Fear conditioning as a pathogenic mechanism in the postural tachycardia syndrome, Norcliffe-Kaufmann et al, 2022

I think this illustrates the issue very well. Medicine having defined anxiety through physical symptoms that have been attributed to anxiety, literally means that basically anything that activates the autonomic nervous system is automatically defaulted to anxiety.

Completely circular, like someone following a trail of their own breadcrumbs and the breadcrumbs of their predecessors through a maze.

And they literally argue that they're on the right track because: look at all the breadcrumbs! There are so many breadcrumbs, they say, as they take out a fistful of breadcrumbs to add onto the track of breadcrumbs. They never make it out of the maze, because they're following the trail of their predecessors and refuse to go beyond the track, as it's all they're allowed to do. Amazing.

 
rvallee said:
By extension of this nonsense, it would also make Parkinson's disease a functional whatever, since everyone knows dopamine is the happy hormone, therefore it must mean they are depressed. Deal with the depression, increase dopamine, and you fix the mood disorder.
Click to expand...

Unfortunately the FND vultures already have their eyes on relatively well understood neurological conditions such as Parkinson’s as if anyone shows any variability, fatigue, mood disturbances or any of the other signs they believe to indicate functional aspects then their illness has a significant functional component are fair game for CBT, ACT or which ever acronym is currently in favour.
 
This post has been copied to a new thread: "The test quality project - part 1: Norwegian psychologists' test attitudes and test use, 2021, Ryder"

Charles B. said:
I don’t understand how people don’t kick these charlatans out of the profession. My guess is that the broader medical establishment feels these conditions don’t warrant legitimate research and should be de-medicalized. Thus, there is absolutely no scrutiny or oversight.
Click to expand...
I think another problem is that it is easy to think that whatever test was used in a published paper is a validated one. After all, it's been peer reviewed! The number of times I've explained that certain tests for anxiety or depression doesn't work for pwIllness due to symptom overlap I'm left with blank stares and/or that the authors must have thought of that. A few months (or maybe two years? can't quite remember) a psychologist wrote an opinion piece on how many scales used in clinical practice should not be used like that because they were tools developed for research and had not been validated for a clinical setting. She argued that unfortunately we use them because we lack something else (and the knowledge that they are not validated).

Edit: The opinion piece was from last year, and I might have misrememberd some of her arguments. Then again there were multiple pieces written since she got replies etc.. but this seems to be the first one:
Opinion piece said:
Imagine that your GP on your own initiative had made a test at home on the kitchen counter and used it to check if you were ill. Or that your doctor left it to the health secretary to interpret the test result. What would it have done with confidence in the test result, in the doctor, yes, in the health care system?

For most people, the answer is self-explanatory. Transferred to mental health practice, the answer is not as obvious. A large number of psychological tests and surveys are performed daily in the health service. There are key tools in the work to investigate and diagnose patients with mental disorders.

...

But today psychological tests are used such as:
Click to expand...
Opinion piece said:
  • is not sufficiently quality assured,
  • does not follow international standards and guidelines for testing
  • and which are imported from outside, but are not authorized for and translated into Norwegian conditions.
Click to expand...

Google translate: No one will take responsibility for quality assurance of psychological tests

She refers to a study on test use, and it is a very nice read (although it is Norwegian centered and touches upon translation and localisation issues that will not be applicable in all settings) written about in the article Test field without control and the actual study can be found here: The test quality project - part 1: Norwegian psychologists' test attitudes and test use

They are all worth reading :)
 
Last edited:
Arnie Pye said:
Referring to the scoring questionnaire in post #11, some of the "sensations" they ask about are things that we are told we must always take seriously e.g. chest pain and choking/throat closing. When and why does it become a stick to beat the patients over the head with?
Click to expand...
The messages from medicine on cardiac symptoms are completely contradictory.

It is worse than even that. What they are really trying to say is that patients must do their own diagnosis. We are supposed to know if it is the 'right' kind of chest pain before we go to a clinic.

If we get it wrong either way, we are stuffed, and get the blame for it.

Wish I could get a job like that.
 
Sean said:
The messages from medicine on cardiac symptoms are completely contradictory.

It is worse than even that. What they are really trying to say is that patients must do their own diagnosis. We are supposed to know if it is the 'right' kind of chest pain before we go to a clinic.

If we get it wrong either way, we are stuffed, and get the blame for it.

Wish I could get a job like that.
Click to expand...
Yes! There was another opinion piece a while back In Norway on this, that how can we expect patients to know if it is a heart attack or something else when the medical profession need tools to do so? Are we putting too much responsibility on patients?

The example used was heart disease, but the same applies for other stuff.
 
Sean said:
The messages from medicine on cardiac symptoms are completely contradictory.

It is worse than even that. What they are really trying to say is that patients must do their own diagnosis. We are supposed to know if it is the 'right' kind of chest pain before we go to a clinic.

If we get it wrong either way, we are stuffed, and get the blame for it.

Wish I could get a job like that.
Click to expand...

I had to do my own diagnosis for my chest pain. When the standard tests for heart attack showed I wasn't having one - and this happened several times - I was eventually asked if I was "anxious" and I said no. I could tell I wasn't being believed.

At the same time this was going on I also had a GI bleed that had been going on for several years. Eventually (it took three hospitals to find it) I had what was described as a "giant polyp" removed which had very fragile blood vessels. I discovered eventually that my GP records suggested that I was seeking treatment for piles (which I wasn't - the blood was much too dark for that) which was why nobody was taking it seriously.

In the end I had to fix my own low iron and low ferritin. It took nearly two years because I absorbed iron poorly, and during that time my chest pain reduced and reduced. I no longer get it now. If you look at links for anaemia the fact that it can cause chest pain and tachycardia is barely mentioned. It certainly isn't given any prominence. I didn't exactly diagnose the cause of my chest pain. I paid for testing, saw I had low iron and ferritin, started fixing that, and ended up fixing the chest pain in the process, as an added bonus.

Replies to this post have been moved to this thread:
Iron deficiency and dysregulation
 
Last edited by a moderator:
Hutan said:
They found that people who have POTS symptoms, including potentially falling over if they don't sit down when feeling faint, think about their body sensations more than people who don't regularly have such symptoms.
Click to expand...
I had my OI under control, more or less, but the last few months I have nearly fallen many times and actually fell twice, once leaving a large bruise on my forehead. Yes, I fall forward, common in OI. I want to add I don't know for sure it was OI, but I am sometimes more vigilant than I used to be. I also completely forget a lot, which is when I am most likely to nearly fall.

These kinds of findings, presuming they are accurate on the questionnaires, cannot determine the direction of causality. An alternative explanation, basically the opposite of their main claims, can easily be constructed. We fall and have problems, of course we get anxious (more focussed) to at least a small amount after this happens a number of times. Not getting anxious/focussed would be more of a psychological problem than getting anxious is. So of course we pay attention, and adrenaline goes up (not read the study so not sure how reliable I consider this), and of course we are more vigilant, if we can be. If the thesis and antithesis are both supported by the same data, it raises the possibility of logical fallacies. In any case they fail to prove their hypothesis.

As has been pointed out already here, we are more concerned after we have a history of problems. It does not fit their claimed hypothesis. In my own case I am much more likely to fall or nearly fall if I am not paying attention. Oh dear, now they will say my subconscious was doing it for me?

Also could someone explain to me how a psychogenic problem can cause cardiac arrest during a tilt table test? I had to be revived when I had one in the 90s. Fortunately I was tested in a hospital, and it was run by my cardiologist at the time.
 
This drivel is, sadly, gaining immense traction. It’s so gut wrenching to see how gleefully pseudoscience is embraced by medical professionals. The simplicity is too seductive I suppose. Anyway, when patients inevitably fail to improve via CBT, we can just attribute it to a lack of motivation and keep on failing upwards.
 
Charles B. said:
This drivel is, sadly, gaining immense traction. It’s so gut wrenching to see how gleefully pseudoscience is embraced by medical professionals. The simplicity is too seductive I suppose. Anyway, when patients inevitably fail to improve via CBT, we can just attribute it to a lack of motivation and keep on failing upwards.
Click to expand...
This is actually a teaching moment about the flaws in medicine. A single mediocre study of no merit whatsoever, and you have physicians declaring from this single mediocre study how it proves the condition is psychogenic. That's all it takes for them, good enough to make life and death decisions about millions. Since it obviously can't be falsified and it's so easy to pretend this is valid by not caring about outcomes ("my patients seem to get better" is all it takes), it can sustain itself indefinitely as long as no one checks anything, which is already the default.

Some facts require a mountain of evidence to be accepted. For others, a doodle on a napkin is more than enough, actually it would take a mountain of evidence for people to stop believing in it. Nothing to do with the facts themselves or their complexity, even less to do with the patients themselves, it's all about what can be concluded from it. The current model of evidence-based medicine simply does not work for anything that isn't a single acute event. It's simply a popularity contest that has no issues validating prejudices and often makes things far worse than doing nothing, which is usually very hard but here is basically the norm.

A radical new approach is needed, this one doesn't yield anything useful while allowing complete nonsense to not only pass through, but be greased up and polished explicitly to be carried ahead of actual useful findings. It may be the most counterproductive system currently in use, and I include old kludged up Cobol mainframe systems from the 1960's in this, at least those work.

This is alternative medicine with alternative medicine standards but given the power and legitimacy of science-based medicine. You couldn't build a worse system than this if you tried your hardest to build one.
 
Let us presume that some kind of anticipatory tachycardia is happening. Its still jumping to conclusions to conclude its a bad thing or causal. It could still be reactive. The brain knows what is coming, and tries to prepare. It might be a very good thing, not a bad thing.
 
Odd. Not entirely surprising. Still odd. I'm not even sure how that makes any sense, other than in seeing only patients with mild issues, they can "succeed" at anything because it probably doesn't matter. For all the talk about clinics exploiting patients with untested treatments and pseudoscience, there is a serious issue with having allowed it to be commonplace in healthcare.
When I first got sick, I contacted the NYU Dysautonomia Clinic (where the authors see patients). And they sent back a referral form clearly stating that they ***DO NOT SEE POTS PATIENTS***
Click to expand...
 
You must log in or register to reply here.
Back
Top Bottom