Letter: Disrespectful language about patients with long COVID 2023 Pelosi

Andy

Andy

Senior Member (Voting rights)
"The Lancet's careless discussion of psychosomatic conditions mirrors disrespectful language that can be encountered in medical, surgical, and even psychiatric clinics throughout the UK. The Editors could make amends by using their writing skills to try to improve doctor–patient communication about biological, psychological, and social influences on long COVID and essentially every other serious human illness."

Open access, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01121-2/fulltext
 
Anyone who questions the validity of psychosomatic conditions is perpetuating stigma, and anyone with the temerity to dissect flaws in the research of psychosomatic clinicians is engaging in targeted harassment. In adopting this framework, we’ve effectively insulated an entire branch of inquiry from criticism, which is undoubtedly the intention of those peddling psychosomatic hypotheses.
 
Charles B. said:
Anyone who questions the validity of psychosomatic conditions is perpetuating stigma, and anyone with the temerity to dissect flaws in the research of psychosomatic clinicians is engaging in targeted harassment. In adopting this framework, we’ve effectively insulated an entire branch of inquiry from criticism, which is undoubtedly the intention of those peddling psychosomatic hypotheses.
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Soon you'll be considered to have a psychosomatic illness if you criticise clear flaws in psychosomatic research. The cure for which is of course GET, where your "graded exercise" is the graded acceptance of such flaws.
 
I think the authors are either imagining the criticism of their views, or fixating on it too much. If they were actually being criticized their would be objective proof. They need to rethink their thoughts and behaviors related to being criticized.
 
Andy said:
"The Lancet's careless discussion of psychosomatic conditions mirrors disrespectful language that can be encountered in medical, surgical, and even psychiatric clinics throughout the UK. The Editors could make amends by using their writing skills to try to improve doctor–patient communication about biological, psychological, and social influences on long COVID and essentially every other serious human illness."

Open access, https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01121-2/fulltext
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:wtf::eek: this is some shapeshifting manifesto. Talk about how to make groups 'untouchables' whilst claiming it is 'in their interests' and you are helping. I always note with said people how little time they must spend on creating and refining actual 'help' they claim their intention is - given it is based normally on biased, small-minded and cliqued ideas of 'normal behaviour' (not normally normal) and generally presumptions of all said individuals thoughts being distorted - for which their supposed treatments are b***ardisations of 60s therapies not intended for htat purpose and not rigorously done like those were (with no real mapping of a decent model) and has little actual effectiveness even if one overlooked the bias and influence/coercion possibilities in the data methods. Rather than even at the clinical level looking at the social or the biological or anything.

On that basis such individuals seems to have a manifesto of blocking access to treatment, understanding or of any 'holistic' aspect being understood about any individual - they are selling sausage-machine de-individualising often untrue models that exclude and involve 'don't listen to them on x,y,z as they don't know their own mind' assumptions and NOT whatever they (maybe they are deluded) are distracting with of 'anything useful' ie non-treatment, non-help.

Criticising that isn't rude. It is appropriate. Noting a very poor area that offers little help isn't inappropriate or stigmatic it is in the interests of those chucked under it. Calling out bad is what bystanders should do, not them 'being not nice about others' but ensuring others are nice etc. This is so full of fallacies and all those twisting of etiquette and which way up the world is re: what is goodness in human nature vs bad I find it hard to even interpret it?
 
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Pelosi said:
The Lancet's careless discussion of psychosomatic conditions mirrors disrespectful language that can be encountered in medical, surgical, and even psychiatric clinics
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Indeed it does. You rarely see an expression of self-aware wolves in academia, but when it comes to psychosomatics they just seem to howl endlessly while insisting that people quiet down with all the howling-like noise.
Why would any clinician dismiss patients whose bodily symptoms are caused or worsened by psychological factors but do their best to help those with similarly severe symptoms that are a direct result of infective, inflammatory, or metabolic abnormalities?
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Why do they do that, indeed? Aside from being taught to do this, trained to do this and encouraged to do this. Why so much disrespect? Why do you respect us so little, insult our intelligence at every turn and fail us so miserably there is no professional failure in the last half-century to compare this to?

Sounds very much like the problem mewling about the consequences of the problem without being able to see that they are, in fact, all the problem. It's almost as if you give people a free get-out-of-work card that they can abuse without consequence... they will. Even more so when it cements into a tradition. At its core is missing basic respect for patients as full human beings. You can't build strong foundations without that.
 
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Charles B. said:
Anyone who questions the validity of psychosomatic conditions is perpetuating stigma, and anyone with the temerity to dissect flaws in the research of psychosomatic clinicians is engaging in targeted harassment. In adopting this framework, we’ve effectively insulated an entire branch of inquiry from criticism, which is undoubtedly the intention of those peddling psychosomatic hypotheses.
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and they still haven't effectively worked out how to prove they exist any better than when they were last hounded out of the subject of psychology for not being psychology (other than individuals own psychologies - which can just be delusions and ideologies and things like misogyny or sexism based) and not being able to provide any decent proof beyond 'parapsychology' as far as I can see. Just this victim-claiming, distraction nonsense. As if this individual is actually writing in the name of the patients stuck under this, the cheek.

And noone turns around and asks these individuals who seems to only write articles levying accusaitons at patients, what it is that they actually do or offer - because that weirdly always seems to be very lacking and strange that noone says hang on, stepping away from this distraction-fallacy argument, is there anything underneath and does it stand up as a reason for being or is it bad news? Can you imagine any other area of medicine that had such power over patients not having to be interrogated for safety and how they treat vulnerable people sent to them as being properly audited and checked as useful and helpful (particularly important when patients themselves report not, report harm and said individuals just reply with 'don't listen to them').

whilst at the same time also claiming that's who they are doing all this for and bystanders asking why they are listening or being scientific (as they should be, and all regulators should be) are told somehow they are doing something bad for the patients when actually they are doing exactly what they should be doing and saying why is this area ignoring the voice of the patients and being paternalist? It is so back to front it is scary these people get away with it.

Isn't it like a garage claiming that a bystander who stands up for all the people who had their cars broken by bad mechanics and who report the damage done is 'anti-garage customer'. Which is of course nonsense. Or some hotelier who got terrible reviews on trip advisor and is interviewed by a regulaor or journalist trying to claim that those who hear the holiday makers who had a bad time are anti-holiday maker for asking the hotelier questions? Or am I getting confused?
 
Well known to long-term members. Author of Personality and fatal diseases: Revisiting a scientific scandal (2019, Journal of Health Psychology).

Note —

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YouTube — Dr. Anthony Pelosi | Personality and fatal diseases; exposing a scientific scandal of Hans Eysenck

How on earth could this work have been published and why was nothing done about it until last year? I will be making a few suggestions. [...] I will be asking for suggestions about how to undo some of the damage to science that has been caused by this scandal.
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SNT Gatchaman said:
Well known to long-term members. Author of Personality and fatal diseases: Revisiting a scientific scandal (2019, Journal of Health Psychology).

Note —



YouTube — Dr. Anthony Pelosi | Personality and fatal diseases; exposing a scientific scandal of Hans Eysenck
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So that latter paragraph is from him? what a contradiction to everything else, that is more recent, above it that seems to be about the same principles and context and yet rather than 'playing the ball' we've got what seems to be him burying in 'playing the man' and distraction criticism?
 
I've looked at Pelosi's list of publications:
https://www.researchgate.net/profile/Anthony-Pelosi

He's done quite a bit in the past of BPS oriented stuff about CFS and FND, including with Carson, Stone and Sharpe. I assume this letter is based on his assumption that psychosomatic attribution is appropriate for these conditions, and therefore that we should all be happy to accept psychosomatic attribution as accurate and therefore not see it as disrespectful.

The trouble is, it is derogatory and disrespectful, partly because in these diseases and in Long Covid it is inaccurate, and partly because such attribution of physical disease to psychosomatic causes leads to gaslighting and wrong treatment.
 
It’s such a cynical rhetorical strategy. When will these people go away? They’ve been at it for 40 years. They have to be approaching retirement. The problem, is that they’ve trained supplicants to essentially mindlessly continue this crusade. The ones most prominent in this second generation being Carson and Stone.
 
Pelosi stood at the cradle of the psychiatric hyjack of ME, so this is not surprising.

E.g. about ME: "We question the value of distinguishing between "organic" and "non-organic" in the context of this illness. Organic factors (immune state, infection, neuromuscular and neuropsychiatric abnormalities, etc) and non-organic factors (personality, emotional reactions, social and interpersonal problems, etc) interact in subtle and complex ways, and this must be appreciated before rational research can progress." and such. (BMJ, 7 May 1988)

He was author of the 1988 "For Debate" article "Postviral fatigue syndrome: time for a new approach" (BMJ, 5 March 1988) with Wessely and David. There they managed to reference their text "Though collaboration among virologists, histopathologists, neurologists, and general practitioners is to be commended,(5) the failure of more psychiatrists (other than those interested in mass hysteria) to contribute leaves a yawning gap in this research.", and "Well designed studies are required with contributions from specialists across disciplines.(5)"with a report on a 1978 symposium at the Royal Society of Medicine that emphasises that ME is an organic illness (with finds like transferral to monkeys, increased proteines, increased lactic hydrogenases and transaminases, indication of persistent viral infection and more. "Indeed, the exhaustion and tiredness are similar to that described by patients with multiple sclerosis..... Some authors have attempted to dismiss this disease as hysterical (McEvedy & Beard ref.) but the evidence now makes such a tenet unacceptable.")
and which names a list of specialists that should collaborate on it ("Future epidemics should be studied by a collaborative team of neurologists, epidemiologists, virologists, and immunologists.") which consists exclusively of biomedical experts and not psychiatrists.


"Such polarization [between psychological medicine and physical medicine] with its malignant effects on the doctor-patient relationship may turn out to be a far more potent agent in causing persistent disability than any virus." (With Wessely and David, BJHM 1991)

This Lancet letter is a rehash of old tricks.
 
RedFox said:
I think the authors are either imagining the criticism of their views, or fixating on it too much. If they were actually being criticized their would be objective proof. They need to rethink their thoughts and behaviors related to being criticized.
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Nah, it's a self-defense strategy: it's about protecting them and their views, careers & "treatment" market. From the very beginning there was posing as victims and prominent indignance at supposedly not taking the disableist imput of psychiatry seriously, which was presented like it was at the detriment of those poor, poor patients they were just trying to help (while stigmatising them at the same time).

It's indeed good to look at what's missing if this was a good faith letter. Not just objective proof of unjust criticism, but also concrete and practical proof that Long COVID's "bodily symptoms are caused or worsened by psychological factors" and how precisely "There is no chance of decent care for this heterogeneous group of patients if psychosocial factors are not taken seriously when considering differential diagnoses, clinical formulation, and appropriately individualised management plans."

I don't mean the usual talking points, I mean actually showing that there is "no chance for decent care" for viral persistence, infection-triggered autoimmunity, latent virus reactivation, inflammatory cell damage, organ damage, blood clotting and all the other concrete pathology unless you involve talking about your mum, explaining how Long COVID on television makes you think you have it, and telling patients to go to bed on time.
 
Arvo said:
Nah, it's a self-defense strategy: it's about protecting them and their views, careers & "treatment" market. From the very beginning there was posing as victims and prominent indignance at supposedly not taking the disableist imput of psychiatry seriously, which was presented like it was at the detriment of those poor, poor patients they were just trying to help (while stigmatising them at the same time).

It's indeed good to look at what's missing if this was a good faith letter. Not just objective proof of unjust criticism, but also concrete and practical proof that Long COVID's "bodily symptoms are caused or worsened by psychological factors" and how precisely "There is no chance of decent care for this heterogeneous group of patients if psychosocial factors are not taken seriously when considering differential diagnoses, clinical formulation, and appropriately individualised management plans."

I don't mean the usual talking points, I mean actually showing that there is "no chance for decent care" for viral persistence, infection-triggered autoimmunity, latent virus reactivation, inflammatory cell damage, organ damage, blood clotting and all the other concrete pathology unless you involve talking about your mum, explaining how Long COVID on television makes you think you have it, and telling patients to go to bed on time.
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I think you didn't get the joke. My comment was facetious, mocking BPS doctors with the same language they use against pwME.
 
RedFox said:
I think you didn't get the joke. My comment was facetious, mocking BPS doctors with the same language they use against pwME.
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I didn't see it as a joke either because your comment, though clearly facetious, was also dead accurate. The psychosomaticians DO need to "rethink their thoughts and behaviors related to being criticized." I'd like to see them all undergoing cognitive behaviour therapy to disabuse them of their unhelpful beliefs in psychosomatic medicine, and to learn to change their defensive and offensive behaviour towards pwME, pwLC etc.
 
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