BPS attempts at psychologizing Long Covid

Sly Saint said:
Michael Sharpe on Twitter
Click to expand...
Just to add a bit of context. This particular researcher published a study that has been widely cited by those in favour of the herd immunity approach, those wanting to keep schools open regardless of the consequences, and so on.

Threats and harassment have been directed towards researchers in favour of stricter pandemic restrictions as well (those criticising the Swedish Public Health Agency's pandemic strategy, and/or asking the Swedish government to start recommending face masks, for example).

Here's a recent article about Björn Olsen, who received disturbing threats and considered quitting but didn't:

Olsen: ”Tänkte sluta forska om covid – var så smutsigt”
https://omni.se/olsen-tankte-sluta-forska-om-covid-var-sa-smutsigt/a/vAw1JB
Google Translate, English

Även Folkhälsomyndighetens kritiker hotas
https://tt.omni.se/aven-folkhalsomyndighetens-kritiker-hotas/a/9O6Vwl
Google Translate, English

The Public Health Agency has received plenty of threats (including death threats) too:

Polisskydd på Folkhälsomyndigheten efter dödshot
https://www.svt.se/nyheter/polisskydd-pa-folkhalsomyndigheten-efter-dodshot
Google Translate, English

ETA: Swedish science journalists/reporters and editors are being harassed too:

Vetenskapsjournalister vittnar om ökat hat under pandemin
https://www.svt.se/nyheter/inrikes/vetenskapsjournalister-vittnar-om-okat-hat-under-pandemin
Google Translate, English

(Edited because I misspelled someone's name, sorry.)
 
Last edited:
Opinion piece in the journal of the Swedish Medical Association :mad::arghh::grumpy:

Läkartidningen: Låt post covid bli startskottet för ett biopsykosocialt kunskapslyft
https://lakartidningen.se/opinion/d...skottet-for-ett-biopsykosocialt-kunskapslyft/

Google Translate, English
Google Translate said:
Let post covid be the starting pistol for a biopsychosocial knowledge boost

[...] a group of physicians affected by post covid have published advice on how healthcare should investigate and treat patients [5]. The fact that researchers and doctors study their own disease is recognizable from, for example, ME/CFS, and in that case it has been debated whether one's own experience can affect the objectivity of research [6, 7].

[...] It is good that research on the consequences of covid-19 takes place at a high level of biomedical competence. In long-term conditions, however, there are always psychosocial components that affect symptoms and course. Taking a broader perspective on the consequences of covid-19 is not about downplaying patients' problems or claiming that they are not "real", but about acknowledging the impact of psychosocial factors on all illness. There is a risk that the psychosocial will be given low priority when research money is distributed and specialist clinics are opened.

It is important to identify psychosocial factors and behavioral factors at an early stage that can form the basis for rehabilitation. A one-sided biomedical focus risks locking the patient in long investigations that delay rehabilitation efforts. The patient's perception of the disease may be decisive for the prognosis and the possibility of assimilating treatment [8], something which the doctor Paul Garner's recovery from post covid highlights [9].

[...] Feel free to create research centers, but [...] they should have a broad perspective with high competence in both biomedical, psychological and social areas.

In its guidelines, the National Board of Health and Welfare should have a biopsychosocial perspective on post covid [...] Let this be the starting shot for the biopsychosocial knowledge boost in complex conditions that Swedish healthcare needs.
Click to expand...
(Edited to correct spelling mistakes, sorry.)
 
Last edited:
From post #526 The opinion piece in the Journal of Swedish Medical Association

about acknowledging the impact of psychosocial factors on all illness. There is a risk that the psychosocial will be given low priority when research money is distributed and specialist clinics are opened.
Click to expand...
With regards to long-covid

OK so this is going to meander from here to . . .

I'd like to point out (again) that the BPS keep saying this (importance of psychosocial impact) and there are a few problems with this statement.

First for illnesses such as ME/cfs it has only ever been about the psychological factors. The whole underpinning of CBT and GET was a psychological construct (pyschological factors were the only important factor). It has always been that biomedical factors were given NO priority by the very people now (seemingly) having a panic attack about being left behind. Generally with illness when one prioritises properly the biomedical must be above any psychological considerations for most if not all illnesses.

Also, where is the social aspect that the BPS are so keen on ensuring that it not be neglected? There are social factors that impact illness. One of those factors (as an example)
would be institutional stigmatisation of a group of people who are vulnerable and may experience distress due to prolonged ill health. Instead of alleviating this distress and using thoughtful consideration when told their treatment was not helping they compounded it with narratives of violent, harassing, angry militants.

So now the tables are turning--we get this. And if I take instruction from the BPS leaders I can call this ravings of people in panic over not being seen as the preeminent eminences of most relevance in the understanding and treatment of ill health. Welcome to reality. I am not accusing anyone of ranting but merely pointing out what fair turn around would look like.

I would like to know exactly what constitutes social factors in the BPS context? I don't recall reading mention of any even as they are supposedly important enough to warrant concern from BPS people that they not be forgotten. Especially when social factors are contributing from outside the persons sphere of influence and exist at the level of need for implementing solutions (I don't know how else to say this) at the social level. Helping people access resources for example is that important?

Here on a number of threads discussion is ongoing regarding the BPS current focus on changing the playing field. Having been caught out that their research methods often really do not meet basic standards of good quality research we now find a movement to lower the bar for their 'preciously special' research that cannot meet those standards and therefore should get a free pass. IMO they can lower the bar as far as they like but they should not expect that research to be given the same level of confidence as uh, real research (or even be called scientific for that matter).

One can only hope that policy makers are wavering somewhat by now realising that 'policy based evidence development' (Thanks @FMMM1) (and which I have cheekily acronymed as P-BED) has been a (to quote some emotional heated words) a 'disastrous misapplication' (see: https://www.s4me.info/threads/bmj-r...mbers-of-the-grade-working-group.19317/page-4 post #65) of policy. It will be refreshing when the day arrives that research in the field of long term illness again leads with science rather than wasting so much time, effort and money on feeding BPS egos and promoting 'disasterous' policies based on prejudice of the healthy.
 
mango said:
Opinion piece in the journal of the Swedish Medical Association :mad::arghh::grumpy:

Läkartidningen: Låt post covid bli startskottet för ett biopsykosocialt kunskapslyft
https://lakartidningen.se/opinion/d...skottet-for-ett-biopsykosocialt-kunskapslyft/

Google Translate, English

(Edited to correct spelling mistakes, sorry.)
Click to expand...


I posted my opinion to that article in English.

Initially it appeared to be published but now I cannot see it.

For the record this was the text of my reply.

To declare my interests, I am a graduate in zoology from Oxford University where I took an interest in animal behaviour (ethology) and I also have a longstanding diagnosis of ME CFIDS, exceeding 20 years.

Psychosocial phenomena have been discussed by none other than well regarded scientist and ethological luminary Konrad Lorenz in his book "The Year Of The Greylag Goose", where he discusses the plight of an outcast lone male goose who goes on to develope immune failure and die. However scientifically speaking you cannot determine from Lorenz's account whether the goose was rejected by partners because he was ill in the first place, or whether he became ill due to the stress of being outcast. It is important in science not to presume association is indicative of cause. Either orientation for the arrow of causality could be true, among other possibilities and empirical experimentation must be undertaken to prove the unimpeachable truth before we can claim knowledge of reliably replicable phenomena. In this case experiments were not done and we will never know for sure.

Psychosocial theory has not been subjected to the experimentation necessary to advance the field to the status of a science, even though what we already understand about evolution, physiology and behaviour suggests it might one day have that potential. It follows that it should be studied scientifically until we can say we understand something useful.

However something is rotten in the state of Denmark. In the very recent past unproven psychosocial ideas have been misapplied, resulting in the false imprisonment of patient Karina Hansen by her own state's legal entities who were mislead by speculative pseudoscientific psychosocial theories from a self declared expert, without empirical basis, without adequate critical opposition within academia. She is not alone.

The scientific advance of psychosocial understanding is not helped by the premature opportunistic misapplication of theory by a handful of shamanic figures, who appear to be moved by a professional impulse to pursue status and income without proper regard for the scientific method, unfortunately encouraged by a perverse synergy with the financial interests of state health provision and health insurance actors.

This is why I say the proponents of psychosocial theory have a duty to put their own house in order by treating longcovid patients responsibly and ethically and compassionately, by critical and sceptical confrontation of speculation, by careful experimental design and empirical testing of hypotheses, if they want the respect, funding and responsibility which are due to a science.

The point would be not putting more people like Karina Hansen through the kind of needless suffering which she bravely endured due to the dysfunction of academia.
 
Snowdrop said:
From post #526 The opinion piece in the Journal of Swedish Medical Association



One can only hope that policy makers are wavering somewhat by now realising that 'policy based evidence development' (Thanks @FMMM1) (and which I have cheekily acronymed as P-BED) has been a (to quote some emotional heated words) a 'disastrous misapplication' (see: https://www.s4me.info/threads/bmj-r...mbers-of-the-grade-working-group.19317/page-4 post #65) of policy. It will be refreshing when the day arrives that research in the field of long term illness again leads with science rather than wasting so much time, effort and money on feeding BPS egos and promoting 'disasterous' policies based on prejudice of the healthy.
Click to expand...

With a bit of luck:
  • fingers have been burnt. Including the public servants who were involved in this [PACE] project and, indeed, it's subsequent adoption as Government policy; and
  • politicians will be aware of the risk of associating themselves with these dodgy psychosocial theories - can't be the first time that has gone wrong!

It's disappointing that NICE fell for this crap - I thought that was their job i.e. objective assessment?
 
mango said:
Opinion piece in the journal of the Swedish Medical Association :mad::arghh::grumpy:

Läkartidningen: Låt post covid bli startskottet för ett biopsykosocialt kunskapslyft
https://lakartidningen.se/opinion/d...skottet-for-ett-biopsykosocialt-kunskapslyft/

Google Translate, English

(Edited to correct spelling mistakes, sorry.)
Click to expand...


News piece from the Swedish Public Service radio channel P4, Sveriges radio P4.

Patienten Charlotte: Det värsta har varit att inte bli trodd.
https://sverigesradio.se/artikel/patienten-charlotte-det-varsta-har-varit-att-inte-bli-trodd

One of the writers, David Gyll (who's an 'St - läkare', still in training) is part of a working group that's planning to start a clinic for Post-Covid patients in Uppsala.
In the interview he expresses compassion for patients who have had their symptoms and suffering dismissed, a stark contrast to the view aired in the article. Looks like a proper BPS proponent in the making.. :bored::grumpy:


Google translation:
"The region wants to open a reception for victims of long-term covid
1:58 min

Published on Tuesday 23 February at 05.23

The Uppsala region is looking to open a post-covid clinic for patients with so-called long-term covid.

"I think it is needed to support GPs and primary care," says doctor David Gyll, who is part of the working group.

The patient group is today spread over health centers and the doctors do not yet have national guidelines to lean on."
 
Again, somewhat out of the blue . . .

For me the present burning question with regard to long-covid is how many people will naturally recover over time (say 5 years) doing nothing special except note when they need to limit activity due to symptoms. I wish there was someone prepared to do a really tight study with all the attributes necessary to answer this question.

So long as some recover the BPS will claim every one of them as a victory of their making.
 
Snowdrop said:
One of those factors (as an example)
would be institutional stigmatisation of a group of people who are vulnerable and may experience distress due to prolonged ill health. Instead of alleviating this distress and using thoughtful consideration when told their treatment was not helping they compounded it with narratives of violent, harassing, angry militants.
Click to expand...
Exactly.

The psycho-social school's claims about psycho-social factors has always struck me as selective and containing some real dangers for them if a more comprehensive and accurate account of those factors ever gets done.
 
Last edited:
Snowdrop said:
where is the social aspect that the BPS are so keen on ensuring that it not be neglected?
Click to expand...
This could be one:
Opinion piece Google Translate said:
Patient involvement is high and "long-term covid" has been described as the first diagnosis created by patients who have found each other via social media [1].
Click to expand...
There was a well-known Swedish idea historian called Karin Johannisson, who used to push the concept cultural illness, also known as culture-bound syndromes (previously culture specific psychological disorders), and was allowed plenty of space in the media etc. She included CFS in this concept. She has since passed away, but Swedish bps proponents are still often citing her. This journal has published several articles about cultural illnesses and how to treat them, over the years.

According to this concept, cultural illnesses can spread through conversations (on social media, for example).

The suggested "treatment" is to "educate" the patient and "agree" on a bps explanatory model.

Here's one of Gyll & Sjöström's earlier opinion pieces about long covid.
 
Last edited:
mango said:
There was a well-known Swedish idea historian called Karin Johannisson, who used to push the concept cultural illness, also known as culture-bound syndromes (previously culture specific psychological disorders), and was allowed plenty of space in the media etc. She included CFS in this concept
Click to expand...

This sounds like exactly the sort of idea that Eisenberg and Kleinmann were expressing from the ivy-clad walls of Harvard in the 1970's and 80's.
 
mango said:
This could be one:

There was a well-known Swedish idea historian called Karin Johannisson, who used to push the concept cultural illness, also known as culture-bound syndromes (previously culture specific psychological disorders), and was allowed plenty of space in the media etc. She included CFS in this concept. She has since passed away, but Swedish bps proponents are still often citing her. This journal has published several articles about cultural illnesses and how to treat them, over the years.

According to this concept, cultural illnesses can spread through conversations (on social media, for example).

The suggested "treatment" is to "educate" the patient and "agree" on a bps explanatory model.

Here's one of Gyll & Sjöström's earlier opinion pieces about long covid.
Click to expand...

I had not considered that aspect of the social dimension of illness. I was thinking they could include social issues around poverty, access to resources and helping aids. But of course the BPS have to subvert this also to their own benefit. In the end it all about servicing their needs.
 
@Snowdrop Yes,... :(

Another example of possible social aspects, this is from the project plan of a Swedish ACT study (aiming to correct so called fear avoidance behaviour through "education"/talk therapy and gradually increased activity) :
mango said:
this one is about session 11 Recruitment, where they will identify behaviours in the patient's surroundings that "steer" towards avoidance. And then make a plan to help these other people coach the patient in a more adequate manner...
Click to expand...
 
As an aside, is there any reason whatsoever to believe that clinical presentation and prevalence of ME differ between cultural and geographical delineations?

Because this reminds me of this report on ME by the German equivalent of the CDC (RKI), stating that prevalence of ME is 11x higher in native Americans. Checking the source got you an odds ratio with a confidence interval that included fucking 56...
 
You must log in or register to reply here.
Back
Top Bottom