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Professor Peter White reviews IOM report in Psychological Medicine

chipmunk1

Senior Member
Messages
765
@Jonathan Edwards
...and this is the "treatment" protocol for the clinic this doctor @Kati mentioned works at (and the only ME/CFS clinic in all of Canada ):
http://www.bcwomens.ca/Professional-Resources-site/Documents/Clinical Protocal-ME-CFS 1.4.pdf

It gives GET and CBT a "level A" evidence rating o_O

Patient handout:

http://med-fom-tcmp.sites.olt.ubc.ca/files/2015/10/Central-Sensitivity-Syndromes-CSS.pdf

I will try to translate from psychobabble speak:

What predispose someone to Central Sensi.vity Syndromes? The syndromes can run in families (parents, siblings, children). Also abuse or trauma in childhood also seems to play a role (as it does in many other condi,ons). Many with these syndromes have neither of These.

So the known causes are classical freudian childhood traumas and the other causes are not known. :eek:

Conversion disorders are supposed to be caused by repressed emotions. A way for the psyche to deal with traumatic events using the body to communicate emotional distress.

What are triggers (precipitants) for Central Sensi.vity Syndromes? In predisposed individuals, there is oJen a trigger (precipitant) in the form of a stressor
.

What triggers them is a stressful event. I believe this is exactly what Charcot said. He believed that hysteria was partially hereditary and triggered by a traumatic event like a railway accident.

http://courses.washington.edu/freudlit/Hysteria.Notes.html

Freud's teacher, the famous French neurologist Jean Martin Charcot (1825-1893), spent a great deal of energy studying hysteria and concluded that it derives from a particular hereditary disposition. (To view an 1885 painting of Charcot demonstrating a hysteric patient--a drawing that Freud hung, moreover, in his office--click here.) In other words, certain people are genetically pre-programmed, as it were, to develop hysteria, just as today we know that the predisposition to other diseases (e.g. cancer, alcoholism) can be genetically based.
a. Charcot believed that real events could serve as the Trigger that released the hysterical symptoms. Hysteria, in short, can lie "dormant" in one until its symptoms are stimulated by some real-life event. Charcot called such events "provoking agents"; they serve to actualize the hereditary potential for hysteria, to transform it from latent possibility to concrete reality.
.

From Charcot Freud borrows the notion of the "trigger" or the "provoking agent" that unleashes the hysterical symptoms. The theory here is that the event that stimulates the symptoms is not itself the cause, but merely areference to a deeper cause. It serves to invoke that cause. It is possible that Charcot's theory of the "provoking agent" of hysteria influenced Freud's later notion of the "day residue" or "trigger" in dreams. The structural mechanism, at any rate, is identical. a. For Freud, however, what this "trigger" activates is not a hereditary predisposition, as for Charcot, but rather:infantile experience.

2. Freud searches in these 18 cases for a single cause that all of them have in common: this would be their uniform basis and would hence point to the general aetiology of hysteria. What is this shared element?A traumatic experience in childhood that is uniformly of aSEXUALnature

Are they doing a bit of Freud and Charcot here?

This includes infec,ons (for example aJer a flu), physical trauma (for example aJer a car accident), or psychological stress or trauma (for example “burn out” or even a single trauma,c event).

Note how they mention car accident and infection. Symptoms from whiplash injuries following car accidents are supposed to be somatisation disorders. Symptoms following infections are of course CFS which is believed to be a somatisation disorder in many circles.

What else goes wrong with Central Sensi.vity Syndromes? Central sensi,za,on is the result of problems with the endocrine (hormone) system, the immune system, and inflamma,on. There are also problems with the cell’s mitochondria (the energy power houses of the cell).

Very vague.

Are there any other factors that come into play in Central Sensi.vity Syndromes? Yes. Poor sleep, overexer,on, reduced ac,vity, stress, depression and anxiety can all turn up the dial of sensi,vity and make symptoms worse.

Depression,Anxiety can make things worse. Worse to the point that they make symptoms that are otherwise not significant, disabling?

They mention "biopsychosocial mechanisms". Now we know we have a BPS model here.

What about pharmacological treatments?

The recognition of the mutual association among the CS conditions is helpful in their diagnosis and in avoiding costly and unnecessary investigations. Also, these conditions usually respond to the same treatments. Drugs that are known to attenuate CS are the NMDA receptor antagonists including amitriptyline and gabapentin, among others.

Psychiatric medications.

The treatment plan.

In addition to medication management, patients can participate in groups including the core group, “Living with Complex Chronic Diseases,” comprising 10 weekly sessions on self-management with a focus on pacing and the energy envelope, mindfulness, and cognitive behaviour therapy. Other program components can include one-on-one or group visits with members of the interdisciplinary team: occupational therapist, physiotherapist, dietitian, social worker, counselor, naturopath, nurses, nurse practioner, family physicians, and specialists. Patients also have access to interventions offered by the program as indicated: acupuncture and trigger point injection. T

pacing and the energy envelope, mindfulness, and cognitive behaviour therapy

to sum it up:

The only known causes are childhood traumas and treatment is mostly behavioural therapy.

If we are lucky we might qualify for antidepressant medication.

Add a lot of random stuff and some neurobabble to the mix and we have the theory of central sensitivity syndromes.. I would say central sensitisation is the new politically correct way of saying Hysteria. New name, same old canard.
 
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Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada

Cheshire

Senior Member
Messages
1,129
featuring "Mrs. Bradbury's establishment for the recovery of ladies nervously affected" :
upload_2015-12-16_15-56-19.png

OMG... This is so sexist and contemptuous. Words fail me:depressed:.

We'd be better if these guys could stop pretend to be scientific and started a PhD on women's vapors and fragile nerves in Wilkie Collins novels.
 
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Chrisb

Senior Member
Messages
1,051
Well they do make no attempt to disguise the fact that they incline to the view that ME is merely neurasthenia. On that basis MUS is merely NYDN, both having symptoms perpetuated by the illness beliefs.
 

chipmunk1

Senior Member
Messages
765
View attachment 13996
OMG... This is so sexist and contemptuous. Words fail me:depressed:.

We'd be better if these guys could stop pretend to be scientific and started a PhD on women's vapors and fragile nerves in Wilkie Collins novels.

Well guess what? This picture is the ONLY picture in the "Evidence based Treatments" section and it is shown several times, on different pages. This is of course the picture of an insane asylum for wealthy females.

Probably shows what they really think of the "service" they are providing to patients.

More excerpts:

Lab - beware false postitives !

Redirect focus from cure

Term "antidepressant" not helpful

"Insight" not always the goal
 

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
Well they do make no attempt to disguise the fact that they incline to the view that ME is merely neurasthenia. On that basis MUS is merely NYDN, both having symptoms perpetuated by the illness beliefs.

They disguise it in public materials because they know that view is both politically incorrect and unsupported by evidence.

They invent new terminology and framing for 'psychosomatic' every few years to make it more palatable and disguise its unscientific freudian basis.
 

chipmunk1

Senior Member
Messages
765
They disguise it in public materials because they know that view is both politically incorrect and unsupported by evidence.

They invent new terminology and framing for 'psychosomatic' every few years to make it more palatable and disguise its unscientific freudian basis.

Yet in public they state that it is not all in the mind and that patients often wrongly accuse them of believing this??!!

Yes, only a lunatic would believe it is all in the mind after reading their presentations.
 
Messages
15,786
They invent new terminology and framing for 'psychosomatic' every few years to make it more palatable and disguise its unscientific freudian basis.
The forced evolution of terminology to deliberately remain obscure reminds me of a bit of a South Park episode:

I think psychogenic proponents will soon be using similarly ridiculous nonsensical terminology. "Please have a seat, sir. I'm afraid the diagnosis is Flippity Floppity Floop. It is very serious, but we are experts and will cure you if you believe everything we say."
 

Sean

Senior Member
Messages
7,378
They invent new terminology and framing for 'psychosomatic' every few years to make it more palatable and disguise its unscientific freudian basis.
There is a pattern there, no doubt. An almost continuous redefining terminology and concepts and shifting of targets.
 

CFS_for_19_years

Hoarder of biscuits
Messages
2,396
Location
USA
All this talk of women's disorders and "Mrs. Bradbury's establishment for the recovery of ladies nervously affected" reminds me of the history of how and why the vibrator (sex toy) was invented:

https://en.wikipedia.org/wiki/Vibrator_(sex_toy)
For centuries, doctors had been treating women for a wide variety of illnesses by performing what is now recognized as masturbation. The "pelvic massage" was especially common in the treatment of female hysteria in Great Britain during the Victorian Era, as the point of such manipulation was to cause "hysterical paroxysm" (orgasm) in the patient.[1] However, not only did they regard the "vulvar stimulation" required as having nothing to do with sex, but reportedly found it time-consuming and hard work.[2]

One of the first vibrators was called the 'Tremoussoir' invented in France during 1734.[3] The first steam-powered vibrator was called the "Manipulator", which was invented by American physician George Taylor, M.D. in 1869.[4] This machine was a rather awkward device, but was still heralded as some relief for the doctors who found themselves suffering from fatigued wrists and hands.[5] Around 1880, Dr. Joseph Mortimer Granville patented an electromechanical vibrator.

They could at least bring back the vibrators.
 

Forbin

Senior Member
Messages
966
But perhaps the most unhelpful aspect of this report is its over-emphasis on the physical, with an almost complete absence of psychological and social aspects of the illness. We have a whole chapter reviewing the potential roles of immune, endocrine and infectious causes, but little if any mention of the potential roles of life events, stress, emotions, beliefs, and behaviour. This report took $1 million to produce, and the authors have missed a golden opportunity to integrate the findings of both mind and body to move us away from the sterile, dualistic understanding that still dominates this illness.

Ah... Desperately seeking a middle ground when there isn't one...

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