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The Relationship of Trauma and CFS (Sean Lynch, psychiatrist)

Dolphin

Senior Member
Messages
17,567
(Not a recommendation)

Free full text: http://www.omicsonline.com/open-acc...rauma-and-cfs-1522-4821-1000274.php?aid=61355

Letter to Editor
Open Access

The Relationship of Trauma and CFS
Sean P. J. Lynch*
Honorary Associate Professor, PCMD Consultant Liaison Psychiatrist, Derriford Hospital, Plymouth PL6 8DH, UK

Abstract:

Chronic fatigue syndrome is a case definition for conditions of chronic, disabling physical and mental fatigue which are not fully explained by medical or psychiatric causes (NICE, 2007). There has been much controversy over both the case definition and its management (Lynch, 1994). Some expert and patient groups have favoured other case definitions such as ME, CFIDS and believe that these may represent distinct groups with different aetiology. All of these case definitions are imperfect and may have limitations.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
'All of these case definitions are imperfect and may have limitations.'
I know squat about how med science research works or diagnostic definitions but isn't this true in many other illnesses. That the case definitions are imperfect and have limitations? So what is he really trying to suggest here?
 

Dolphin

Senior Member
Messages
17,567
I only skimmed the full text but my impression is the abstract is odd and doesn't get across the main points he is making.
 

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
It has long been known that preceding childhood adversity and traumatic events can be a loading for later psychiatric disorder (Brown & Anderson, 1991) so it is perhaps unsurprising that attention has focussed on their role in conditions of uncertain aetiology such as fibromyalgia, irritable bowel syndrome and, chronic fatigue syndrome

"that attention has focussed " — in other words, *WE* in the psychiatric profession have focussed on these things in relation to FM, IBS and CFS because we've already decided that these are "psychiatric disorders" (we're not sure why, we just have)

Basically, he seems to be saying that CBT and GET don't work for everybody. No, some people need therapy for childhood trauma, too.

Deep sigh. Move on.

Do these people read anything that isn't it psychiatric journals?
 

Jonathan Edwards

"Gibberish"
Messages
5,256

Perhaps the most salient feature of this publication is that it is a letter to the editor in the International Journal of Emergency Mental Health and Human Resilience. The function of such a format is to provide, once you have had your piece rejected by the first five journals you have submitted to and then even by the above journal as a full paper, a slightly less prominent alternative to pasting the text in the window of Polly's Teashop alongside the adverts for never used rowing machines and cleaning ladies from Russia who provide other services if required.

But beware! It also serves to expose yourself to the psychosocial analysis of the psychiatric profession by people worried about the mental health of said profession. It is a good thing that people are worried about this, although I am not sure we have any treatment yet.
 

whodathunkit

Senior Member
Messages
1,160
This may not be popular, but I think it's entirely possible that a shock or trauma can precipitate biological changes that could leave someone predisposed to have a fatigue or mitochondrial illness. But if it does, it does so physiologically. It's not about the psychological, except that the psychological is merely the manifestation of the physical, anyway. We know, for example, that shock or trauma can affect the balance of gut flora, which can affect both immune and mental function. Immune function seems to play a role in ME/CFS. Etc.

I haven't read the article...just something I've been thinking about lately.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
In other words, if the CBT/GET didn't work, it's because a "trauma-focussed intervention" wasn't used first. That's what I got from reading the article. What a load of
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In the UK the NICE clinical guidelines for the treatment of CFS (NICE, 2007) support the use of cognitive behaviour therapy (CBT) and graded exercise therapy (GET), based on the existing evidence from randomised controlled trials. However, a substantial proportion of patients do not benefit from these interventions. Bearing in mind what has been found about the inter-relationship between a history of childhood adversity and fulfilling the case definition of CFS/ME it is perhaps unsurprising that not all patients may show treatment response to CBT and GET. This may reflect the complexity of the disorder, or the acceptability of these interventions to patients and their beliefs about illness causation. For example, some patients with CFS have a history of childhood adversity or trauma and the CBT and GET interventions suggested are not specifically trauma focussed as would be therapies such as EMDR or trauma-focussed CBT which are treatments supported by NICE in PTSD (NICE, 2005).

Future research may need to consider whether patients with CFS and a possible trauma history differ from CFS patients without this history in terms of their outcome and in their response to CBT, GET and other interventions. Modification of treatment programmes to include sequential treatment approaches trauma focussed interventions (possibly before use of GET or CBT) or modifying existing treatment programmes to add this focus may be an important and fruitful area to study.
 

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
This may not be popular, but I think it's entirely possible that a shock or trauma can precipitate biological changes that could leave someone predisposed to have a fatigue or mitochondrial illness. But if it does, it does so physiologically. It's not about the psychological, except that the psychological is merely the manifestation of the physical, anyway. We know, for example, that shock or trauma can affect the balance of gut flora, which can affect both immune and mental function. Immune function seems to play a role in ME/CFS. Etc.

I haven't read the article...just something I've been thinking about lately.

Even if you buy that shock or trauma can cause damage to mitochondria or whatnot in some subset of people, its a massive leap from there to the conclusion that talk therapy will magically reverse these physiological changes.
The thesis of this letter is that "trauma-focussed CBT" is a treatment for "CFS".


Bearing in mind what has been found about the inter-relationship between a history of childhood adversity and fulfilling the case definition of CFS/ME it is perhaps unsurprising that not all patients may show treatment response to CBT and GET

Modification of treatment programmes to include sequential treatment approaches trauma focussed interventions (possibly before use of GET or CBT) or modifying existing treatment programmes to add this focus may be an important and fruitful area to study.
 

Vic

Messages
137
This may not be popular, but I think it's entirely possible that a shock or trauma can precipitate biological changes that could leave someone predisposed to have a fatigue or mitochondrial illness. But if it does, it does so physiologically. It's not about the psychological, except that the psychological is merely the manifestation of the physical, anyway. We know, for example, that shock or trauma can affect the balance of gut flora, which can affect both immune and mental function. Immune function seems to play a role in ME/CFS. Etc.

I haven't read the article...just something I've been thinking about lately.
Exactly.
 
Messages
3,263
whoadthunkit said:
We know, for example, that shock or trauma can affect the balance of gut flora, which can affect both immune and mental function.
Actually, we know very little about these things because the quality of the psychological research out there is so poor: so riddled with confounds and so open to misinterpretation.

A lot of these so-called relationships between trauma and biomedical illness may turn out to be suprious when psyc research is finally held to the same standards as biomed research.
 
Messages
15,786
A lot of these so-called relationships between trauma and biomedical illness may turn out to be suprious when psyc research is finally held to the same standards as biomed research.
The trauma theories are already disproven by larger, more rigorous, prospective studies. But those don't support the author's viewpoints, so he ignores them :)
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
Why is inflicting trauma, neglect and abuse on adult CFS patients seen by some in the psychiatric profession as a legitimate way to help those patients deal with the effects of any trauma, neglect and abuse they may have suffered in the past?

What I really don't get is that even if the causes of CFS were psychosomatic, since when did bullying become an acceptable treatment? That's all the BPS brigade has to offer - force the patient to do things that make them feel worse, invalidate everything a patient says, lie to them, do what you can to get their benefits cut, lock them away. Even if psychosomatic illness was a thing, where's the compassion? They seem driven by a sociopathic hatred of ill people.
 

Aurator

Senior Member
Messages
625
You can read more about Sean Lynch here:
http://www.omicsonline.com/editor-biography/sean_p_j_lynch/
He was the man largely responsible for developing the Leeds CFS service, which has been the subject of disapproving scrutiny on our forum in the past.

I'm tempted to pull his writing to pieces, but knowing where to start would be a problem. Instead I'll content myself with saying that a few minutes ago I accidentally trod on a spider in my house and killed it, and I instantly reflected how, whilst it was alive, the spider was probably more helpful to me than Sean Lynch is, and possibly also had a better brain.
 

Countrygirl

Senior Member
Messages
5,429
Location
UK
Why is inflicting trauma, neglect and abuse on adult CFS patients seen by some in the psychiatric profession as a legitimate way to help those patients deal with the effects of any trauma, neglect and abuse they may have suffered in the past?

A number of this doctor's patients have phoned me.....................some frequently. Most, if not all, who have contacted me have found attending his clinic to be both a frustrating and distressing experience. Sadly, some who describe what appears to be a clear-cut diagnosis of ME have been sectioned and locked away for months. They are forcibly administered antipsychotics and when they don't respond are labeled 'treatment resistant'. There are two cases ongoing to my knowledge now. One person I know is living in fear of being sectioned again after her health worsened considerably following being locked away and given antipsychotics.

Dr SL has recently moved down to Plymouth, but his legacy lives on.

A number who have spoken to me, in my opinion, clearly do not have the illness, yet the clinic labels them with CFS which they inform them is the same as ME. I have formed the impression that the clinic believes that ME is just chronic fatigue with attitude and when they are faced with a genuine ME patient they don't recognise it and regard the patient as delusional and in need of antipsychotics.

I phoned the clinic and was informed by the member of staff who answered the phone that 'CFS' and therefore ME in their opinion is a mental health problem. (I don't know the member of staff's status)

Most I know with ME in the county avoid this clinic and wisely so.
 

Sidereal

Senior Member
Messages
4,856
This may not be popular, but I think it's entirely possible that a shock or trauma can precipitate biological changes that could leave someone predisposed to have a fatigue or mitochondrial illness. But if it does, it does so physiologically. It's not about the psychological, except that the psychological is merely the manifestation of the physical, anyway. We know, for example, that shock or trauma can affect the balance of gut flora, which can affect both immune and mental function. Immune function seems to play a role in ME/CFS. Etc.

I haven't read the article...just something I've been thinking about lately.

The thing about childhood abuse / trauma is that we also have to take into account the fact that insane people are more likely to abuse and traumatise their children than normal people. In addition to abuse these people also pass on their genes to the child and, in the case of mothers, their microbiome during delivery so what on its surface looks like a psychological factor in disease causation may actually be genetic or infectious.
 

SOC

Senior Member
Messages
7,849
Do these people read anything that isn't it psychiatric journals?
I doubt it. Psychiatry/psychology is a very incestuous field. Many practitioners only interact with each other and in that way convince themselves that their sick way of thinking is perfectly healthy and normal.

Let me be clear that I believe there are some brilliant, caring, amazing people working in psycholgy-based fields. I've known some of them. These are intelligent people who can think for themselves, think critically, and have a deep desire to help other people. Unfortunately, there are far, far too many of the other kind -- those who were attracted to the power psychologists wield over the weak and fragile and have none of the necessary intelligence and compassion that make good psychologists (and psychiatrists).
 

SOC

Senior Member
Messages
7,849
In other words, if the CBT/GET didn't work, it's because a "trauma-focussed intervention" wasn't used first.
What is it with these people? They start with the assumption that CBT/GET must work, as if it is an established physical reality like the speed of light in a vacuum. When CBT/GET doesn't work, they don't conclude that it doesn't work, which is the obvious conclusion; they look for reasons why it didn't work as if it's efficacy is indisputable. o_O Occam's Razor would seem to apply here. CBT/GET didn't work because.... wait for it... IT DOESN'T WORK. It's an ineffective treatment. That's why it doesn't work, people.

No, they have to go looking for even more ways in which we are mentally unstable in order to explain why their
"perfect" treatment didn't work. So not only do we over-react to minor health issues, have false beliefs about our health, and have an irrational fear of exercise, we must also be dealing with unresolved childhood trauma. All this to explain what is more readily explained by the hypothesis that we have an as-yet-poorly-understood disease.
 
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Denise

Senior Member
Messages
1,095
What is it with these people? They start with the assumption that CBT/GET must work, as if it is an established physical reality like the speed of light in a vacuum. ....

No, they have to go looking for even more ways in which we are mentally unstable in order to explain why their
"perfect" treatment didn't work. So not only do we over-react to minor health issues, have false beliefs about our health, and have an irrational fear of exercise, we must also be dealing with unresolved childhood trauma. All this to explain what is more readily explained by the hypothesis that we have an as-yet-poorly-understood disease.


And since childhood trauma is not clearly defined, it could be said that "everyone" has had some sort of childhood trauma. (Anything from a skinned knee, rebuf by your first crush, that time when your parent had to take your sibling to the doctor and therefore you had to miss a birthday party....)

And another grumble
It feels as though childhood trauma is considered a much more serious factor in this disease than in others.
 

SOC

Senior Member
Messages
7,849
And since childhood trauma is not clearly defined, it could be said that "everyone" has had some sort of childhood trauma. (Anything from a skinned knee, rebuf by your first crush, that time when your parent had to take your sibling to the doctor and therefore you had to miss a birthday party....)
Yes, it's more of their sociopathic manipulative game. By selecting "childhood trauma" as a cause and then defining "childhood trauma" as any number of normal childhood experiences, they can classify any of us as having had childhood trauma which they then use to explain our adult illness. :rolleyes: It's a very sick and distorted way of thinking.