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Personality Features and Personality Disorders in Chronic Fatigue Syndrome: A Populat

IamME

Too sick for an identity
Messages
110
It seems to me that most CFS patients are not grateful for the pioneering help they've recieved in this regard.

"Pioneering help"?! If you're being sarcastic you need to make it clearer.

"I think that psychological and social factors often will affect the way allmost all illnesses develop, disable and are treated."

You can read here about what the BPS model seems to think these factors are;

http://en.wikipedia.org/wiki/Biopsychosocial

(I've yet to see the supposed "social" component used in ME/CFIDS as anything other than criticism of carers "enabling" disability etc.)

"The biopsychosocial model of health is based in part on social cognitive theory."

"This is in contrast to the traditional, reductionist biomedical model of medicine that suggests every disease process can be explained in terms of an underlying deviation from normal function such as a pathogen, genetic or developmental abnormality, or injury"

Funny that's just what's censured and what we need more of, in contrast to the abysmal failure of CBT/GET. All the helpful social and psychological helpful stuff oddly enough flows on from that, but it would be "validation" which is why Peter White et al don't want it. If cancerous cells were unknown in cancer the priority would be to find them, otherwise cancer would be as subject to abuse as with us.

"The biopsychosocial model presumes that it is important to handle the three together as a growing body of empirical literature suggests that patient perceptions of health and threat of disease, as well as barriers in a patient's social or cultural environment, appear to influence the likelihood that a patient will engage in health-promoting or treatment behaviors, such as medication taking, proper diet or nutrition, and engaging in physical activity.[6"

Small wonder the psychobabblers aren't willing to scrutinise this "model" very closely, it makes for a nice comfortable polysyllabilic velvet glove to compel your average "chronic fruitcake shirker" or "CFS" as the CDC misdiagnosed us ("unexplained fatigue" = mental illness), into popping some antidepressents, shutting up and ignoring their serious exertional limitations, while at the same time on a grand social-engineering scale generally, conveniently blur the boundaries between disease and irresponsibility.

"Since the collapse of the 19th century models (psychoanalysis, biologism and behaviourism), psychiatrists have been in search of a model that integrates the psyche and the soma. So keen has been their search that they embraced the so-called 'biopsychosocial model' without ever bothering to check its details. If, at any time over the last three decades, they had done so, they would have found it had none. This would have forced them into the embarrassing position of having to acknowledge that modern psychiatry is operating in a theoretical vacuum" (Niall McLaren)

It's our bad luck to get sick in an age where apparently huge swathes of the population are eating/drinking/lazing/thinking themselves sick, if public health arbiters are to be believed. Still, on most sites where BPS examples are listed they tend towards traditional psychosomatic/lifestyle illnesses than something you'd get a non-psychotropic drug for, which is a bit of a give away.
 

Dolphin

Senior Member
Messages
17,567
(OT?) link for some critiques of biopsychosocial model

(If people want a detailed discussion of the biopsychosocial model it might be better to move it to another thread)

If one Googles:
biopsychosocial model "peter white" site:meactionuk.org.uk
one gets articles and critiques of relevance to people with ME to the biopsychosocial model

http://www.meactionuk.org.uk/PROOF_POSITIVE.htm

http://www.meactionuk.org.uk/The_Model_of_the_Myth.htm
In The myth of the biopsychosocial model, N McLaren exposes once and for all the myth upon which the so-called biopsychosocial model of illness so favoured by Wessely School psychiatrists depends (Australian and New Zealand Journal of Psychiatry, March 2006:40:277).
 

Sean

Senior Member
Messages
7,378
...while at the same time on a grand social-engineering scale generally, conveniently blur the boundaries between disease and irresponsibility.

This, IMHO, is right on the money. It is what really drives people like Wessely, Shape, White, Chalder, Prins, Reeves, Jones, etc. Nasty psycho-drama, morality play thuggery, with more than a sprinkling of political ideology, all dressed up in pseudo-scientific, pseudo-compassionate rhetoric.

Their real skill is not in science or medicine, let alone constructive compassion. Their real skill is in political manoeuvring, public relations, and sales. They know how to work the system, how to tell the powerful (and, to some extent, the general public) what they want to hear and win their support. They know how to build empires.

And they are very, very good at it. Wessely, in particular, has this skill in lavish abundance, he is a master at the political game, and without doubt has (thus far, at least) comprehensively outplayed his critics and opponents. As we patients know all too well.
 

biophile

Places I'd rather be.
Messages
8,977
McLaren's views on ME/CFS

In The myth of the biopsychosocial model, N McLaren exposes once and for all the myth upon which the so-called biopsychosocial model of illness so favoured by Wessely School psychiatrists depends (Australian and New Zealand Journal of Psychiatry, March 2006:40:277).

McLaren offers interesting criticism of the biopsychosocial model in general. Unfortunately, his beliefs regarding ME/CFS (as expressed in pages 192-194 of his book, "Humanizing Madness: Psychiatry and the Cognitive Neurosciences") are perhaps even worse than those ascribed to "Wessely School psychiatrists".

He does not believe ME/CFS and other supposedly similar illnesses exist as valid clinical entities, but instead are examples of an obsessive hypochondriacal response (cycle of self-reinforcing fear / abnormal illness beliefs) to the typical but non-descript symptoms of anxiety and depression. So I wouldn't expect McLaren to be supporting our team any time soon. However, what if XMRV/MLV turns out to be significant? Who knows.
 

Dolphin

Senior Member
Messages
17,567
McLaren offers interesting criticism of the biopsychosocial model in general. Unfortunately, his beliefs regarding ME/CFS (as expressed in pages 192-194 of his book, "Humanizing Madness: Psychiatry and the Cognitive Neurosciences") are perhaps even worse than those ascribed to "Wessely School psychiatrists".

He does not believe ME/CFS and other supposedly similar illnesses exist as valid clinical entities, but instead are examples of an obsessive hypochondriacal response (cycle of self-reinforcing fear / abnormal illness beliefs) to the typical but non-descript symptoms of anxiety and depression. So I wouldn't expect McLaren to be supporting our team any time soon. However, what if XMRV/MLV turns out to be significant? Who knows.
Thanks for that biophile. I tend to distrust psychiatrists on ME/CFS unless I see good stuff on them specifically.

Also, he's very critical of antidepressants. There can be value in that. But psychiatrists sceptical of antidepressants are presumably into talk therapy more than most. So may be less into the biological side of conditions. Which made me cautious about his views on ME/CFS until I saw them given somewhere.
 

biophile

Places I'd rather be.
Messages
8,977
Your instincts are accurate here Dolphin. McLaren rejects biological reductionism, is very skeptical about biological factors in mental illness, has even stated that further biological research in psychiatry is a waste of money, and thinks the treatment should target "thought content".

He acknowledges that the mind is dependent on organic hardware, but emerges with its own set of software-like rules, with mental illness (almost always or by default) being maladaptive rules operating within a perfectly healthy brain. I still have to read more of his work, but as far as I know he offers no obvious breakthroughs in treatment protocols, and is instead trying to establish a theoretical framework for psychiatry to proceed, because the profession lacks one and is currently a cluster**** of eclecticism. I think his work is intriguing but too black and white on the subject of biological factors in mental illness.

The topic of this thread is personality in CFS patients, with the CDC reporting that 29% of Reeves-criteria CFS patients had at least 1 "personality disorder" and then apparently adding the caveat that it is not specific to CFS but may be general to serious and chronic disease. As far as I know about his views on personality as the sum of mental rules which affect behaviour, McLaren would probably view 100% of CFS patients as having a personality disorder simply because he views CFS as being the result of chronic anxiety (depression is attributed to chronic anxiety as well), which itself is the result of maladaptive personality factors/beliefs/rules.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Your instincts are accurate here Dolphin. McLaren rejects biological reductionism, is very skeptical about biological factors in mental illness, has even stated that further biological research in psychiatry is a waste of money, and thinks the treatment should target "thought content".

Sounds like a classic case of "Retreat to commitment". (ie retreat towards faith in Psychiatry)
 

Dolphin

Senior Member
Messages
17,567
I know of 4 letters that have gone in (or are just about to go in) complaining about this. Fingers crossed they publish one or more.
 

Enid

Senior Member
Messages
3,309
Location
UK
Hasn't the whole psycho babble lobby learned yet this has nothing to do "types" - better they direct energies to solid scientific biomedical pathology findings as all respected researchers do - discovering/revealing/unravelling the complexity of viral behaviour not only for ME but a vast arrange of human disease.
 

Dolphin

Senior Member
Messages
17,567
I know of 4 letters that have gone in (or are just about to go in) complaining about this. Fingers crossed they publish one or more.
I know three went in (not sure if the fourth person ever sent there's in). Two that went in in recent weeks have been rejected. The third one went in in November. There was no mention of another letter on the subject being accepted in the two latest rejections (one referred to the Heins et al. letter and the Van Houdenhouve letter which weren't on the same topic) so I imagine it [November letter] has been rejected also. :(
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Yes, I personally found it the most rewarding book on philosophy that I have read (though I haven't read that much). Some people may find it deeply unsettling though.
There is a review here: http://www.the-rathouse.com/bartagree.html

Hi Snow Leopard

I'm ploughing through this at the moment- I hven't got to the denouement yet - where he shows us how to outsmart the tu quoque of the irrationalist position like he promised ; )

Don't tell me what happens!!
 
Messages
13,774
Do you know for what sorts of reasons are the letters being rejected?

I've seen some of the stuff circulated about. It seemed like they weren't interested in posting more stuff criticising their CFS work. They'd recently carried a letter from Tom K about a different CFS piece, and felt that meant no more was needed. Who knows... there was that ABC mainstream media piece critical of the paper, some of the CFS charitites had been critical... they didn't want to draw any more attention to it? It's a shame that this means no criticism of the piece will be published though.
 
Messages
13,774
Hi Snow Leopard

I'm ploughing through this at the moment- I hven't got to the denouement yet - where he shows us how to outsmart the tu quoque of the irrationalist position like he promised ; )

Don't tell me what happens!!

That reminds me... I read that review Snow Leopard posted a while back, and it alone is worth reading for those of us too lazy to read a whole philosophy book. It laid out a position I already held, but helped clarify and explain my own instinctive thoughts on the matter. Recommended.
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
That reminds me... I read that review Snow Leopard posted a while back, and it alone is worth reading for those of us too lazy to read a whole philosophy book. It laid out a position I already held, but helped clarify and explain my own instinctive thoughts on the matter. Recommended.

Yeah - it doesn't quite for me - though on reflection I might be prone to say it's my own position - but I see problems in the review (or at least it feels incomplete) so I'm ploughing through, for my sins.