Another thread recently caused me to recall my introduction to the work of Wessely and Chalder in 1988/89. There was something in the ME Association magazine. I think there was a view at the time that it was absurd, but that it wouldn't catch on. Oh well. This seems to be it: http://bjgp.org/content/bjgp/39/318/26.full.pdf Management of chronic (post-viral) fatigue syndrome P27 top of right hand column. "Sufferers have been told that " physical and mental exertion is to be avoided" (ME Action Campaign factsheet 1988). THIS MAY BE CORRECT IN SOME CASES, BUT THERE IS AS YET NO WAY THAT THESE CASES CAN BE IDENTIFIED. IN GENERAL SUCH ADVICE IS COUNTERPRODUCTIVE AND MUST BE SET AGAINST THE FOLLOWING (bolding mine) -the harmful effect of disuse and inactivity on muscle function, in addition to respiratory and cardiovascular performance; -the psychological benefits of exercise on emotional disorders; -the adverse psychological effects of lack of exercise; -the deleterious psychological effects of avoidance of feared situations, as in agoraphobia; -recent evidence that dynamic muscle function is normal in patients with chronic fatigue syndrome, muscles being neither weak nor fatiguable." As an analysis this could be considered third rate only in a system allowing for no lower categories. Whatever happened to peer review? Oh, I forgot, we know the answer to that. Why would it be wrong to assert that what this paper suggests is that , within a group of patients, it is known that exercise will be inappropriate and possibly harmful for some, but that they should nevertheless be encouraged to exercise, on the basis that exercise may benefit others within the group, and it is not possible to distinguish between them? This seems analogous to the idea of herd immunity, but at least in the case of vaccine damage there is supposed to be a compensation scheme. The "treatment", says he mockingly -now that I do mock-seems to presuppose that the condition to be treated is entirely psychological or emotional. Presumably those who will not benefit may have a physical condition, but that can be ignored, on the basis that they are specific and not general cases. In their world do muscles exist in complete isolation from and act totally independent of, other physical systems? The recommendations include no further visits to specialists or hospitals unless agreed with the therapist. Decisions such as this would normally be expected at well above the pay-grade of those involved, but this is exactly what happened a couple of years later. Does this tell us anything about this "research?. It was always known that physical and mental exertion could be inappropriate for some but they went on to make that the basis of their system anyway.