Relevance of Wessely quotes related to Coyne's critique of PACE

[SOC]

Actually, very few academic psychiatrists including Wessely would consider mood disorders to be "all in the mind". They have a significant biological component. So this quote wouldn't get you very far I'm afraid.

So basically he's playing a mind game with us. If all psychiatric conditions have a biological component, then NO condition is "all in the mind". What the general public is thinking when they hear "all in the mind" is a purely psychiatric condition. That's what SW thinks we have -- a purely psychiatric condition and he has said so. He knows that if he says, "I never said it was all in the mind" the general public will hear, "I never said it was a purely psychiatric condition." So he has his cake and eats it too.

I wonder, though, if his words are getting enough play in the general (and more usefully, scientific) public that more people than just PWME are starting to think :thumbdown: because you can only play that manipulative game so long before people start to see things are not adding up. Until now he's been playing to an audience who wants his nonsense to be true, so they're willing to overlook the... er... inconsistencies.

 

[Sean]

I wonder, though, if his words are getting enough play in the general (and more usefully, scientific) public that more people than just PWME are starting to think :thumbdown: because you can only play that manipulative game so long before people start to see things are not adding up.

This is the weakness of propaganda, its Achille's heel: it doesn't work forever, eventually reality intrudes, one way or another.

 

[barbc56]

I don't think DW thinks his view is propaganda. Unfortunately, I believe he thinks what he says is true. and has such an investment in his theory, he may never waver from this view.. He may think we are spreading proganda, (which we aren't). My point is that the propoganda argument is not as effective as scientific arguments. The "look at all the damage you've done", "he needs to apologize", nitpicking over every little thing he does will also not make him waver. As I said, he may never change his view. We do not need to prove his "nefarious deeds", at least in this situation, and frankly it may be a waste of energy after a certain point.

There is a time and place when these strategies are important. But with the emphasis on the science we are closer to "his turf" and hopefully this will at least being us closer as far as showing what he is saying is not grounded in credibility.

I think his as well as other psychobabblers Achilles heel is that the science that will discredit these theories.

But I'm still keeping my fingers crossed.

Barb

 

[Valentijn]

"So it is all in my mind, is it doctor?" says the patient threateningly. The correct answer from our truth telling neurologist would of course be "yes", followed by a plaintive "but psychiatric disorders really are genuine illnesses", but by that time the doctor will be addressing an empty room, since the patient may well have left in disgust.

He's talking about what the neurologist believes is the truth. He's more careful about directly stating his own beliefs.

The more interesting message from that paper is that Wessely thinks it's fine to lie to patients, and I've included the quotes which show that.

 

[Kati]

He's talking about what the neurologist believes is the truth. He's more careful about directly stating his own beliefs.

The more interesting message from that paper is that Wessely thinks it's fine to lie to patients, and I've included the quotes which show that.

Where are the quotes @Valentijn ? i will use them.

 

[Valentijn]

I admit this whole bottle of wine thing made me uncomfortable too. SW is a sneaky...er... fellow. Either he has some underhanded manipulative plan in place with this bet (and we're falling into his trap) or he's completely delusional about most of what he himself has said over the last... how many?... years. Either possibility is disturbing. I have no ability to deal effectively with master manipulators, so I can't figure this situation out, but it has left me with a very uncomfortable feeling that this is ultimately going to go bad.

He's trying to draw out the fake, misattributed, and out of context quotes so that we look like a bunch of disreputable nutjobs.

Which is why I hate that bad list of quotes which people like to latch on to, and why I hate it when people try to use them against him. When people do that, he's winning. Period.

No one should be throwing quotes around without very careful reading and full understanding of them.

 

[Kati]

He's trying to draw out the fake, misattributed, and out of context quotes so that we look like a bunch of disreputable nutjobs.

Which is why I hate that bad list of quotes which people like to latch on to, and why I hate it when people try to use them against him. When people do that, he's winning. Period.

No one should be throwing quotes around without very careful reading and full understanding of them.

I think Wessely and co have to worry about the science or rather the lack of.
Quotes are a great eye catcher for 140 character tweets. While i have tweeted them to Wessley, other times
I have usedthem in addition to the David Tuller serie link for folks to understand what's been happening.

Regardless, you posted them somewhere on this forum. i just can't remember where. Not wanting to answer this question right now is annoying to me.

 

[Valentijn]

@Aurator - Wessely stating that an hypothesis exists is not the same as Wessely endorsing it. If you want to nail him, you need to do it with statements he does clearly endorse, or that clearly originate from him.

 

[adreno]

Focus on the PACE trial, not on wessely. Forget him. It's not important what his personal hypothesis is. What's important is what he can prove, and so far he has proved nothing. This is the point we need to stress.

"Simon says this, Simon believes that"...fuck that. "There is no evidence to support the BPS school of thought" should be the mantra.

 

[Valentijn]

Where are the quotes @Valentijn ? i will use them.

http://forums.phoenixrising.me/index.php?threads/simon-wessely-quotes.21025/

Then you can search for "to tell or" or similar.

I have little experience of formal writings on ethics, and qualified from a UK medical school before ethics teaching was a part of the curriculum. Nevertheless, it seems clear that one of the principal ethical duties of the doctor is to tell the truth.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

Patients will be more inclined to get better when they are provided with satisfactory explanations for their problems. By satisfactory I mean from the patient’s point of view - not satisfactory in a narrow scientific sense, but in a symbolic or even metaphorical perspective.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

By now I hope I have convinced the reader that there are insuperable objections to the neurologist "telling it as he sees it". The loser will be the patient, who will be denied a chance of receiving effective treatment, who will be less likely to engage in such treatments at a later date, and more likely to shift allegiances to those who are less in a position to help.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

NOTE THAT HE IS NOT SAYING HERE THAT ME/CFS IS A PSYCHOLOGICAL PROBLEM. HE IS STILL TALKING ABOUT THE NEUROLOGIST'S SIMPLIFIED UNDERSTANDING:

In all other circumstances telling the patient that not only are they wrong, but that the alternative label is one that is totally unacceptable to them, a psychological problem, is ruinous to the doctor patient relationship. So why do it? Instead it seems to this author that the only sensible option is to agree. This is ethical - CFS is an operational diagnosis, and if someone fulfils the appropriate criteria, then that is what they have.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

This is a strong quote, because he is implying that ME is curable and not chronic. But the only pathological process he is specifically denying is encephalomyelitis:

Giving a patient a label that implies both a chronic incurable condition, and one which can only be palliated by chronic rest, is indeed an indefensible action for a health professional. Confirming the existence of non existent pathological process, such as encephalomyelitis, only adds to the patient's difficulties by denying any prospect of cure except a medical "breakthrough", always promised and never forthcoming.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

This is the hard-hitting (shocking) quote:

. . . trust between doctor and patient may be better served by not telling the truth.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

This is a good illustration of his approach in dealing with patients. Don't disagree even if you "know" the patient is wrong, but don't lie outright:

Given the clear ethical imperative against lying, what can be left? I suggest the solution is to say little. Is it imperative that the patient be told their illness is truly "all in the mind"? I suspect not.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

And this is grossly insulting to patients, which can also be useful:

. . . improvement only requires a shift in the patient's view on the relative merits of rest and exercise.
Wessely S. “To tell or not to tell”: The problem of medically unexplained symptoms. In ; Ethical Dilemmas in Neurology (eds Zeman & Emanuel), WB Saunders, 1999, 41-53

 

[Valentijn]

Then the mea need to pull or seriously revise that document at the link above.

To be clear, that website doesn't belong to the MEA (ME Association). It's a different group, and apparently not a reputable one.

 

[eafw]

I wouldn't be surprised if James Coyne might find these quotes. But just in case I think sending him any quotes with citations is more prudent at this point in time instead of posting them ourselves.

This was my original suggestion, that we send Coyne quotes with sources or the original article/papers so that he can have a bit more background while he is dealing with Wessely on twitter

Don't mean to sound grumpy, but isn't it falling into the trap of allowing him to trivialise the matter? .. How about we bet him his knighthood and his career that he's been deliberately lying and abusing ME patients for years to boost his own ego and status, without regard to the thousands of lives he's ruined?

Coyne has chosen to engage Wessely on Twitter. If we can supply Coyne with previous articles and statements that Wessely has written it gives him information as to the background of Wessely's comments.

I admit this whole bottle of wine thing made me uncomfortable too. SW is a sneaky...er... fellow. Either he has some underhanded manipulative plan in place with this bet (and we're falling into his trap) or he's completely delusional about most of what he himself has said over the last... how many?... years. Either possibility is disturbing. I have no ability to deal effectively with master manipulators, so I can't figure this situation out, but it has left me with a very uncomfortable feeling that this is ultimately going to go bad.

The bottle of wine bet shows us that Wessely thinks he is untouchable and that this is all a big joke to him (I was was being sarcastic with my comment in the first post I made that started this discussion "glad you're having fun chaps" ).

I think the situation already is bad and will likely get worse. The PACE/BPS/SMC crew have HUGE vested interests here along with time, money, staff and a lot of institutional clout. Just playing nice about the science is not going to be sufficient for us. We need to respond to their dirty tricks too, and dragging some of their behaviour - such as their own quoted words and inconsistencies - out into full public view has a part to play in that.

 

[eafw]

He's talking about what the neurologist believes is the truth. He's more careful about directly stating his own beliefs. The more interesting message from that paper is that Wessely thinks it's fine to lie to patients, and I've included the quotes which show that.

I've read the whole paper. His hypothetical neurologist shares his beliefs but not his clinical strategy. The neuro thinks that the "all in the mind" patients should be told so, Wesseley, as you say thinks they should be lied to.

To be clear, that website doesn't belong to the MEA (ME Association). It's a different group, and apparently not a reputable one.

It's not clear at all, which is a problem

 

[Valentijn]

I've read the whole paper. His hypothetical neurologist shares his beliefs but not his clinical strategy. The neuro thinks that the "all in the mind" patients should be told so, Wesseley, as you say thinks they should be lied to.

Show me the quote where you can clearly see that Wessely agrees with the fictional neurologist about it being all in the mind.

 

[Tyto alba]

Ad hominem will only weaken any arguments. Stick to the methodological design flaws, facts and results of the PACE trial. The arguments need to be sharp and incisive without distractions.

 

[adreno]

Can we get back on topic please? If you insist on discussing wessely quotes, do it in a thread dedicated to it. This thread is about James Coyne taking on the PACE trial.

 

[Cheshire]

Trying to find THE quote that proves Wessely did say "it's all in the mind" is a waste of time, IMO. He never said so literally. Indeed, he had numerous ambiguous claims, but he will always play with that vagueness to escape. Going into that blurry world of lexical nuances, you just play the game according to Simon's rules, and he is a master at it.

What we should focus on is that the PACE trial, and the theory that sustains it, is a failure, and how a scientific analysis demonstrates that. And on the level of scientific soundness, Simon is not that skilled...

 

[adreno]

Why would you want to discuss these vague philosophical terms with Simon? It's exactly what he wants, to derail the discussion from the facts, into blah blah land. It's doomed to failure. Keep focus on the poor methodology, poor results.

I'll say it again; his views are irrelevant. The facts matter.

 

[eafw]

Show me the quote where you can clearly see that Wessely agrees with the fictional neurologist about it being all in the mind.

Ha, spot the lawyer. Ok, I shall ask counsel for the defense (of Wessely's weasling) whether your client agrees with his hypothetical neurologist or not. If he claims not, then show me the quote where he says he disagrees.

Seriously, I think he needs to be asked this in public - by people who have already chosen to engage with him - and then people can judge for themselves as to his credibilty on this whole subject.

 

[Valentijn]

Seriously, I think he needs to be asked this in public - by people who have already chosen to engage with him - and then people can judge for themselves as to his credibilty on this whole subject.

He has been asked. Dozens of times, if not hundreds. He will never give a straight answer - it's a lost cause.

The only place where he comes close to plainly saying what he thinks is in situations where he thinks it won't be repeated. Such as the Awylward letter, or speaking to groups of like-minded individuals.

And as far as saying what he really thinks? I doubt that goes beyond the walls of his own home.