BPS attempts at psychologizing Long Covid

[rvallee]

Norway is not the capital of Denmark (sorry, just an old saying that really fit here)

I belive Recovery Norge is also part of another study with Wyller, but I don't remember the name at the moment.

That was a real swing-and-a-miss...

Is Recovery Norway in Denmark or what? Sure, why not? Oops.

 

[rvallee]

The fact Vogt is needing to go out and proactively engage like this on social media shows he’s non league level in terms of influence. The usual suspects won’t be using social media to influence key peers they’ll be speaking through professional channels, on the phone etc.

Yeah I expect it more to be in the form of short interviews, maybe some comments on a panel or a video. Doubt there will be much more of that on Twitter. Just anything that isn't published with formal scientific review.

 

[dave30th]

I'd suggest almost all of the PVS recoveries are spontaneous in nature, based on luck/natural recovery.

I think that's likely. I've wondered about the super-athletes who have horrible post-viral fatigue for a year and then have a great "recovery"--and if they've been given GET, they attribute it to that and say that's what got them over their CFS or ME.

 

[dave30th]

Yeah I expect it more to be in the form of short interviews, maybe some comments on a panel or a video

And Professor Chalder is out there already saying that in the posted interview.

 

[Mithriel]

I think that's likely. I've wondered about the super-athletes who have horrible post-viral fatigue for a year and then have a great "recovery"--and if they've been given GET, they attribute it to that and say that's what got them over their CFS or ME.

There is a confusion, even (especially!) among medical people about PVFS. It was a new name for ME which only lasted a short time before we went with the complete CFS.

In the dim distant days of my youth it was taken for granted that some infections could take moths to a couple of years to resolve and we called it a post viral. But there has been a constant and deliberate confusion in the same way as CFS and chronic fatigue.

My husband had a fatiguing illness for about 10 months after a bad flu when he was forced back to work while still ill. We never associated it with my illness though now he would be told he had ME/CFS and recovered.

One of the things Ramsay emphasised is the variability of ME. He said it , I think, in the context of post viral states where the fatigue is constant while ME (and long covid has people who keep thinking they are fine but collapsing again.

Athletes seem to get an overtraining syndrome where they take a working aerobic system beyond its limits, while we have a broken aerobic system which reaches its limit too soon. The symptoms may appear the same but they have different causes so one can resolve with rest.

 

[Hoopoe]

One of the things Ramsay emphasised is the variability of ME. He said it , I think, in the context of post viral states where the fatigue is constant while ME (and long covid has people who keep thinking they are fine but collapsing again.

I had this a lot in the first few years. I just couldn't make any sense of it. I often felt fine after resting, but resuming my usual daily activities always led to a relapse. It was very demoralizing.

I don't normally have extreme and constant fatigue. It's mostly mild, but will quickly worsen with activity, and can turn into intense fatigue at some points throughout the day. It also always gets worse with PEM.

 

[mango]

Sweden: Hanne Kjöller (controversial writer, BPS extremist, background in nursing) attacks people with long-covid in her latest editorial in DN, Sweden's largest daily newspaper. CFS is mentioned.

DN: Coronapandemin får sjuktalen i psykisk ohälsa att minska
https://www.dn.se/ledare/hanne-kjoller-coronapandemin-far-sjuktalen-i-psykisk-ohalsa-att-minska/

Google Translate, English ("The corona pandemic reduces the number of people on sick leave due to mental illness")

The framing/narrative she's using is so called "cultural illnesses" (psychological/emotional/existential/social threats are supposedly "internalised" and expressed as physical symptoms), referring to Karin Johannisson's earlier works.

“To be successful, cultural diseases must interact with the threats that contemporary people are exposed to. Conversely, highly exposed threats can be internalized into a disease picture. The diagnoses that became major in the 1980s - mercury poisoning, electromagnetic hypersensitivity, multiple chemical hypersensitivity, sick house syndrome - could all be linked to current threats taken from the external environment in the form of poisoning, radiation or harmful substances. The 1990s major diagnoses of chronic fatigue and chronic pain were linked to current threats taken from the work environment, while the 21st century's dominant cultural diseases burnout, fatigue depression and other fatigue conditions are synchronous with its most popular threat of the time: performance and project culture.”

Today, the threat comes from viruses and pandemics. The fact that people do become ill and that a significant number die of covid-19 does not exclude that it may at the same time be a new emerging cultural disease. Which bodily phenomena are really related to viruses and which are internalized to the threat picture, time will tell

I find it a very bizarre piece of writing. I think maybe the point she's trying to make (imply) is that "fewer people are currently on sick leave due to mental illness, and more people are on sick leave due to long-covid. Therefore long-covid must be a mental illness"?

She seems to suggest that long-covid is one of many similar disorders (including CFS) that are best managed with "de-dramatization and normalization". Which I guess means comforting reassurances (instead of medical tests etc) in order to dispel patients' "false illness beliefs" and "irrational fears", thereby making the "cultural illness" go away?

There are so many problematic/nonsensical assumptions and misrepresentations of facts here... For example, the fact that fewer people are currently on sick leave due to a mental illness diagnosis, those numbers are from Försäkringskassan/the Swedish Social Insurance Agency and doesn't reflect people's actual health but the number of people who have had their applications for social security payments approved. (According to a recent investigation by Sveriges Radio -- Sweden's national publicly funded radio broadcaster -- the rejections have increased by 70% during the pandemic compared to last year..!)

ARGH!

For context, here's what Wikipedia says about Kjöller:

Kjöller has presented controversial points of view in editorials and news commentaries. A recurring theme in these articles is that the individual should take greater responsibility for their problems, and that many people on sick leave, [4] and people in social group III use the system, fake, "take on the role of martyr", "whine" and cost money in various ways . Among other things, she has questioned the concept of burnout and the diagnosis of fatigue syndrome [5], which prompted criticism from medical experts [4].

She has also criticized what she considers to be the abuse of social services [6] [7] and expressed herself positively about female part-time work [8]. Kjöller has also played a prominent role in the debate on apathetic refugee children [9], where both she and her opponents were accused of misquotations and distortions [10] [11] [12].

Another area where Kjöller's statements have created debate is when she spoke out against transgender people's right to avoid being forcibly sterilized when changing legal gender. [13] [14].

ETA: DN's Facebook post, in case anyone wants to read the comments.

 

[rvallee]

Sweden: Hanne Kjöller (controversial writer, BPS extremist, background in nursing) attacks people with long-covid in her latest editorial in DN, Sweden's largest daily newspaper. CFS is mentioned.

DN: Coronapandemin får sjuktalen i psykisk ohälsa att minska
https://www.dn.se/ledare/hanne-kjoller-coronapandemin-far-sjuktalen-i-psykisk-ohalsa-att-minska/

Google Translate, English ("The corona pandemic reduces the number of people on sick leave due to mental illness")

The framing/narrative she's using is so called "cultural illnesses" (psychological/emotional/existential/social threats are supposedly "internalised" and expressed as physical symptoms), referring to Karin Johannisson's earlier works.



I find it a very bizarre piece of writing. I think maybe the point she's trying to make (imply) is that "less people are currently on sick leave due to mental illness, and more people are on sick leave due to long-covid. Therefore long-covid must be a mental illness"?

She seems to suggest that long-covid is one of many similar disorders (including CFS) that are best managed with "de-dramatization and normalization". Which I guess means comforting reassurances (instead of medical tests etc) in order to dispel patients' "false illness beliefs" and "irrational fears", thereby making the "cultural illness" go away?

There are so many problematic/nonsensical assumptions and misrepresentations of facts here... For example, the fact that less people are currently on sick leave due to a mental illness diagnosis, those numbers are from Försäkringskassan/the Swedish Social Insurance Agency and doesn't reflect people's actual health but the number of people who have had their applications for social security payments approved. (According to a recent investigation by Sveriges Radio -- Sweden's national publicly funded radio broadcaster -- the rejections have increased by 70% during the pandemic compared to last year..!)

ARGH!

For context, here's what Wikipedia says about Kjöller:

Wow, so chronic pain began to exist in the 90s? Damn, TIL. It was never talked about before, of course. Nope, not ever. Completely new thing, somewhen in the 90's people just began claiming "it hurts" and mass hysteria ensued. Totally. This is SMART.

What I love the most about this is just how obvious this is all projection, these extremists don't seem to understand that other people have different life experiences than they do, that non-health care professionals don't think about things related to health, as is presented here. These are people whose job is to think about those things and they seem to extrapolate that this is what everyone does.

No offense but here's a simple truth about doctors: "ordinary" people don't think about you, ever. It's not a thing. People certainly don't think about doctors as saviors or lifelines or other stuff like that unless they are sick. Literally never. People don't think about hospitals, or medical clinics, or sick people. Not a thing. Nobody likes illness and death and thinking about doctors means thinking about that, hence why this is not a real thing.

This way of thinking reeks of narcissism, these people place themselves at the center of the universe and obsess over what people think of them. Nobody cares, dude. Get over yourselves. You are professionals in your respective field, an important one but one of many, and unless they are sick, people think about doctors exactly as much as they think about chemical engineers or hydrologists. It's just not something relevant to their lives.

Today, the threat comes from viruses and pandemics

Haha you're totally right about that. Nobody was thinking about viruses before 2020. Nobody. This is all brand new stuff that did not exist before January of this year. You are very smart people.

 

[DigitalDrifter]

It shouldn't have been a problem to lift forward the voices of those who have recovered and to listen and learn from them. The ME movement isn't a movement that really represents the patients, only those who fit their political narrative. I'm not ok with that. I am done here..

May be it seems that way because ME patients have erroneously been placed in to and drowned out by the larger group of Chronic Fatigue.

Doctors aren't necessarily saying "it is all in their heads". But underneath a lot of this activism I find deep contempt for "psychological" problems. Such problems can become VERY serious. Would you call that "all in your head"? If so, you have a problem with being derogatory.

This is just gaslighting. I was sectioned for having ME and told by staff that I wasn't in pain. Also the psychiatrists told my carers that my illness was "All in my head". You can't blame society's unfair views about mental health on ME patients.

 

[Hoopoe]

One can sort of feel sorry for these people who so badly need to devalue and discredit patients just for having inconvenient health problems.

 

[Arnie Pye]

My emphasis

One can sort of feel sorry for these people who so badly need to devalue and discredit patients just for having inconvenient health problems.

I can't.

 

[Trish]

Moderator note: Some posts have been moved from this and other threads to a new thread:
The Science Bit: Post-Covid syndrome, Myalgic Encephalomyelitis, and the recurring pseudoscience of mass hysteria, July 2020, by Brian Hughes

 

[Snow Leopard]

This is just gaslighting. I was sectioned for having ME and told by staff that I wasn't in pain. Also the psychiatrists told my carers that my illness was "All in my head". You can't blame society's unfair views about mental health on ME patients.

Indeed. The claim that we have contempt for mental illness is deliberately misleading and continued mentions of "mental illness is real and serious" is just whataboutism.

If they'd actually listen to our point of view, instead of attacking us they'd have a very different impression.

One can sort of feel sorry for these people who so badly need to devalue and discredit patients just for having inconvenient health problems.

I'd feel pity if not for the fact that they are the ones who have the power to start to listen and improve the situation.

 

[Joan Crawford]

Sweden: Hanne Kjöller (controversial writer, BPS extremist, background in nursing) attacks people with long-covid in her latest editorial in DN, Sweden's largest daily newspaper. CFS is mentioned.

DN: Coronapandemin får sjuktalen i psykisk ohälsa att minska
https://www.dn.se/ledare/hanne-kjoller-coronapandemin-far-sjuktalen-i-psykisk-ohalsa-att-minska/

Google Translate, English ("The corona pandemic reduces the number of people on sick leave due to mental illness")

The framing/narrative she's using is so called "cultural illnesses" (psychological/emotional/existential/social threats are supposedly "internalised" and expressed as physical symptoms), referring to Karin Johannisson's earlier works.



I find it a very bizarre piece of writing. I think maybe the point she's trying to make (imply) is that "fewer people are currently on sick leave due to mental illness, and more people are on sick leave due to long-covid. Therefore long-covid must be a mental illness"?

She seems to suggest that long-covid is one of many similar disorders (including CFS) that are best managed with "de-dramatization and normalization". Which I guess means comforting reassurances (instead of medical tests etc) in order to dispel patients' "false illness beliefs" and "irrational fears", thereby making the "cultural illness" go away?

There are so many problematic/nonsensical assumptions and misrepresentations of facts here... For example, the fact that fewer people are currently on sick leave due to a mental illness diagnosis, those numbers are from Försäkringskassan/the Swedish Social Insurance Agency and doesn't reflect people's actual health but the number of people who have had their applications for social security payments approved. (According to a recent investigation by Sveriges Radio -- Sweden's national publicly funded radio broadcaster -- the rejections have increased by 70% during the pandemic compared to last year..!)

ARGH!

For context, here's what Wikipedia says about Kjöller:


ETA: DN's Facebook post, in case anyone wants to read the comments.

Wow shocking attitude Quite some opinion

 

[mango]

Another Swedish opinion piece, written by 11 BPS doctors...

DN: ”Aktivering är den effektivaste formen av behandling”
Google Translate, English ("Activation is the most effective form of treatment")

Why so much focus on the remaining symptoms? Do they signal danger? Do they need to be treated away?

Symptoms in themselves are not the same as having a treatable medical condition.

Why increase fear? Is it helpful for the population to read about suspected medical complications and to be a patient for these? Our opinion is that warning articles instead contribute to morbidity by focusing on something that is not useful. [Making patients] passive through sick leave is directly harmful by signaling that activity such as work is unfavorable to health. What we do know is that activity benefits the immune system. This is why patients are already allowed to "bed cycle" during intensive care.

Something that is really dangerous is physical inactivity. Vessels thicken, bones decalcify and muscles weaken. These consequences increase the risk of, among other things, cardiovascular disease. In addition, with low physical activity, you can get mental symptoms with anxiety and depression.

When you become preoccupied with symptoms and your fear of them, you instead maintain the symptoms. The body's emergency system - the autonomous (self-activating) sympathetic system (fight/flight) is activated by fear and catastrophic thoughts and gives bodily symptoms that are the ones that start up in "anxiety". The treatment is acceptance and exposure [...]

Thus, there is no need for medical rehabilitation in the form of medication or sick leave with the aim of waiting for symptoms to disappear. The most effective medicine against all forms of morbidity can be carried out by oneself - activation. Healthcare can help make medical assessments. This is not dependent on luck but on competence. Primary care physicians have that. They are responsible for the medical in general and must be able to separate treatment-requiring disease from symptomatic disorders that are best managed with de-dramatization and normalization.

 

[Wonko]

Symptoms in themselves are not the same as having a treatable medical condition.

I suspect that author fundamentally misunderstands the point of medicine/doctors, from a patient's perspective.

 

[chrisb]

The one thing of which stupid people are convinced is that what they consider to be generally true is true in every particular case.

 

[Invisible Woman]

Another Swedish opinion piece, written by 11 BPS doctors...

I'm not a particularly vengeful person, I have better uses for my energy, but reading that piece it occurred to me to hope karma exists.

 

[rvallee]

I suspect that author fundamentally misunderstands the point of medicine/doctors, from a patient's perspective.

"Why do these people keep coming to me with their symptoms?", said the very weird doctor.

Seriously, why do people keep going to the mechanic with car problems? What's up with that?

Why do customer service representatives have to deal with complaints from customers? What's up with that? Can't they just accept to live with their problems?

I would suggest an experiment: let's give those people chronic low-grade nausea. I'm sure that can be done safely. Just non-stop nausea. It's just a small symptom. Nothing threatening, nothing that can't be shrugged off, just stop thinking about it and it won't have any effect. I'm sure they will totally just go on with their normal life as if nothing was happening. Totally. Absolutely. Then let's go boating. Let's have a heavy meal made entirely of meat, let's have the meat sweats, then let's go dancing. What's wrong? Are you having unhelpful illness beliefs that the nausea is a signal of something actually serious?

Seriously is there some major disconnect over what symptoms are? They're not just some "check engine" light where you see the light before the problem manifests itself. It seems like there is a huge missing component in medical training, I don't get how it's possible to undergo this much training and so fundamentally misunderstand this stuff.

 

[rvallee]

The most effective medicine against all forms of morbidity

Do these people know that morbidity is still a thing despite exercise also being a thing? Even in people who do actually exercise? Hello?

Seriously that makes no sense whatsoever, they argue that there is an easy universal cure for all morbidity, therefore morbidity should not exist. Except it obviously does. So what the hell? This is completely delusional. How does it make sense that such irrational people have power of life and death over vulnerable people? Something's completely broken here.