Paul Garner on Long Covid and ME/CFS - BMJ articles and other media.

Looks like Garner is on the Central Sensitisation bandwagon. I guess he must that it’s a bit of a sturdier bandwagon to be on than the deconditioning bandwagon, which has the wheels falling off.

PS The graphic is from Australia’s outdated 2002 clinical guidelines for CFS. No doubt Australia’s BPS brigade (who are furious that the government agreed that our guidelines need to be updated) are thrilled that someone like Garner is using their work.

 
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rvallee said:
I imagine there's supposed to be some sort of coherent idea here but I can't make sense of it, all I see is a bunch of labels and boxes with arrows thrown with no discernable sense.
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It very much reminds me of when we were pinning up our degree project drawing submissions prior to crits ( where you present and people verbally pull.your design to bits )

One of my year had produced wonderful watercolour renderings . Impressive imagery , but technical content summed up in 2 mins by a year tutor - wonderful presentation, shame the scheme is shit. ...
 
As an aside, I hadn't seen this before. Someone on Twitter posted it in response to Gerada's latest nonsense:
Doctor given job of transforming GP care ‘runs one of the worst surgeries’

A flagship GP surgery run by the doctor appointed to “transform” primary healthcare in London has been branded among the worst in Britain.

The findings, in the 2013 NHS National Patient Survey, will be an embarrassment for Dr Clare Gerada, named by NHS England as “clinical chair for primary care transformation in London”. The former head of the Royal College of GPs is part of a team that runs the Hurley and other practices. She said she was “very disappointed” and “sorry”, adding: “We are desperately trying to improve ... but we are facing a bottomless pit of demand from some of the most vulnerable patients around.
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As usual, it's not her fault. Those horrible patients are to blame yet again.
 
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Central sensitisation hypothesis has always struck me as another form of denial of patient symptoms, i.e another incarnation of trying to pretend ME is hysteria.

This is what suits the financial interests because they can say it isnt what it is and dont need to pay for it and the megalo-psychs can continue patient blaming.

From my own experience I think the CNS is affected by ME but ME is not caused by CNS dysfunction.

I doubt that Garner ever had ME of the kind I experienced, he may just have convinced himself he had ME during Covid + Dengue recovery to play Trojan horses for GET which he was already well aware and probably had opinions about because of the reversal of Cochrane on GET, which significantly diminished Cochranes credibility i.e. sour grapes poser.
 
Simone said:
Looks like Garner is on the Central Sensitisation bandwagon. I guess he must that it’s a bit of a sturdier bandwagon to be on than the deconditioning bandwagon, which has the wheels falling off.

PS The graphic is from Australia’s outdated 2002 clinical guidelines for CFS. No doubt Australia’s BPS brigade (who are furious that the government agreed that our guidelines need to be updated) are thrilled that someone like Garner is using their work.

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Simone said:
Looks like Garner is on the Central Sensitisation bandwagon. I guess he must that it’s a bit of a sturdier bandwagon to be on than the deconditioning bandwagon, which has the wheels falling off.
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I guess...

That diagram is yet another from the annals of nonspecific and meaningless medical illustrations. If he thinks it explains anything useful, he doesn't know much about biology.
 
Snow Leopard said:
I guess...

That diagram is yet another from the annals of nonspecific and meaningless medical illustrations. If he thinks it explains anything useful, he doesn't know much about biology.
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Its the dangerous combination of both thinking you know what you are talking about, speaking from a position of authority and professional realignment .
Toxic combination
 
Of course even if the idea of central dysregulation of homeostatic pathways were correct it does not require one to believe either that psychological stress has caused it to persist nor that thinking oneself well will cure it. They have no evidence for that interpretation.

Yet putting this forward as 'the science bit' seems to allow them believe that their magical thinking concept can be quietly tagged on without notice. Where is their pretty diagram for how the dyregulation persists and how it's cured?
 
boolybooly said:
Central sensitisation hypothesis has always struck me as another form of denial of patient symptoms, i.e another incarnation of trying to pretend ME is hysteria.

This is what suits the financial interests because they can say it isnt what it is and dont need to pay for it and the megalo-psychs can continue patient blaming.

From my own experience I think the CNS is affected by ME but ME is not caused by CNS dysfunction.

I doubt that Garner ever had ME of the kind I experienced, he may just have convinced himself he had ME during Covid + Dengue recovery to play Trojan horses for GET which he was already well aware and probably had opinions about because of the reversal of Cochrane on GET, which significantly diminished Cochranes credibility i.e. sour grapes poser.
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It's plucked from chronic pain and fibromyalgia research and passed across as if these things are assumed by some to be the same where they are not. (CS is not understood as being driven by dysfunction psychology in chronic pain).
 
Joan Crawford said:
It's plucked from chronic pain and fibromyalgia research and passed across as if these things are assumed by some to be the same where they are not. (CS is not understood as being driven by dysfunction psychology in chronic pain).
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As if proven when CSS is hypothetical. As if CSS can account for dislocating your jaw when you chew due to inflammation of the TMJ membrane. As if CSS can account for a day of IBS squits because you ate too much pepper. These CSS ideas do not stand up to even a modicum of common sense let alone scientific scrutiny.

And yet it would seem, if I may mix my metaphors, the BPS brigade are well into trying to hoover up all these syndromes (FM TMJ* IBS* etc) which are not well understood using Central Sensitisation Syndrome as a springboard to shoehorn in BPS.

e.g. "Psychosocial Factors and Central Sensitivity Syndromes" Adams & Turk
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728142/#:~:text=Central sensitivity syndromes (CSSs) represent,being the most prominent feature.
Medical interventions alone have not proven to be sufficient for helping people with CSSs manage their symptoms. A biopsychosocial perspective that considers the ways that biological, psychological, and social factors work independently and jointly to affect a person's experience is the most effective conceptualization and guide for effective treatment. In this article, we discuss several psychological and social features that may influence the experience of a person with CSS and their symptom management, regardless of their specific diagnosis.
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As far as they are concerned, evidently, its the same blag by a different acronym and as far as I am concerned BPS and CSS are fiction, without a shred of hard evidence.

Another thing which strikes me about this Garner episode besides his own bias is that he has probably been targeted by BPS sycophants because of his role in Cochrane.
 
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