BPS attempts at psychologizing Long Covid

Honestly, I think the concern here is a bit unwarranted. The downside of being a discriminated patient community is that no one cares what we say, or even happens to us. The upside, when stuff like that happens, is the same. No one cares about this stuff and it's already roughly the current paradigm it's not as if this will change anything. The same nonsense will be repeated by the same people with the same frequency and derpitude anyway.
 
Gez M has been causing this kind of trouble since I first became aware of him. I am sure he is familiar with the issues, as he has faced rounds of criticism before, along with Asad Khan for sharing the content. (I unfollowed him as did others). Here is a thread from July 2021 in which they both respond to criticism and questions about motivations:





I am troubled that this is continuing.
 
hibiscuswahine said:
Type A personality is a pop psychology term and played little role in my training in personality development, disorders and treatment. It angers me that he is using a BPS trope which has been disproven many times. The relationship to predisposing you to illness and trauma is speculative and unproven and interestingly many people with these qualities are seen as “successful” and society rewards them by giving them influence and power.

It is his personal journey and I can relate (having seen the other video on his emotional experiences in the psychological strategies video) that he may have experienced trauma and while dealing with the maelstrom of emotions that come with having a life-changing illness, that similar emotions arising from trauma may have become important to attend to and wishes to treat the trauma to help in his recovery but I am not convinced it will solve the biological effects of covid.
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I came to a similar conclusion, which was: the illness he is experiencing or went through may have been a time where he felt awful and hopeless, a time for reflection and reevaluating his life, and also remembering other events from the past that were similar. I suspect he does not have a good grasp of statistics and reasoning about causes of illness, and like many people wants to make sense of what happened to him, and so jumped to the conclusion that there was some causal connection between past events and long covid.

And maybe there is also this element of being scared that long covid could return ro get worse again, and so the idea of controlling long covid by working on old trauma could seem appealing.
 
rvallee said:
Honestly, I think the concern here is a bit unwarranted. The downside of being a discriminated patient community is that no one cares what we say, or even happens to us. The upside, when stuff like that happens, is the same. No one cares about this stuff and it's already roughly the current paradigm it's not as if this will change anything. The same nonsense will be repeated by the same people with the same frequency and derpitude anyway.
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I should have proffered a more cogent response initially. I didn’t mean that Gez would spur a revolution in interest from outside, unaffiliated parties. I meant that his endorsement of the trauma narrative would drum up the same antiquated tropes from the usual suspects, and indeed it has.

However, I do think that in itself is damaging from a patient welfare standpoint. It’s exhausting to revisit these apocryphal theories, and Gez merely exacerbated said exhaustion.
 
I think this thread can be retired, there's no point adding anything to it, almost everything Long Covid falls under this. I actually expected medicine to get to work and that this BPS nonsense would be a sideshow that would be mostly laughed at as clownish.

Instead this is the norm, almost everything has fallen under this model. I'm not sure why I expected this, it just seems like the bare minimum, doing anything less just seemed morally and professionally unacceptable. And yet here we are.

This is what medicine is, fundamentally. It wasn't just the product of ideologues who fail at science, it's in the culture, as a tradition. It's not a fringe thing happening in the shadows while others are busy elsewhere. It's just how medicine deals with things they can't work out easily.

To sum up:

ourexpectations.jpg
 
Hutan said:
Oh, for goodness sake. I haven't been tracking Gez Medinger closely, but I thought he had been reasonably sensible. Seems he's succumbing to the idea that personality and trauma are responsible for getting Long Covid. I guess the idea that you can overcome Long Covid by fixing your personality is more attractive than feeling that you are stuck with it.
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Although Gez has been an excellent source of information for those with Long Covid. He is definitely beginning to dabble with the dark side. If you watch the videos there's a 'eureka' sense when the type a personality is described and a bit too much glow of the converted.
He's well and truly fallen down the rabbit hole of the parasympathetic/sympathetic nervous system upstream interventions. The Gupta video was bad enough but the type A and polyvagal stuff is just claptrap. Yet whatever is said to him he stands by it all ‍♀️. He really needs to do his research more - he did start tweeting it was software not hardware issues with no realisation that is how FND is described. Him and Asad Khan are buddies and it's a real shame to see Dr Khan standing up for this harmful point of view when he seems to be so against the BPS, FND etc.
 
I think a lot of us with ME spent time and money in the early years of our disease trying all sorts of nonsense. I certainly did. The problem now is that we have thousands of medics and media people with Long Covid splashing their latest enthusiasms all over Twitter, YouTube etc without realising what harm this can do to their thousands of followers.
 
Art Vandelay said:
"Mindbody Medicine" claim to be inspired by Dr John Sarno
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I was watching an interview of someone who 'healed herself' after a major trauma (sexual assault) and eventually diagnosed with ME/CFS which she says she had for 13 years, and having tried everything spoke to someone who told her all about the mind-body stuff. She then did loads of courses and has been a life coach, mind-body therapist for a few years.

I've been digging around a bit and John Sarno (inventor of 'TMS' tension myositis syndrome seems to come up quite a lot in other similar talks/interviews).

quick googling brings up quite a lot of skeptical commentary about his theories but equally, even quite recently, there are those who are convinced of their validity and applying them not just to pain but healing of just about anything.
 
Merged thread

Long COVID highlights why we need to overhaul the term ‘psychosomatic’

This is a rather embarrassing article (for the authors) in Canada's the Globe and Mail. They repeat all the usual pseudo-scientific tropes about hardware vs software and buy into the myth of the placebo and nocebo effects.


Long COVID highlights why we need to overhaul the term ‘psychosomatic’
Ralph Lewis, Matthew Burke and Ari Zaretsky
Contributed to The Globe and Mail
Published April 10, 2023
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Many cases of long COVID have been associated with signs of illness that are difficult to observe. Patients are often struck by persistent fatigue and difficulty concentrating (commonly known as “brain fog”), along with other non-specific ailments including palpitations, dizziness, headache, insomnia, and mood dysregulation. This constellation of symptoms is non-specific and common to other distressing syndromes and chronic illnesses from across the medical spectrum. Patients who are suffering debilitating symptoms in the absence of verifiable, objective signs of illness can understandably feel insulted and/or dismissed when doctors suggest their condition may be “psychosomatic” (traditionally viewed, too simplistically, as a physical ailment caused by mental distress as opposed to a physical condition.)
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Newer research and a better understanding of brain circuitry has revealed a much more complex explanation – one that sufferers are likely to find far more validating. We now understand that a wide range of symptoms can be produced by biologically based abnormalities in the function, rather than the structure, of the brain. You might think of this as a problem of “software” rather than “hardware.” Software, or functional, changes in the brain can have many real impacts on the body’s hormonal, metabolic and immune-system functioning.

Neuroscientists now understand that the brain is essentially a prediction machine. To efficiently process a flood of incoming information, the brain makes predictions about what it thinks this information is going to tell it based on expectations and assumptions. Most of the time these are accurate guesses, but the cost of such an efficient system is that sometimes the brain gets it wrong. This is what creates the “magic” of optical illusions, and it also underlies the placebo effect (the real phenomenon of positive expectations leading to symptom improvement) and its counterpart, the nocebo effect (the onset of new, or worsening, symptoms in the wake of negative expectations).
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Comments are the usual cesspit.

Approximately 37 years ago I became ill with a virus over the Christmas holidays. [Describes ME]. I sought help from many doctors who simply classified me as neurotic. [...] Fortunately in my case I fully recovered after about 12 months and have suffered no further symptoms from that infection. I did learn however that doctors were very quick to label my symptoms as psychosomatic simply because they had no other explanation.

Sounds like you were extremely neurotic 37 years ago and got tired of your own neuroses after about a year.​
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As a neurologist myself, let me say bravo for this! A terrific explanation of functional symptoms, which are as complex and bewildering to all of us. We've seen functional illnesses for decades before COVID as well (functional weakness, tremors, body jerks, 'spells' that look like seizures, etc), and are finally getting a better handle on this complex interaction between mind and body. The change to rehab-based mindset has improved things dramatically.

Still much left to learn!
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Oh god, imagine if the “brain retraining” evangelists lean into the software analogy and start borrowing buzzwords from tech. They’ll be wittering about agile, iterative cognitive design, and neural dev ops for hot-deploying health affirmations, probably attracting stacks of venture capital along the way.
 
It's quite a clever article in the way it builds its story of what they say is happening in LC with a series of reasonable and scientific sounding steps.

First, the high prevalence of symptoms like fatigue and pain that doctors can't measure but are 'very real' (patronising) and evidence based in terms of prevalence reported by doctors.

Then the scientific sounding stuff about the brain working by prediction, and the stuff about functional problems in the brain,

Then the 'very real' placebo and nocebo effects, especially nocebo which they describe as 'the onset of new, or worsening, symptoms in the wake of negative expectations'.

Then the pandemic and all the expectations that built about disease and after effects and anxiety etc, and the spread stories about LC in the media and social media building expectations.

Then of course the logical conclusion is that lots of people will get symptoms their doctor can't measure as a result of this chain from pandemic to expectation to nocebo effect to the brain acting on what is predicted by nocebo effect to functional changes in the brain, and bingo, we have the new version of psychosomatic.

So this model sounds like it's based on observation, evidence, logic and science - when in fact it's an unevidenced, ie made up, story to suit the prejudices of the psychiatrist et al. who wrote the article.
 
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