Chronic Fatigue Syndrome the roles of perfectionism and metacognition in co-morbid depression and anxiety, 2020, Wright (D.Clin.Psy.)

[Forbin]

So, I believe when you boil this concept down to its essence you get...



Thanks.

 

[cfsandmore]

My brain is fried from reading this Trojan horse. As a blue-collar worker who worked in the pharmaceutical industry my job demanded perfection. Quality control was extremely high. The drugs we manufactured went straight into the patient's veins. That's why I gave my energy to read this paper.

Liverpool College doesn't have the mental capacity to grasp this fact, people with MECFS limit and sometimes avoid physical activity as a tool. They see the cause of avoidance as maladaptive perfectionism.

We start with the CBT model for depression and anxiety, look at the questionnaires, take a close look at the one on pages 124-128. The questionnaires are rigged, they are loaded dice. Using the questionnaires we would find every illness, every disease, every dysfunction, causes sufferers anxiety and depression in greater numbers than healthy controls. Why has logic died in psychology? Is this model we could test people with faulty automobiles. We would discover they have more anxiety and depression than people with properly running automobiles. If we dug deeper using this model we would find people without the money to repair their faulty automobile suffers greater anxiety and depression than those who have the money to fix their automobile. Using the model of this paper we would discover the owner of the automobiles suffered from maladaptive perfectionism. The authors of this paper could not see the reliability of the automobile as the cause of anxiety or depression.

The paper arrives at a similar conclusion as CBT, patients with CFS have a phobia.

"Once physically unwell, bursts of activity to meet unrealistic, pre-morbid standards are often punctuated by post-exertional malaise and the need to recuperate [56]."

The clueless authors have no idea that energy is so precious to people with MECFS that we do not wish to waste even the smallest drop. MECFS patients use the push and bust cycle for the author's theory of maladaptive perfectionism. Yet, again we see a logic failure. As patients suffering from MECFS we know the push and bust cycle is caused by many different reasons. There was no investigation into the causes of PEM by the authors.

In the next paragraph, we see they have already arrived at their predetermined conclusion.

Higher levels of maladaptive perfectionism occur in people living with CFS/ME
compared to healthy controls [57]. Maladaptive perfectionism has also been positively associated
with self-critical coping strategies and adjustment difficulties in this patient group [58].
Perfectionism is a shared risk factor for depression, anxiety [59] and CFS/ME [60,61], suggesting the prudence of investigating associations between perfectionism and depression/anxiety within a CFS/ME population.

They set out to find perfectionism and by golly, they found perfectionism.

To date, however, research has primarily focussed on the relationship
between perfectionism and fatigue [60, 62] and perfectionism as a predisposing factor to CFS/ME
[61]."

I would be predisposed because I worked in pharmaceuticals. This was used against me in CBT. Child abuse was used against me, to say I was suffering from perfectionism to stay safe from my abusive parent. I've been the patient receiving the treatment.

Leaving all the dishes for the end of the day as I did before CFS doesn't work now. Using Classic Pacing For A Better Life With ME, I do the dishes in small amounts. What these circular thinkers don't realize, it is not due to a phobia. It is not maladaptive perfectionism. It is pacing. I am living outside the boom and bust cycle. I am using avoidance as a tool.

Patients with MECFS who live in the boom and bust cycle have a pacing problem due to physical disease. This is not a cognitive-behavioral dysfunction, it is an education void. The psychologists are blinded by their own projection.

So one day I'm overly active what happens after a crash? Can I pace the same as my baseline? No. So the dirty dishes increase and I have anxiety over the pile. In the author's eyes, the anxiety is maladaptive perfectionism. I have a physical energy production problem. This idea never occurs to the authors.

Maladaptive perfectionism manifests in cognitive, emotional, behavioural, and
physiological responses [48] which can lead to emotional and physical exhaustion, as well as
physical symptoms through overburdening the stress response system [49-52].

The word you are looking for is Psychosomatic. The model in this paper sees feelings, emotions, and thoughts as the cause of physical exhaustion. The authors have revealed to us their projection. We know it is an energy problem, and a problem managing our limited energy.

Once again we see the anxiety and depression in CFS being treated as if it is caused by a phobia. For the authors, PEM is caused by a phobia. I do not think, I have been a bad little boy because I have dirty dishes. I do not live in the terror of dirty dishes. I have no guilt over dirty dishes. The sink isn't full because I fear failure. The sink is full because I saw my physician today, or took my kid to school, or had a visit from a friend, etc.

I see the dirty dishes as physical activity. I needed to avoid a big washing due to PEM. I use avoidance as a tool, to help me cope with fatigue and PEM. Psych academia can not perceive avoidance as a useful tool. In Psych, avoidance is almost always a sign of cognitive dysfunction.

The blind wants to lead. Get ready for phobia treatment. The patient will be told they are avoiding and over-exerting themselves out of fear, guilt, or shame, at not being able to keep a perfectly clean kitchen.

I will be asked to let the dishes pile up. To let my dishes become untidy. To be a bad little boy with a nasty kitchen. This will be done to break the perfectionism. I will explain, No, that doesn't work, I use pacing to keep my physical efforts small, it helps me manage my fatigue.

If I'm lucky and get a therapist who also thinks for themselves they can see the logic in preventing fatigability and PEM. I love those therapists, if you are one, I thank you for your wisdom and insight. Thank you for your empathy.

If I'm unlucky and get a robot therapist, I will be listed as an untreatable patient. Instead of following directions like a good little boy, I thought for myself. If you listen to the therapist closely, you can hear them following the directions so they are a good little boy or girl. Psychiatry and Psychology are the parents of these therapists.

If we ask a Pastor to write a theology paper, we will see the same system. The Pastor's paper is based on belief. The Pastor has a theory and uses commentaries to support his belief.

Belief is what we see in this paper on anxiety and depression in MECFS. The paper has no investigation because it is based on belief, if there was an investigation we would see many different causes of anxiety and depression in MECFS. The investigation would quickly find that the boom and bust cycle is only one of many many causes of PEM.

Come on Psychologists, you can do better than this. Please go back to your roots and spend a little time conducting an investigation. Have an open mind. Go back to using logic.

 

[Snow Leopard]

"Once physically unwell, bursts of activity to meet unrealistic, pre-morbid standards are often punctuated by post-exertional malaise and the need to recuperate [56]."

This is a key point that many people need to realise - these researchers believe that PEM is the "bust" of boom-bust! They don't seem to acknowledge the fact that PEM doesn't require a "boom" or "burst" of activity.

(56 is a Chalder/Spence 2005 study of the BRIQ questionnaire of "medically unexplained symptoms following acute infection", focusing on irritable bowel syndrome)

 

[Simon M]

Simon Ponting

A distraction

A long time ago there was another flaky personality study, which I tried to send up. You don't need to know the details of the study, but it was this one by Nater.

Errant scientist called to see the Headmaster:

"Nater, come here!

I've just read your paper and it's complete garbage! [sound effect: Rrrriiiiipppp]

You use a dodgy case definition that includes people who don't do much because they have psychological problems then conclude that people with the illness have psychogical problems. What do we call that? Yes: a ciruclar argument! Don't do it!

Then you make up a Personality Disorder that was explicitly rejected by the American Phsychological Association - what do you think are you playing at?!

But even then you find that the level of personality disorders in CFS is similar to that of other chronic illness - so it can't have anything to do with the cause of this illness, can it? Especially as even by your definitions most patients don't have a personality disorder! Where is the intellectual rigour in all this?

The worst thing is you do actually know all this because you admit it the discussion section. So what exactly is the point of publishing this nonsense?! The idea of research is supposed to be advancing scientific knowledge, not your standing with your friends.

And how may times have I told you not to quote references misleadingly? Yes, I read the Taillefer reference and it actually says that neuroticism was only higher in CFS patients with comorbid depression - it was lower in CFS patients without depression. So that's evidence against your point not for it - an important distinction to make in proper science, Nater.

And what's your speculation doing in the abstract, for goodness sake? In the conclusion section! Conclusions are things you've proved by your research, not things you wish were true!

I've had enough of this. You can stay behind tonight and write lines - 100 of each of these:

"I must not fib about what references say"
"I must not try to pass off my opinions as the findings of proper research"
"The purpose of research is to find the true nature of things, not to impress my mates"

Tell the rest of your gang who were in on this - Reeves, Heim, the lot of them - I want the lines from them too.

Maybe one day I'll turn you all into proper scientists.

Sigh....

Now, get out of my sight."

 

[Mij]

This is a key point that many people need to realise - these researchers believe that PEM is the "bust" of boom-bust! They don't seem to acknowledge the fact that PEM doesn't require a "boom" or "burst" of activity.

Exactly. It's cumulative activities outside of a pwME 'energy window'.

 

[shak8]

I'm convinced that, in general, psychologists are at the lower end of the IQ range of other health professionals and that

they pursue a career in psychology because of their own deep psychological problems that they seek to remedy, and in so doing

they tend to castigate others as 'sick' psychologically. Makes them feel better about themselves and their problems, that they are above it all.

 

[Hoopoe]

At least the ones that hold on to weak and incoherent theories that depict marginalized social groups in an unfair and untrue way. There's clearly a lot of bias of some sort at work.

 

[NelliePledge]

I'm convinced that, in general, psychologists are at the lower end of the IQ range of other health professionals and that

they pursue a career in psychology because of their own deep psychological problems that they seek to remedy, and in so doing

they tend to castigate others as 'sick' psychologically. Makes them feel better about themselves and their problems, that they are above it all.

harsh to bracket the whole profession with the worst. We know there are great people like Brian Hughes, L Jason, Joan Crawford in psychology

 

[FMMM1]

A distraction

A long time ago there was another flaky personality study, which I tried to send up. You don't need to know the details of the study, but it was this one by Nater.

Errant scientist called to see the Headmaster:

"Nater, come here!

I've just read your paper and it's complete garbage! [sound effect: Rrrriiiiipppp]

You use a dodgy case definition that includes people who don't do much because they have psychological problems then conclude that people with the illness have psychogical problems. What do we call that? Yes: a ciruclar argument! Don't do it!

Then you make up a Personality Disorder that was explicitly rejected by the American Phsychological Association - what do you think are you playing at?!

But even then you find that the level of personality disorders in CFS is similar to that of other chronic illness - so it can't have anything to do with the cause of this illness, can it? Especially as even by your definitions most patients don't have a personality disorder! Where is the intellectual rigour in all this?

The worst thing is you do actually know all this because you admit it the discussion section. So what exactly is the point of publishing this nonsense?! The idea of research is supposed to be advancing scientific knowledge, not your standing with your friends.

And how may times have I told you not to quote references misleadingly? Yes, I read the Taillefer reference and it actually says that neuroticism was only higher in CFS patients with comorbid depression - it was lower in CFS patients without depression. So that's evidence against your point not for it - an important distinction to make in proper science, Nater.

And what's your speculation doing in the abstract, for goodness sake? In the conclusion section! Conclusions are things you've proved by your research, not things you wish were true!

I've had enough of this. You can stay behind tonight and write lines - 100 of each of these:

"I must not fib about what references say"
"I must not try to pass off my opinions as the findings of proper research"
"The purpose of research is to find the true nature of things, not to impress my mates"

Tell the rest of your gang who were in on this - Reeves, Heim, the lot of them - I want the lines from them too.

Maybe one day I'll turn you all into proper scientists.

Sigh....

Now, get out of my sight."

Thank you very much for the laugh @Simon M --- oh it's not just funny it's true ---

 

[shak8]

harsh to bracket the whole profession with the worst. We know there are great people like Brian Hughes, L Jason, Joan Crawford in psychology

You're right. Maybe I was tripping down memory lane at my po-dunk uni, from whence these observations became quasi-truisms.

 

[dave30th]

Not sure how great a reference Kelland is.

she's an authoritative source on Science Media Centre propaganda so I think citing her is fine.

 

[MSEsperanza]

A distraction

A long time ago there was another flaky personality study, which I tried to send up. You don't need to know the details of the study, but it was this one by Nater.

Errant scientist called to see the Headmaster:

"Nater, come here!

I've just read your paper and it's complete garbage! [sound effect: Rrrriiiiipppp]

You use a dodgy case definition that includes people who don't do much because they have psychological problems then conclude that people with the illness have psychogical problems. What do we call that? Yes: a ciruclar argument! Don't do it!

Then you make up a Personality Disorder that was explicitly rejected by the American Phsychological Association - what do you think are you playing at?!

But even then you find that the level of personality disorders in CFS is similar to that of other chronic illness - so it can't have anything to do with the cause of this illness, can it? Especially as even by your definitions most patients don't have a personality disorder! Where is the intellectual rigour in all this?

The worst thing is you do actually know all this because you admit it the discussion section. So what exactly is the point of publishing this nonsense?! The idea of research is supposed to be advancing scientific knowledge, not your standing with your friends.

And how may times have I told you not to quote references misleadingly? Yes, I read the Taillefer reference and it actually says that neuroticism was only higher in CFS patients with comorbid depression - it was lower in CFS patients without depression. So that's evidence against your point not for it - an important distinction to make in proper science, Nater.

And what's your speculation doing in the abstract, for goodness sake? In the conclusion section! Conclusions are things you've proved by your research, not things you wish were true!

I've had enough of this. You can stay behind tonight and write lines - 100 of each of these:

"I must not fib about what references say"
"I must not try to pass off my opinions as the findings of proper research"
"The purpose of research is to find the true nature of things, not to impress my mates"

Tell the rest of your gang who were in on this - Reeves, Heim, the lot of them - I want the lines from them too.

Maybe one day I'll turn you all into proper scientists.

Sigh....

Now, get out of my sight."

@Simon M -- I realize you are busy with the DecodeME study as much as your health allows.But I would love to see this on your or @dave30th 's blog.

Perhaps @chrisb could help with a short introduction and others could help with adding references if needed?