Michael Sharpe: Mind, Medicine and Morals: A Tale of Two Illnesses (2019) BMJ blog - and published responses

Barry said:
I'm not entirely sure. I wonder if it gives insight into how incredibly blind he is to perspectives other than his.
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The illness model they propose tells us something about them. They did not gradually develop this model while being guided by evidence. They pulled it out of thin air, asserting that it was the truth. This model then gave them the authority to pressure patients, for example in the context of disability compensation claims.
 
So the comments will be paywalled (according to a previous post). That's unfortunate. I'm hoping that there will only be a few replies. It's tricky playing into this lure to respond. The Wessely school has made the ambiguous use of language an art form. I have found from social media that anything less than a very tight and strict use of language as to what is meant will be deliberately misunderstood. So it's not just about making the counter argument it's about how the counter argument is phrased.
 
Barry said:
I'm not entirely sure. I wonder if it gives insight into how incredibly blind he is to perspectives other than his. Given the way he (and the PACE mindset generally) believes ME/CFS is an illness solely of faulty perceptions, I strongly suspect he may truly still believe that pwME need nothing more than "support" to overcome their illness. I think it maybe gives insight into the deeply flawed perceptions of his breed of psychiatrists.
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That's a plausible explanation but it would make him so buffoonishly incompetent about the disease he claims to be a world expert in that it's just as bad an explanation as knowing and not caring about hurting millions and leading to the early death of thousands.

It rises to the level of a diabetic expert who doesn't agree or understand that diet is relevant to managing the disease or that it can lead to severe complications. It's the kind of excuse that you give while handing your resignation from everything and just retire out into the woods and stay silent forever.

It is plausible, but it is not credible.
 
It’s not like he hasn’t been told the complex patient’s view. It’s wilful blindness and misrepresention for his own ends which is much harder to forgive than someone genuinely convinced they were right and are helpful.
Or as said if he’s that blinkered and dense he shouldn’t be doing scientific research
 
Amw66 said:
I suspect that the supportive variety of CBT can be a helpful tool.
The issue is that people are not aware that there is a different type, so will have more trouble understanding why someone would refuse it.
If the " special type" of CBT was explained, particularly as public awareness seems to be growing, the argument may be undermined.
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Yes, I've read the "special form of CBT for pwME" called brain washing.

Persuading pwME they don't have a devastating disease that has ruined their lives is a human rights issue - one that governments have ignored for decades.
 
“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean—neither more nor less.” “The question is,” said Alice, “whether you can make words mean so many different things.” “The question is,” said Humpty Dumpty, “which is to be master—that's all.”
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fivetowns said:


To add insult to injury it looks like the theme of this special issue the article is to appear in is 'psychosomatics'. (I'm trying to double check that this is the case and have asked them directly via twitter)
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The interview is in podcast form, I've listened to it so you don't have to! There is absolutely no mention of ME/CFS in this interview; I tried to take rough notes as I went along. It's definitely suggesting more of a philosophical approach to the subject of psychomatic medicine in this special edition.

Creativity in history of psychosomatic thinking. What is health and non-health? ; daring thinking.

Reason for special edition:-
Frustration with quality of public debate and conversation: media headlines.
Responsibility for health; blaming/excusing smokers/lack of exercise etc.

Does blame leak into public policy?

Richer repertoire of language to discuss responsibility/management etc.

Mind-body connection again.

Journal is encouraging criticism/conversation. Readers drawn into debates they may not have considered or want to engage with previously.

Want to leave readers perplexed by what psychomatic may mean.
Want to acknowledge how powerful dualism is to then be able to dismantle it if necessary.

ETA: Italics are direct quotes, not my words!

 
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Barry said:
I lost a friend and colleague to cancer not so long ago, and he and his wife both attended counselling sessions. They saw these sessions as lifelines for them both in horrendously difficult circumstances. So I don't see any need or point to knock it, it's just not the same thing, nor for the same purpose, as it is when applied to ME. Anything that helps people to cope with any illness is OK, just not when there is a pretence it will fix the illness itself. If we start trying to knock supportive help, then we undermine our own case, and give validity to MS's question "Why is this?".
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But my point was - what is the source of the scientifically validated claim that CBT helps people to "cope" with cancer anymore than a multitude of other things they could be using as coping mechanisms. When did CBT come out on top against any range of other possibilities that people already access in everyday life and do not call them treatments?

If such studies exist how did they control for bias of people changing how they answer a question rather than actually measuring "coping" accurately". What definition of "coping" was used etc.

Who reviews such studies, was there any critique of them, did they suffer from the same flaws and biases that most or many psychological studies seem to nowadays?


Basically the claim that CBT even works purely as a coping mechanism treatment has to stand up to scientific scrutiny in cancer as much as it would have to stand up to the recovery or improvement claims for ME.

Different aims yes, but anecdotal claims automatic pass for outcomes claims no.
 
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Pechius said:
Not CFS, but still relevant:


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Especially given the recent Chalder paper about online CBT treatment for IBS and the media blitz pushing a psychological model not just as treatment but as the full explanation.

I don't know what status IBS has, it seems mixed, but it would be great if more professionals dealing with disputed diseases started paying attention to this nonsense. The MUS train will not stop and already lays claims to autoimmune conditions like MS and psoriasis.
 
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