Chicago Health: Chronic Fatigue Syndrome Is Debilitating but Often Dismissed

Kalliope

Kalliope

Senior Member (Voting Rights)
I wonder what Jason means with this statement:

Jason agrees that mental health approaches, like cognitive behavioral therapy, can “allow patients the mental space to be able to do more and decrease the belief that their condition is serious,” but he cautions that therapy doesn’t actually cure the physical symptoms of ME/CFS.

MD Leslie Mendoza, medical director of the Integrative Medicine Program at Northshore University Healthsystem is also interviewed and talks about her holistic approach to treating ME/CFS with among others acupuncture, massage, herbs, cannabis, yoga and movement..

https://chicagohealthonline.com/chronic-fatigue-syndrome-is-debilitating-but-often-dismissed/
 
That's a contradiction of his own work... Must be a miscontextualised quote, esp regarding the word 'serious'.

Does he know about it? Is he on this forum BTW?

Just one example of an LJ article:

https://www.ncbi.nlm.nih.gov/pubmed/29430570

Differentiating Multiple Sclerosis from Myalgic Encephalomyelitis and Chronic Fatigue Syndrome.
Jason LA1, Ohanian D1, Brown A1, Sunnquist M1, McManimen S1, Klebek L1, Fox P1, Sorenson M1.
Author information
Abstract
Multiple Sclerosis (MS), Myalgic Encephalomyelitis (ME), and Chronic Fatigue syndrome are debilitating chronic illnesses, with some overlapping symptoms. However, few studies have compared and contrasted symptom and disability profiles for these illnesses for the purpose of further differentiating them. The current study was an online self-report survey that compared symptoms from a sample of individuals with MS (N = 120) with a sample of individuals with ME or CFS (N = 269). Respondents completed the self-report DePaul Symptom Questionnaire. Those individuals with ME or CFS reported significantly more functional limitations and significantly more severe symptoms than those with MS. The implications of these findings are discussed.
 
When I say contradiction, I am meaning the implication that ME is not serious and that it is resolvable by CBT contradicts what I know about LJ and his work.

Sure, the first part about "mental space" is fine for anyone, let alone the chronically ill. But that second point regarding seriousness and the implication of just pushing through it because it is not serious... If instead he had suggested that 1) some people might benefit from doing a bit more than they do and that 2) such people hold back a little too much would be totally different message that could be open for discussion if made forensically (however dangerous it might be in the hands of ignorant medics). But that's not what was quoted...

Very odd and needs from clarification from him
 
InfiniteRubix said:
When I say contradiction, I am meaning the implication that ME is not serious and that it is resolvable by CBT contradicts what I know about LJ and his work.

Sure, the first part about "mental space" is fine for anyone, let alone the chronically ill. But that second point regarding seriousness and the implication of just pushing through it because it is not serious... If instead he had suggested that 1) some people might benefit from doing a bit more than they do and that 2) such people hold back a little too much would be totally different message that could be open for discussion if made forensically (however dangerous it might be in the hands of ignorant medics). But that's not what was quoted...

Very odd and needs from clarification from him
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He says CBT isn't curative for ME. It's the 'decrease the belief that the condition is serious' that's out of character.
 
Earlier this year he said the following in a DePaul interview (where I assume it would be easy for him to get a quote corrected if it was wrong)

Psychological, autonomic, and biological risk factors predispose people to developing ME/CFS following IM. We will determine which of these factors, if any, is also important for maintaining ME/CFS over time,” noted Jason, director of the Center for Community Research in DePaul’s College of Science and Health.

(my bold)
It's discussed in this thread:
https://www.s4me.info/threads/depau...no-in-college-age-students.13245/#post-230904
 
adambeyoncelowe said:
He says CBT isn't curative for ME.
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Agreed, and he's been on the record about that for a long time in many forms of media. I wasn't explicit enough, sorry.

That second part about seriousness could be selectively understood, in fact I would suggest will be selectively misunderstood, as implying exactly the opposite idea that CBT works. Even on top of the implication that ME is not serious.

Either 1) it will be read selectively to confirm existing baseless ideas about CBT, despite the statement that CBT is not curative, or 2) be taken at face value and implemented with little/no substantive difference in practice or harm to PACE assumptions. Society and medicine were predilected that way even pre BPS IMO :(
 
Kalliope said:
Earlier this year he said the following in a DePaul interview (where I assume it would be easy for him to get a quote corrected if it was wrong)

Psychological, autonomic, and biological risk factors predispose people to developing ME/CFS following IM. We will determine which of these factors, if any, is also important for maintaining ME/CFS over time,” noted Jason, director of the Center for Community Research in DePaul’s College of Science and Health.

(my bold)
It's discussed in this thread:
https://www.s4me.info/threads/depau...no-in-college-age-students.13245/#post-230904
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Thank you. I had seen and been concerned about that paper, and then totally forgot about it. I'll comment on that thread.
 
Sly Saint said:
@Leonard Jason
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Thank you. For some reason he doesn't come up in the editor when using @

@Leonard Jason - many thanks for all you do and have done. Not hollow words - I know many of us depend on your work or cite it directly in work released or yet to be.

Re your new NIH funded work, there are a number of posts on the following thread, including caveating how distinct words like predisposition, correlation and even comorbidity will too often end up being interpreted as causation in practice. While you may not be able to reply in detail at this stage, reviewing or commenting the following will be gratefully appreciated:

https://www.s4me.info/threads/depau...no-in-college-age-students.13245/#post-230904

InfiniteRubix said:
There is a serious risk about blurring correlation vs causation when talking about predisposition.

Random example. Hypermobility can lead to people requiring orthotics. Orthotics are not a predisposition or comorbidity of ME. Most would say it is the hypermobility. In fact, I would suggest the hypermobility is not even the comorbidity per se - because hypermobility is merely a symptom of some collagen anomalies, which could also manifest themselves cardiacly, the cornea or in the gut perhaps. With physiological, and sometimes surgical and then antibiotic, implications for some of these. The gut issues maybe even then having a psych effect, but I defer to others on that.

Biological features or conditions, which are entirely physiological nature, might have a higher comorbidity with psych issues, sure. But where there is any evidence to suggest the psych issues are caused by the biological condition, either physiologically or even behaviorally, that's causation of the psych by the phsyiological issue or maybe even just correlation. But it is definitely not causation of the physical by psych methinks.

Therefore, the predisposition and correlation of ME would be with the biological feature in this example, not the psych collateral impact.

Christmas cards don't cause Christmas. That difference between causation and correlation needs to be made very clear and not just cut through, particularly with the dangerous history of ME.
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InfiniteRubix said:
Another important analogy.

Autism spectrum disorder is is correlated with hypermobility, as I understand it (potential role of the gut). And being on the spectrum clearly has an implication psychologically, in terms of how one deals with the world and the additional cognitive load, let alone stress, that can result.

But again there is a massive distinction to be made between correlation and causation. Even if the causative mechanisms are not 100% clear, the distinction must be made. Children are born autistic or hypermobile and with any caused predispositions, not with psych issues off the bat.
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InfiniteRubix said:
The burden to caveat is substantial.

Distinct words like predisposition, correlation and even comorbidity will too often end up being interpreted as causation. My memory of the behavioural research is that it's a common behavioural failing to mix these when interpreting, even in technically skilled people. I think it's that same phenomenon that makes some articles be insufficiently clear about what they are NOT saying. And insufficiently break down what they are saying. Psychology is a hugely important profession, but does inherently allow for a philosophical lack of rigour more akin to social science. They have to break down and tie down more thoroughly.

Heavy caveating is needed in the specific light of the history and sociological of many conditions, even in terms of the sociology of the medical profession... ME is a textbook example of where it is needed.
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Kalliope said:
I wonder what Jason means with this statement:

Jason agrees that mental health approaches, like cognitive behavioral therapy, can “allow patients the mental space to be able to do more and decrease the belief that their condition is serious,” but he cautions that therapy doesn’t actually cure the physical symptoms of ME/CFS.

MD Leslie Mendoza, medical director of the Integrative Medicine Program at Northshore University Healthsystem is also interviewed and talks about her holistic approach to treating ME/CFS with among others acupuncture, massage, herbs, cannabis, yoga and movement..

https://chicagohealthonline.com/chronic-fatigue-syndrome-is-debilitating-but-often-dismissed/
Click to expand...

Thank you for alerting me to this quote, which I never said. I have alerted the media outlet and asked them to delete this. My position on this type of therapy is very clear, in multiple publications including this one: Sunnquist, M., & Jason, L. A. (2018). A reexamination of the cognitive behavioral model of chronic fatigue syndrome. Journal of Clinical Psychology, 74, 1234–1245. https://doi.org/10.1002/jclp.22593. PMCID: PMC6002889
 
Leonard Jason said:
Thank you for alerting me to this quote, which I never said. I have alerted the media outlet and asked them to delete this. My position on this type of therapy is very clear, in multiple publications including this one: Sunnquist, M., & Jason, L. A. (2018). A reexamination of the cognitive behavioral model of chronic fatigue syndrome. Journal of Clinical Psychology, 74, 1234–1245. https://doi.org/10.1002/jclp.22593. PMCID: PMC6002889
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Thank you very much
 
Leonard Jason said:
Thank you for alerting me to this quote, which I never said. I have alerted the media outlet and asked them to delete this. My position on this type of therapy is very clear, in multiple publications including this one: Sunnquist, M., & Jason, L. A. (2018). A reexamination of the cognitive behavioral model of chronic fatigue syndrome. Journal of Clinical Psychology, 74, 1234–1245. https://doi.org/10.1002/jclp.22593. PMCID: PMC6002889
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Thank you so much for clarifying @Leonard Jason :)
 
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