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

I watched the interview earlier. Apart from talking nonsense, the thing that really stuck with me as shocking, but sadly not surprising, was this bit from PG, starting a bit after 11 minutes:

Transcript:

PG says:
'I know a doctor who treats people with similar kinds of conditions and he says at the first consultation he will say to them - he spends and hour with them - he says there's generally two kinds of people. There are those that understand that some of the symptoms are connected to how your brain is managing your body and your own perception. He's not saying that your symptoms don't exist, they're not there, but there's a group of people that understand that and will work with that in order to recover. There is another group of people who believe this is entirely biomedical and that the reason that they remain symptomatic is doctors haven't found out what's wrong with them and they believe that they need more tests to determine the biomedical cause of it. And he says to them, there are these two kinds of people and the first group get better and the second group don't.'

The interviewer replies
'that's so profound'...
 
Trish said:
I watched the interview earlier. Apart from talking nonsense, the thing that really stuck with me as shocking, but sadly not surprising, was this bit from PG, starting a bit after 11 minutes:

Transcript:

PG says:
'I know a doctor who treats people with similar kinds of conditions and he says at the first consultation he will say to them - he spends and hour with them - he says there's generally two kinds of people. There are those that understand that some of the symptoms are connected to how your brain is managing your body and your own perception. He's not saying that your symptoms don't exist, they're not there, but there's a group of people that understand that and will work with that in order to recover. There is another group of people who believe this is entirely biomedical and that the reason that they remain symptomatic is doctors haven't found out what's wrong with them and they believe that they need more tests to determine the biomedical cause of it. And he says to them, there are these two kinds of people and the first group get better and the second group don't.'

The interviewer replies
'that's so profound'...
Click to expand...

That's the bit that stood out to me and why I started the clip there. It's shocking.

Thanks for doing the transcript. Do you mind if I post just the transcript on Twitter. Will do it without your avatar.
 
Trish said:
PG says:
'I know a doctor who treats people with similar kinds of conditions and he says ...
Click to expand...
That's a scientific nonsense red flag right there: "similar kinds of conditions". Rock solid scientific argument sure to follow on from that ... not!
Trish said:
The interviewer replies
'that's so profound'...
Click to expand...
Showing that she is profoundly deluded by PG's BS.

Does PG really not see what a fool he is making of himself.
 
The more I see of Garner's antics the more I feel moved to contact him and point out what a complete fool he is making if himself, along with Flottorp.
If I did Twitter I would have tweeted by now. But I am glad I don't.
He has sunk to the level of popular alternative fact medicine, which seems extraordinary from someone linked to Cochrane.
It is almost as if he wants to expurgate himself from a brief association with ME advocacy (Out Damned Spot).

I would be interested to know how he responds to the arguments laid out in plain English in my testimony to the NICE committee. And why he should think there is any corruption either in that or in the committee who followed the same approach.
 
Robert 1973 said:
Trish said:
The interviewer replies
'that's so profound'...
Click to expand...
If I was writing a satire (which I hope I may be able to one day), that is a line I would use – it’s like something out of Spinal Tap! Surely most medics and scientists are intelligent enough to see this nonsense what it is, aren’t they?
Click to expand...
Yes, you can imagine that line being uttered with heavy sarcasm.
 
Garner's behaviour explains so much about Cochrane, doesn't it? The anti-pharma and the pro-lifestyle changes bias.

In the end it all seems to come down to difficulty adjusting to the reality of having a mortal, vulnerable body and the existence of terrible uncontrollable diseases.

I can understand if someone needs positive thinking beliefs to manage their fears. There's just a problem when there is also claims that it's an actual treatment.
 
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strategist said:
Garner's behaviour explains so much about Cochrane, doesn't it? The anti-pharma and the pro-lifestyle changes bias.
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Cannot help wondering if there might be political (ME-related politics here!) forces driving some of this, no matter how obliquely. All about cutting back on public health costs. Patient-blaming for lack of determination with BSP 'fixes' is a the go-to approach for that; those striving to bring it about may well be starry eyed with thoughts of peerages, whatever.
 
In PG's own words:

There are those that understand that some of the symptoms are connected to how your brain is managing your body and your own perception.
Click to expand...

So what is to be done about the symptoms (he believes) are NOT connected to perception? And how is that recovery if you are still symptomatic?

ie "some of the symptoms are connected . . ."
 
Trish said:
I watched the interview earlier. Apart from talking nonsense, the thing that really stuck with me as shocking, but sadly not surprising, was this bit from PG, starting a bit after 11 minutes:

Transcript:

PG says:
'I know a doctor who treats people with similar kinds of conditions and he says at the first consultation he will say to them - he spends and hour with them - he says there's generally two kinds of people. There are those that understand that some of the symptoms are connected to how your brain is managing your body and your own perception. He's not saying that your symptoms don't exist, they're not there, but there's a group of people that understand that and will work with that in order to recover. There is another group of people who believe this is entirely biomedical and that the reason that they remain symptomatic is doctors haven't found out what's wrong with them and they believe that they need more tests to determine the biomedical cause of it. And he says to them, there are these two kinds of people and the first group get better and the second group don't.'

The interviewer replies
'that's so profound'...
Click to expand...
That sounds a lot like a lecture that was given to the Norwegian Labour and Welfare Administration, where the descripton was you had people at "two different planets". One where they "got it" and wanted to get better, and the other with people who believed in a biomedicine solution and would not get well.
 
I believe in a biomedical solution because the just-try-harder and the think-myself-well and the good-lifestyle approaches didn't work. And also because over time my illness worsened and it becomes harder to believe in non-biomedical solutions with increasing illness severity.

This depiction of believers in biomedical solutions as ideologists is nonsense. The belief is the result of experience, understanding and education.
 
Yes, so many people who were ill long before any forum or information on the internet had positive beliefs that they would get better and tried ever so many things.

Even now when people get ill there has been so much positive press for exercise (and has done for decades) that I expect there's barely anyone (Until covid and twitter) that did not have the idea that exercise would be good for getting back to normal.
 
Trish said:
He's not saying that your symptoms don't exist, they're not there, but there's a group of people that understand that and will work with that in order to recover. There is another group of people who believe this is entirely biomedical and that the reason that they remain symptomatic is doctors haven't found out what's wrong with them and they believe that they need more tests to determine the biomedical cause of it. And he says to them, there are these two kinds of people and the first group get better and the second group don't.'
Click to expand...
Maybe it's the fact that I live a sad life --- but I laughed when I read this.
Others, long familiar with psychological interventions, and having seen tragic outcomes, simply dismiss this as nonsense.
If these statements were correct, then surely the PACE trial would have seen at least some of those housebound, ++++ return to their previous normal healthy lives? Maybe the healed haven't revealed themselves, or only reveal themselves to the Paul Garner's - his similarly minded practitioners.
EDIT - just occurred to me that the NICE Committee, which produced the new guideline, dismissed some interventions on the grounds that they didn't represent value for money - so Paul Garner's claims fail the test of being cost effective - even if you accept that they work for some people. I haven't seen any credible evidence that they do work.

Trish said:
The interviewer replies
'that's so profound'...
Click to expand...
As per others above - this seems like some form of comedy. Presumably the interviewer was really thinking - we've got one here!
It reminds me of Paul Garner's appearance on BBC Newsnight, it looked like the interviewer was struggling to keep it together as Paul explained his moment of enlightenment -- moving from being ill to realising [that] it was all in his head and he could overcome the negative thoughts and hey presto he recovered to his former health.
The Newsnight program could have been challenged on the grounds that it was a Professor of Medicine self harming, with the spectacle broadcast on TV ---- same re Twitter but it doesn't have producers etc.
 
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I also found Paul Garner's suggestion that he's been on a two year journey, and the content from the 10 minute mark interesting:
Not assuming that … you press a button and everything vanishes. That, you know, you have to run 20 kilometres or 10 kilometres, or, you know, you’ve got to do this, because that’s the way you drive it out of your body. It isn’t like that at all. You have to be kind to yourself but also persistent. You do not let go of advancing your recovery. You do not let go of what’s inside and you brush off any little sort of side steps that sometimes occur during it.

You might get a headache like you think you didn’t before. But you know, I mean, I was getting tired before to be honest with you. I’d have a little nap in the office if I’d done a long day. We’re not all perfect. You can’t get this impression that before Covid we were out there 100% of the time and doing everything at full blast and totally happy in our own lives. But it wasn’t true! You feel a bit tired or we get a headache for no particular reason. It’s important to hold onto the reality and realise that you are normal and things are back to normal.

And you know, for some people it’s a time to slightly alter their work-life balance. I was doing 55 hours a week, it’s crazy. And you have to change the situation that you’re in as you move forward.
Click to expand...

It seems that Paul Garner is not working the hours he used to work. I'm reminded of the young people in an ME/CFS followup study by Katherine Rowe. She found that many of those reporting that they were 'recovered' upon followup had altered their life to accomodate a new, lower, capacity for activity.

Of course I don't know Paul Garner's particular situation, but what do you do if your identity is bound up with saying that the clever sensible people recover, and you haven't quite recovered? Perhaps you reframe your new, lower capacity and the symptoms that come more frequently than they used to as 'normal'? Perhaps you say that having the illness has been a blessing, as it helped you find a 'healthier' work-life balance?

It seems to me that if, even with PG's superior knowledge and intellect and strength of character and the support of BPS experts, it can take 2 years to recover health to a point that isn't quite as good as it was before, then that has a considerable economic impact when scaled up to the national level. So, just maybe, there might be some scope for biomedical research to find some treatments to help the body along?
 
Hutan said:
I also found Paul Garner's suggestion that he's been on a two year journey, and the content from the 10 minute mark interesting:


It seems that Paul Garner is not working the hours he used to work. I'm reminded of the young people in a followup study by Katherine Rowe. She found that many of those reporting that they were 'recovered' upon followup had altered their life to accomodate a new, lower, capacity for activity.

Of course I don't know Paul Garner's particular situation, but what do you do if your identity is bound up with saying that the clever sensible people recover, and you haven't quite recovered? Perhaps you reframe your new, lower capacity and the symptoms that come more frequently than they used to as 'normal'? Perhaps you say that having the illness has been a blessing, as it helped you find a 'healthier' work-life balance?

It seems to me that if, even with PG's superior knowledge and intellect and strength of character and the support of BPS experts, it can take 2 years to recover health to a point that isn't quite as good as it was before, then that has a considerable economic impact when scaled up to the national level. So, just maybe, there might be some scope for biomedical research to find some treatments to help the body along?
Click to expand...


I am "sure" he just means he is taking more time these days to "smell the roses". (IF, of course, his sense of smell is not impaired by LC.)
 
Hutan said:
I also found Paul Garner's suggestion that he's been on a two year journey, and the content from the 10 minute mark interesting:


It seems that Paul Garner is not working the hours he used to work. I'm reminded of the young people in an ME/CFS followup study by Katherine Rowe. She found that many of those reporting that they were 'recovered' upon followup had altered their life to accomodate a new, lower, capacity for activity.

Of course I don't know Paul Garner's particular situation, but what do you do if your identity is bound up with saying that the clever sensible people recover, and you haven't quite recovered? Perhaps you reframe your new, lower capacity and the symptoms that come more frequently than they used to as 'normal'? Perhaps you say that having the illness has been a blessing, as it helped you find a 'healthier' work-life balance?

It seems to me that if, even with PG's superior knowledge and intellect and strength of character and the support of BPS experts, it can take 2 years to recover health to a point that isn't quite as good as it was before, then that has a considerable economic impact when scaled up to the national level. So, just maybe, there might be some scope for biomedical research to find some treatments to help the body along?
Click to expand...

David Bell's follow-up also found that much depends on how one defines recovery....
 
Another thing I think people like PG get confused over is that the BPS approach is the standard. It has been the norm, the entrenched status quo view for decades. As such it is the view that is in the position of being overturned by a paradigm shift of newer and better understanding. That is what science does. That is what it is for.

Whatever PG or anyone of our beliefs is it will yield eventually to reality. As Hutan pointed out, it's all about framing and whether that framing most closely matches reality.
 
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