Yes, I do appreciate your point Jo. My hope is that, no matter what the (sort of) technicalities are, the innocently uninformed will interpret what they read, from a publicly popular doctor, the message that he got it wrong and that ME/CFS is real. Yes the message is a little muddled, but at the very least it must make some people think again, and hopefully rattle some cages.
Yes Barry, I said in another thread that I agree that it's fine on the face of it and I wouldn't bother to comment on reading between the lines were it not for the context and timing (FITNET, MEGA etc.) My other comment was here -
http://forums.phoenixrising.me/inde...-eye-me-cluster-bomb.48034/page-3#post-789281
The confusion and difficulty here stems from the fact that the Eye article (November 25, 2016) is two things at once. It is a genuine and welcome turnaround in opinion from someone who has clearly been listening to people with M.E (pwme), but it is also playing British medicine's new game: paying lip service to biological causation while continuing to treat M.E as if it were "predominantly perpetuated by unhelpful illness beliefs" (Pace).
The conflation of psychological and physical conditions continues unabated (hence the importance of addressing the proposed "MEGA" trial's apparently broad selection criteria at the outset). Prof. Holgate of the UK "CFS/ME Research Collaborative" appeared, at first, to have recognized the problem of "CFS"'s heterogeneous population. However he unfortunately seems to have failed to grasp that the contradictory grouping of "CFS" (containing both those helped and those harmed by exercise) was the result of simple, reversible, choices and prejudices from doctors as opposed to unspecified unknowns within the disease itself.
Progress within Myalgic Encephalomyelitis could be made at stroke were those with Post Exertonal Malaise separated from those with Pre-Exertional malaise (or "Deconditioning"). However, at present, British medicine appears to have lost the ability or the will to even try to make such judgements.
That there is a grave problem here is clearly underlined by the fact that medicine is responding to a heterogeneous population with a homogeneous treatment programme: CBT/GET. The latter has become a "one size fits all" treatment for M.E patients despite repeated reports of harm.
Medicine should act as a telephone exchange: the job here is to connect the right person to the right treatment. Any treatment capable of effecting change can effect negative change if applied to the wrong context, in this case, the wrong disease. If you approach doctors with this idea (as I have done) they will readily agree with the concept, but will then simply fail to address the issue in practice.
We are left with the vacuity of declaring "CBT safe" without specifying which cognitions will be challenged and why. We are left with Evidence Based Medicine founded upon the opposite of M.E patient values. We are left with physicians attempting to increase patients' levels of exertion while simultaneously accepting that the primary symptom of M.E is Post Exertional Malaise (PEM).
Sadly such contradictions appear immune to reason. Yet they are very powerful for those who wield them. They cover all bases, and all exits. They confuse and confound opposition. They are nothing and yet via Logical Explosion, can be used to justify everything.
Within M.E self-contradictions enable physicians to have their cake and, impossibly, to eat it too. However, in the real world such intellectual dissonance quickly reduces down. Doctors end up with double rations while patients are left to go hungry.
@batteredoldbook
14:19 26/11/2016