halcyon
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Good catch, I didn't even look closely at the article or its references. I'll edit the page.
Fear-of-Exercise hypothesis
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jimells
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I've heard a number of anecdotes that suggest smoking can help control symptoms for some of these patients. Now that the "Tobacco Is Evil" dogma has taken hold, these unfortunate folks really suffer when the illness forces them into locked facilities. Not only are the patients deprived of the symptom control, they also are forced to go through the misery of withdrawal, and now are also subjected to the stigma of smoking. It's all "for their own good", of course.
I am aware of the many health problems caused by smoking tobacco. I am also aware of the serious adverse effects caused by many psychiatric drugs. A little less dogma and judgement, and a little more compassion, is certainly in order.
NilaJones
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I think the fear-of-exercise theory is an attempt by medical people to rationalise their emotional response.
I think doctors, psychologists, etc. feel upset when they see someone seriously ill and they cannot explain or help. Then they don't want to face their own incompetence/helplessness, so they resolve this cognitive dissonance by telling themselves the person is not 'really' ill.
There is also some magical thinking involved -- the idea that is the patient just ACTS like they are better, they will BE better.
I saw an elephant mother once, on a nature show, with her sick baby. The baby could not stand up, and the mom kept trying to lift it to its feet with her trunk. If baby would just get up, everything would be ok, right?
I think doctors are doing what that elephant mom was doing. They just dress it up in fancy words to try to cover up the fact that it is their OWN fear that is the topic.
I think doctors, psychologists, etc. feel upset when they see someone seriously ill and they cannot explain or help. Then they don't want to face their own incompetence/helplessness, so they resolve this cognitive dissonance by telling themselves the person is not 'really' ill.
There is also some magical thinking involved -- the idea that is the patient just ACTS like they are better, they will BE better.
I saw an elephant mother once, on a nature show, with her sick baby. The baby could not stand up, and the mom kept trying to lift it to its feet with her trunk. If baby would just get up, everything would be ok, right?
I think doctors are doing what that elephant mom was doing. They just dress it up in fancy words to try to cover up the fact that it is their OWN fear that is the topic.
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To repost my thoughts: António Caetano de Abreu Freire Egas Moniz, appart from having a stupid name, he also recieved the Nobel prize for inventing the hidious practice of prefrontal lobotomy by sticking a sharp instrument though the eye socket.I think that in time Sir Simon will be viewed in the same light as the above.
So titles do not mean much.
So titles do not mean much.
alex3619
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Here is a question, only in part sarcastic: these researchers refuse to put these hypotheses in perspective and embrace modern scientific method. What is it they fear?
There seems to be a huge phobia/delusion thing in psychiatry that is quietly acknowledged and largely ignored with a hope nobody will notice. That is that most psychiatric diagnoses are created by committee, have no scientific basis, and even lack biomarkers. In other words, we don't know which ones are discrete clinical entities, nor even if the notion of a discrete category is valid. I wonder if we should put a name to this delusional fear complex syndrome? Where does delusion stop and medical politics start?
Its a lot like ME would have been many decades ago, before we had oodles of biomedical abnormalities discovered.
Further, psychiatrists use these unproven and unstable theories to coercively treat some patients, including sectioning.
They often lie to patients, and dress it up as encouragement and helpful for a placebo effect. They usually do not acknowledge this can destroy the patient-practitioner trust.
They assemble data for their hypothesis, in as large a mess as possible, yet fail to examine data against their hypothesis adequately, nor to test their hypothesis to see if it breaks. Counter-arguments used to defend their theories tend to be irrational and fallacious, and include ad hominem and strawman arguments.
They know, to a fair certainty, that many of the causative and treatment theories have to be wrong, but nobody knows how many - it could be nearly all of them. So they don't attack other schools of thought. This applies to the whole medical profession, not just psychiatry. Glass houses, stone throwing, and all that.
They seem afraid of losing power and authority, largely due to poor image. Yet at the same time they fail to realize they have lost much of their authority due to medical politics and failed economic theories. This leads to ...
They quite rightly think that medicine needs to be based on solid evidence, but miss that this needs to be scientific evidence. They also fail to recognize that institutional uses of the evidence based approach are increasingly less about good medicine but more about cheap medicine. Doctors are losing control of their own profession.
Argument of many psychiatric theories is by rhetoric and indoctrination, not by evidence, and reason, and most importantly there is a distinct lack of scientific evidence. The mathematical validation in psychiatry, for example by the use of kappa for the APA's DSM, is not proper scientific validation. Its about diagnostic reproducibility.
These arguments of mine apply to a variable degree on individuals, but are largely valid (in my opinion) for the profession.
I think there are huge numbers of very sick and distressed people who need their help, and huge numbers who do not need their help but have it forced on them. I think we need psychiatry, or something like it, but the entire profession needs drastic change. Much of it is unscientific, and this component needs to be removed and placed in alternative psychiatry. How to do that though?
Psychiatry, as a profession, needs a reality check.
There seems to be a huge phobia/delusion thing in psychiatry that is quietly acknowledged and largely ignored with a hope nobody will notice. That is that most psychiatric diagnoses are created by committee, have no scientific basis, and even lack biomarkers. In other words, we don't know which ones are discrete clinical entities, nor even if the notion of a discrete category is valid. I wonder if we should put a name to this delusional fear complex syndrome? Where does delusion stop and medical politics start?
Its a lot like ME would have been many decades ago, before we had oodles of biomedical abnormalities discovered.
Further, psychiatrists use these unproven and unstable theories to coercively treat some patients, including sectioning.
They often lie to patients, and dress it up as encouragement and helpful for a placebo effect. They usually do not acknowledge this can destroy the patient-practitioner trust.
They assemble data for their hypothesis, in as large a mess as possible, yet fail to examine data against their hypothesis adequately, nor to test their hypothesis to see if it breaks. Counter-arguments used to defend their theories tend to be irrational and fallacious, and include ad hominem and strawman arguments.
They know, to a fair certainty, that many of the causative and treatment theories have to be wrong, but nobody knows how many - it could be nearly all of them. So they don't attack other schools of thought. This applies to the whole medical profession, not just psychiatry. Glass houses, stone throwing, and all that.
They seem afraid of losing power and authority, largely due to poor image. Yet at the same time they fail to realize they have lost much of their authority due to medical politics and failed economic theories. This leads to ...
They quite rightly think that medicine needs to be based on solid evidence, but miss that this needs to be scientific evidence. They also fail to recognize that institutional uses of the evidence based approach are increasingly less about good medicine but more about cheap medicine. Doctors are losing control of their own profession.
Argument of many psychiatric theories is by rhetoric and indoctrination, not by evidence, and reason, and most importantly there is a distinct lack of scientific evidence. The mathematical validation in psychiatry, for example by the use of kappa for the APA's DSM, is not proper scientific validation. Its about diagnostic reproducibility.
These arguments of mine apply to a variable degree on individuals, but are largely valid (in my opinion) for the profession.
I think there are huge numbers of very sick and distressed people who need their help, and huge numbers who do not need their help but have it forced on them. I think we need psychiatry, or something like it, but the entire profession needs drastic change. Much of it is unscientific, and this component needs to be removed and placed in alternative psychiatry. How to do that though?
Psychiatry, as a profession, needs a reality check.
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Outside Psychologists Shielded U.S. Torture Program, Report Finds.
Saturday headline in NY Times, says it all, psychs are still involved with torture now but it is ME patients who are suffering.
Saturday headline in NY Times, says it all, psychs are still involved with torture now but it is ME patients who are suffering.
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And in Sundays Times: The New Child Abuse Panic
which also involves the Psych industry.
which also involves the Psych industry.
alex3619
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To be clear, this is about psychologists not psychiatrists, and the APA is the other APA for psychologists.
Thread here: http://forums.phoenixrising.me/inde...ter-report-alleges-post-9-11-collusion.38665/
Snow Leopard
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The hypothesis was tested and was found to be flawed:
"Chronic Fatigue Syndrome: Lack of Association Between Pain-Related Fear of Movement and Exercise Capacity and Disability"
http://ptjournal.apta.org/content/84/8/696.short
"Chronic Fatigue Syndrome: Lack of Association Between Pain-Related Fear of Movement and Exercise Capacity and Disability"
http://ptjournal.apta.org/content/84/8/696.short
I read this study too (it's from 2003), but I wasn't sure what they really meant by:
To me this sounds like they're saying: 'there is no reason to fear exertion, because you are certainly capable of exerting yourself.' Or am I missing something?
PS It's written by BPS people (minus KDM, but I believe he was only involved in the logistics/administrative part of the study - I read this somewhere but can't find it right now)
A lack of correlation means that there is no connection: fear does not result in disability.
I know what correlation means (duh). They say there is no connection between fear of exercise and exercise CAPACITY. So we are afraid of exercise, although our capacity to exercise is fine, aka we are afraid of nothing. That is how I understood this very old study.
If there wasn't disability, they would say there wasn't disability. Saying that there was no connection between the two factors implies that each factor exists. I'm not sure where you're getting your interpretation from.
@Valentijn just wondering 
You always have to read a bit more into these BPS studies to make sure you're not missing anything. It's a really old study anyway, so let's just leave it at that.
You always have to read a bit more into these BPS studies to make sure you're not missing anything. It's a really old study anyway, so let's just leave it at that.
Snow Leopard
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If you didn't like that study, here is another study from Peter White and colleagues saying the same thing:
http://www.ncbi.nlm.nih.gov/pubmed/15992572
"CONCLUSION:
The data suggest that CFS patients without a comorbid psychiatric disorder do not have an exercise phobia."
http://www.ncbi.nlm.nih.gov/pubmed/15992572
"CONCLUSION:
The data suggest that CFS patients without a comorbid psychiatric disorder do not have an exercise phobia."
Now THAT is a clear conclusion! Thanks for posting @Snow Leopard
panckage
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For me it makes sense. What you said is correct too though. I reduced activity because I would feel like passing out (as well as having bad symptoms for years also lead to extreme muscle weakness) . OTOH I seem to have a milder form of CFS as sometimes I feel somewhat better and exercise is tolerable.
The problem is I don't know when to draw the line. Forgetting CFS for a moment I usually feel like crap if I don't exercise so when my symptoms are less (and I am capable of more exercise) I am often not aware of it. I am so used to merely surviving that when i do feel a bit better it takes me a long time to figure out that my condition has actually improved.
I believe a fair number of people with my 'mild' type of CFS would test positive for 'irrational exercise avoidance' on such a test
Have you tried using a heart rate monitor as a guide to pacing and/or exercising?
panckage
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Yep. But it doesn't help. When I'm not good (or medicated
my heart rate just stays low and I feel feint. It's really obvious even without the heart rate monitor
NilaJones
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I have recently become well enough to physically go to doctors, and have run into this problem. I wonder if any of you all could advise me on how to handle doctors?
My real problem is that I push myself too hard, physically and mentally. But 'too hard' IRL looks like 'fear of exercise' to healthy doctors.
How can I explain this to them? Is there any way, if I encounter someone who is not 100% closed-minded? What do you say?
My real problem is that I push myself too hard, physically and mentally. But 'too hard' IRL looks like 'fear of exercise' to healthy doctors.
How can I explain this to them? Is there any way, if I encounter someone who is not 100% closed-minded? What do you say?