Just wanted to add re my post above that it was the patients telling the psychiatrists that they had good mental health and that they were functioning fine and enjoying life right up until their illness that is at issue with the psychiatrists denying that reality of the patient and imposing their ideological views onto the patient. The patient had no agency in their eyes. The psychiatrist was in the position of always being right.
There are many issues - not just one.
This is the main one - psychologization -
https://www.me-pedia.org/wiki/psychologization
Fundamental to the origin BPS model are the following beliefs that continue to be held despite significant evidence against them and little if not any in indication that they have a basis in science
* the BPS model is a psychosocial model not a Biopsychosocial model - with only trivial biological differences, no biological treatments are to be suggested except anti-depressants
*
vast amounts of money have been earned by many heavily pushing these harmful approaches, and a large amount of professional reputation depends on continuing them, it is a get-rich-quick model that any inexperienced clinician from any specialty can very easily deliver, can improvement their employment prospects and the sums earned from self-help books - many of which have been bought in huge numbers by UK libraries, royalties from chapters written in other books, delivering training to other professionals, speaking engagements,
expert witness or report fees for denying patient disability claims for private health insurance, and creating their own private companies delivering the treatments - these have made millions for some people - it would cost them too much to be able to be open change. They refuse to disclose most of these are conflicts of interest and it is not possible to get an accurate total sum for individuals.
* decades of poor prognosis from patients which have not (as a group) improved do not count as evidence that their treatments don't work - the Royal Free Hospital outbreak survivors who had ME from their 20s until they died of old age despite trying CBT, GET and everything else but still has ME when they died are also not evidence that the treatments don't work and that it is a disease that is incurable and people rarely return to ill health
* insisting that
illness without disease is the problem, which means that the patient is to blame (directly or indirectly) for their "symptoms" especially fatigue, pain, orthostatic intolerance, and everything that can't fit this model is kept out of the notes and out of mind or is a matter of "patient perception" not reality - ignore all immune symptoms - do not allow any medical testing after diagnosis since it may show disease, reveal misdiagnosis, or contradict the BPS model
* falsely claiming ME is not a disease and is not neurological,and is exactly the same as idiopathic chronic fatigue or fatigue from some other medical illness - burn out is also the same - and even claiming this with a World Health Organization - despite contradicting the WHO classification
* Patients who cancel or stop appointments early must have "recovered"
* Patients must be "grateful" even those significantly harmed - anything else like trying to raise the alarm so others aren't harmed should be interpreted as some "personality issue" or complicated psychological attack on the professional (because the professionals beliefs are so utterly entrenched that they can't possibly ever by wrong about the treatment)
* ME cannot kill anyone because it is "illness without disease", and never mind the deaths...
* if nobody has the answers then they (arrogantly) insist that they can treat it - patients are given the same treatment for ALL conditions - including those clearly unsuitable or that they are totally unable to do, even treatments that are likely to cause harm to better understood illnesses that the patient also have are pushed on the patient - the diagnostic process and symptom differences are considered meaningless labels which is unscientific and against scientific consensus - which they don't care
* patients who do not have any "dysfunctional" or "maladaptive" illness beliefs will improve by CBT to address these beliefs - it's not necessary to identify *if* they actually have these beliefs - make the patient do that instead - if they can't, blame them for not doing the work
* it's perfectly acceptable for psychiatrists or other professionals to hold on tightly to their own maladaptive beliefs including
their black and white thinking, their belief that they do not need to look any further than first impressions to make a permanent decision, and others, reflective practice and continual improvement must be shunned!
* liasion psychiatry / MUPS psychiatrists claim to be able to treat every person for any condition - therefore they never say no - and funding floods to those who (claim to) year whatever is untreatable - which is ridiculous - nobody and no medical specialty can do that
* their treatments work therefore patients who don't get better are to blame for not correctly following them, especially those who drop out because they got sicker
* patients and their close family do not have anything useful to tell the professional and must isolate themselves from any other patients or support groups in order to increase dependence on the professional, but in reality because that makes them easier to manipulate, and less likely to be able to question the professional's treatment or views
* keep repeating to yourself and others that CBT and GET work and write it on every research paper, and don't listen to anyone who points out evidence against them - Orwellian style creation of "the truth" though authority figures - the original PACE study before the data release showed *most people* were not helped by CBT or GET - but they pretended it was evidence that showed the opposite (the PACE data release proved no statistical improvement)
* entirely false understanding of their own abilities, which is maintained by persistently ignoring or discrediting all specialists whose findings they don't agree with
* medically unexplained physically symptoms are never or almost never - the result of unknown diseases or misdiagnosis or rare diseases - therefore do not ever consider these
* medically unexplained physical symptoms cannot possibly be the result of a physical illness that science does not understand or that science has not identified yet - "science knows everything"
* physical diseases will improve in virtually every person who is given mental health input whether they need it or not
* it's perfectly acceptable to trick patients into thinking that you believe they are reporting reality, and somehow this is not an ethical issue or manipulative
* there must never, ever be any treatment studies looking at treatment failures of the psych approach - any other kind of psych specialism will do these studies and seek to understand more so different treatments can be developed but the BPS model is too fragile to handle this
* researchers who have withheld data, indulged in outcome swapping, made nasty personal attacks on individual patients (like that aimed at Alem Matthes when he was severely ill) and mass character assassination in mainstream media (eg Wessely), persistently and knowingly made false ethical statements in their research (Crawley) should still be listened to and their opinions should be respected and viewed as objective
* Writing a book about a self -help approach to healing for an incurable disease is not unethical, and is not a conflict of interest no matter how much it makes
