That's a disengenous argument because "heart attacks" encompasses almost anything that leads to a heart attack, it's like talking about deaths and failing to distinguish between deaths due to a disease, suicide, accident, murder, etc... just because they all end up much the same way. Any such statement is so general it becomes worthless. A bit like Oxford/Fukuda "CFS".
We see this broad generalisation used in some of the weak arguments to try and convince pwME about CBT and GET, as if viral cardiomyopathy is the same as someone who stuffed themselves with cream buns all their life. It's confusing irresponsibility with sheer misfortune, something that seems increasingly useful to health policy makers and psychiatrists making a living out of "difficult to define" vagueness.
AFAIK no RCTs to date have shown increased survival of cancer patients through CBT, so it is really the proverbial rearranging deckchairs. Though I'd be surprised if some enterprising psych didn't have another bash.
The argument of personality types/disorders is weak as well; for a long time it was thought men should talk about their feelings more and bottling up made "stress" worse, but then a study was published showing that when that happened it had the opposite effect.
... CBT, he agreed, was used as a helpful therapy a range of physical illnesses including cancer, but ME was the only illness where it was promoted as treating the underlying cause.
That's not much more helpful, because when you look at CBT that is being practised in cancer, it seems either to not be actual CBT (as per the CMO Report definition) or it's aimed squarely at the minority of "abnormal illness behaviour" cases, eg. AIDS patients who persist in unsafe sex and refuse drugs, or my above example of the cream buns. These cases shouldn't really be considered the norm as most patients are reasonably sensible (and if having a heart attack isn't going ot give you a kick up the backside nothing will).
It's not suprising Shepherd swallows this though, as he's on record as regurgitating the "maintained by ... mood or depression" argument of ME/CFIDS:
http://www.cfids-cab.org/rc/Shepherd.pdf
Maintaining factors linked to the actual illness
To complicate matters further, a number of symptoms and
consequences of the illness may also play a role in maintaining
or exacerbating ill health and disability. These include the
presence of constant pain, and/or any significant sleep or
mood disorder such as depression.
(Sleep only makes a big difference on "disability" [as opposed to how crap you feel] if the disability is mainly chronic fatigue - or a sleep disorder. It's difficult to see how mood, depression or sleep can somehow
maintain the
actual illness rather than making what's already there more subjectively miserable.)
I imagine confronting CS on this would be met with the usual dissembling, minimising, defensive accusations etc. It's a typically tricksy enough bit of writing that he can claim it doesn't mean what it looks like it means, but ultimately the psychs, policy makers, LHAs, the government, MRC, BMJ, all know what it means as they're very fond of meaning it themselves.
As someone who has ME heart failure I do take exception to the continual confuddlement over psychobabble's worth in "one size heart disease for all" faux-comparison. I work damned hard to keep from dying and minimising ghastly suffering with virtually no help and don't need anyone to suggest I'm "doing it all wrong" aka "would benefit from a different coping approach" aka "CBT helps you to find new ways of looking at problems" etc etc.
Modern psychiatry's only real home is abnormal psychiatry (there are other people doing a better job of listening etc) pity they're not honest enough to stick to it and say what they mean all the time.
Which brings us back to IBS... The medical advisor of the "GUT Trust" is you guessed it, a shrink. IBS is very heavily psychologised and there seems less resistence to that (AFAIK) than with ME, probably largely due to it never having been accepted as a disease in the first place, and likely it has the similar problems with psych misdiagnoses etc.