BPS attempts at psychologizing Long Covid

[Hoopoe]

Again I can't tell the difference whether they think we're completely stupid

To illustrate his idea, he chose an example where (allegedly) a group of men in Africa started believing that someone had stolen their penises. In this story, the patients are portrayed as utterly dumb. Presumably he also thinks patients with long covid are utterly dumb - for failing to see the to him obvious truth that their symptoms aren't caused by a virus but by stress.

 

[chrisb]

I seem to have read this story elsewhere. I think Wessely may have told it. Can't remember where.

 

[Hoopoe]

I had a story to tell today at dinner with the family, about penis thefts. We all laughed. At least these stories are good for something. Maybe entertainment is why they're popular.

 

[Wonko]

The story is not credible.

If, from the authors perspective it is true, then that would imply that a 'person' has had the mickey taken out of him - and has fallen hook line and sinker for it.

Believe it or not there is a fairly easy test to determine if such a thing has been stolen, that doesn't require a medical degree to carry out.

Thick, stupid and ignorant as we are, most men could carry out such a check, without extensive training.

One has to ask why, in the face of such 'allegations' the recipient chose to make an anecdote out of it rather than do a quick physical.

 

[Mij]

I wonder if having ME gives me the power to heal others? I feel a business opportunity coming on ...

I already opened up shop on S4ME a few years ago. I couldn't afford malpractice insurance, many who were 'treated' through my transparant (thanks @Invisible Woman) business manager simply wanted to sue for feeling worse. Who knew?

 

[Andy]

Tweets by Solve ME.

We were disappointed and concerned by a piece published in @PsychToday titled, “When the Body Speaks” by @roygrinker. Despite tens of thousands of published papers demonstrating the biological underpinnings of ME/CFS, some still push the outdated notion of "deconditioning."

Let's be clear: 1. Graded exercise therapy (GET) is shown to cause harm & worsen health outcomes for people with #MECFS 2. The characterization of ME/CFS as a “psychosomatic” illness is a gross mischaracterization & has been disproven by 1000s of peer-reviewed published studies.

3.Those who promote of these incorrect and outdated beliefs cause unnecessary pain and suffering to patients and their families. We urge @PsychToday & @roygrinker to issue a retraction and correction. Read our letter to Mr. Grinker here: ow.ly/8BBQ50CPN4o

This post has been copied and the discussion of the suggestion in the letter that MS was once seen as psychosomatic have been moved to this thread:
https://www.s4me.info/threads/psych...of-physical-diseases.16931/page-4#post-311082

 

[Sly Saint]

Excellent letter. It would be good to have a 'standardised' version to send/quote to any similar publication/ author of such false statements , particularly here in the UK.

 

[Mithriel]

What he does not realise is that the anecdote about the African men actually illustrates the main problem with BPS practitioners. They prefer to come up with long complicated theories about disease being caused by stress and faulty cognition without doing any basic physical examinations.

 

[rvallee]

What he does not realise is that the anecdote about the African men actually illustrates the main problem with BPS practitioners. They prefer to come up with long complicated theories about disease being caused by stress and faulty cognition without doing any basic physical examinations.

Often having to use anecdotes going back farther than a century. That is usually (by which I mean almost always) a very clear sign of a fool's errand.

And I do love those examples where they take obvious metaphors, obviously nobody believed their dick was actually missing, people can be weird about spiritual beliefs and say things that are not meant to be literal, and pretend they were said seriously.

When you have to use obviously fake examples, reaching back decades, to prove a point, that point was never meant to be taken seriously.

And of course it's telling that Internet trolls say the exact same things. I mean exactly, it's almost remarkable how identical the arguments are, even and including how "post-viral fatigue has always been around" on the topic of Long Covid. That's usually another big tell but people who don't clue in on that were never going to clue in on anything anyway.

 

[rvallee]

I can't really find a suitable thread for this. Symptom focus is a very common trope relating to "somatization". It is assumed to be true, that focus is what makes the symptoms bothersome. Nevermind... everything and especially common sense. In fact diminishing symptoms tend to go unnoticed, the relief of taking notice of the symptom and marveling that it's gone long is common. Not surprising as this is how it almost always goes, including minor acute ones.

Of course we know this to be BS but it's interesting how people improving with Long Covid yet again blow the entire concept to bits and pieces. This is but one example but it is frankly a good one. There are many like it.



Especially interesting as I remember one of the PACE-style trials, the one on IBS, that basically blamed everything on doing exactly doing this: waking up, focusing on symptoms and assuming they will be there, making them bothersome. Again, complete BS.

 

[rvallee]

The Austrian psychosomatic zealots are at it again.

https://www.bhswien.at/iii-med-abteilung-psychosomatik/angebot/post-covid-19-programm

https://translate.google.com/translate?hl=en&sl=auto&tl=en&u=https://www.bhswien.at/iii-med-abteilung-psychosomatik/angebot/post-covid-19-programm

The current Covid-19 pandemic is very challenging. Patients suffering from Covid-19 have a high rate of anxiety disorders, depression, panic attacks or post-traumatic stress syndrome. Further consequences of the critical illness are fear of death or fear of being a carrier and of endangering other people or family members. Add to this the experience of social isolation, loneliness and frustration. Patients after a Covid illness often suffer from physical symptoms such as CFS (chronic fatigue syndrome), which are accompanied by tiredness, nausea and listlessness. The new program offers patients stabilization and physical strengthening so that they can return to their everyday lives as much as possible.

The innovative Post Covid-19 program for patients takes place twice a week on an outpatient basis from 8.30 a.m. to 3.30 p.m. and extends over 6 weeks. It consists of various psychotherapeutic modules as well as medical rounds, physical activity (training), relaxation and individual psychotherapy. Patients must be in such a physical or psychological condition that they can take advantage of outpatient treatment twice a week. Reasons for exclusion are addictions or psychotic diseases. Registration or assignment takes place via the telephone hotline: +43 1 599 88 3224 Tuesday and Thursday from 10 a.m. to 11 a.m.

"Innovative"

The Medical Department for Internal Medicine and Psychosomatic Medicine is a pioneer and renowned department in the treatment of psychosomatic diseases.

 

[Amw66]

I wonder how David Tuller' a seminar/ talk to Paul Garner and colleagues (?) Re PACE went?

Is there potentially a means of a counter narrative bring prompted from within the medics ranks?

@dave30th

 

[Esther12]

I wonder how David Tuller' a seminar/ talk to Paul Garner and colleagues (?) Re PACE went?

Is there potentially a means of a counter narrative bring prompted from within the medics ranks?

@dave30th

https://translate.google.com/transl...12/11/covid-waar-geen-einde-aan-komt-a4023536

Others stop moving altogether because they are so tired and get nowhere. But continuing to exercise is crucial, says Hoefman. “Otherwise you will go downhill. Then they really have to force themselves to walk for ten minutes three times a day, and then always rest. That is more effective than half an hour once. ” An important thing about walking is that it clears your head. "These people are understandably unsure of what is happening to them and they grind a lot."

Many patients suffer from anxiety. “Fear that it will happen again, that it will not work out, or fear because of the erratic aspect of the construction. One week it goes better, the next week they relapse. You see that more often in rehabilitating people, but not so strongly. That is quite unique for these patients. ”

Read about chest tightness with Covid-19:In severe Covid-19, breathing muscle can weaken Some patients start to breathe more shallowly or speak differently out of fear. “We can improve that with two hours of practice. Body and mind interact, it is a collaboration that you must tackle as a whole. It is the combination that makes you stronger. ”

That insight also pulled Paul Garner out of the doldrums. “I was so afraid that I had something serious, and it would always stay that way. And checking Facebook pages and other places where people obsessively exchange their symptoms every day and seek out the craziest explanations only made things worse. That is really harmful. ”

A psychologist friend explained to him how much fear can have an effect and strengthen itself, and that it is better to just lie down when you are exhausted and think about beautiful things. "In October I quit Facebook, and also the group with three fellow sufferers, which initially helped me well." He focused on what went well throughout the day, and no longer kept track of how things were going every day, but per week. In addition to getting a little more exercise - he now walks and cycles 20 minutes a day - that acceptance is key, he says. "I was healed within three weeks."

Most people recover from post-viral symptoms so I'm not sure it should be assumed that fear played a role in his symptoms, but who knows? He did end up in a very odd position.

 

[Sean]

The Medical Department for Internal Medicine and Psychosomatic Medicine is a pioneer and renowned department in the treatment of psychosomatic diseases.

Says The Medical Department for Internal Medicine and Psychosomatic Medicine.

 

[Trish]

27 posts have been moved to this thread:
Psychosomatic medicine and the psychologising of physical diseases

 

[Hutan]

Some posts about Paul Garner have been moved to this thread:
Paul Garner on Long Covid and ME/CFS. BMJ articles.

 

[rvallee]

Maybe this needs its own thread but... uh... not worth it. Same old predictable tripe. Also: pre-print.


Post-COVID-19 Symptom Burden: What is Long-COVID and How Should We Manage It?

https://www.researchsquare.com/article/rs-164000/v1

Abstract:

The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety (p=0.001), fatigue (p=0.004), and myalgia (p=0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology.​

Discussion:

We suggest the impact of a new, poorly understood, and lethal virus and the associated societal disruption it has caused must not be understated.
...
With the paucity of evidence available, we question whether Long-COVID exists as a new disease with distinct pathophysiology. We suggest it is a new manifestation of a well-recognised phenomenon that can be observed after other traumatic events, as opposed to the persistent effect of COVID-19.
...
Data from the COVID symptom study App identified self-reported fatigue as the commonest complaint in a large group of Long-COVID patients [8]. If these symptoms were persistent at 4 months, they would meet the National Institute for Health and Care Excellence (NICE) diagnostic criteria for Chronic Fatigue Syndrome (CFS). A CFS diagnosis is considered when patients report post-exertional fatigue, cognitive difficulties, sleep disturbance, and chronic pain [16]. This is a remarkably similar symptom complex that we and others have observed in Long COVID. There are also marked epidemiological similarities. Female preponderance is well described in the CFS literature [17] and obesity is also associated with greater symptom burden [18].
​

Conclusions:

We report data consistent with current evidence on the prevalence of post-COVID-19 symptom burden. We demonstrate an absence of association between symptom burden and radiographic or biochemical abnormality. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, but rather the neuropsychiatric insults may play a greater role in its aetiology. Our observations help to inform decisions on service design and priorities for the care of these patients.​

At least they are honest that all it is a belief. But it is kind of telling how they admit that when they mean "biopsychosocial effects" they 100% mean psychiatric, or something like that. It's largely argued here because... women be hysterical. As best as I can tell from the ramblings. And not enough coughing? Honestly I can't make sense of this tripe. This is a position paper, not serious research. It's an NHS trust promoting its belief system.

Edit: just marveling at the argument here: we checked known things and didn't find anything, therefore this is not an unknown thing. It ages like fine wine. Same stuff as Wessely, who did the same thing. True galactic genius.

 

[Leila]

They only looked at people who were hospitalized with pneumonnia, right? And say their post covid symptoms are (neuro)psychiatric.

What about pwLC that only had very mild symptoms and never needed hospital care? What has been so "traumatic" about their illness? The mere diagnosis of a positive Corona PCR? Mass hysteria?

 

[Sly Saint]

We suggest it is a new manifestation of a well-recognised phenomenon that can be observed after other traumatic events, as opposed to the persistent effect of COVID-19.

I wonder if they would have been saying the same to HIV/AIDs patients back in the day?

"Neurological impairment affects approximately 60% of HIV-infected patients"

(haven't posted a link because there are numerous research articles on the subject of HIV dementia)

 

[mango]

Paywalled editorial by infamous columnist/journalist Hanne Kjöller, in Sweden's largest morning paper (I can't believe they keep publishing her harmful rubbish ).

DN: Berättelsen om långtidscovid går inte ihop ("The story about long covid does not make sense")
https://www.dn.se/ledare/hanne-kjoller-berattelsen-om-langtidscovid-gar-inte-ihop/

She starts off by suggesting that the proportion of covid patients who go on to develop long-term symptoms is very different from country to country. According to her, this means you can't explain it biomedically.

She points out that almost everyone's strength and fitness gets worse as we age.

Then she starts talking about social infection (meaning people catching a mental/psychsomatic illness from talking and reading about it, for example on social media) and cultural illness (a culture-bound syndrome, ie psychosomatic).

If there are no elements of social infection and cultural illness - how is it that twice as large a proportion of the British as of the Danes have suffered from long-term symptoms? And how come the Chinese manage so much work and everyday life as usual? Could it be that the prevalence of cultural diseases is linked to the existence of - and the degree of accepting - health insurance system? [...]

If you as a Swedish pediatrician can get death threats because in a register study you showed that few teachers and children in primary school have become seriously ill in covid, it is perhaps not so strange that none of the doctors who contact me about what some in the medical profession think is a new cultural illness wants to be named. But in Norway's edition of Dagens Medicin I find two worried doctors.

Henrik Vogt and Andreas Pahle write that the medicalization of what are mainly functional disorders (ie without a biomedical explanation) around covid-19 in itself contributes to making the symptoms chronic. And they call for a holistic view of man, different from the almost mechanical troubleshooting scheme that characterizes the hospital specialists' activities (and which serves its purpose). Thoughts, symptom focus and stress can also be the cause, the two write.

She then goes on to talk about sex, how she finds the experience is negatively affected if she's thinking about what an idiot her boss is, while she's doing it... in what looks like an attempt to demonstrate that touch is not just touch but thoughts too.

What happens in our bodies is partly a consequence of what happens in our heads. And what happens in our heads is partly a consequence of what happens to our bodies. The one-sided search for biomedical explanations for functional symptoms is headless.