comments by @JamBob and @Cheshire are both visible on the blog now

 

[alex3619]

Framing it as mental disorder: a way to limit payments for the insurance industry (many will cut off payments to patients after 2 years if the patient's problem is considered a mental disorder).

One of the reasons mental disorders have limited insurance is that insurance companies are not convinced they really exist. Ooops. ME currently has objectively verifiable severe pathophysiology. One might argue the diagnostic label is flawed, but its ill informed at best to argue there is no objective pathophysiology in most patients.

 

[JamBob]

The comments by @JamBob and @Cheshire are both visible on the blog now

Oh that's a surprise - I didn't think they'd publish dissenting voices! Unfortunately I didn't realise that the author is a psychologist (I assumed she was a doctor) when I commented but I think the principle remains - it's a duty of all health care professionals to be up to date.

 

[Aurator]

This bit grabbed my attention:

"A previous high level athlete and school teacher, he was experiencing overwhelming and disabling fatigue. So there I was, new kid on the block in a strange country, faced with a condition I had never heard off (sic) and a very distressed patient. Still to this day I regret the fact that I wasn’t much help to Mr X. I subsequently learned that he more than likely had CFS/ME and so began my research career. 25 years later I am confident that if I knew then what I know now – I could have made a difference to this patient."

What difference does she think she could have made exactly?

It's very telling that just as in the "Rachel" chapter of "It's all in Your Head", where O'Sullivan abandons her narrative with her patient completely uncured, whilst apparently hoping she has convinced the reader that just a bit more CBT would have done the trick, Moss-Morris does a similar thing in claiming she could have made a difference to this athlete. When she has so safely positioned herself at a remove of a quarter of a century from the patient, how can we ever disprove her claim?

Not content with holding to psychogenic theories that are completely untestable, these "doctors" can't show us a single real example of a seriously ill ME/CFS patient who has been cured by their brand of therapy. And yet they expect people to take their claptrap seriously.

They need psychiatric help, these doctors, more assuredly than most of the people they claim to be able to help and whose illness they recklessly claim to understand.

 

[A.B.]

It's very telling that just as in the "Rachel" chapter of "It's all in Your Head", where O'Sullivan abandons her narrative with her patient completely uncured, whilst apparently hoping she has convinced the reader that just a bit more CBT would have done the trick

Per Fink's patient testimonies are pretty much the same. The patients write how wonderful it is to know the name and cause of their illness and to be finally taken seriously . The patients are still experiencing the same symptoms but are positive that they'll soon see improvement (which suggests they haven't done therapy long enough to realize it's not working).

 

[Cheshire]

This bit grabbed my attention:
Not content with holding to psychogenic theories that are completely untestable, these "doctors" can't or won't show us a single real example of a seriously ill ME/CFS patient who has been cured by their brand of therapy. And yet they expect people to take their claptrap seriously.

It reminds me of a video where T Chalder was talking about two cured "cfs" patients (sorry I don't have the link and my brain's too slow to search)

The first one was a young girl with a weekly schedule full to the top. No reduction of activity, so I don't know how she could have fulfilled any CFS criteria.

The second one was a young woman that suddenly withdrew from her CBT sessions, and came back weeks later, miraculously cured of her tiredness after she quit her boyfriend, something she had never talked about with Trudy. So I don't know how it could be taken as a proof that CBT healed her.

So two off topic cases...

 

[MeSci]

This bit grabbed my attention:

"A previous high level athlete and school teacher, he was experiencing overwhelming and disabling fatigue. So there I was, new kid on the block in a strange country, faced with a condition I had never heard off (sic) and a very distressed patient. Still to this day I regret the fact that I wasn’t much help to Mr X. I subsequently learned that he more than likely had CFS/ME and so began my research career. 25 years later I am confident that if I knew then what I know now – I could have made a difference to this patient."

What difference does she think she could have made exactly?

It's very telling that just as in the "Rachel" chapter of "It's all in Your Head", where O'Sullivan abandons her narrative with her patient completely uncured, whilst apparently hoping she has convinced the reader that just a bit more CBT would have done the trick, Moss-Morris does a similar thing in claiming she could have made a difference to this athlete. When she has so safely positioned herself at a remove of a quarter of a century from the patient, how can we ever disprove her claim?

Not content with holding to psychogenic theories that are completely untestable, these "doctors" can't show us a single real example of a seriously ill ME/CFS patient who has been cured by their brand of therapy. And yet they expect people to take their claptrap seriously.

They need psychiatric help, these doctors, more assuredly than most of the people they claim to be able to help and whose illness they recklessly claim to understand.

We must show kindness and sympathy to these deluded psychs, who are suffering from Persistent Ignorance of Science Syndrome (oh dear - that's a bit of a mouthful - must think of an abbreviation...).

I am fairly sure that it is infectious, as when sufferers come into contact with other psychs they seem vulnerable to acquiring it, and even some patients do as well.

As someone who studied psychology for a year at Bachelor level I am an expert.

 

[MeSci]

Per Fink's patient testimonies are pretty much the same. The patients write how wonderful it is to know the name and cause of their illness and to be finally taken seriously . The patients are still experiencing the same symptoms but are positive that they'll soon see improvement (which suggests they haven't done therapy long enough to realize it's not working).

I don't think Karina Hansen is grateful, is she? This post of yours puts that rather well.

 

[Never Give Up]

CFS/ME is one of many conditions falling under the broader umbrella term 'Medically Unexplained Syndromes' or MUS...If you are a practising GP in the UK, recent estimates suggests that these patients are around 18% of your caseload.

Hmmm, sounds like a very large number of underserved patients. If GET/CBT were working wouldn't this number be much, much smaller?

The blog has 5 great comments now, the only comments, and probably all from you. I hope they give her pause for thought that the lack of a medical explaination does not validate a psychological diagnosis, and that she might want to read some contemporary research on ME lest she soon find herself on the losing side of this judgment game.

 

[SOC]

I hope they give her pause for thought that the lack of a medical explaination does not validate a psychological diagnosis, and that she might want to read some contemporary research on ME lest she soon find herself on the losing side of this judgment game.

Hah!

People have been pointing out the logical fallacy of assuming the absence of evidence is evidence of absence for decades. The psychosomatic school has been ignoring them for decades. They are practiced self-deluders and completely arrogant in their belief that they know better than everyone else and logic does not have to apply to their belief system.

 

[Never Give Up]

Hah!

People have been pointing out the logical fallacy of assuming the absence of evidence is evidence of absence for decades. The psychosomatic school has been ignoring them for decades. They are practiced self-deluders and completely arrogant in their belief that they know better than everyone else and logic does not have to apply to their belief system.

I think she will just spin the comments to "prove" her paradigm, and when the contrary biological proof actually arises she will say that it is merely one part of her BPS trinity, and thank Freud that she is there to help with the heavy lifting of the most important 2/3 of her trinity.

But, I can hope that she is capable of rational evaluation and has a concience.

Hey, the whole crew could still make a living off of treating the PTSD that their cruel and twisted "false health beliefs" inflicted upon the 18%.

 

[JamBob]

This (from twitter) is an example of the kind of thing she was saying in the talk, which happened this morning:

"Risk factors for MUS incl. childhood trauma, perfectionism, acquired autonomic nervous system changes due to long-standing stress #sapcasm"

Really annoying as it just presents a false view. What evidence does she have to say that the autonomic nervous system changes are due to stress rather than say autoimmunity?

From the twitter response - the GPs are all lapping it up uncritically.

 

[Scarecrow]

Risk factors for MUS incl. childhood trauma, perfectionism, acquired autonomic nervous system changes due to long-standing stress

Blah, blah, blah

 

[jimells]

They are practiced self-deluders and completely arrogant in their belief that they know better than everyone else and logic does not have to apply to their belief system.

Hmmm, sounds like the very definition of religious fundamentalism. A former insane asylum would be the perfect location for their monastery, where they can practice their religion in peace.