An interesting story, but as all doctors know, anecdote is not evidence. I am pleased, of course, that Prof. Garner has recovered from his post viral symptoms, and wish him well. I am, however, very concerned that this anecdote may be taken by other clinicians as evidence to push their patients to exercise. Or to recommend unevidenced 'therapies' like the one described here.
As someone who has experienced a six month severe post viral illness much like that Prof Garner describes 43 years ago, I recognise the anxiety it can induce. But the deduction that it is changing thought processes that leads to recovery is, I have to say, nonsense. There was no such pyschobabble for me to turn to back then. I simply rested while I felt too ill to do anything else, tried to get going again a couple of times but felt worse again, so went back to resting. Until one day when I tried activity I found I no longer relapsed. I had recovered. No magical thinking needed, no therapy. Just time and rest.
30 years ago, following another infection, a similar post viral illness set in. This time, I wasn't told to rest, I was told to keep going, and did so to the best of my ability. I wasn't afraid to exercise, I was very positive that I would gradually recover, I continued working part time and caring for my young family. For 14 long and difficult years I struggled on, not giving in to the illness, pushing and crashing, feeling dreadful but not giving in to it. I had no preconceptions about whether my symptoms had a physical or mental component, I just did my best to ignore them and get on with life with the job and family I loved as best I could, though if I pushed a bit too much, I would relapes and be confined to bed for days. I always dragged myself to get going again, just as Paul Garner describes. But I kept on crashing and getting sicker until I had to give up work altogether.
I was devastated that I couldn't beat this thing as Paul Garner claims to have done by thinking himself better. I am now largely confined to bed after all those years of not giving in to my symptoms. If I try to do a bit more, as is my natural longing to do, every time, I end up getting sicker. I know lots of others in the same boat. We keep trying whatever 'cure' is on offer with the desperate wish to get well, we push ourselves to see if a bit of exercise, or some postive thinking, or doing enjoyable things, may help, and find yet again that is worsens our symptoms.
What I take from that is, if you can get up and get on with life, and push yourself to exercise, as I did after 6 months 43 years ago, you don't have ME/CFS. If, no matter how postive you are, and how much you ignore your symptoms, you find that trying to exercise makes you sicker, you may have ME/CFS, and no program of positive thinking is going to change that.
Tellling people with ME/CFS who still suffer post exertional malaise that forces them back to bed for days at a time when they try to exercise, that magical thinking will cure them is cruel and unethical. There is no credible research evidence that any changes in thought patterns or graded exercise program will cure ME/CFS. In fact, to the contrary, there is evidence from many clinical trials that graded exercise therapy does not lead to any objective or long term benefit to people with ME/CFS. If exercising makes you feel better, you don't have ME/CFS. If it makes you sicker, you probably do.
Many hundreds of people with ME/CFS, including the cardinal symptom post exertional malaise, have been made much sicker by graded exercise therapy that persuaded them to push through and ignore their symptoms, and by courses of magical thinking wrapped up in scientific sounding terminology that has not a shred of clinical trial evidence to back it up.
As I said at the outset of this response, I wish Prof Garner well, but please, please, take a step back and consider the impact of one person's anecdote on others not so lucky.
