BPS attempts at psychologizing Long Covid

Well, at least they're not holding anything back..

Ekspertar meiner korona varer lenger om du er redd
google translation: Experts believe corona lasts longer if you're afraid

- The cause is complex, but worries and stress seem to both prolong and worsen the symptoms, says Wyller.

Signe Flottorp, head of research at FHI, also says that if one monitors the symptoms too much, the disease can last longer.

- Being afraid of getting ailments can in itself aggravate and perpetuate similar symptoms, she says.

- Then it sounds as if those with long covid are hypochondriacs. Are they really that?

- It is not the case that one should feel ashamed of not having recovered. It's a balance. Certainly if you're really struggling you can't just pull yourself together, says Flottorp in FHI.

Wyller explains that symptoms from long covid can be related to other connections in the brain.

- It is not something that is someone's fault, or something one imagines. The brain monitors the body all the time. Sometimes he will perceive things wrong.

If this is the case, the brain needs to be retrained. And then the brain needs other experience.

And here comes the attention one gives the disease in, according to Wyller.

- This means that it may make sense to use the body carefully. Then the brain will gradually learn that it is going well.

The challenge for doctors is to convey this to people, without those who are ill feeling that it has not been taken seriously.
 
Is it just me or would these people be much more useful standing next to a wall, on a plain, thousands of miles away from other people, and cellphone towers?

After all, we can't have remote walls being unsupervised.

They might get depressed, jealous, commit criminal acts, or simply wander off.

I've heard rumours that Mars had lots of canal walls that could have done with supervision, but no one thought to do so, and now they aren't there any more. So hundreds of thousands of miles of walls are out there, up to god knows what, simply because no one thought to supervise them.

So, before we lose any more unsupervised walls.....

We need our 'best people' on constant guard, observing them, talking to them, explaining their various 'theories' about illness to them, to ensure that doesn't happen.
 
Wyller or whatever who cares? said:
The challenge for doctors is to convey this to people, without those who are ill feeling that it has not been taken seriously.
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This is genuinely bringing discredit to the entire profession. They are completely unaware of what the patients are thinking because they never had to bother with that, but these quacks are seriously hurting the credibility of medicine by continuing to not care that the "WTF is this jerk talking about lying to my face and talking woo-woo?" faces are really just that, the face of someone who's been slapped in the face and can't believe this is happening in this context, not one who is confused by the imagination of some ideologues.

This is talked about a lot in LC forums, and the only defense presented is always in the form of "this is new, medicine moves slowly, they can't be expected to be up-to-date on everything", which is completely undone by the fact that this nightmare has been destroying millions of lives for decades, and 2 years is frankly already way too slow anyway. There is no other defense for this, I see none that isn't explicitly based on recency bias, and ignorance that this is an old issue. This excuse will not hold for long, and it's already seriously overstretched.

At this point it's legitimate to consider that the fears these people are obsessed with are their own, there always seems to be some story of panic at a transient episode that convinced them of whatever it is they imagine happened. The way they talk about it is explicitly centered on their perception and has everything to do with "what am I supposed to do with that patient?" It has nothing to do with us, nothing at all, only their imagination and whatever fears they attribute to us.
 
[I'm not sure where this quackery should go.]

A BMJ blog arguing that Long Covid rehabilitation needs to expand 'beyond the biomedical paradigm'. It recommends yoga, mindfulness among other nonsense:

The Rehabilitation of Long Covid Requires Understanding of Not Just the Biomedical Dimensions But All Aspects of Being Human
Many members of the long covid support groups are using yoga, mindfulness, Tai Chi and acupuncture for their rehabilitation. The 2021 WHO rehabilitation guideline mentions these modalities and Salman et al too have postulated gentle yoga may help. So, we should be mindful of this holistic and consensus guidance.
...
There is some evidence that mindfulness meditation appears to be associated with reductions in proinflammatory processes, increases in cell-mediated defence parameters, and increases in enzyme activity that guards against cell aging, and improvement of cognitive function, all of which could potentially help recovery.
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This bit blew me away:

Holistic LC rehabilitation could also utilise the Arts as demonstrated by the ENO Breathe LC recovery research program, run by the English National Opera and utilises the singing of international lullabies to improve breathing and voice. ENO Breathe also incorporate practices derived from mindfulness, yoga breathing (pranayama) and seated Tai Chi/ Chi Gung to inculcate an embodied awareness posture and breath. This has been directly experienced by author AL in her recovery. Furthermore, human musicality and the singing of lullabies may arouse endogenous oxytocin (mothering and social bonding hormone) secretion, and oxytocin is known to have neurobiological homeostatic effects on the limbic system and the immune system.
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The authors are apparently both 'senior doctors'. If that isn't bad enough, they are also Long Covid patients. Why go to the doctor to be gaslighted about your post-viral illness when you can simply gaslight yourself?

Can modern medicine descend any further?
 
A Senior Medical Officer at the Norwegian Institute of Public Health shared a picture on Twitter showing that Covid-19 hospital admissions are going down, which is good news.

He comments: - But, what about "long-covid"?

I read the comment as a sarcastic attempt to ridicule both long covid and people who are trying to raise awareness, and worry this attitude is representative for the institute.

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Kalliope said:
A Senior Medical Officer at the Norwegian Institute of Public Health shared a picture on Twitter showing that Covid-19 hospital admissions are going down, which is good news.

He comments: - But, what about "long-covid"?

I read the comment as a sarcastic attempt to ridicule both long covid and people who are trying to raise awareness, and worry this attitude is representative for the institute.
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I used to watch Independent Sage (YouTube) and I seem to recall the issue of politicians saying --- "we've broken the link between infection and hospitalisation" --- being discussed. The point was that they may not have broken the link between infections and long covid ---- not to mention the issue of vulnerable people dying.
So the comment may be fine.
 
Art Vandelay said:
A BMJ blog arguing that Long Covid rehabilitation needs to expand 'beyond the biomedical paradigm'. It recommends yoga, mindfulness among other nonsense:
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The authors are these two:

At the meeting, two of us, Clare Rayner and Amali Lokugamage, both doctors who are experiencing long term impacts of covid-19, discussed their perspective of having long covid.
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https://blogs.bmj.com/bmj/2020/09/0...ge-about-long-covid-and-we-will-act-says-who/

Kalliope said:
I read the comment as a sarcastic attempt to ridicule both long covid and people who are trying to raise awareness, and worry this attitude is representative for the institute.
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It could also be a genuine question?

edit - actually other tweets make his views clearer:

 
Last edited:
Webinar:

How to Approach Long COVID: Research Update and Practical Applications
Presented by Professor Trudie Chalder

"...We have developed an approach which is based on the idea that after the initial illness has subsided physical and psychological processes contribute to ongoing symptoms, distress and disability. By targeting these processes and regulating sleep, rest and activity, as well as reducing distress it is possible that symptoms will reduce and quality of life will improve. This workshop will emphasise the importance of a formulation driven approach."

https://babcp.com/Events/Event-Details/eventDateId/275

Note that this is from Dec 2021. I did search but we don't seem to have it posted on the forum.

Source: Tweet from maxwhd
 
Developed an approach?

One that has existed for donkeys years, and has been shown to have no evidence supporting it, and a fair bit against, in another post viral condition?

But it's all new of course, freshly developed for pwLC, and nothing at all to do with thousands of people not being 'allowed' to inflict exactly the same approach on pwME, any more. Nothing to do with all of the resources and people having to find something to do, because their entire body of work has been deemed too dangerous to inflict on the patients it was developed to be inflicted upon, pwME.

That no research, not even their own, has shown to be beneficial - but, well, got all these 'trained' staff, and they is looking for something to do.
 
'developed an approach which is based on the idea'
'the importance of a formulation driven approach'
'it is possible that symptoms will reduce and quality of life will improve'

What does that word salad mean?

They are not even bothering any more to pretend there's any evidence to support any of it now. It's all about pretending to be knowledgeable and useful, gaslighting patients, and keeping their jobs and status.
 
Confidence trick:
A confidence trick is an attempt to defraud a person or group after first gaining their trust. Confidence tricks exploit victims using their credulity, naïveté, compassion, vanity, confidence, irresponsibility, and greed. Researchers have defined confidence tricks as "a distinctive species of fraudulent conduct [...] intending to further voluntary exchanges that are not mutually beneficial", as they "benefit con operators ('con men') at the expense of their victims (the 'marks')".[1]
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Sadly, it is not us, the patients, who have been tricked. It's medicine. Although we are definitely the mark. Like wolves deciding what the sheep get.
 
Preprint: Does pre-infection stress increase the risk of long COVID? Longitudinal associations between adversity worries and experiences in the month prior to COVID-19 infection and the development of long COVID and specific long COVID symptoms, Paul & Fancourt, 2022

Interpretation Results suggest a key role of stress in the time preceding the acute COVID-19 infection for the development of long COVID and for difficulty with cognition specifically. These findings point to the importance of mitigating worries and experiences of adversities during pandemics both to reduce their psychological impact but also help reduce the societal burden of longer-term illness.
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The study is covered in Medscape:
Stress Plays Key Role in Developing Long COVID and Cognitive Symptoms

Why This Matters
  • Long COVID is increasingly recognized as a public health burden.

  • Long COVID often results in reduced productivity or an inability to work and places additional strain on other aspects of one's life.

  • Demographic and infection-related characteristics have been identified as risk factors, but less research has focused on psychosocial predictors, such as stress immediately preceding the index infection.
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Kalliope said:
Preprint: Does pre-infection stress increase the risk of long COVID? Longitudinal associations between adversity worries and experiences in the month prior to COVID-19 infection and the development of long COVID and specific long COVID symptoms, Paul & Fancourt, 2022
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Given that it was a convenience sample and entirely self-reported, the effect could also be explained by a pattern of reporting behaviours, namely those who report worries (prospectively) may also be more likely to seek explanations for their symptoms and thus report they had LongCOVID.

Paul and Fancourt said:
“Do you consider yourself to have (or have had) Long Covid?”. The four response options (given in Supplemental Table S8) were categorised into (i) no and (ii) yes (formally diagnosed or suspected). Sensitivity analyses were carried out to test whether results were consistent when including participants who were “unsure” about whether they had had long COVID within the case group. Due to the self-reported nature of our long COVID outcome variable, an additional sensitivity analysis was also carried out with participants reporting COVID-19 symptoms four weeks or more as the case group and compared to those whose symptoms lasted less than four weeks.
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