Trudie Chalder, BPS and MUS proponent - presentations, interviews and news

Sly Saint said:
Why Do Patients With Gout Not Take Allopurinol?
[...]
Results. The most frequently endorsed reasons for not taking their urate-lowering therapies (ULT) were because participants wanted to lead a normal life (23%) or think of themselves as a healthy person again (20%). Patients also reported not taking allopurinol as a way of testing if they really needed it (22%).
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And here I was thinking that pretending to be well and acting as if healthy was the solution to all manner of illnesses...
 
bobbler said:
I don't fully get why the research is needed.
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I agree. The problem is actually something quite different. It is the need for doctors to understand enough about biochemistry to be able to explain to their patients why they should take allopurinol and the arguments for and against continuing.

bobbler said:
a couple of bouts of gout following forgetting or deciding not to take it will quash any boundary-testing in the dumbest of creatures surely
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The situation is actually much more complicated.

Allopurinol lowers plasma rate levels. That in itself does not stop gout because gout is due to shifting around of crystal deposits that have taken months or years to build up in joints and take about three months to dissolve once irate levels are low enough for that to happen. Moreover, while the crystals are dissolving gout tends to be more likely to occur perhaps because the deposits become unstable.

So you need to explain to the patient that the first objective is to go on taking allopurinol for at least three months, whether or not they have any attacks, which they may well do, to get rid of deposits.

Once the deposits have gone the situation is different. Continuing with allopurinol is designed to prevent new deposits forming over a long period. If the rate has come down with weight loss in the interim there may be no need. If no attacks of gout occur it is not unreasonable to stop allopurinol for a while if it is inconvenient to take - perhaps on holiday. The decision to continue long term in the face of no deposits and no attacks is a matter of weighing up pros and cons. Most intelligent people would probably agree that it is worth taking the drug to prevent another attack maybe in a year or so's time, but if the rate level is not very high they might get away without it.
 
Ravn said:
And here I was thinking that pretending to be well and acting as if healthy was the solution to all manner of illnesses...
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That's the most common behavior, most people downplay illness rather than exaggerate it.

Which probably makes the whole MUS/FND thing so fascinating to those people, how the norm is for people to downplay health concerns whereas there's "us" who do the opposite, so unnatural.

Somehow they can't imagine that it's them who are the outlier in this process. That takes psychological flexibility, self-efficacy and being unbiased. Because every thing they say and do is pure projection...
 
Sly Saint said:
Fountech Ventures


team; Portfolio Advisors Dr Trudie Chalder Psychotherapist
https://www.fountech.ventures/#team

o_O
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There are thirty people listed on that link, and presumably they all want a return on their investment. Only three of them (and one of them is Trudie Chalder!) appear to have any claim to medical knowledge (two clinicians and a psychotherapist, wow!), so I assume there isn't much of a plan to get involved in medical technology. Just imagine how expensive it must be from the customer's point of view. It must be like having a family of thirty to support.
 
Presumably the deal is: we stick a picture of you on our website so that rather than just looking like another gang of sharks in a sea of mendacity and hype, we look like rather well-connected sharks, and then if you ever tip us off on anything investable, we’ll cut you in for a share of the loot at the next funding round.

Not an expensive ecosystem to support, and presumably this offer is available to anyone who gets stuck talking to one of the founders at a dismal party.
 
Adam pwme said:
Thread on Trudies presentation with a 2 min Twitter video



I also did a 5 min highlights video



@dave30th will you be writing an article? I think it might be important given Health Education maybe the biggest provider in England, I think.
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This was recently discussed in Useful arguments regarding the evidence provided by psychological and biomedical ME research?
Here are transcripts.
2-min Twitter vid
Text: A growing number of patients with Long COVID are experiencing adverse effects from exercise therapy

Person asking Trudie Chalder a question: "She said she couldn't get out of bed for two weeks afterwards. Absolutely laid flat. The worst symptoms of fatigue she'd felt at any point for the fortnight after her pulmonary rehab for rehab assessment."

Text: Trudie Chalder is teaching medical professionals to dismiss this as anxiety and extreme behaviour

Trudie Chalder: Given that she went for the walking test and then spent two weeks in bed, she's clearly...that's quite an extreme behavioral response to that, isn't it? So, it sounds like she's very, very health anxious.

Text: A large survey of Long COVID patients found a high proportion of relapse after activity but Trudie states that exercise is not harmful...

Chalder: I would say that exercise clearly is not damaging to people. The advantages of exercise far outweigh the disadvantages.

Text: ...and medical professionals shouldn't blame themselves if patients experience a worsening of symptoms after an exercise test or rehab assessment.

Chalder: I don't think you should blame yourself for that. Because I think it's not what you did that resulted in the person being in bed for two weeks, you have to remember that the way in which any of us respond to symptoms that we're experiencing, is all--that behavioral response is going to be influenced by our thoughts and our feelings too.

Text: Trudie recommends increasing exercise despite the risk of relapse

Chalder: But after you've done the five minute walk every day, you can increase it to ten minutes, and then you can increase it the following week to fifteen minutes.

Text: Trudie Chalder has a history of promoting harmful and ineffective treatment. She was a principal investigator of the discredited PACE trial.

Carol Monagham MP: When the full details of the [PACE] trial become known, it will be considered one of the biggest medical scandals of the 21st century.
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5-min highlight vid
Title:
Edited Highlights from
Fatigue in the Time of COVID-19
Professor Trudie Chalder
NHS Health Education England
Original Webinar: 18 November 2020 (1 hour)
Text on screen:
Fatigue in the COVID Follow-up Clinic
A case:
38 year old
Lives with husband and two children (aged 12 and 16)
Previously worked in finance, now a stay at home mum
Unremarkable illness in April 2020--typical COVID symptoms of fever, cought and breathlessness lasting 3 weeks. Presented to A&E due to palpitations during illness but was not admitted to hospital.

Dr. Hamish McAuley: She'd done her pulmonary rehab assessment, which involved a bleep test; I think it was an incremental shuttle walk test. And she'd done that, and she worked as hard as she could, and she said she couldn't get out of bed for 2 weeks afterwards. Absolutely laid flat. The worst symptoms of fatigue she'd felt at any point was for the fortnight after her pulmonary rehab for rehab assessment.

Woman: Thanks Hamish and I think those of use doing Post COVID Clinic, that's not an uncommon scenario with this post exertional fatigue. Trudie, I think we'd really welcome your advice.

Trudie Chalder: First of all, you know, what was going on in her life around the onset of the pandemic? A little bit about if she's ever had anything like this before? Whether she's ever had a history of fatigue or somatic symptoms, on indeed anxiety? Because she sounds a little, quite health anxious. And what expectations did she have of herself? Because, from what you said (I can't remember which bit but), there was something that you said that made me think she's a lady who has high expecations of herself. Had she tried to go back to running in the way that she had previously? So she had a kind of, even though she'd been quite sick, had she gone for gold, then suddenly?

McAuley: So, in that hiatus before, when she sort of started recovering, but before she started getting the joint pains and aches, she mentioned that she'd gone to the Peak District for a walk with her husband, and kids. And they went for a few miles. And again, she mentioned that as one of the key moments when she realized she couldn't do what she'd previously done. So she'd tried and felt that she couldn't.

Chalder: Yeah, so the Peak District's quite hilly, isn't it? I think, people underestimate how hard hill walking is. And I think if you're doing some distance, it can be quite demanding. So I suppose the first thing I might do is to say, acknowledge her difficulties, you know, it's understandable, she's feeling, she felt fatigue because she probably did have quite a nasty illness. But that probably she did try and get back to her normal self rather quickly.

And of cource, she's probably got quite a lot on at home with the children. And I suppose the other, in terms of where she's at now I think, is addressing her fears, you could say, the research suggests that people do get better from this in other nasty infections. And that the important thing is doing something very, very small, and often in the first instance, even if it's just a little, you know, I don't know what she's able to do now. But given that she went for the walking test and then spent two weeks in bed, she's clearly--I mean--that's quite an extreme behavioral response to that, isn't it? So, it sounds like she's very, very health anxious.

Woman: So Trudie, I also had a similar case. A similar aged lady actually, a nurse that was fit and well, a runner, a cycler and she'd also had that expectation, well, I'll be a bit ill for two or three weeks. And then she said, "I'm back to work" and she actually went back to work and cycled to work and then was absolutely wiped out in a similar way. So can you give us some sort of tips?

Chalder: I would say to her, "you've got to be mindful of the amount that you feel you can do at the moment, but whatever it is, do it regularly. If it was walking, you might was even if you can't do more than a ten minute walk, a ten minute walk is fantastic, if that's what you can do, every day. If you can't do a ten minute walk every day, do a five minute walk every day. But after you've done the five minute walk every day, you can increase it to ten minutes, and then you can increase it the following week to fifteen minutes.

Woman: I've just put in the chat about obviously, there's quite a bit of anxiety from the chronic fatigue syndrome and ME community, particularly on Twitter and things about doing Graded Exercise Therapy and rehab.

Chalder: I would say that exercise clearly is not damaging to people and I always say that the harm done to one's health or the lack of benefit of health, that's far worse than any, you know. The advantages of exercise far outweigh the disadvantages.
Woman: I just feel slightly guilty about that patient Hamish mentioned that I clearly pushed too hard on the walking test.

Chalder: I don't think you should blame yourself for that. Because I think it's not just what, it's not what you did that resulted in the person being in bed for two weeks, you have to remember that the way in which any of use respond to symptoms that we're experiencing. is all, that behavioral responce is going to be influenced by our thoughts and feelings too. And that people worry, you know, that when people have a huge worry about the symptoms they're experiencing, it is going ot affect them behaviorally, you know, the may actually behaviorally respond in a way that isn't necessarily helpful.
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Edit: Break into manageable-sized paragraphs
 
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Adam pwme said:
Thread on Trudies presentation with a 2 min Twitter video



I also did a 5 min highlights video



@dave30th will you be writing an article? I think it might be important given Health Education maybe the biggest provider in England, I think.
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Adam is the 2min video & the original on youtube? If so do you have links please? I find twitter really difficult & nobody i want to show them to is on twitter
 
The finger of blame in depression and the brain
Professor Roland Zahn delivered the eighth inaugural lecture of the 2022/23 IoPPN Inaugural Lecture Series, entitled 'The finger of blame in depression and the brain' on Thursday 29th June 2023 to a packed audience at the Wolfson Lecture Theatre.
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Professor Trudie Chalder, Professor of Cognitive Behavioural Psychotherapy closed the lecture and delivered the vote of thanks, saying:

I’d like to thank Roland for delivering such an erudite lecture on the nature of blame. The devil is in the detail when it comes to understanding complex problems such as depression, so Roland’s detailed approach helps us to understand and ultimately treat the symptoms, cognitions and emotions (whether they are one and the same or not) associated with depression and anxiety. He has shown us that by targeting very specific aspects of depression i.e., blame that improvements in global depression can occur quite quickly. It’s been such a pleasure Roland; you are such a wonderful colleague and a shining example of how to remain connected (pun intended!) whilst doing such wonderful work.

Professor Trudie Chalder, Professor of Cognitive Behavioural Psychotherapy, King’s IoPPN
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The finger of blame in depression and the brain - King's College London (kcl.ac.uk)

hmm says the mother of patient blaming
 
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