I know this seems pedantic but precision of language is important, as the PACE/BPS crowd so often pick up on it as a way to divert from the valid criticisms of their research. As far as I’m aware – and as Sharpe has pointed out on Twitter – the PACE authors do not refer to “false beliefs”. They refer to “unhelpful beliefs”. Of course, it is reasonable to infer that an unhelpful belief which needs to be challenged by a therapist in order to effect recovery is false. But they don’t use the term, as far as I’m aware.
Again, I agree with your point but I’m not sure “pathological” is the right word.
Exactly. This illustrates that at least some of their beliefs may be unafalsifiable. Just as a creationist can claim that God created the evidence of evolution to make it looks as though the earth is more than 10,000 years old, whatever evidence of organic illness is found in ME, there may remain some BPS beliefs that can only be discredited by demonstrating their unfalsifiability.
One of the difficulties seems to be in pinning down exactly what it is that they believe. Their framework appears to be able to change without being acknowledged to have been wrong – a bit like the SMC factsheet which was updated to remove falsehoods about the CDC without any acknowledgement of the error (
https://www.s4me.info/threads/cdc-responds-to-false-smc-factsheet-claim.4355/page-2#post-76922)
I am too slow for this ultralong and exciting thread, sorry. (Could be of interest for communication sociology, though - a forum thread that reports live from a debate taking place on twitter, at the same time commenting on all possible aspects of the debate)
Thus, apologies in advance in case of being redundant.
I posted this as reply to
@Robert 1973 to acknowledge his awareness of the precise wordings of the PACE trial - which I unfortunately do not have (too long since I read the paper). I have learned I will refer to alleged "unhelpful" instead of "false" beliefs in the future.
ATM, I would like to try to clarify the aspect in my comment on contradictory premises of the PACE trial re the alleged "unhelpful" illness beliefs by PWME.
[
https://www.s4me.info/threads/micha...ohnthejack-on-twitter.3464/page-64#post-82285 ]
Underlying I think is the assumption that PWME are unwilling to accept a possible psychological factor in their illness, based on an alleged general disapproval of Psychiatry or Psychology, or at least on an alleged fear of being stigmatized. (This became clear in their responses to the PACE critisms. Unfortunately, the PACE defenders' arguments were in part backed by some wordings in the media coverage of the debate, and also to some extent in the social media, e.g. that new evidence of biological abnormalities would prove that ME was a "real" as opposed to a mental illness and the like, ignorig that mental illnesses are also real.)
IMO this assumption about PWME is false. I think many pwme in the first months or years of their illness, when they repeatedly get the information from their doctors that there are no findings directing to a biological cause of their illness, are open to seek psychological consult. Only when this doesn't help and psychologists or psychiatrists won't acknowledge this fact, they begin to mistrust the therapist (as it was in my case).
(
@Carolyn Wilshire:would be interesting whether there are studies addressing this issue - also relating to "MUS"/ "Functional Disorders"? -- how high is the actual percentage of patients with these diagnoses generally rejecting psychological explanations of their illness?)
Thus, the question, why people who assume that they detoriate severely from exercise would participate in a trial which investigates the benefits of exercice, is similiarily applicable to the question why peoble who generally dislike psychological explanations of their illness would voluntariliy participate in a trial where they have to undergo CBT.
What does this mean for the understanding of the trial?
Perhaps there a diverse points:
A) That the PACE investigators didn't cling to the BPS narrative of ME/CFS, just believed that GET/CBT would work better than nothing, without an underlying hypothesis/ being able to explain why?
B) That the PACE investigators did cling to the BPS narrative, but saw the possibility of only mildly delusional patients who could improve by GET+CBT?
C) That the trial investigators did cling to the BPS narrative, and based on the contradiction described above, assumed that the majority of trial participants would consist not of ME sufferers, but on sufferers of unspecific fatigue who actually are deconditioned and would improve?
etc.
I will stop here -- the implications of each point should be quite obvious. Sorry for not being able to put this thougts in a shorter form.