Chapter on Chronic Fatigue, Sharpe, in Science and Practice of Cognitive Behaviour Therapy

rvallee said:
Might as well put this here since it's the same nonsense anyway:

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I'd highlighted this part of the transcript in another thread... have forgotten the rest of that video now:

why does it seem to affect some
01:41

people much more than others? well that's
01:45
a good question I mean certainly the
01:47
research would suggest that some people
01:51
may have a biological predisposition I
01:53
think it's true to say that some people
01:56
who are more prone to distress and or
02:00
fatigue that they may be more vulnerable
02:03
and they develop fatigue after an
02:05
infection we also know that the longer
02:08
people convalesce for at the onset is
02:12
associated with some delayed recovery
02:15
but the caveat up obviously to that is
02:18
that
02:18
when you're in an acute stage of illness
02:20
you do need to rest as long as you as
02:22
soon as you start to feel better that
02:24
you start engaging in activity again
02:27
thank you and building on that what are

02:30

the main recommendations on how to

02:32

manage this type of post-viral fatigue

02:34

and to help recovery? well we know from
02:39
work in other types of nasty viruses
02:42
that the important thing is to get back
02:44
to activity as soon as possible and
02:48
obviously that has to be done carefully
02:49
and for many people if they're just
02:52
given some guidance about how to be more
02:54
consistent in their activities and how
02:57
to build up gradually over a period of
03:00
time as well as developing a very
03:06
regular sleep routine that then they
03:09
will improve and get better for some
03:14
people they may actually need some
03:15
additional help from a health
03:17
professional
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Peter Trewhitt said:
I would love to know what Sharpe thinks his answerable research questions are? His subsequent research has consistently failed to address any theoretical understanding of ME/CFS, but rather seems designed to confirm his belief that exercise and CBT are wonderful.
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Well, we see how this works with the "health anxiety" behavior. They are sure when they set out to do a trial that it will definitely provide further evidence for their interventions. And when it doesn't, as in the CBT for dissociative seizures trial and every other trial, it doesn't matter because you just say it did and no one seems to care if the statements even match the study findings.
 
rvallee said:
Basically they take all positions so they can use it as cover when convenient. Nothing they say actually matters, they gleefully contradict themselves without afterthought since it makes no difference, nobody pays attention to the substance of their claims, people are simply content with believing in the same conclusions giving them free license to dehumanize us as mere "complaints".
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This comment could fit right in the "Why do people believe in psychosomatic explanations" thread. Sceptics often say "We're not saying your symptoms are fake by saying it's psychosomatic", but that's usually just gaslighting in my experience (including of being sectioned and told by staff that I was in no pain).
 
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Treating chronic fatigue syndrome
The 'Oxford definition'
Research by Professor Michael Sharpe and his team from the Department of Psychiatry has revolutionised our understanding of the illness. As recently as the 1980s, the illness lacked an agreed clinical definition and was widely regarded as untreatable; patients were simply advised to rest.

In order to meet the challenge of improving the outcome for patients the team first led a national initiative to establish clear diagnostic criteria for the disorder. Published in 1991 and known as the ‘Oxford definition’ these UK criteria have been influential in getting replicable research off the ground and have formed the basis for subsequent international case definitions.
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The effectiveness of cognitive behavioural therapy
Once diagnostic criteria were available, Michael’s team conducted careful clinical studies to help them to understand the illness better from the patients’ perspective. Drawing on these studies he devised a treatment based on cognitive behavioural therapy (CBT), which helps patients alter the way they think about and cope with their symptoms.

In a ground-breaking study, published in 1996, the team reported the first ever randomised clinical trial to identify an effective treatment for chronic fatigue syndrome. After one year, 73% of patients who received the CBT reported a significant reduction in their disability compared to only 23% of patients who received medical care alone. This trial disproved the theory that CFS was untreatable and offered patients a therapy based on scientific evidence. The effectiveness of CBT was confirmed in a trial published by a team from Kings College in London and subsequently by numerous independent studies to this day.

CBT is now acknowledged as a cost-effective treatment for chronic fatigue syndrome, benefiting not only the patient but also reducing the burden of care on family members. In England alone, there are now 49 NHS specialist treatment centres for chronic fatigue syndrome treating over 7000 patients a year. CBT is provided at 46 of these centres.

This pioneering work has had global impact and CBT is now recommended by the Centres for Disease Control in the USA. It has also led to a revaluation of how fatigue should be treated in other conditions such as multiple sclerosis.
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https://www.neuroscience.ox.ac.uk/how-we-are-making-a-difference/treating-chronic-fatigue-syndrome

has no one told them?

Jul 3, 2017, the CDC's Chronic Fatigue Syndrome page has been changed to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS); graded exercise therapy (GET) and cognitive behavioral therapy (CBT) recommendations have been removed.[4][5]

  • US NIH Report Calls for UK Definition of ME/CFS to be Scrapped - The Argus Report By: Penny Swift.
Excerpt
The United States National Institutes of Health (NIH) has issued a draft report that highlights the dire need for scientific research that will help find a cure for the millions of people suffering from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) worldwide. The report also highlights the fact that the decades-old UK Royal Society of Medicine’s Oxford criteria for ME/CFS are severely “flawed,” and that continuing to use these criteria may “cause harm.” Further, the NIH report says that the Royal Society definition should “be retired” and replaced with a single case definition agreed to by the ME/CFS community.[9]

eta:
Email: neuroscience@medsci.ox.ac.uk
 
His definition of ME would have been more accurate if he had actually asked patients what symptoms they had. Dr Derek Pheby tried to get research money to look at what patients experienced but it was rejected because it was not necessary.

The theory of patients being deconditioned was put forward without any research being done on whether this was true or not.
 
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