Simon Wessely Research & Related Quotes

[MEMarge]

shall see if I can find one. I found that one searching for 'mad professor'

Could have been drawn with him in mind!

 

[chrisb]

I thought that these quotations ought to be added, presumably uttered within fifteen minutes of each other.

Wessely: "Thinking of Weir Mitchell and George Waterman reminds me that neurologists aren't what they used to be any more! You were in fact too kind to our study, Dr Sharpe. This was not a study at all; we were just trying to treat people (Butler et al 1991). We started this treatment at the time when the view was that CFS patients were untreatable; not only that, but this kind of approach was considered harmful. We did everything we could, in a completely uncontrolled fashion, using antidepressant drugs, and behaviour and cognitive therapy, just to demonstrate that something would work. This enabled us to get funding for a controlled trial."

Non-pharmacological approaches to treatment. Michael Sharpe
1993 Chronic fatigue syndrome. Wiley, Chichester C iba Foundation Symposium 173) p298-317 in the discussion @p310

Wessely:"In your (Lloyd's) recent CBT study, 89 out of 90 patients have completed what you have labelled cognitive behavior therapy (Lloyd et al1992) However in our study of CBT (Butler et al 1991), 18 patients out of 50 refused treatment and a further five dropped out...."

ibid @p315

So was it or wasn't it a study?

Edit full title of "study"is

Butler S, Chalder T, Ron M, Wessely S Cognitive behaviour therapy in the chronic fatigue syndrome. J Neurol Neurosurg Psychiatry 54:153-158.

Edit. The abstract concludes:

These results suggest that current views on both treatment and prognosis in CFS are unnecessarily pessimistic. It is also suggested that advice currently offered to chronic patients to avoid physical and mental activity is counterproductive."

Caveat emptor

 

[Barry]

We did everything we could, in a completely uncontrolled fashion, using antidepressant drugs, and behaviour and cognitive therapy, just to demonstrate that something would work. This enabled us to get funding for a controlled trial.

Have to be very careful in case I'm taking this out of context, but as it stands it sounds incredibly amateurish. But of course the full context might be that he is in fact saying that.

 

[chrisb]

@Barry I have edited the post to include a quote from the abstract. I am not sure that amateurish is le mot juste.

 

[Inara]

to avoid physical and mental activity is counterproductive

Come on, we know that. But if it leads to substantial worsening, what should you do? Oh man...

 

[Jonathan Edwards]

Oh dear, @chrisb, I am going to have to put those quotes in my notebook and I am struggling with an iPad in foreign parts just now. Does @dave30th knowof these?

 

[Forbin]

"...clinical research should be carried out by those without the inevitable, albeit unconscious, biases caused by suffering from this condition."

Well, looks like we won't be seeing a paper on hubris coming from him anytime soon.

 

[James Morris-Lent]

biases caused by suffering from this condition

Like what? Biased towards wanting it to be understood rationally and treated effectively so as many of us as possible can lead good, productive lives? Biased against adherence to pet theories because the condition is actually real for us and dogmatism distracts and detracts from making actual progress towards these ends?
Bias against suffering and bias against... bias?

Well, you know what? You're right and, upon reflection, I am irredeemably biased; I plead guilty on all counts. I recuse myself. If you want me, I'll be compulsively studying newts.

 

[chrisb]

On further reflection the earlier post shoed the real beauty of the BPS approach. SE was referring mot to something said by Sharpe in the discussion nut to comments in his paper. He referred to "a well conducted case study of out-patients.........The improvements in many cases were marked and resulted in return to work."

Although Sharpe properly entered caveats with regard to the study the fact that he referred to it gives the appearance of enhancing its validity.

 

[Sean]

"...clinical research should be carried out by those without the inevitable, albeit unconscious, biases caused by suffering from this condition."

Coz that's worked out soooooo well.

Does having a reputation, career, empire, income, etc, to protect count as inevitable, albeit unconscious, biases? Are these considered secondary gains?

Just asking for a friend.

 

[Sly Saint]

"I found that one searching for 'mad professor'"

Now, how to get this one to come up when doing a similar search........

 

[unicorn7]

Wow, that is just crazy... Even though every outcome is not agreeing with him, he spins it all to his point of view. How can he never have thought: "maybe the most logical explanation is that the patient is actually right". Gasp! That would be a crazy thought, listings to the patient

The correlation with alcohol is the funniest, how can you spin that in a negative way?

 

[Inara]

Hi @Valentijn Could you group these quotes in sections with headers so that they are easier to find when looking for something relevant? Eg. Some comments will be about secondary illness gain, some about deconditioning, some about not running tests on patients and so on. Great compilation.

Has anybody a source for that quote about chronic fatigue and secondary gains and sick role? I simply can't find it.

 

[chrisb]

Has anybody a source for that quote about chronic fatigue and secondary gains and sick role? I simply can't find it.

I'm not sure to what you are referring. You did raise a question on a different thread, I forget which, to which I replied. I don't know whether you missed that' or whether this is a different question.

 

[Inara]

Ah, I remember now...(I hope we mean the same ) I checked the thread, and it was about "undeserving patients", something which could refer to Sharpe although I think Wessely might have said something like that, too.

There are some quotes circulating, and I was trying to find the originals. One is about the sick role in chronic fatigue and secondary gains that are linked with it (I found a source for that although I don't know if there's a better quote), which perpetuates the symptoms.

Another one I regularly read about is the one with "undeserving patients", i.e. having a medical or psychiatric diagnosis classifies you as "deserving" (of benefits, treatment...) and the rest (simulants, those that reject psychiatric diagnoses - like viewing ME as physical, not psychological) classifies you as "undeserving". Finding the original quotes is very difficult...

 

[rvallee]

Ah, I remember now...(I hope we mean the same ) I checked the thread, and it was about "undeserving patients", something which could refer to Sharpe although I think Wessely might have said something like that, too.

There are some quotes circulating, and I was trying to find the originals. One is about the sick role in chronic fatigue and secondary gains that are linked with it (I found a source for that although I don't know if there's a better quote), which perpetuates the symptoms.

Another one I regularly read about is the one with "undeserving patients", i.e. having a medical or psychiatric diagnosis classifies you as "deserving" (of benefits, treatment...) and the rest (simulants, those that reject psychiatric diagnoses - like viewing ME as physical, not psychological) classifies you as "undeserving". Finding the original quotes is very difficult...

It would be great if we had a quotation repository. For both sides: statements from competent researchers and institutions but also the true beliefs of the psychosocial ideologues in all their contempt and contradiction.

Because one thing they get away is playing all sides of their own argument. It's both "marginally helpful to some" while also "fully curative" depending on the audience and context. That this has had no effect on their credibility is a testament that science has enormous gaps in self-correction.

 

[Inara]

About secondary gain (it's about MUS, but it's known - and can be deduced from other publications - that ME is a subset of MUS is FSS is somatoform disorder is conversion disorder is hysteria (it's even in the correct time order from new to old )):

What are the factors that lead to persistence of MUS in some individuals? Examples of possible precipitating events include chest pain induced by hyperventilation 12 and muscle ache after unaccustomed exercise.13 Some of these
mechanisms may become chronic. Additional psychosocial factors may be ‘secondary gain’10 (for example, when chronic pain spares a parent the burden of caring for a difficult child) or maladaptive psychological coping strategies.14 In this paper, we focus on the adverse effects of medical interventions at various stages of the doctor–
patient encounter.

Page LA, Wessely S. Medically unexplained symptoms: exacerbating
factors in the doctor-patient encounter. J R Soc Med 2003; 96: 223–27.

Henningsen cites them:

Apart from organic comorbidity, maintaining factors have mainly been described on the psychosocial level, such as personality factors that contribute to predisposition, mental comorbidity, a persisting organic illness attribution, and context factors surrounding so-called secondary gain. However, the behaviour of treating physicians also contributes to maintenance and exacerbations of FSS.41

Henningsen, Management of functional somatic syndromes, Lancet 2007; 369: 946–55, Published Online February 6, 2007 DOI:10.1016/S0140-6736(07)60159-7.

Hysteria itself is an outmoded diagnosis and is being replaced by the concept of "abnormal illness behaviour."

David, Wessely, Pelosi, Postviral fatigue syndrome: time for a new approach, BRITISH MEDICAL JOURNAL VOLUME 296 5 MARCH 1988.

Regarding "undeserving patients", I only found this quote by Sharpe, but not the original lecture:

“Purchasers and Health Care providers with hard pressed budgets are understandably reluctant to spend money on patients who are not going to die and for whom there is controversy about the ‘reality’ of their condition (and who) are in this sense undeserving of treatment.

“Those who cannot be fitted into a scheme of objective bodily illness yet refuse to be placed into and accept the stigma of mental illness remain the undeserving sick of our society and our health service”

- “M.E. What do we know (real illness or all in the mind?)” – lecture given in October 1999 by Dr Michael Sharpe hosted by the University of Strathclyde, my emphasis

from: http://fumblings.com/weblog/archives/2005/02/the_undeserving_1.html

It has to be noted that Sharpe insisted that this was not meant as an insult:

michael sharpe
OCTOBER 31, 2005 AT 9:37 PM
A very well constructed website. And I agree that patients with CFS and related condition suffer as the undeserving sick of modern society.
But if you read Pygmalion by Bernard Shaw you will understand that that is a criticism of social morals and conventions – not a literal statement!
MS

Although, personally, I think that Sharpe was looking for an excuse, I would like to find a better quote. It's open to interpretation. I'm still reading more articles, but if anyone has something at hand...

 

[Inara]

Page LA, Wessely S. Medically unexplained symptoms: exacerbating
factors in the doctor-patient encounter. J R Soc Med 2003; 96: 223–27:

"What are the factors that lead to persistence of MUS in some individuals? [...] Additional psychosocial factors may be ‘secondary gain’".

JMS Pearce, Psychosocial factors in chronic disability, Med Sci Monit 2002; 8(12): RA275-281:

"To understand the effects secured by disability, one must appreciate that there are several benefits of the sick role—secondary gains."

David, Wessely, Pelosi, Postviral fatigue syndrome: time for a new approach, Br Med J (Clin Res Ed) 1988; 296, doi: https://doi.org/10.1136/bmj.296.6623.696:

Hysteria itself is an outmoded diagnosis and is being replaced by the concept of "abnormal illness behaviour."

Edit: I've just realized I repeated some quotes from above. sorry.

 

[JemPD]

It seems to me that the only people who think there are gains to be had from the 'sick role' are people who've never actually been sick for any length of time.

 

[Arnie Pye]

It seems to me that the only people who think there are gains to be had from the 'sick role' are people who've never actually been sick for any length of time.

Isn't the point that SW and MS and people of their ilk think that we aren't sick at all, we are just pretending to be sick? So they think that they don't need to have experienced it themselves, (because neither have we).