Dr David Tuller: King’s College London Still Promoting Discredited CBT/GET/Deconditioning Paradigm

[Countrygirl]

https://www.virology.ws/2022/08/09/...UYii9MvdlR2LcUG8pQ3sJxA5BPCzYxt3AMWm4E_A7RjUs

Trial By Error: King’s College London Still Promoting Discredited CBT/GET/Deconditioning Paradigm
9 August 2022 4 Comments

By David Tuller, DrPH

I have written a few posts about how various health entities have so far not changed the information about ME/CFS on their websites or acknowledged the revised recommendations published by the UK’s National Institute for Health and Care Excellence (NICE) last October. In addition to replacing the name CFS/ME with ME/CFS, the new guidelines have rescinded approval of graded exercise therapy (GET) and cognitive behavior therapy (CBT) as treatments for the illness. (The guidelines leave room for CBT as supportive care rather than a curative intervention.)

The ME Association’s medical advisor, Dr Charles Shepherd, has written to a number of regional National Health Service trusts to express concern about the matter, with varied results. Recently, he sent another letter–this time to King’s College London. With Professor Sir Simon Wesseley and Professor Trudie Chalder leading the posse, KCL is home base, or one of the home bases, for the GET/CBT ideological brigades. (I mean, what else is a professor of CBT like Professor Chalder going to offer anyone?)

At some point–I don’t know exactly when–KCL’s CFS/ME service has rebranded itself as being devoted to addressing “persistent physical symptoms” (PPS), another term for so-called “medically unexplained symptoms” (MUS). But it still highlights the importance of reversing the purported deconditioning that purportedly is a cause of what it continues to call CFS/ME. The KCL site does not, apparently, reference the new NICE guidelines or inform patients that its approach to treatment has been officially discredited.
Below is the letter sent by Dr Shepherd..............................

 

[BrightCandle]

This one has some potential for fireworks since this is Dr Trudy Chalder's department. I imagine this one doesn't change just because they are asked to, she is well aware of the guidance and thinks its wrong. Will be interesting to see how the department of health handles direct violation of this request.

 

[Husband of]

I don't get it honestly. How can deconditioning be the cause when the same exertion intolerance is present on day one? Are they saying everyone who ever got MECFS was deconditioned before they got it? If so, given MECFS most often has a sudden onset, are they saying people get suddenly deconditoned?? If so, graded exercise therapy won't help, what they need is sudden exercise therapy - some sort of mega exercise that does the opposite of their mega couch potato day that caused them to suddenly become deconditioned.

to be fair my wife did have half a four person chocolate pudding with a shid tonne of whipped cream for dinner the day before getting MECFS; that was a mega couch potato day for sure!

 

[BrightCandle]

It must have been that from scratch homemade pizza for me, I made one a few days before getting ill and I bet that was what caused my extreme deconditioning from someone who was swimming 3 times a week and spent his weekends in the woods playing airsoft. Who knew just eating one bad meal could cause instant de-conditioning, people need to know!

 

[wabi-sabi]

How can deconditioning be the cause when the same exertion intolerance is present on day one?

The BPS brigade doesn't believe that exertion intolerance exists. They believe they are dealing with normal, physically healthy couch spuds who have an emotional freak out when they try to exercise.

Think of how you would feel if you signed up for the couch potato to 5K at your local running club. Those first few days of training you feel pretty sore and tired. The BPS people think that we are so stupid, we mistake that feeling for a real illness. We have a freak out about actually having to do something slightly hard. We crawl home and demand hugs and chocolate to get over the horrible experience of exercise. Then we get more out of shape and have an even bigger freak out and emotional melt down the next time we decide to go to the gym. Our families aid and abet us in being sick by not taking us back to the gym everyday, no matter how big an "But I feel so sick" fit we pitch.

That's not really what's happening of course, and you have to ignore quite a bit about how sick and healthy bodies function to maintain this level of willful ignorance. But the BPS brigade soldiers bravely on against us evil patients trying to malign them and their research. One day we will all realize that we aren't really sick at all, we just have exercise-phobia and they will be vindicated. They live in hope of this day.