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Simon Wessely Quotes

Valentijn

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Currently digging up the harder-to-find articles and chapters. I just hit one that mentions (and dismisses) PEM:
One of the consequences of neuromuscular deconditioning is delayed onset postexertional muscle pain, partly resulting from eccentric muscle contractions, where the muscle lengthens whilst doing work, especially in the untrained person . . . .
Wessely S, Chalder T. Chronic Fatigue. In; "Neurological Rehabilitation". (eds Greenwood, Barnes, McMillan, Ward). Edinburgh; Churchill Livingstone, 2nd edition, in press.
I'd seen this elsewhere, so decided to see what the hell he's talking about. According to http://en.wikipedia.org/wiki/Muscle_contraction#Eccentric_contraction it's called delayed onset muscle soreness. While the time frame is about right, wikipedia has this to say: "The pain is felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest."

Whereas in PEM/PENE, the pain is constant and symptoms are more widespread than just muscles that were used.

There might indeed be a problem with eccentric muscle contractions, but if so it's a pathological version of it - not standard deconditioning.
 

Persimmon

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Valentijn, this is great!

Thanks for all the hard work.

Here's a Wessely" quote that acknowledges the severity of our disease: it's good to be able to point to our biggest critics admitting this much:

"... far from merely representing the “worried well”, many such patients are severely disabled. For example, chronic fatigue syndrome is associated with worse disability than conditions such as heart failure."

The quote is from page 396 of 'Functional somatic syndromes: one or many?'
S Wessely, C Nimnuan, M Sharpe
Lancet 1999; 354: 936–39
 

Valentijn

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"... far from merely representing the “worried well”, many such patients are severely disabled. For example, chronic fatigue syndrome is associated with worse disability than conditions such as heart failure."
These sorts of quotes are difficult ... I try to choose the ones where he's stating things very plainly, but in one like this I think his meaning is different than what would usually be inferred by someone reading it. That is, there's a suggestion in this quote that CFS is a serious physiological disease by comparing it to heart failure, but what he really seems to mean in the greater context of his other work is that mental illnesses like his version of CFS can be just as disabling as physiological illness.
 
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"Finally, it should be noted that our conclusions are primarily based on common sense, in the absence of a sound evidence base."
Huibers M, Wessely S. The act of diagnosis: pros and cons of labelling chronic fatigue syndrome. Psychological Medicine 2006: 36

This one pissed me off the most. How can he claim that his research is based in science and then conclude it is primarily based on common sense. After admitting this, why is it that people still listen to this man? I don't get it.

I think this is a good idea (keeping his quotes in one area). When he contradicts himself, we will know; and, hopefully, can get others to see it to.
 

Valentijn

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While reviewing quotes today, I realized that this recent one:
No one has ever advocated that CBT or GET should be made compulsory, but surely patients must be able to make informed choices on the basis of an unbiased quality assessment of the evidence, after which they are free to choose either way.
Smith Ch, Wessely S. Unity of opposites? Chronic fatigue syndrome and the challenge of divergent perspectives in guideline development. JNNP 2012.
... is directly contradicted by Wessely's earlier work here:
Sickness benefits....At present individual [CFS] cases should be treated on their merits, but it is reasonable to expect a patient to cooperate with treatment before being labelled as chronically disabled.
Wessely S, David A, Butler S, Chalder T. The Management of the Chronic Postviral Fatigue Syndrome. J Roy Coll General Practitioners 1989; 39: 26-29.
... and here:
When asked to comment on benefits or insurance claims we support the patient as much as is possible, but do not support claims for permanent disability or medical retirement until all reasonable efforts at rehabilitation have been tried.
Sharpe M, Chalder T, Palmer I, Wessely S. Assessment and management of chronic fatigue syndrome. General Hospital Psychiatry 1997:19:185-199
Though perhaps he could claim it wasn't strictly compulsory, since the patient could always opt to starve on the street if benefits were withheld pending a course of CBT :rolleyes:
 

Sidereal

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While reviewing quotes today, I realized that this recent one:

... is directly contradicted by Wessely's earlier work here:

... and here:


Though perhaps he could claim it wasn't strictly compulsory, since the patient could always opt to starve on the street if benefits were withheld pending a course of CBT :rolleyes:
No disability for you unless you let us make you bedridden with GET first.
 

msf

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Valentjin, you forgot this one:

'I'm a ******* idiot' - Simon Wessely (not the Simon Wessely you know, of course!)
 

Dufresne

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I've been a member of this forum for six years now and never bothered reading anything from Wessely. I basically understood what he was about from little snippets picked up here and there.

But with nothing to do this afternoon I decided to skim through these quotes and can't help but be impressed by the extent of his assholeness. I actually like the fact that he's been knighted, it sort of punctuates his absurdity. And now that he's doing a bit of rebranding since the rituximab study came out... Make no mistake, the knight is falling on his sword.
 

worldbackwards

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@Valentijn I couldn't see if you have anything from Wessely's very blunt (and now paywalled) New Scientist interview from 2009, "How people can think themselves sick", but I don't think so. Anyway, I have a print copy here, so I'll put some quotes up from it:

On the effects of the mind on the body:
Most people instinctively know that when bad things happen, they affect your body. You can't sleep, you feel anxious, you've got butterflies in your stomach…you feel awful…Such symptoms only become a problem when they become trapped in excessively narrow explanations for illness - when they exclude any broader explanation for the many reasons why we feel the way we do. This is where the internet can do real harm. And sometimes people fall into the hands of charlatans who give them bogus explanations

On how CFS starts:
Often there's an organic trigger, like glandular fever. That's the start and usually most people get over it, albeit after some weeks or months. But others can get trapped in vicious circles of monitoring their symptoms, restricting their activities beyond what is necessary and getting frustrated or demoralised. This causes more symptoms, more concerns and more physical changes, so much so that what started it all off is no longer what is keeping it going.
On severe CFS:
In that kind of disability, psychological factors are important and I don't care how unpopular that statement makes me.
On CBT and GET treatment:
Roughly a third of people recover and a third show good improvement. About a third we can't do much for.
On CFS/IBS/FS overlap:
If you ask people with IBS if they suffer from fatigue they all say yes…Likewise, if you talk to someone with CFS, you find that nearly all of them have gut problems. If you systematically interview people with these illnesses, you find that a big proportion of these so-called discrete syndromes have a large overlap with the others. You have to think that we have got the classifications wrong.
I think his views are unusually clear in this interview - I can't think of any way this could be spun as anything other than an insistence on this being a primary psychological problem.
 
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Sean

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I don't care how unpopular that statement makes me.
Yeah, you're a real hero.

Roughly a third of people recover and a third show good improvement.
Liar.

Also inconsistent. He has made widely differing statements over the year about the effectiveness of CBT for ME/CFS, ranging from the above, to it being "not remotely curative".

He just says whatever version he thinks his audience wants to hear, or that he can get away with.

I will also bet that when the official records are finally released about his advice to governments (assuming they ever are), they will show that his real views were much more unscientific and extreme than anything he has said in public.

I think his views are unusually clear in this interview - I can't think of any way this could be spun as anything other than an insistence on this being a primary psychological problem.
Agree. He nailed his views to the mast for all to see in this interview.
 

Hip

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Roughly a third of people recover and a third show good improvement.
When it comes to ME/CFS that appears after mononucleosis, a third of such ME/CFS patients show good improvement (eg: back to work) after around decade, and around half of those were considered to be fully recovered. Ref: 1
 

Sean

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When it comes to ME/CFS that appears after mononucleosis,
That may be true, as far as that subset goes. But no definition of ME/CFS requires it to be triggered by mononucleosis, so at the least it has to be a heavily qualified statement. If Wessely's comment about thirds was clearly confined to that subset, then he is probably on safe ground (as far as it goes), and I am happy to withdraw and apologise.

If he did not clearly qualify that claim, then he is playing his usual games with words.
 

Hip

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If Wessely's comment about thirds was clearly confined to that subset, then he is probably on safe ground (as far as it goes)
Well I am not sure where Wessely gets his figures from, but in the case of this mononucleosis triggered ME/CFS subset, the study shown that only 13% reached fully recovery, so that is less than a half of the 33% figure that Wessely is quoting for recovery.

However, Wessely's quote of 33% getting good improvement would appear to tally with that study.

Agreed that ME/CFS does not have to be triggered by viruses like EBV that can cause mononucleosis, and it may be that enterovirus triggered ME/CFS might have different recovery rates.

I'd like to know where his figures come from. Presumably they must be from some study or other.