In-Patient Treatment of Chronic Fatigue Syndrome (1996) Wessely et al

Note that this is not a new study.

Full text at http://sci-hub.bz/10.1017/s1352465800015241

Chalder T, Butler S, Wessely S. In-patient treatment of Chronic Fatigue Syndrome. Behavioural and Cognitive Psychotherapy 1996, 24; 315-365.

I don't recall seeing anything published about in-patient CBT/GET treatment, and there's not much regarding severe ME, so this might be fairly rare. A lot of blunt statements are made expressing the authors' views, and I found it rather disturbing due to the vulnerable position of the patients, both due to being severe and being in-patients.

 

There's a lot of the typical background (mis)information about ME/CFS. High achiever, fear avoidance, deconditioning, blah blah blah:

Who would've guessed that the state of medicine in 1996 was advanced enough to exclude all possibility of organic pathology? It's not clear what sort of consent was required for the patients to participate, though I haven't looked at the larger studies cited which these patients were drawn from. There's the usual dig at calling it "ME" and organic attributions, with the added implication that the ME Association causes severe psychological disorders :

Average illness was 3 years, so pretty short. The bullshitting started early in treatment:

This study provides a good illustration of what these assholes mean when they say patients have real and severe symptoms:

"Problems" and "targets" were two of the outcome measurements, but seem too narrow in scope to be taken as a general indication of improvement:

The Social Adjustment Questionnaire, Fear Questionnaire, and short form Beck Depression Inventory were also used, as well as the Chalder Fatigue Questionnaire.

I find it a bit creepy that the therapist was giving advice on treatment (or lack thereof) to other staff:

5 of the patients were given varying doses of a tricyclic antidepressant, dothiepin, which is rarely used now due to toxicity.

A fairly nasty form of GET was a big part of treatment:

They emphasize patients agreeing to goals, but given their manipulations elsewhere, it seems likely that it was really a goal created by the therapist. Again, it's not clear if reaching that goal was required before the patient was allowed (or supposed?) to leave:

Again, this seems controlling and manipulative, to claim the patients are in change while giving them strict instructions, reviewing their compliance, and recruiting family members to manage the compliance of the patients:

Pretty much everything about this is awful. I feel a bit traumatized just reading about it, and I hope the patients have managed to psychologically recover from what I can only describe as deliberate medical abuse:

Therapists attempted to undermine the self-awareness of patients, and to replace it with the thoughts of the therapist:

The failure of the treatment is blamed on the patient's lack of belief in it:

 

So not much of a step up from "chuck 'em in the pool" therapy then

 

that link didn't work for me. Am I being more than usually incompetent?

 

Maybe your ISP blocks sci-hub? It can also be downloaded from Wessely's site: http://www.simonwessely.com/Downloads/Publications/CFS/75.pdf

 

Shudders....they really are quite nasty aren't they? Almost stuff of nightmares. It's the sinister tone throughout I think with the facist views. I Feel I need to do something happy and try and forget that this is real.

 

"However, the results show,

that for the patients described here, despite the severity of their problems, substantial

improvement and even complete recovery was possible."

It seems that the problems of definitions of improvement and recovery are of long standing. These were all members of the MEA. It would be interesting if(if they are still around) they could, through some confidential channel, indicate their views on the treatment and any long term effect, beneficial or otherwise.

This exercise avoidance model really bugs me. There is overwhelming evidence here of people who have at every opportunity got up and tried to get on with life, until forced to stop. Apparently evidence is not evidence unless suitably filtered.

 

Thanks for compiling these @Valentijn

But I can only read 2 or 3 quotes before my blood boils at the utter depth of destruction Wessely has done to our community.

I soooo look forward to the day he is widely and publicly exposed and vilified.

 

What I always wonder about: How do they find volunteers for such studies? Or aren't they volunteers at all, getting the "option" to participate or social aid is cut?

Even if one believed in psychological illnesses, wouldn't one feel weird about being told "all is in your head and we will re-educate you to overcome this"? Or is hope to recover much too huge?

 

Thank you, @Valentijn, for your analysis and opinion on this topic! Honestly, this high degree of narcisstic love for one's self and the way how they're treating humans (as mindless little beings who have no self and will) is quite annoying, especially for an autarchy and freedom loving human like me.

This spoke my feelings:

 

Quite possibly. This is what Wessely and Chalder were saying a year after this study:

 

If they replaced CFS with Cancer (which would have an equal response rate) they would probably face a disciplinary hearing. Both are debilitating physical conditions, and neither should be treated with lies and abuse and quackery.

I hope we get a disease mechanism so we can hang these losers out to dry.

In the last quote they almost talk as if they are gods, the patient failed to do well because she didn't listen to their lies which they are completely sure are true.
They are not looking for the truth, they think they already know it and have to force patients to improve. Thats not science. Again using cancer it would be reprehensible to say the patient did not go into remission because they didn't believe strongly enough in the chemotherapy regimen.