A Qualitative Study of the Views of Patients With [MUS] on The BodyMind Approach®: Employing Embodied Methods and Arts.., 2020, Payne and Brooks

Andy

Retired committee member
Full title: A Qualitative Study of the Views of Patients With Medically Unexplained Symptoms on The BodyMind Approach®: Employing Embodied Methods and Arts Practices for Self-Management
The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach® (TBMA). It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms (MUS) applied in primary healthcare. The relevance of embodiment and arts practices in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services.

This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: (1) body with mind connections; (2) importance of facilitation; (3) potential benefits; (4) preparedness for change; (5) self-acceptance/compassion.

This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing.
Open access, https://www.frontiersin.org/articles/10.3389/fpsyg.2020.554566/full
 
So is this another lot of psychobabblers wanting their share of the lucrative IAPT market. Another way of diverting sick people from actually getting medical help and persuading them they just have to think differently and all will be well. And if their symptoms remain, it's their fault. :sick:

Edit: I started reading the detail. It's even worse than I thought.
 
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Helen Payne, nothing to hope from her.
We've talked about one of her videos here. That's one of the dumbest and unevidenced thing I've ever watched.

She says about the MUS patients "they just keep going back to the GP, every day, every single day" and that tey can get better with "one nostril breathing, relaxing, drawing animals and singing nursery rhymes".

Edit grammar
 
So, the conclusion I drew from this is:

If a researcher uses a qualitative method, they can write a whole paper on themes that align with their own hopes and beliefs, without ever mentioning any of those that might run counter to them.

Reading the paper, you would go away thinking that there was unanimous satisfaction with this "body-mind" programme, and I think this is extremely unlikely with any programme, no matter how amazing. So looks very fishy to me.

In Psychology, qualitative methodologies are often not accorded the same respect as other methods, and the people who work with them often feel undervalued. I personally think that qual methods are extremely important. But this paper demonstrates the limits of those methods. You absolutely cannot use them to assess the effectiveness of a programme that you're heavily invested in, because there are no universally agreed checks and balances within the methods. Which leaves them wide open to researcher bias and expectations.

Even the shitty questionnaires the BPSers use at least allow for the possibility of disconfirmation.

To me, this research reads like an ad for a patented weight loss programme, the type that includes (carefully selected) customer endorsements. No, its worse than that, because there is no legal requirement to place a warning underneath those endorsements, saying "individual results may vary" ;)
 
I have no words.


Edit to add:

1) interestingly her editors and reviewers are located in Israel. Does that mean anything?

2)Helen Payne published this last year:


Medically Unexplained Symptoms and Attachment Theory: The BodyMind Approach

This article discusses how The BodyMind Approach®(TBMA) addresses insecure attachment styles in medically unexplained symptoms (MUS). Insecure attachment styles are associated with adverse childhood experiences (ACEs) and MUS (Adshead and Guthrie, 2015) and affect sufferers’ capacity to self-manage. The article goes on to make a new hypothesis to account for TBMA’s effectiveness (Payne and Brooks, 2017), that is, it addresses insecure attachment styles, which may be present in some MUS sufferers, leading to their capacity to self-manage. Three insecure attachment styles (dismissive, pre-occupied and fearful) associated with MUS are discussed. TBMA is described and explanations provided of how TBMA has been specifically designed to support people’s insecure attachment styles. Three key concepts to support insecure attachment styles involved in the content of TBMA are identified and debated: (a) emotional regulation; (b) safety; and (c) bodymindfulness. There is a rationale for the design of TBMA as opposed to psychological interventions for this population. The programme’s structure, facilitation and content, takes account of the three insecure attachment styles above. Examples of how TBMA works with their specific characteristics are presented. TBMA has been tested and found to be effective during delivery in the United Kingdom National Health Service (NHS). Improved self-management has potential to reduce costs for the NHS and in General Practitioner time and resources
https://www.frontiersin.org/articles/10.3389/fpsyg.2019.01818/full

3) paging @Hilda Bastian and @Carolyn Wilshire... there may be others...



 
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Ok I have more to say. This part is particularly cruel and insensitive:

Of the 18 participants interviewed, 15 were female and 3 were male. Of those participants who were invited to complete the PEF, 24 were returned out of which only 14 answered the question on gender. The gender mix, 8% male and 92% female, reflects the literature whereby more women than men somatize

and then this indicates where they are going with this...

The potential benefits of TBMA to support patients with MUS to learn to self-manage could be that it replaces current treatments (which are unacceptable to patients) and integrates the body and mind in one holistic biopsychosocial model. Furthermore, it could reduce the high costs for MUS conditions, freeing up GP time, and increasing capacity and resources
 
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And if wishes were horses, beggars would ride.

Also if the Moon were made of cheese we could all feast for eternity, therefore world hunger has been solved so let's stop all efforts, there will be no questions this is obviously REAL SCIENCETM.
 
I see where all this health psychology is going, all the emphasis on mind-body, all the watering down of intellect, and clumping and lumping the real with their imaginary.

Why yes, there are money-making opportunities arising from the MUS designation, a nation of practitioners shall arise.

Are we as a culture just running out of empathy with those who suffer so that doctors, health psychologists, therapists, and psychiatrists can feel more competent and get more job satisfaction by dumping the difficult to understand into the sewer of MUS?

It is ivory tower imbecility, basking in conceptualizing nonsense, a lack of clinical acumen, a huge missing chunk of empathy and it's intellectually dishonest, wrong, wrong-headed and I assume, headed for the grave in the next five years, I hope.
 
This research appears to have taken well over a decade from approval to completion. I waded through some of the paper.

I noticed, among many other things, that patients enrolled in these groups had a half hour preliminary interview to assess suitability. I am imagining it was sold to them as free sessions of enjoyable things like art and dance in a mutually supportive environment where they would be with others suffering similar symptoms.

That could be appealing on all sorts of grounds for reasons nothing to do with any alleged therapeutic effect. Those for whom such activities are unappealing would not join, so would not be counted as therapeutic failures, nor was there any control group. The obvious thing would be to offer parallel groups with the art, dance and social support without all the body-mind psychobabble.
 
She says about the MUS patients "they just keep going back to the GP, every day, every single day"

I find it impossible to believe that this ever really happens. Apart from anything else, if I ask for an appointment to see a doctor I get given one that can be 3 - 6 weeks in the future. It will never be "tomorrow".

Edit : I'm talking about getting an appointment pre-Covid. I have no idea how to see a doctor since Covid started.
 
This research appears to have taken well over a decade from approval to completion. I waded through some of the paper.

I noticed, among many other things, that patients enrolled in these groups had a half hour preliminary interview to assess suitability. I am imagining it was sold to them as free sessions of enjoyable things like art and dance in a mutually supportive environment where they would be with others suffering similar symptoms.

That could be appealing on all sorts of grounds for reasons nothing to do with any alleged therapeutic effect. Those for whom such activities are unappealing would not join, so would not be counted as therapeutic failures, nor was there any control group. The obvious thing would be to offer parallel groups with the art, dance and social support without all the body-mind psychobabble.

If i get sick, i want to see a doctor. I do not want to be in a circle talking about my emotion and psycho-babble stuff. I do not want to have to meditate each and every time there is a meeting and i do not want to hear about how someone felt liberated after dancing in last week’s session. I do not want to have my disease diluted into something where all of the dead end diseases end up, where terms like ‘catastrophizing’ and ‘somatizing’ are commonly implied.

i’ll be damned if this stuff flies for the Long-COVID ER junior doctors who got sick and land in that kind of health care.
 
Previously called “psychosomatic conditions,” MUS (or somatic symptom disorder/body distress disorder) is now defined as chronic bodily complaints for which examinations do not show explanatory structural or other specified pathology (Henningsen et al., 2007), for example, chronic fatigue, headache, chronic pain, fibromyalgia, etc. (Department of Health, 2008; Fink and Schroder, 2010).
This is an example of medical Gerrymandering (Moving the goalposts, dishonest definitions). It's interesting that they admit they mean psychosomatic by saying MUS. I wish we didn't have to deal with the outdated belief that anything we can't explain is psychosomatic still in 2020. Lets hope #LongCovid changes things.

I personally think that qual methods are extremely important. But this paper demonstrates the limits of those methods. You absolutely cannot use them to assess the effectiveness of a programme that you're heavily invested in,
I agree that qualitative outcomes can be useful where quantitative fails, sometimes it's like putting a square peg in a round hole.
 
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