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For those who attend the UK's Fatigue Clinics: what your therapist is told/believes

Valentijn

Senior Member
Messages
15,786
And when hundreds of thousands of sufferers say "tried that, didn't work", what kind of arrogance does it take to ignore that feedback from the patients and plough on with the same shit regardless?
Arrogance or some form of insanity. Abusers who start out inadvertently might get trapped in a cycle of denial of reality which results in more abuse. People want to (and almost always do) see themselves as good. Admitting that CBT/GET does harm, and that they've harmed people with it, requires seeing something bad or flawed in themselves.

Hence they'll feel a need to protect their self-image by creating a justification for their actions. So the patient is then wrong - they're crazy, or lazy, or excessively negative. Then the CBT/GET and the therapist can be right and good again.

And then there's the ones who do it to advance their careers at any cost.
 

Chrisb

Senior Member
Messages
1,051
So the patient is then wrong-they're crazy, or lazy, or excessively negative

I may have been crazy, but I don't think I was lazy or negative. After a few months, convinced that it was only a matter of time to recovery, I remember racking up the phone bills in the middle of the night, trying to contact a man in DC to get the number of a man in Canada, whom I had met in West Virginia, to ask if I could join his caving expedition to Mexico. Fortunately he was away. I would probably have died.

This is why I may sometimes seem rather cross at being lectured by people who seem to know nothing and even less willing to learn.
 

Skippa

Anti-BS
Messages
841
Grrrr, I went because it was the only treatment EVER offered to me for "shrug, maybe you don't warm down properly", erm, I mean ME (oh, alright, they insisted it was CFS and ME doesn't exist).

They are so full of shit.

You don't improve "you didn't push yourself enough"

You get PEM "you pushed yourself too much".

Sickening, they parrot this mantra to a room full of people over and over, we're all glancing at each other with rolley eyes.

There were pictures of a caveman to demostrate "fight, flight or freeze" - and we are all just freezing with anxiety.

Vacuuming your house hurts your back and brings on PEM? Real quote: "perhaps it's not as enjoyable as other activities, I can't imagine anyone enjoys doing it" wink wink.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
The psycho social club are bent on establishing a cushy existence for themselves with as many benefits as possible for the least amount of effort, and have no morals about achieving that role and maintaining it. So why does this bunch of lazy freeloaders hate us so much?

According to Freud and Jung, you hate in others what you hate about yourself. They find it impossible to accept that everyone else isn't playing their game, so when they see us adopting the sick role to accrue it's benefits, financial and otherwise, the best way to deal with us is to withdraw those benefits and give us a hearty kick up the arse with all the venom they can muster. The prospect of anyone playing their game and getting away with it is like a red rag to a bully.

They've even made up some shit about it:

Parsons was a functionalist sociologist, who argued that being sick means that the sufferer enters a role of 'sanctioned deviance'. This is because, from a functionalist perspective, a sick individual is not a productive member of society. Therefore this deviance needs to be policed, which is the role of the medical profession. Genuinely, Parsons argued that the best way to understand illness sociologically is to view it as a form of deviance which disturbs the social function of the society.

https://en.wikipedia.org/wiki/Sick_role

Psychology - anyone can do it :). Now how do I get published, can't be that difficult ....
 
Messages
14
If I may put a different slant on this topic. Whilst I totally agree with all the members above comments, I think there is some positives to be taken from these clinics.

After having a serious relapse around 7 years ago my doctor suggested I could attend a clinic that ran one afternoon a week for about 8 weeks. Bewildered by the catastrophic change in my health I pushed myself to attend. What it did give me was more of an insight into the illness and suggested ways of coping with it. Meeting other people on the course who were in the same boat so I did not feel so isolated. It got me out of the house with some effort.

I guess the downside is that once the course had finished, that's it, back to square one and totally forgotten about again. Also I am sitting on my bed in the middle of the day, 6 years on, no recovery, hey ho. Apologies if have veered off topic. The advice the clinic gave was I am sure well intentioned and the lady had had ME to some degree as well and was not completely recovered.

Actually, in my experience of being involved with a regional ME Charity for the past decade, what you describe can be a benefit of ME Clinics. Many people are struck down by ME and have absolutely no idea what is happening to them, to the point where they wonder whether they're going mad, when family, friends, Health Professionals and basically everyone around them either disbelieves or trivialises their illness. (I'm sure no one on here needs to be told this.)

When they finally arrive at the ME/CFS Clinic, they are met by sympathetic Health Professionals who've actually seen it all before and, importantly, believe that they are ill. They also meet other PWME and realise that they're not the only ones with this illness. Basically, it's a "port in a storm." This comes as a huge relief, which is bound to lessen the stress that they are experiencing , if only very slightly.

Unfortunately, what these unsuspecting patients don't realise is that these Health Professionals have been trained, as per the OP above, that this is a "false illness belief" and disastrously, many are made much worse by GET.

I remember attending a conference some years ago, hosted by the researchers who are now involved with the UK Biobank, and one of the researchers told me that they were horrified, when hosting a Conference specifically for Occupational Therapists, when the OTs said "But we HAVE a treatment for ME."

Naively, I asked my GP to refer me to my local ME/CFS service 11 years ago, when I first became ill. He said he was happy to do that, but he hadn't referred me before, because he hadn't had any good reports of it. (He's a very open, well-informed GP).

I was treated with great consideration during my appointment at the ME/CFS Clinic, but declined the treatment that was offered, as I'd already tried CBT privately, as I had been told that this was the only "treatment" that worked. (I was desperate. I threw myself into the therapy, but of course, it didn't make a blind bit of difference, in spite of me waking up every morning, if I'd actually managed to get any sleep, determined that it would have made a difference.)

I declined GET, because even in my ignorance of the facts, it seemed bonkers to me. Thank goodness I did refuse. I had to spend most of the time in bed for a few years, but this didn't mean that I didn't try to be active when I felt that I could. Over the years, these periods of activity have increased to the point where I can now walk up to 4.5 miles at a time, without payback at the same pace as my fit husband. It took years of NOT pushing myself to reach this stage and I still have to pace myself and take my time in the morning, but if I do that I can go through until midnight feeling fine. If I don't do that, my health soon deteriorates. I realise that in the grand scheme of things, I'm extremely lucky.

Although I know that the NHS Clinics obviously work to NICE Guidelines, I was still, strangely, shocked when I spoke to a young woman at a local Support Group event only this week, when she told me that her OT at the local NHS ME/CFS Service has told her to walk a certain distance, outdoors, everyday and to complete the whole distance, no matter how bad she feels doing it. Thankfully she realised in time that this was just making her worse and was not the way to recovery.

The whole NICE debacle is outrageous. God help us with the 3 Psychiatrists, 2 Neurologists, a Paediatrician and 1 Patient Representative on the GDG.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Suddenly after a few sessions, she told me the rehabilitation was done. I thought we had hardly even started yet. I had a talk with the overseeing rehabilitation docter and she was very nice. As soon as I said I was very disappointed in the whole process, she turned completely around, said I was't positive enough and basically it was all my own fault for not trying hard enough.

Sorry to hear you had such a nasty experience - first gaslighting, then victim blaming!

Things could be very different if they simply focused on developing coping skills with severe illness, instead of trying to tell people that they aren't really ill.
 

Woolie

Senior Member
Messages
3,263
I think that @A.B. and @Sean are both right. These therapists have been misinformed. But it is the nature of that misinformation that makes it so insidious - it undermines the very processes of empathy and critical evaluation that would lead a normal person to question what they've been told.

This is the real stigma of mental illness - once the question of mental health has been raised, everything the person says in their defense is sullied, compromised, they are to be treated a children and their testimony dismissed.
 

Skippa

Anti-BS
Messages
841
Based on what @CarolB said, yes there were a couple good points.

I met some great people (other patients) I really wish I had stayed in touch.

And the volunteers that were there to assist, they were SO lovely and helpful. I can walk (I've got my limits) but the nice lady insisted on staying with me, making small talk and asking if she could push me/get a wheelchair etc - was really touching.

The two paid therapists WERE really nice, but sadly they had been brainwashed, I mean trained, that we needed to learn how to live properly, eat, sleep, exercise, relax and we WOULD get better if only we would do everything "properly".
 

GreyOwl

Dx: strong belief system, avoidance, hypervigilant
Messages
266
Based on what @CarolBThe two paid therapists WERE really nice, but sadly they had been brainwashed, I mean trained, that we needed to learn how to live properly, eat, sleep, exercise, relax and we WOULD get better if only we would do everything "properly".
It has never occurred to me that there is an "improper" way to do things. How far does it go? Is there a "proper" way to put bread in a toaster? What is the reasonable consequence if one doesn't?

I will always remember the quiet chat the school nurse gave me while my daughter was unwell and missing lots of school. About how much the nurse *needed* to do exercise, how if she didn't exercise every single day she just felt so weak and sick, if she skipped a single yoga session she would really feel it...

As an unfit and inactive well person, I felt like suggesting she see a doctor if she was so dependent on exercise just to live a normal life. There wasn't really much difference to my mood or my life whether I was running 7km a few times a week or eating chips on the couch on the weekend after a week of working my desk job.

The idea that PwME (or their parents) are deviant in either deed or perception is so perverse.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Vacuuming your house hurts your back and brings on PEM? Real quote: "perhaps it's not as enjoyable as other activities, I can't imagine anyone enjoys doing it" wink wink.

Vacuuming is totally enjoyable since I got this robot vacuum cleaner:


Yes this is totally off topic, but I figure you all need a bit of a laugh after reading this thread.
 
Last edited:

daisybell

Senior Member
Messages
1,613
Location
New Zealand
I'm a therapist, and I know how to engage in critical thinking. If you try a technique/therapy with a patient and it doesn't work, then you need to think 'why not?' The answer is always that it's the wrong therapy, not that the patient hasn't tried hard enough.....
If the patient actually hasn't tried, then it's still the wrong therapy.
 

unicorn7

Senior Member
Messages
180
You don't improve "you didn't push yourself enough"

You get PEM "you pushed yourself too much".

This is the real stigma of mental illness - once the question of mental health has been raised, everything the person says in their defense is sullied, compromised, they are to be treated a children and their testimony dismissed.

I was shocked how easy it was to dismiss me and everything I said. It's just a circle you can't get out of. Even though there's literally nothing to "get me" on, the psychologist was still trying to dig something up.

I have had a ridiculously happy childhood, right up until I got ill. I am from a family of doctors, all my friends are doctors, I am myself in a field very close to medical. I was very active in sports. I have my own business where I'm extremely passioned about and because I'm self-employed: no benefits. My whole family and partner have been understanding and helpful form the beginning of the illness.

There is literally no reason to think I'm either making it up or being depressed or have some underlying mental illness, but they still got me to doubt myself (am I not "just" depressed, stressed, making it up etc etc.?). I really feel for the people that actually aren't as lucky as I am, have some mental problems unrelated to the illness to dig up and get lost in the mental illness circle:(
 

Skippa

Anti-BS
Messages
841
@unicorn7 yes exactly, how easily they get you to doubt yourself by all joining together to repeat the same old crap. Over and over.

I have thought in the past "this is not mental, there is definitely symptom xyz" .... followed by "aha! But perhaps that's exactly what I would think if I was being mental at the moment".

How would I know?

When you THEN find a whole bunch of other people reporting EXACTLY the same symptoms (usually around the PEM phenomena) and put it together with obviously visible phsyical symptoms (swollen lymph nodes, a golf ball in the armpit!) you have to realise it's physical. That, and the fact that the "mental" treatment never did a damned thing to help or make it better, even if you did everything asked of you and went along with it.
 
Messages
44
I remember my local NHS clinic being gobsmacked at how ill I was when I first saw them. It was a 90min trip on public transport to get there so that probably didn't help! But the reason I mention it is that I had already been through 23 weeks of GET through a private provider, who turned out to be the lady who trained this NHS clinic.....they were seriously stunned and appalled at the state of me. They just couldn't get their heads around it - they told me I had been pushed far too much and they would never have let me get that bad. They were really supportive and took a look through my symptom and activity diaries (which they said clearly showed I was getting worse and should have indicated the need to stop GET) but concluded that I was too far gone now for them to help me, plus all they would offer is lifestyle management and GET again. I'm hoping and praying the clinics will soon be able to put the guidelines to one side and use common sense pacing and management and judge people and their health on the person they see before them and not what the guidelines say we should be like.
 

Aurator

Senior Member
Messages
625
I was shocked how easy it was to dismiss me and everything I said. It's just a circle you can't get out of. Even though there's literally nothing to "get me" on, the psychologist was still trying to dig something up.
Some psychs would have it that a patient's claim, or even objective evidence obtained by a clinician, that there is "nothing to get you on" is itself evidence that there is something to get you on. Have a look at the research into so-called alexithymia, which, according to clinical psychologist Richard Gipps, can be defined as a "diminished recognition of one's own emotions". It's a classic damned-if-you-do damned-if-you-don't situation that belongs to the realms of Kafkaesque fiction.