"Chronic Fatigue Syndrome" by Chalder in The Wiley Handbook of Cognitive Behavioral Therapy

[meandthecat]

All becomes clear....Harry Potter as political satire.

I had underestimated J K Rowling, fooled by her prose and folksy characterisation, and being English the underlying tangle of prejudice and class bias are my normal landscape. The thickness and indigestability of the latter books, where I and my children gave up the reading, was profound!...The medium is the message.

I have become wary of 3am revelations, much as those that emerge from the Herb but this has given me much to dwell upon.

Following Voldemort's demise, according to Rowling, Umbridge is arrested, interrogated, and imprisoned for crimes against Muggle-borns.[14https://en.m.wikipedia.org/wiki/Ministry_of_Magic#Dolores_Umbridge

So it is the destruction of the horcrux that will lead to the demise of He who shall not be named.......... I wonder what they might be?

I shall spend the knight pacing

Thank you JaimeS, just wonderful

 

[alex3619]

Maybe they should be writing a section in their books on how this kind of lying causes distrust between them and their patients once they are found out. Also leads to ME patients then not trusting other doctors either.

Quite so. Its one of several factors that is causing a decline in the public perception of the medical profession. This is in a time when they need the public on their side to help stop the bureaucratic reinterpretation of the profession.

Nearly every doctor I have ever met has lied to me, deliberately. They do not call it that, of course. What they do is make their best educated guess, even if they do not have the facts or do not understand them, then project confidence and certainty. That illusion of certainty sounds nice, particularly if you believe in the placebo effect as a therapeutic tool, but its also where they come unstuck. Patients typically discover what happened in the current age. Gone are the days of ignorant patients blindly following medical advice from voices of authority. The medical profession is rapidly losing trust, and they are in large part to blame for that.

I recently had a near relative told they were free of cancer. A few weeks later they died. Guess what of?

 

[Woolie]

@JaimeS, I love the Umbridge comparison. I actually did laugh out loud

22% recovered? This is a cooked up number that doesn't stand even the mildest scrutiny. "Sorry, Professor, but I must not tell lies".

 

[Skippa]

"About 20% of patients recover" in the case of cancer or e coli would be a death sentence, a condition that strikes fear into the hearts of all.

Here doc, if you get a patient with ME/CFS, send them our way (says the psycho crowd).

Sure, you are condemning 80 PERCENT of your patients to misery, but but muh 20% can recover.

That would be unacceptable for any other condition. Gee, what a "message of hope".

On what planet is admitting 80 PERCENT, that is FOUR FIFTHS of your patients to doom acceptable?

And that's before we start picking apart the remaining 20 percent.

Grrr.

 

[alex3619]

On what planet is admitting 80 PERCENT, that is FOUR FIFTHS of your patients to doom acceptable?

And that's before we start picking apart the remaining 20 percent.

This planet, unfortunately. To the tune of in excess of a trillion dollars loss every decade, if you project the known numbers across the world economy. (Roughly 25 billion annually for the US, which is a quarter of the world economy, thankfully this is not hard math as my brain no longer does that.)

 

[Sean]

And they wonder why it is called psychobabble ?

 

[worldbackwards]

In what world is a 20% recovery rate an "optimistic message"?

"Work really hard to overcome your illness beliefs and you too could end up merely as sick as someone with Lupus"

Literally staggered by the sheer nastiness and disingenuousness on display in this article.

 

[snowathlete]

set goals with a view to establishing a consistent level of activity every day regardless of symptoms.

all this stuff is disturbing. I've seen it all before but still astonishes me. This point is utterly dangerous though and surely a clear breach of basic medical ethics.

 

[Valentijn]

I knew they were saying some awful stuff in the 1990's before we had online access to everything, but I'm a bit surprised to see it being said so blatantly still, even behind a paywall. But on the other hand, we're talking about Chalder, who seems to have a habit of bluntly saying daft things.

So just a few years ago we still have the rather shocking suggestions to manage (not treat) ill people by:

1. Severely restricting medical access:

   Where abnormalities are revealed on physical or laboratory investigation, further investigations can be helpful (serological tests for Epstein–Barr virus, cytomegalovirus, Q fever, toxoplasmosis, and HIV; chest X-ray, rheumatoid factor, and antinuclear factor) but should otherwise be limited to avoid the risk of iatrogenic harm. Specialist referral should be limited to situations where there is an increased probability of an alternative diagnosis.

2. Cutting off physical support:

   Overly concerned carers may reinforce patients’ maladaptive beliefs and coping strategies by inadvertently encouraging disability.

3. Cutting off financial support:

   Others may be on state benefits, which makes recovery more difficult.

4. Lying to the patients:

   In the first instance, the therapist should support the patient’s point of view, thus accepting and working with his or her attributions of cause and control. Therapeutic change can then occur slowly without arousing too much dissonance.

Would any of this advice be appropriate or tolerable even for people with an actual mental illness? Surely not. But in regards to treating ME patients, she's pretty much built an entire prima facie case of abuse and medical malpractice against herself

 

[JaimeS]

All becomes clear....Harry Potter as political satire.

Quite literally that bit was, even before I got hold of it.

Following Voldemort's demise, according to Rowling, Umbridge is arrested, interrogated, and imprisoned for crimes against Muggle-borns.[14https://en.m.wikipedia.org/wiki/Ministry_of_Magic#Dolores_Umbridge

So it is the destruction of the horcrux that will lead to the demise of He who shall not be named.......... I wonder what they might be?

I think that Tuller and Twisk might be on to a Horcrux, in combination: one of public perception. Davis has located a Horcrux but hasn't destroyed it, yet. I think Hornig and Lipkin are hunting down the same one, together, and last I heard they were on to a pretty reliable source for a location. Newton is after another. The patient advocacy groups are chasing the sixth in one, giant mob.

The seventh is inside us, of course. Our tendency to claw at each other in sheer frustration.

Thank you JaimeS, just wonderful

Loved that series in my early 20s, still very fond of it.

-J

 

[NL93]

Illness beliefs and the attribution of symptoms to a physical cause, with minimization of psychological or personal contributions, are also important and have been related to increased symptoms and worse outcomes in CFS

OMG, people who are more ill, think they are more ill than people who are less ill. And people who are more ill have worse outcomes. Who would have thought?

 

[JaimeS]

Patients typically discover what happened in the current age. Gone are the days of ignorant patients blindly following medical advice from voices of authority.

There is a brilliant novel from the 1930s about a young physician, in which he's told by a more experienced practitioner to prescribe his patients water when they come calling. At first he's horrified, but he eventually does it when he gets overworked and can't tell that there's anything wrong with them.

"About 20% of patients recover" in the case of cancer or e coli would be a death sentence, a condition that strikes fear into the hearts of all.

Here doc, if you get a patient with ME/CFS, send them our way (says the psycho crowd).

Sure, you are condemning 80 PERCENT of your patients to misery, but but muh 20% can recover.

That would be unacceptable for any other condition. Gee, what a "message of hope"

The rather unfortunate message, here, is that those 20% of patients "really try" and are worthy of wellness. Those who don't get better must not be trying hard enough, and therefore they deserve their fate. When you state that recovery is 'all up to the patient', this is the sentiment lurking behind it.

What lurks behind all of this is the stigma against people with psychological disorders. I made this into a blog post because it diverges somewhat from the main thread.

Would any of this advice be appropriate or tolerable even for people with an actual mental illness?

Relates to the topic of my reply.

-J

 

[A.B.]

OMG, people who are more ill, think they are more ill than people who are less ill. And people who are more ill have worse outcomes. Who would have thought?

Practicising mind body holism leads to the magimystical explanations becoming the default, while the down to earth common sense explanations become impossibly difficult to grasp.

 

[A.B.]

So, speculation and theory equal fact?

In their world, yes. Reason being, they have no way to prove their ideas. Thoughts and beliefs can't be objectively measured or injected into a person to see if they develop the illness. So they just skip the "proving" step and their ideas attain fact status.

Psychosomatic research: some people think they have done research but the research is all in their head.

 

[Snow Leopard]

Sounds like it is worth a read.

 

[eastcoast12]

I think we can all agree that she absolutely sucks as a human being

 

[Never Give Up]

I knew they were saying some awful stuff in the 1990's before we had online access to everything, but I'm a bit surprised to see it being said so blatantly still, even behind a paywall. But on the other hand, we're talking about Chalder, who seems to have a habit of bluntly saying daft things.

So just a few years ago we still have the rather shocking suggestions to manage (not treat) ill people by:

1. Severely restricting medical access:
   
2. Cutting off physical support:
3. Cutting off financial support:
4. Lying to the patients:

Would any of this advice be appropriate or tolerable even for people with an actual mental illness? Surely not. But in regards to treating ME patients, she's pretty much built an entire prima facie case of abuse and medical malpractice against herself

Go get her!

 

[Yogi]

And she is only a nurse let's not forget albeit one with a big ego.

https://www.nmc.org.uk/registration/search-the-register/
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Trudie Ann Chalder London - South East View details

Practitioner Details

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Name
Trudie Ann Chalder
Geographical locations
London - South East
Expiry date
31/12/2016
Registration status

Registered - no restrictions on practice

An explanation of these terms can be found in the glossary of terms.

Register entry Start date
Registered Nurse - Adult 03/08/1981
Registered Nurse - Mental Health 24/07/1984
Recorded qualifications Start date
No Recorded Qualifications found

 

[Esther12]

And she is only a nurse let's not forget albeit one with a big ego.

Although, this is probably the least of her problems. I've got much more respect for plenty of people with no qualifications than some professors with an alphabet of letters after their name.

 

[TiredSam]

The Wiley Handbook of Cognitive Behavioral Therapy

Wiley? As in sly, takes risks, a little bit crazy? As in

Just couldn't make this stuff up.

In the first instance, the therapist should support the patient’s point of view, thus accepting and working with his or her attributions of cause and control. Therapeutic change can then occur slowly without arousing too much dissonance

Very wily of nurse Chalder to use the word "dissonance" instead of "suspicion".