Video on individuals at a UK Malingering and Illness Deception Meeting

[Ben H]

There is so much fundamentally+ morally wrong in that quote by Sharpe, I don't know where to begin. His apparent thought process is so unbelievably simplistic.

 

[Snow Leopard]

Biopsychosocial models
None of the above models on its own succeeds in taking account of the range of factors which can influence the nature and extent of physical or psychological dysfunction. They all fail in one way or another to acknowledge attitudes and beliefs, psychological distress, social, and cultural influences, and personal experiences brought to greater or lesser extent by an individual person to the display of functional limitations and restrictions in its social context. A better understanding of chronic low back pain and disability, and management, is best provided by a
biopsychosocial model which considers all the physical, psychological, and social factors which may be involved (Engel 1977; Waddell 1987; Mendelson, Chapter 17). Many patients with medically unexplained symptoms do not have psychiatric disorders; these may be the result of minor pathology, physiological perceptions, and other factors including previous experience of illness (Nimnuan et al. 2000).

According to the attractive biopsychosocial model developed byWaddell (1998) and Main and Spanswick (2000), an initiating physical problem or perception, when filtered through the affected individual’s attitudes, beliefs, coping strategies, cultural perspectives, and social context, may be experienced as magnified or amplified and predispose to illness behaviour. Thus, the development and maintenance of chronic pain and fatigue, chronic disability and, indeed, long term incapacity for work, particularly in the context of low back pain and chronic fatigue states, rests more on psychological and psychosocial influences than on the original benign and mild forms of physical or mental impairments.

Waddell (1998) further argues that disability is not static but a dynamic process which evolves through distinct phases over time: the relevant model of disability may be different at various stages of this process. Waddell (2002) argues that the medical model may well be the most appropriate for most patients in the immediate aftermath of a physical injury, acute illness or disease. But within a few short weeks psychosocial issues start to predominate, and following the lapse of 1 or 2 years the initiating physical or psychological dysfunction will bear little, if any, relevance to the manifest illness behaviour. Psychosocial factors, expectations, and behaviours are thus very different at the acute, sub-acute, and chronic stages in the development of chronic disability. Capacity for work deteriorates and the chances of effective rehabilitation and return to work recede. Social Security statistics also demonstrate that some 40 per cent of new claimants for incapacity benefits return to work within 6 months, but those on benefit at 6 months have a very strong likelihood of remaining on benefit for years. Of those beginning a claim in 2000 around 30 per cent will be on benefit for at least 4 years (Aylward 2002).

Illness behaviour itself is not considered to be a formal diagnosis but is a melange of an affected individual’s observable activities, conduct and performance to express, and to transmit to others, his/her self-perception or interpretation of an altered state of health. Nor should it be defined in terms of a continuum of pathology. The manifestations of illness behaviours according to this model do not necessarily provide information about the initiating biomedical stimulus whether this be pain, fatigue or psychological distress. Nonetheless, in keeping with the traditional medical model, the biopsychosocial model recognizes that psychological and behavioural change are secondary to pain, fatigue or some other distressing complaint that most frequently has its origins in musculoskeletal and neurophysiological processes. As pointed out by Sharpe and Carson (2001), biopsychosocial models offer the potential (and indeed a danger) for an explanation and re-medicalization of unexplained symptoms around the notion of a functional disturbance of the nervous system. A paradigm shift indeed, or just a return to some of the competing theories offered to explain neurastheria in the nineteenth century (Aylward 1998)?

Is there any place for volition and or intentionality within the constraints of biopsychosocial models of disability? (See Halligan et al., Chapter 1, and Malle, Chapter 6.) For the most part, the assumption is that ‘patients cannot help how they react to pain’. Emotions are outside our conscious control and most illness behaviour is involuntary. Our professional role is not to sit in judgement but to understand the problem with compassion to provide the best possible management for each patient’ (Waddell 1998). This view reflects the philosophy that humans are not freely determined creatures: thought, behaviour, actions, and apparent free will are determined by factors beyond the individual’s control. And yet, if evolutionary psychology defines the human as the moral animal endowed with a capacity to make value-driven choices and an intentional approach to life then the emergence of a moral sense in human consciousness drives us away from genetically programmed behaviour, instinctive responses and the overriding effect of emotion. No doubt, we are creatures who are in conflict with ourselves; creatures in whom the life-force has started observing itself (Holloway 2001). Frankl (1963) called this our ‘ultimate freedom’—the potential freedom to exercise individual choice about one’s attitudes, behaviours, and responses to a given situation (see Halligan et al., Chapter 1).

The recent International Classification of Functioning, Disability and Health (ICFDH) (World Health Organization 2000) no longer focuses solely on people with disabilities, but by attempting to describe functional states associated with health conditions is applicable to all. The limitations of the medical model are recognized and thus assumptions on cause and effect are avoided. Functional states are classified across three dimensions. Disability encompasses all of these interrelated and interacting biopsychosocial dimensions. According to a biopsychosocial model a person’s functioning or disability in the social context is affected by complex interactions between their health condition, environmental, social and personal factors (Table 22.5). Activity limitations (equivalent to disability) are no longer required to be described as ‘resulting from an impairment’. The biopsychosocial model is triumphant; aetiology no longer features in the equation.

Of course, people who have never had a severe illness or disability would know best right?

 

[Mrs Sowester]

Of course, people who have never had a severe illness or disability would know best right?

Yes, of course that is true because their magical thinking protects them from all weakness like a shield of steel.

 

[Chrisb]

I like the sentence "If it was true, ......that self interest and self aggrandisement were the engines of society and the individual, then how could the testimony of (claimants) be believed?"

Why only claimants? Substitute any other group for claimants and the sentence makes equal sense. Employers? Doctors? Pschiatrists?

 

[SilverbladeTE]

Yes, of course that is true because their magical thinking protects them from all weakness like a shield of steel.

yeah as I keep saying that is what partially it's really about:
abuse and denigrate one group, to make you feel superior
if you are superior, you are a "god", immortal, nothing to fear

it explains a lot about religion, wanting to make "God" like some nice old grandpa who'll buy you presents and keep you safe, and, do what you want him to.
and some decide to hurt others in the name of "grandpa", whatever it is, religion or politics, then they may find they really enjoy having helpless victims in their power, to toy with as they wish....

You'll find a lot of these people are really driven by fear and abuse (usually neglect) when they were children
I understand this because almost every day I am scared, sometimes out right terrified and have to fight that crap.
Live my life and know what I do, and you'd understand why.

Lot of folk out there are stalked by anxiety and insecurity, but don't abuse innocent people, some do though and in many cases it's tragic as they aren't malign people, just messed up, but some are lousy gits and that just makes it worse.
I'm not going to start a witch hunt though to feel better however, however the thought of these particular ***holes being slowly roasted in a courtroom by a prosecutor and sent off to jail sure does help!

PS
your reference maybe ot Superman, but I can't help thinking of...

 

[SilverbladeTE]

I like the sentence "If it was true, ......that self interest and self aggrandisement were the engines of society and the individual, then how could the testimony of (claimants) be believed?"

Why only claimants? Substitute any other group for claimants and the sentence makes equal sense. Employers? Doctors? Pschiatrists?

this!

 

[Luther Blissett]

substantial state benefits

My arse.

 

[SilverbladeTE]

My arse.

yeah tell me about it I'm literally fighting for my life at moment
or rather relying on others to help, can't take any more of the BS

 

[Mrs Sowester]

You are right @SilverbladeTE , I was thinking Batfink "Your bullets cannot harm me! My wings are like a shield of steel!" is one of my all time favourite catch phrases.

I understand where you're coming from. People repeat familiar patterns of behaviour and psychs are no different, in fact they are more likely to have underlying trauma which is the reason they chose the profession in the first place.
It takes a lot of strength and self awareness to identify and correct poor behaviour in oneself. Many people kick the metaphorical cat when they've had a bad day - as Mr S says "Shit rolls downhill". Those of us with a conscience try not to take our feelings of inadequacy out on those weaker than ourselves.
When trying to understand the thinking of some of the BPS crowd I wonder how many are baby boomers, grammar school scholarship boys who've fought their way up the class ladder and achieved power, influence and status. I wonder how this affects their thinking and judgement. They will have been raised by the traumatised survivors of the war. They must carry the burden of being made to feel inferior to their peers who have come from the public school system whilst feeling superior to the people from the communities they came from. And of course when an individual has achieved power they must maintain it.
I'd imagine a person must need to do some complicated cognitive gymnastics to cope with all that dissonance.

Sorry if this post makes little sense, I'm having problems with nausea while my new meds settle in and it's hard to think in straight lines today. And really sorry you're having a bad time at the moment, it's disgusting what the Tories are doing to the benefit system, they obviously hope we'll all just give up and die quietly in a corner. Hang on in there SilverbladeTE.

 

[Aurator]

What's the chap in the mac, front row, doing with his hands?

Attempting but failing to reassure himself that he measures up to the girth boasted of in the two-handed gesture of the guy on his right.

 

[SilverbladeTE]

You are right @SilverbladeTE , I was thinking Batfink "Your bullets cannot harm me! My wings are like a shield of steel!" is one of my all time favourite catch phrases.

I understand where you're coming from. People repeat familiar patterns of behaviour and psychs are no different, in fact they are more likely to have underlying trauma which is the reason they chose the profession in the first place.
It takes a lot of strength and self awareness to identify and correct poor behaviour in oneself. Many people kick the metaphorical cat when they've had a bad day - as Mr S says "Shit rolls downhill". Those of us with a conscience try not to take our feelings of inadequacy out on those weaker than ourselves.
When trying to understand the thinking of some of the BPS crowd I wonder how many are baby boomers, grammar school scholarship boys who've fought their way up the class ladder and achieved power, influence and status. I wonder how this affects their thinking and judgement. They will have been raised by the traumatised survivors of the war. They must carry the burden of being made to feel inferior to their peers who have come from the public school system whilst feeling superior to the people from the communities they came from. And of course when an individual has achieved power they must maintain it.
I'd imagine a person must need to do some complicated cognitive gymnastics to cope with all that dissonance.

Sorry if this post makes little sense, I'm having problems with nausea while my new meds settle in and it's hard to think in straight lines today. And really sorry you're having a bad time at the moment, it's disgusting what the Tories are doing to the benefit system, they obviously hope we'll all just give up and die quietly in a corner. Hang on in there SilverbladeTE.

loved Batfink as a kid


yeah i'ts a sick system that acts like an "oroborus" snake swallowing it's own tail
the Rat Race, the spiral of ever worsening BS chasing their own needs to feel safe, superior etc

My Dad was traumatized by what happened to him in WW2 as a kid (one of the many reasons I loathe the British Establishment), and that caused him to have psychotic violent episodes, he'd just snap.
tragic as he was actually very gentle nice fella, I can understand it better now, sigh, forgave him very long time ago but it's not nice to be so grumpy etc.
Watching him slowly be eaten away as a person by dementia and then left like...shrivelled up shell of a man sure didn't help, poor sod, what an obscene thing to happen to anyone

not just the Tories, Labour started it, or rather "new Labour", those swine brought in ATOS so I ended up getting zero points....
the NeoLiberal Agenda is spreading, modern day Fascism, same ends, just treading more softly as they know if they boil us frogs gently we won't protest until it's too late....
such slime can never be bargained or reasoned with and it would take a Divine Act to wake them up.
traitors of the worst kind, sold the country bit by bit down the river, while beating their breasts saying how big and tough and rich we are....pfft!
One bloody destroyer and 3 minelayers to protect the WHOLE of the UK's waters.
Aircraft carriers with no aircraft.
Mad determined to waste £100 billion on Doomsday weapons we went invaded Iraq over (supposedly) and no one questions the fact that junkie child abusing criminal incompetent ratbags have their finger on the nuclear trigger?
The biggest "Bubble" in history ready to deflate and wipe out our economy (London Housing Bubble, which the government just helps keep inflating)
Ram rodding through a Chinese nuclear reactor, while slashing support for renewables and the amount of deadly dangerous nuclear materials we have stored at Windscale is stark raving mad, enough to make about 5000 nukes never mind the rest.


so I stay in Fallout 4, or read books where the British Fleet Air Arm wasn't screwed by the "Whitehall wallahs" of the RAF Air Ministry before WW2 and thus WW2 went a hell of a lot better AND avoid the atrocity of the terror raids we did against German civilians
HATE the BBC's bull**** lately making WW1 and 2 look so "jolly good fun!", utter rubbish, horrendous times, total cock ups for first 2 years in each case that cost tens of thousands of lives needlessly

kind of from that interesting link to our problem and this post
during WW2, the Uk government commissioned a bunch of scientists etc to come up with plans for how best to prosecute the air war
they came up with the plan of "area bombing", mass murder of German civilians to ruin German morale and war production
not only was it murderously inhuman and criminal, it was utter bull****,
some truly brilliant people had worked out the mathematics etc, but screwed up, or the actual facts were "smudged" to give the Air Ministry what they wanted to hear, the right to have a huge bomber fleet to burn tens of thousands of German civilians to death

their sums were wrong, they needed at least 3 times more aircraft than they actually had during WW2 to do it.
they still murdered over 600,000 German civilians between the RAF and USAAF, and Germans moved their production plants underground or split them up into small back lot factories and used slave labour from across Europe. so the mass bombing was largely useless. enormous numbers of UK, Commonwealth and USA pilots died in that, and took part in a great evil, even if they didn't mean or think of it so.

if instead they'd concentrated on precision bombing using Mosquitoes and the likes of 617 Squadron, ahd supported the Fleet Air Arm before the war, had worked on ground attack aircraft and coordination with the army before 1939, they could have avoided so much slaughter and hammered important targets maybe even taken Hitler & Co out at the end of a 10 ton Grand Slam bomb.
the RAF top brass refused to believe that dive bombers were any use and demanded a push on heavy bombers, so at start of the war, despite lessons learned from US experiments and Spanish Civil War, Stuka dive bombers blew the living hell out of UK and French forces with comparatively excellent accuracy compared to the high altitude bombers which had trouble even hitting a city at the start of the war.
but it was easier mentally, lazy, cruel, selfish and barbaric to wish a huge force the "top brass" could preen their ego with, and get "revenge" on the "germans", most of whom didn't support the Nazi atrocities, especially in Hamburg and Berlin which of course got firebombed to hell.
note, top aircraft pilot of the entire war was a German Stuka ace, NOT a fighter pilot. may loathe the man's politics and beliefs but not his bravery or skill. if only the RAF had had such aircraft....

Rudel flew 2,530 combat missions on the Eastern Front of World War II. The majority of these were undertaken while flying the Junkers Ju 87, although 430 were flown in the ground-attack variant of the Focke-Wulf Fw 190. He was credited with the destruction of 519 tanks, severely damaging the battleship Marat, as well as sinking a cruiser, a destroyer and 70 landing craft. Rudel also claimed to have destroyed more than 800 vehicles of all types, over 150 artillery, anti-tank or anti-aircraft positions, 4 armored trains, as well as numerous bridges and supply lines. Rudel was also credited with 9 aerial victories, 7 of which were fighter aircraft and 2 Ilyushin Il-2s. He was shot down or forced to land 30 times due to anti-aircraft artillery, was wounded five times and rescued six stranded aircrew from enemy held territory

the parallels to our situation are there, and also where some of the emotional etc damage that has spurred some of the folk and cabals screwing us, as you note.
the inertia, wilful stupidity, cowardice, cruelty, arrogance of the Establishment has done more harm to us all over the last 250+ years, than any enemy action ever has.

 

[duncan]

@SilverbladeTE , your style of writing has reminded me of someone for quite some time, but I couldn't quite remember.

It just hit me: Hunter S. Thompson. He was an American political journalist. I thought he was the best. My kids were politically weaned on his writings. He held nothing back. He could accurately and vividly vilify politicians of his day and make you grin while he did.

I just wanted to volunteer that.

 

[SDSue]

What's the chap in the mac, front row, doing with

He looks like he’s getting ready to flash someone. The entire picture looks like something out of a Monty Python sketch.

 

[SilverbladeTE]

@SilverbladeTE , your style of writing has reminded me of someone for quite some time, but I couldn't quite remember.

It just hit me: Hunter S. Thompson. He was an American political journalist. I thought he was the best. My kids were politically weaned on his writings. He held nothing back. He could accurately and vividly vilify politicians of his day and make you grin while he did.

I just wanted to volunteer that.

Though I know of the man and he seems both a hoot and very insightful, I've never actually read his work.
But I'll take that as a compliment

 

[Mrs Sowester]

He looks like he’s getting ready to flash someone. The entire picture looks like something out of a Monty Python sketch.

I've worked it out! He has castration anxiety, unresolved Oedipal complex and fears emasculation by the other, bigger BPS boys onto whom he's projecting his fear of his father... Either that or he's just holding it for reassurance

 

[sarah darwins]

I've worked it out! He has castration anxiety, unresolved Oedipal complex and fears emasculation by the other, bigger BPS boys onto whom he's projecting his fear of his father... Either that or he's just holding it for reassurance

yes. I've previously carried out a systematic review and metanalysis and have found a strong correlation between getting pushed around by the other kids at school and becoming a behaviourist psychiatrist.

 

[tinacarroll27]

Very depressing! This was under new labour as well. It was totally fuelled by greed. I think Unum was there as well, a very corrupt medical insurance company. Their point scoring system has been used by Atos and the work capacity assessment. This was the start of what we have now with benefit cuts for the disabled and austerity. Labour sold their souls on that day! I am hoping that when Jeremy Corbyn gets in power this lot will go back to where they belong!

http://blacktrianglecampaign.org/20...e-ifdm2012-conference-on-11th-september-2012/

http://blacktrianglecampaign.org/20...ish-uncomprehending-hysterical-or-malingering