Seems to me also that this is a crafty re-branding of pacing/energy envelope as CBT/GET.
Interesting that time is devoted to discussing whether CFS is physical or mental (or both).
Are HIV, childbirth, autoimmune conditions etc (all in the book) subjected to the same preliminary questioning as to status? What does mind over matter mean in the case of CFS/ME as presented in the article, anyway?
For the sake of argument:
Grade A mind over matter in medicine might be he application of mental techniques resulting in improvement of physical parameters.which are themselves rooted in biophysical rather than psychological mechanisms. Burns are biophysical. If healing can be sped up by psychological techniques, that is mind over matter..
Grade B might be be the reprogramming of perception to alleviate response to biophysical problems. Psychological techniques of pain control where there is a real lesion e.g. a healing burn would be an example.
Grade C might be psychological relief of a purely central condition e.g. phantom limb pain, where the pain is real but outlasts the damaged limb.
Surely the power of mind over matter in treating CFS/ME would be better demonstrated by first placing ME/CS on a par with HIV, autoimmunity etc and then showing the benefit of mental techniques in an illness whose biophysical status is not subjected to doubt ab initio. Rhetorically, why not take some rituximab responders for example, withdraw the drugs andgive them CBT/GET. If they improve as well as those on the drug, that would be high value mind over matter data. (God forbid that this should be done, of course).
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Instead of an endorsement of ME/CFS as biophysical but alleviable by mind over matter, we are treated to mental-physical doubting and later to Noakes' musings regarding resetting of the so-called "master-controller", which put CFS/ME firmly in the Grade C camp of "no ongoing peripheral physical cause or process" - apart from a little deconditioning, naturally., Is this the scientific reality according to the latest research? . Further Noakes has worked, largely amongst athletes who may not represent the bulk of CFS/ME patients and who may have had athletic overtraining rather than ME/CFS,. It may be that these subjects have (had) a centrally based syndrome which might well be some kind of subconscious conditioned over-response to the particular noxious input which caused their malady - i.e excessive physical exertion, but is this a fair model of the general ME/CFS population? Even if it were, we would be dealing with a psycho-central condition, rather than a physical illness such as lupus, MS, HIV. This is of course the contention of the CBT/GET lobby but if true, puts "mind over matter" in the context of CFS/ME into Grade C, so why mention it alongside HIV, burns etc.?
This is not a demonstraton of mind over matter in the case of CFS. Rather it demonstrates the ongoing determination of White et al to present CFS/ME as a not very material condition in the first place, which requires a not very biophysical treatment - while mentioning us in the same breath as HIV etc. to show how seriously they take us.
