1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for CFS here.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 18th March 2024 is here.
    Dismiss Notice
  3. Welcome! To read the Core Purpose and Values of our forum, click here.
    Dismiss Notice

Chronic Fatigue Syndrome and chronic pain conditions – vitally protective systems gone wrong, 2019, Pederson

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Jul 1, 2019.

  1. Andy

    Andy Committee Member

    Messages:
    21,810
    Location:
    Hampshire, UK
    Paywall, https://www.degruyter.com/view/j/sjpain.ahead-of-print/sjpain-2019-0072/sjpain-2019-0072.xml
    Sci hub, not available at time of posting.
     
  2. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

    Messages:
    3,819
    Location:
    Australia
    More nonsense about the sense of fatigue being "protective" in the abstract. The sense of pain is protective, but fatigue is not pain...

    The brain does work in a predictive/anticipatory manner, but it is a non-sequitur to suggest this is why cognitive behaviour therapies and stress relief therapies could be beneficial.

    Unfortunately I don't yet have access to this one so I can't comment further.
     
  3. Mithriel

    Mithriel Senior Member (Voting Rights)

    Messages:
    2,815
    They seem to be using CFS as the symptom chronic fatigue and chronic pain where others have spoken about fibromyalgia. They have downgraded diseases into symptoms.

    ME is a disease which has fatigue as part of its presentation in the same way as many other neurological diseases. When CFS was invented and we complained it was trivialising they insisted that chronic fatigue syndrome was obviously different from chronic fatigue so nothing to worry about - see how well that has worked out.

    There ideas could possibly be right (maybe...) if anyway does experience fatigue or pain with no cause (It is just about possible that a switch could be triggered but not turned off) but the pain and fatigue from chronic disease is another issue altogether.

    We experience fatigue and pain because the processes causing that fatigue and pain are still happening.

    They are ignorant of what ME is and how it affects people, they take a single symptom out of context, refuse to learn anything to plug the gaps in their knowledge, ignore anyone who tries to educate them then pontificate on causes which simple observation would show did not exist (like deconditioning) and go on to promote treatments with no basis in reality
     
  4. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    12,296
    Location:
    Canada
    This shift happens to align with the disastrous status quo. It is actually the foundation of why things are so bad, integrating woo-woo alternative medicine into the fold of genuine medical practice by lowering the bar for an alternative research tract built on clinical psychology, itself in the midst of a massive crisis of reliability.

    Acknowledging the problem does not help when its cause is pointed at as being the solution. In both cases the shift is built entirely on ignorance and contradiction of all patient experience and testimony so drop the damn holistic crap, you are doing exactly the opposite of considering the person as a whole, you are in fact negating our agency and self-perception by insisting that we are confused and/or exaggerating.

    It's like noticing that famine in a region is growing worse because of crop failure while noting changes in water management that happened at the same time and failing to understand the link. You're not helping by promoting an expansion of those changes in water management. You're not helping at all!

    It is absolutely right that there is a lot of similarity between our disaster and that of chronic pain patients. It's also right that much of that failure is precisely a direct consequence of this psychosocial alternative medicine creep. Yesterday I saw an article from a Stanford pain journal talking about how chronic pain and emotional pain are essentially two sides of the same thing. Complete quackery and life-threatening to millions.

    This creep of pseudoscience is seriously alarming. Medicine is completely unequipped to deal with this in a self-regulated process. And the goopification of medicine continues, full speed ahead. Trolley problem? What trolley problem? If you don't look at the tracks, ahead or behind you, you can simply focus on how far ahead you're getting, there is no problem.
     
    MEMarge, shak8, JohnM and 11 others like this.
  5. Kalliope

    Kalliope Senior Member (Voting Rights)

    Messages:
    6,237
    Location:
    Norway
    Atle, MEMarge, Esther12 and 4 others like this.
  6. DokaGirl

    DokaGirl Senior Member (Voting Rights)

    Messages:
    3,664
    Yes, and since cancer, MS, and many other diseases also involve fatigue, "CBT and other stress relief therapies can help these patients recover to better health" as well. :wtf::banghead::mad:
     
    MEMarge and Mithriel like this.
  7. DokaGirl

    DokaGirl Senior Member (Voting Rights)

    Messages:
    3,664
    You are absolutely right @rvallee.
    There is nothing holistic about the current BPS model. Over 3 decades ago, some with good intentions did use the BPS model as a three-pronged approach.

    Maybe they're using the term "holistic" because it's an "in thing" term - it's cool and all that. Nothing cool about their beliefs, or "therapies" though.

    Unfortunately, these theories will be with us forever. People love voo-doo, magic, blaming others for their misfortunes, and the like. But hopefully, we can overcome this dangerous clap trap and gain a solid, and permanent standing in the biomedical realm.
     
    shak8, rvallee and Simbindi like this.
  8. DokaGirl

    DokaGirl Senior Member (Voting Rights)

    Messages:
    3,664
    @rvallee, I like your term the goopification of medicine.

    I think that some in medicine welcome this pseudoscience, as it confirms their beliefs that many patients are just whingers and moaners. However, this belief is life-threatening for patients whose pain or fatigue is caused by cancer for example.
     
    rvallee likes this.
  9. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

    Messages:
    3,494
    Location:
    Belgium
    Just read the paper, but not much new here.

    The author, Maria Pedersen argues that fatigue is much like pain. They are "important sensations with protective value in an acute situation" but can become chronic and cause severe disability. She argues that in its chronic form, perception and interpretation are important. She gives the example of a builder who stepped on a 15 cm nail and was in immense pain. It was only when the doctors sedated him and removed his booth that it became clear that the nail had penetrated between the toes and the foot was entirely uninjured. She then argues that CFS and Chronic Widespread Pain are two clinical conditions were fatigue and pain sensations respectively are amplified. She writes:
    She closes off with claiming that a biopsychosocial approach to these treatments, including GET and CBT, is advised. The text reads more like a blog, than a scientific paper. The author didn't actually do a systematic review or develop a hypothesis, it's more like an opinion piece.
     
    MEMarge, sea, shak8 and 8 others like this.
  10. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    12,296
    Location:
    Canada
    Experiencing both, I find that absurd. I know what they mean by that and even taking that framing into account doesn't make it any more meaningful. This is a classic case of wanting something to be true and being validated by nothing more than an absence of genuine understanding, the only thing that can contradict a conjectured opinion.

    I find the example of the nail particularly underwhelming and it's not the first time I've seen it used recently (Sharpe's latest rambling?). Pain isn't only caused by destruction, it just as likely may have been at a bad angle and pressing on a nerve. This thing about pain only being "real" when there is physical damage is really weird considering it would lead to ordinary headaches not being possible. Accounts of being an immense pain may have been exaggerated, this is mostly hearsay and we know first-hand how medical records are a lousy source of information, subject to interpretation. It's a great example of obsessing over a nearly century-old unreliable extreme anecdote to prove a weak point, it hardly gets any less scientific. To use it as a positive example is... telling.

    All this reveals from those who espouse this opinion is that in the early era when natural philosophy was maturing into the modern system of science, they would have been on the side arguing that divine intervention and creation are perfectly valid explanations and that there is no need to search for an explanation when you already have one that you like and feels so warm and cozy and you can't prove it's wrong anyway so QED.
     
    MEMarge, chrisb and shak8 like this.
  11. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

    Messages:
    3,819
    Location:
    Australia
    I still don't understand why people conclude that fatigue sensation is "protective"? Pain is protective. Fatigue sensation is something else. We know that fatigue sensation is associated with uncertainty about the level of motor units recruited to perform a movement at a specific force. Which is to say, it predicts uncertainty in the level of (brain) effort required for a particular task.

    PS, I have stepped on a long nail and it hurt more in the subsequent days (my whole foot was swolen/purple) than it did in the few hours afterwards. It was pretty obvious I was injured as I was dripping blood all over the ground. I do not find the nail example credible at all. It was not published as a peer reviewed case study.
     
    Last edited: Jul 6, 2019
    ukxmrv, MEMarge, Amw66 and 1 other person like this.
  12. Mithriel

    Mithriel Senior Member (Voting Rights)

    Messages:
    2,815
    I think she is confusing fatigue with sickness behaviour which was a valid thing until it was psychologised. In humans and animals infections and hurts often lead to a specific set of behaviours involving hiding and lying down. There are changes in the body too which is why people go off food.

    These are protective measures which ultimately give a better chance of survival. One theory from the BPS was that fatigue sensations induced these behaviours but that in us the switch gets kept on even when we are well again
     
    lansbergen and MEMarge like this.

Share This Page