Embodied: The psychology of physical sensation (2015) by C. Eccleston

Embodied: The psychology of physical sensation
by Christopher Eccleston
Oxford University Press 2015
E-book: https://www.oxfordscholarship.com/v...o/9780198727903.001.0001/acprof-9780198727903

Chapter 6 about fatigue deals with "chronic fatigue" as identical with "Chronic Fatigue Syndrome"; promotes cognitive-behavorial model.

https://www.oxfordscholarship.com/v...27903.001.0001/acprof-9780198727903-chapter-6

Google books: https://books.google.co.uk/books?id...ce=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

The author Christopher Eccleston is Senior Editor at Cochrane, Cochrane Mental Health and Neuroscience Network and Professor at the University of Bath Centre for Pain Research.

see the posts by @Peter Trewhitt and @Esther12 :
https://www.s4me.info/threads/which-cochrane-review-group.7459/#post-133033

https://www.s4me.info/threads/which-cochrane-review-group.7459/#post-133038

He co-authored the rather promising-sounding paper 'Let’s talk about pain catastrophizing measures' discussed here.

@Michiel Tack

 

Judging by the blurb for the book Ecclestone is an ignorant nutcase.
He also seems to be a senior editor at Cochrane.
Embodiment is about the biggest bullshit buzzword in study of the mind.

As to what logically valid conclusions one can draw from these premises I would not pretend to know.

 

That's not much to judge on!

There were some really annoying and thoughtless things in there, but there were bits of critical engagement as well. I wouldn't be too sweeping in judgement=.

 

I like your expression, ignorant nutcase. Says it all.

 

I'm still working my way through it, but in the introduction "the fallacy of resource depletion" the author discusses "ego depletion" which is one of those findings in social psychology that has failed to replicate. https://replicationindex.com/category/ego-depletion/

Wow, it is clear this guy understands neither the neurology of exercise physiology, nor the basic biochemistry involved. Our cells are quite sophisticated, utilising multiple substrates for energy - the limitation is the kinetics by which this occurs - so performance rarely just stops, but rather, performance of the currently stimulated motor units becomes limited, requiring greater effort to stimulate more motor units to maintain the same performance over time. (with a similar analogue for mental exertion)

Marathon runners (one of the examples in the book) only use a fraction of their motor units at any one time at race pace. Similar Consider measurements of elite cyclists - who can peak out at 1500-2000w for <8 seconds, 800w for 30 seconds and over 400w for an hour. So for that hour where they are riding as hard as they can, they're still only utilising 20-25% of their maximal force. Notably over time, cyclists riding at above the lactate threshold (but below VO2Max - which is not limited by the muscle, but the cardiovascular system's ability to deliver blood to the muscle) will require more oxygen to maintain the same output, known as the VO2 slow component - as motor units fatigue, more motor units are recruited to maintain the same output. There is no oxygen steady state at a constant performance output.


Hence fatigue is an important part of of provocative system, namely it warns when it will require more effort to maintain the same level of output - this is evolutionary important, for if we are not warned in advance of a decline in performance then we might not be able to escape danger - or gain our next meal. The key point is our brain makes predictions about our output capabilities which are constantly calibrated by afferent feedback. Real world fatigue is not defined as a decline in maximal performance induced through twitch interpolation, it is requiring greater effort (nerual drive) to achieve the same level of force (or equivalently, concentration in terms of mental exertion).

This is nonsense. Fatigue is not an emotion, it is a warning that higher levels of effort are being expended for the same level of performance.

None of this is backed up by empirical study.

Wow. Of course in the real world, if fatigue increases, which is to say the effort required increases to a point at which it can no longer be maintained metabolically, then stopping is inevitable, regardless of one's motivation. ('hitting the wall' is one example)

Fatigue is not "urge to stop", and I think the author is stretching this concept to the point of nonsense.

 

Competitive cyclists took cocaine to stop fatigue and help them keep going. They often died because they used all their resources.

These ideas of fatigue keep using athletes who are fit way beyond the normal. Hunter gathers do not have to be fit enough to run marathons. If anything, in the average healthy person fatigue probably irons out "boom and bust" in their beloved jargon.

Just chose your facts to fit your idea, don't test your idea to see if it is correct.

 

haha. He was my first boss at Cochrane. We didn't get on...

 

Sadly, the general public love this type of approach to health. The recipe seems to be:

• Take a complex interaction of complex systems that we presently know little about and ignore completely.
• 
  
• Replace with vague concepts that use 'cutting edge' buzzwords with no meaning (I now refer to this as goop)
• 
  
• Make sure that it all sounds wonderful to be a part of. I'm surprised no-one has coined 'health orgasm' as the term to use for this (unless they have)

Come to this approach for the health issue--stay for the warm fuzzies you get in feeling you are in control of everything that happens to your health.

If I had the ability to read all this stuff (not that I'd want to) I'd devise a goop scale.
5 'GOOPS' and you are deep in alternate reality.

 

I am really stunned by this, and have to share with you a few excerpts. Look at this bit where Eccleston slides so seamlessly between the (probable) physical causes of fatigue in CFS and the idea that its actually all about motivation.

He argues that because fatigue in disease might have an adaptive value in helping the organism withdraw and heal, then fatigue is "motivational". That is, it isn't a straightforward consequence of depleted resources, but actually serves a function. He does not seem to understand that evolutionary functions are not the same as motives. The giraffe's long neck serves an evolutionary function, but it has nothing to do with motivation. Similarly, while fatigue in illness might have some benefits in some situations, these may not necessarily have anything to tell us about the mechanisms that give rise to it. Although "illness behaviour" might have some upsides in some situations, it probably had a huge downside too - when the neighboring tribe came charging into your village with machetes and whatnot, I'm reckoning those with a fever were unlikely to have been the ones who got away!

Then this:

Notice the word "ruminating", an explicitly negatively valenced word that describes recurring thought patterns that do not serve to address the problem in any productive manner.

then this on the PACE trial:

So apparently, PwMEs live with the constant "urge to stop"!

Now, what did Sarah say? exactly what you'd expect from a PwME:

Sounds pretty reasonable. Anyone here could have written that. Look at what Eccleston concludes from it:

Edited for typos and to finish one of my sentences!

 

And of course it's all about fatigue.....

 

I can't stop thinking about Dr Who. Did Christopher Eccleston change careers after playing the part?

 

I don't think so - he was in the first season of Fortitude and also in The A Word & I think both were filmed after that.

 

I mean no disrespect, but that guy's an idiot. Somehow manages to miss 100% of the shots he takes. All the details are either completely wrong or so wrong as to be meaningless. Totally fictitious misrepresentation of PACE. Of course it's the same as the PACE authors' own misrepresentation, no surprise there. I guess we should call it a philosophical trial, rather than a pragmatic trial, then? Complete nonsense.

That fake-ass dialogue is nothing at all like my experience, absurdly trivial and superficial. I don't know where they come up with this stuff but I'd suggest putting down the crack pipe and pursue creative writing instead.

That's just goopy nonsense and frankly shows how utterly clueless they are about their own selected topic of expertise. Quacks like this guy know nothing of the experience of illness but because the only people who can contradict it, those being misrepresented as they testify to the experience, have been stripped of agency they just continue making stuff up, not knowing when to stop because they destroyed the feedback mechanism and created a mutual admiration society in which every claim gets a shiny participation gold stamp.

Completely made-up tripe. If there is one defining characteristic of illness, not freaking fatigue, it's completely poverty of thought, the mind just goes blank. Well, even blanker than usual. But they can make up fake-ass dialogue so nothing matters anyway.

This is completely embarrassing. It devalues expertise to allow people to simply make stuff up like that. Way beyond simple incompetence to have such nonsense published. Especially as if you go back well over a century you can find the exact same pseudoscience, with the exact same basis in "evidence" and the exact same set of beliefs underlying it.

 

This strong urge to stop thing.....

Anybody else have issues with that? I find when I have been overdoing it, especially if I overdo a little bit on a few occasions within a shirt period of time, I feel absolutely awful & like I could just drop in the spot, but also a weird compulsion to carry on.

It's like the cognitive function has dropped below the level needed for good decision making or maybe a final burn off of adrenaline.

Anyway it's the opposite of an urge to stop.

Stopping can sometimes take huge strength of will.

 

Well, quite, and Sarah's narrative - which he inserts right there in the chapter - doesn't mention an urge to stop, but rather hard-earned knowledge about what's likely to cause kickback if she doesn't obey. Most of what she talks about is annoyance when she later has to pay the price for NOT stopping.

Its an amazing example of how someone can believe they've "listened" to a person's narrative, but really, they've just superimposed their own preconceptions onto it.

 

I had this with my usually very good consultant years ago when we were discussing cognitive issues.

I explained the usual stuff many of us are familiar with and he immediately said " ah yes problems with concentration ". I disagreed and repeated what I just said and he went "yes, concentration problems are very common".

I just looked at him and said "you do realize you're not listening to me, right?" He looked surprised and I pointed out my cognitive difficulties were primarily processing problems. Concentration fade was secondary as I expended more and more effort to process information.

He looked surprised, thought about it & then seemed to get it.

I think our difficulties communicating aren't always taken fully into account - we say something during an appointment, but they hear what they expect to hear. We don't always have the ability to put them right and so they assume.

The ability to actively listen without allowing your assumptions to filter what is heard is a rare skill it seems.

 

precisely, I never feel 'urge to stop' & I certainly don't think I need to stop, there is no stopping cognition. Once I've gone even a liitle too far, the fact that there is no cognition around it is precisely the problem... people will say to me afterwards why on earth did you carry on for that long? What on earth made you do that Jem? you know you cant do all that without payback why did you do it? And there is no answer other than 'because I have ME'. They assume we are constantly body watching for symptoms... if only I were! PEM would never occur. But it's precisely that when I have been mentally/physically active & am starting to overdo it, the signal recognition disappears & I become completely stupid, unable to respond appropriately to anything. If only I were having thoughts that said 'I need to stop now', or even 'I want to stop now' i'm sure I wouldn't ever crash. But by that time I am too cognitively impaired to work it out.

Which is basically what Sarah says - she "ended up leaving at 5pm & had a chore to do on the way home"

He is incapable of hearing. As has been said... they cant listen without superimposing their own preconceptions onto what is said. It drives me completely nuts.