Michael Sharpe skewered by @JohntheJack on Twitter

Carolyn Wilshire said:
I think we used "model" in the paper.
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".. interventions were built upon a behavioural/deconditioning model of CFS."

Carolyn Wilshire said:
In psychology, to avoid this kind of confusion, we tend to only use "hypotheses" for the fully operationalised version(s) of the prediction(s), the ones that are actually put to the test statistically.
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Adrian said:
I think they refer to a model in their CBT and GET manuals. But I don't think I would call it a model as its a few boxes with lines between them. That is I don't think there is enough to tie down what they are saying.
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I agree that "model" is probably a misnomer, and as @Robert 1973 points out, a lot of the slipperiness is around the imprecise use of language. But I would think just "model" or "framework" as a shorthand term in informal public discourse is nonetheless preferable to "theory" or "theoretical framework". Inclusion of a modifier clarifying substance and precisely synonymous with "hypothetical" would be preferable, but I'm afraid I'm unable to offer a decent candidate.
 
Carolyn Wilshire said:
I'm not as sure as others of this argument. So for example, there are people with a pathological fear of spiders, sometimes so bad they avoid going anywhere outdoors, of even into cupboards. But these folks often choose to go into therapy to fix it. Even though they know that they'll probably have to meet a spider head-on at some point in the process.
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One needs to distinguish between a clinical trial and treatment in clinical practice. I might be willing to subject myself to a treatment which I believe is ineffective and potentially harmful in a clinical trial if I felt it would help to advance the understanding of my condition. But I would not choose to try such a treatment in other circumstances.

In order for someone with a phobia to seek psychological treatment they presumably must first acknowledge that their fear is (or at least could be) irrational. Is there any evidence of people with phobias who refuse to accept the irrationality of their fear (even if they are unable to overcome it)? If someone were unable to acknowledge the irrationality of their phobia, might another diagnosis be appropriate?
 
I don't think we are in fear of exercise, it's not the right word to use.

Fear involves a physiological response to a threat. With ME we avoid overexerting ourselves for rational reasons as Trish said, because we know it will have a deleterious affect, there is no physiological experience involved.

It is the BPS brigade who push the notion of fear avoidance, but we're not in fear, and I don't think we should use the F word, it is playing into their agenda of fear avoidance, it is rational avoidance with no physiological correlate.


"The unpleasant emotional state consisting of psychological and psychophysiological responses to a real external threat or danger. ... Fear is a nursing diagnosis accepted by the North American Nursing Diagnosis Association, who defined it as a response to a perceived threat that is consciously recognized as a danger."
Fear | definition of fear by Medical dictionary
https://medical-dictionary.thefreedictionary.com/fear



Abstract
Anxiety is a psychological, physiological, and behavioral state induced in animals and humans by a threat to well-being or survival, either actual or potential. It is characterized by increased arousal, expectancy, autonomic and neuroendocrine activation, and specific behavior patterns. The function of these changes is to facilitate coping with an adverse or unexpected situation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181681/
 
Lucibee said:
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But no explanation for his claim about the need for 'additional occupational support' here:



Also, there's been a failure to update this document since PACE showed CBT and GET failed to improve employment levels, so there's still a promotion of the notion that CBT/GET do aid return to work: "Occupational Aspects of the Management of Chronic Fatigue Syndrome: a National Guideline"?

https://www.nhshealthatwork.co.uk/images/library/files/Clinical excellence/CFS_full_guideline.pdf
 
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Lucibee said:
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He is confusing PIP (a UK benefit to help cope with disability when one needs lots of care and has mobility problems - and which can be an in-work benefit) with ESA (which is an out of work due to ill health benefit... meant to replace some of the lost income, it is pitifully little). If someone doesn't understand basics of the UK benefits system, how can they make pronouncements on their research relating to it?
 
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