This is often said, but is it really true? The intention (and often stated outcome) of CBT use in cancer, MS, etc. is a reduction of fatigue/pain and increase in quality of life/functional capacity. Yeah, the CFS CBT model goes a step further and talks about the presumed psychosomatic etiology, but on a high level the treatment model seems identical to me.
It's very much not.
CFS CBT goes beyond CBT to active symptom denial, which leads to 'pushing through', which many believe can cause severe long term worsened disability.
CBT - if it was 'don't think overly about your symptoms and how they ruin your life, but how your symptoms allow you to maximise your available energy' - would be great.
For CBT for cancer to be similar, it would be about teaching patients not to worry about new lumps, and to accept their body image as beautiful.
https://www.nice.org.uk/guidance/cg...general-management-strategies-after-diagnosis
CBT for a person with CFS/ME should be planned according to the usual principles of CBT, and should include:
- Acknowledging and validating the person's symptoms and condition.
- Explaining the CBT approach in CFS/ME, such as the relationship between thoughts, feelings, behaviours and symptoms, and the distinction between causal and perpetuating factors.
- Developing a shared formulation and understanding of factors that affect CFS/ME symptoms.
- Agreeing therapeutic goals.
- Tailoring treatment to the person's needs and level of functioning.
- Recording and analysing patterns of activity and rest, and thoughts, feelings and behaviours (self-monitoring).
- Establishing a stable and maintainable activity level (baseline) followed by a gradual and mutually agreed increase in activity.
- Challenging thoughts and expectations that may affect symptom improvement and outcomes.
- Addressing complex adjustment to diagnosis and acceptance of current functional limitations.
- Developing awareness of thoughts, expectations or beliefs and defining fatigue-related cognitions and behaviour.
- Identifying perpetuating factors that may maintain or exacerbate CFS/ME symptoms to increase the person's self-efficacy (sense of control over symptoms).
- Addressing any over-vigilance to symptoms and related checking or reassurance-seeking behaviours by providing physiological explanations of symptoms and using refocusing/distraction techniques.
- Problem solving using activity management and homework tasks to test out alternative thoughts or beliefs, such as undertaking pleasure and mastery tasks (tasks that are enjoyable and give a sense of accomplishment).
- Building on existing assertion and communication skills to set appropriate limits on activity.
The whole lot (some deleted, and some highlighted is problematic.
There is the underlying assertion that the whole pathology of the disease is fear-avoidance, with no other pathology. The 'provide physiological explanations' part for example is to instruct doctors to lie to patients (the supposed hypothesis makes no sense from an exercise physiology point of view).
This is not neutral or harmless therapy.
It is DANGEROUS, and sets the scene for worsenings possibly meaning people spending the rest of their lives in bed, or housebound.
It is doubly dangerous as non-compliance may have other consequences.