Is CFS a mental illness
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Article of the month February 2012 part 2
Quotes from Simon Wessely and Michael Sharpe
Quotable quotes about ME / CFS
by Margaret Williams
Commentary on the collection of quotations
The quotations of the psychiatrists Simon Wessely and Michael Sharpe reproduced here and provided with sources and original English provide an insight into the so-called "biopsychosocial model", which is the basis of the recently revised guidelines for fatigue of the German Society for General Medicine. This "model" is used in this guideline to justify the handling of ME / CFS patients in particular.
The "biopsychosocial model" is also the basis of numerous textbooks and advanced training measures for doctors as well as instructions for writing pension and other reports on people with ME / CFS.
This collection of inhuman statements by Simon Wessely and Michael Sharpe should be given to anyone who still believes that the Wessely School means well with ME / CFS patients - or any sick people at all.
It should be made available to anyone who, due to the widespread use of Wessely's ideology in health care, still believes that ME / CFS is a somatoform disorder or a behavioral disorder, but not a serious disease.
It should be given to everyone who recommends "therapy" measures in accordance with this ideology, namely cognitive behavioral therapy to drive out "false beliefs about illness" and the alleged "excessive attention to harmless body sensations" and increasing physical training in order to counteract the consequences of "excessive relieving posture", ie "deconditioning".
Read for yourself, but no liability will be accepted for any damage to health or mental health that you may suffer from reading!
PS .: You can order the booklet, from which the quotations below come from, for 1 pound + postage here or read it here on the Internet. R.C.
Quotes from Simon Wessely
From: Attribution and self-esteem in depression and Chronic Fatigue Syndrome. R Powell R Doln S. Wessely J Psychosom Res 1990: 34: 6: 665-667
“This research shows that (patients) experience less guilt in CFS: such a style of external attribution has certain advantages; external attribution protects the patient from being exposed to the stigma of being labeled with a psychiatric disorder, which offers reduced responsibility for one's own health. ”(“ This research shows that in CFS, (patients) experience less guilt: such an external style of attribution has certain advantages; external attribution protects the patient from being exposed to the stigma of being labeled psychiatrically disordered, (affording) diminished responsibility for one's own health. ")
"Inappropriate referrals to physicians can lead to extensive physical investigation that may then perpetuate the symptom pattern of physical attribution."
From: Chronic fatigue and myalgia syndromes Wessely S. In: Psychological Disorders in General Medical Settings. Eds: N Sartorius et al pub: Hogrefe & Huber 1990
"Most CFS patients fulfill dignostic criteria for psychiatric disorder."
“It's interesting that the 'germ theory' is gaining popularity at the expense of a decline in the acceptance of personal responsibility for illness. ")
"Such attibution conveys certain benefits, in other words, there is avoidance of guilt and blame."
From: Old wine in new bottles: neurasthenia and ME Simon Wessely. Psychological Medicine 1990: 20: 35-53
“Mental disorders are found in many cases of ME, but that's not the only psychiatric disorder. Beard's neurasthenia began as a physical illness - it offered the most respectable label for excruciating but not life-threatening ailments, a label that offered many benefits - and the fewest obligations - related to illness. It was preferable to the alternatives - hypochondria, simulation, and insanity. There is little evidence that this has changed today. "
("Mood disorder is found in many cases of ME but it is not the only psychiatric disorder. Beard's neurasthenia began as a physical disease - it provided the most respectable label for distressing, but not life-threatening complaints, one that conferred many of the benefits - and the fewest of the liabilities - associated with illness. It was preferable to the alternatives - hypochondria, malingering and insanity. There is little evidence of any change in the current era. ")
From: The chronic fatigue syndrome - myalgic encephalomyelitis or postviral fatigue. S. Wessely, PK Thomas, In: Recent Advances in Clinical Neurology. Ed: Christopher Kennard. Pub: Churchill Livinstone 1990 pp85-131
“A number of patients diagnosed with myalgic encephalomyelitis who complained of persistent muscle weakness were neurologically examined by one of the authors of this chapter. For many, the usual finding was simulated muscle weakness. " simulated muscle weakness were present. ")
"A physical diagnosis implies the illness has an external (physical) cause.")
“Such an attribution confers certain advantages, regardless of its accuracy. In other words, there is an avoidance of guilt and blame. ”(“ Such attribution always confers certain benefits, irrespective of accuracy. In other words, there is avoidance of guilt and blame. ”)
“Physical training is needed as a specific therapy. There is no evidence that physical activity worsens the underlying process. "
"Efforts are made to over-interpret laboratory findings"
"It is regrettable that ME has become a fashion disease, even a quirk." ("It is regrettable that ME hs become a disease of fashion, even a‘ fad ’.")
“Suggestible patients with a tendency to somatize are often found in the ranks of patients suffering from a disease with poorly defined symptomatology until doctors learn to cope with them more effectively.” (“Suggestible patients with a tendency to somatize will often be found among the ranks of sufferers from disease with ill-defined symptomatology until doctors learn to cope with them more effectively. ")
“Over-advocacy for new diseases can be harmful. It may legitimize some of the maladaptive behavior already described. "
From: Chronic Fatuge and Myalgia Syndromes Simon Wessely In: Psychological Disorders in General Medical Settings Ed: N Sartorius et al Hogrefe & Huber, 1990
"Most CFS patients fulfill diagnostic criteria for psychiatric disorder."
"Other symptoms include muscle pain and many somatic symptoms, especially cardiac, gastrointestinal and neurological."
“Do any of these symptoms have any diagnostic significance? The answer is basically no. ”(“ Do any of these symptoms possess diagnostic significance? The answer is basicallylly negative. ”)
“The description given by a leading gastroenterologist at the Mayo Clinic is still accurate: 'The average doctor will recognize that you are neurotic and he is often disgusted by you.'” (“The description given by a leading gastroenterologist at the Mayo Clinic remains accurate: 'The average doctor will see they are neurotic and he will often be disgusted with them.' ”)
From: Chronic Fatigue, ME, and the ICD-10 David, A, Wessely, S, Lancet 1993: 342: 1247-1248
"Neurasthenia would easily be enough for ME." ("Neurasthenia would readily suffice for ME")
From: Microbes, Mental Illness, The Media nd ME: The Construction of Disease. Simon Wessely 9th Eliot Slater Memorial Lecture, Institute of Psychiatry, London, 12th May 1994
“I claim that ME is just a belief, the belief that one has an illness called ME.” (“I will argue that ME is simply a belief, the belief that one has an illness called ME”)
"The Royal Free Disease itself is part of the world of myth."
From: Patients with medically unexplained symptoms Alcuin Wilkie, Simon Wessely British Journal of Hospital Medicine: 1994: 51: 8: 421-427
"Most doctors in clinical practice are familiar with patients who complain of a wide range of symptoms, but whose physical examinations show no abnormalities." symptoms but whose physical examination and investigations show no abnormality. ")
"Such symptoms have no anatomical or physiological basis."
"Patients at the severe end of the spectrum exert a disproportionately large and avoidable financial burden on the health and social services." )
“Patients with inexplicable physical symptoms are usually strongly resistant to any psychological interpretation (and) are generally viewed as an unavoidable, untreatable and unattractive burden. ")
From: Psychiatry in the allergy clinic: the nature and management of patients with non-allergic symptoms. LM Howard, S Wessely Clinical and Experimental Allergy 1995: 25: 503-514
“The disease is usually sporadic, but epidemics have also been reported. Such epidemics overlap with the related phenomenon of mass psychogenic illness (MPI), a term that has partially replaced that of mass hysteria. ”(“ The illness is usually sporadic but epidemics have been described. Such epidemics overlap with the related subject of mass psychogenic illness, a term which has partly replaced mass hysteria. ")
"The epidemiology of environmental illnesses recalls the difficulties in distinguishing between the epidemiology of myalgic encephalomyelitis (ME), a belief, and the chronic fatigue syndrome, an operationally defined syndrome." in distinguishing between the epidemiology of myalgic encephalomyelitis (ME), a belief, and chronic fatigue syndrome, an operationally-defined syndrome. ")
"Somatization sufferers consume vast amounts of health resources for little benefit."
"The risk of psychiatric diagnosis is known to increase linearly with the number of symptoms with which the patient presents.")
“The attribution of unexplained symptoms to a 'virus', as is the case with most patients with the label ME, preserves self-respect and protects against the stigma of a psychiatric illness.” (“Attribution of unexplained symptoms to a“ virus ” , as happens in most patients with the label of ME, may preserve self-esteem and protect against the stigma of psychiatric disorder. ")
“Further investigations will add nothing to the management but will reinforce the patient’s beliefs in organic pathology.”)
From: Chronic Fatigue Syndrome: an update Anthony J Cleare, Simon Wessely, Update 1996: 14 August: 61
"Chronic fatigue can be better understood by focusing on the perpetuating factors and the way in which they interact in a self-sustaining cycle of fatigue, behavior, beliefs and disability."
("Chronic fatigue may be better understood by focusing on perpetuating factors and the way in which they interact in self-perpetuating vicious circles of fatigue, behavior, beliefs and disability.")
"The perpetuating factors include inactivity, illness beliefs and fear about symptoms, symptom focusing, and emotional state." )
“CFS is haunted by unconstructive and false beliefs about illness that are compounded by numerous, ill-informed media reports; this includes fears and beliefs that CFS is caused by a persistent viral infection or immune disorder. ”(“ CFS is dogged by unhelpful and inaccurate illness beliefs, reinforced by much ill-informed media coverage; they include fears and beliefs that CFS is caused by a persistent virus infection or immune disorder. ")
“People with CFS become more focused on symptoms; (This) heightened anxiety leads to selective attention and 'body observation': This can intensify the perceived frequency of symptoms and thereby confirm beliefs about the disease and solidify disease behavior. ”(“ Increased symptom focusing occurs in CFS sufferers; (this) increased concern leads to selective attention and 'body watching': this can intensify the perceived frequency of symptoms, thereby confirming illness beliefs and reinforcing illness behavior. ")
From: Chronic Fatigue Syndrome. Report of a Joint Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners October 1996 Simon Wessely, Anthony David, Peter White et al.
“The group among CFS patients with more symptoms, more pronounced fatigue, more disability, and longer illness is the subgroup with the strongest association with psychological illness.” (“The group within CFS with more symptoms, profounder fatigability, greater disability and longer illness duration is the subset with the strongest associations with psychological disorder. ")
“Some would like to keep using the term ME. Patients probably want to keep it because they are only eligible with this label to be able to claim the state welfare benefits. ”(“ Some would prefer to continue to use the term ME. Patients may wish to keep (it) because only with that label are they eligible to call upon the welfare of the state for help. ")
"The term ME may mislead patients into believing they have a serious and specific pathological process."
“The possibility that immune function abnormalities may play a role in the pathogenesis of CFS has drawn considerable attention. Such anomalies should not distract the doctor from the biopsychosocial (psychiatric) approach and should not focus attention on the search for an 'organic' cause. ”(“ The possibility that abnormalities of immune function play a role in the pathogenesis of CFS has attracted considerable attention. Such abnormalities should not deflect the clinicians from the biopsychosocial (psychiatric) approch and should not focus attention towards a search for an 'organic' cause. ")
“A chronic condition is likely to be related to 'perpetuating factors', which include poor disease management or untreated psychological problems. We therefore strongly advise that no patient should be considered permanently disabled until they have had the opportunity to participate in all reasonable rehabilitation efforts. ”(“ Chronicity is likely to be associated with 'perpetuating factors', which may include poor illness management or unaddressed psychosocial issues. We therefore urge that no-one should be regarded as permanently impaired until they have had the opportunity of participating in all sensible efforts at rehabilitation. ")
“Research suggests that dysfunctional disease beliefs are common in CFS patients. Such false beliefs about illness can fuel avoidance behaviors towards activities. "(" Reserch suggests that dysfunctional illness beliefs are common in CFS patients. Such inaccurate beliefs might fuel avoidance of activity. ")
"There is no compelling evidence linking immune dysfunciton with disability."
From: Chronic fatigue Syndrome: a practical guide to assessment and management Sharpe M Chalder T Wessely S et al. General Hospital Psychiatry 1997: 19: 3: 185-199
It is especially important to focus on factors that can perpetuate the disease. A conviction of a solely physical cause for symptoms is the singlemost consistent predictor of poor outcome. ")
"(Patients') beliefs are probable illness-maintaining factors and targets for therapeutic intervention.")
“Many patients receive social benefits and other payments that can help keep them doing badly. A gradual recovery may therefore pose a threat of financial loss. "(" Many patients receive financial benefits and payment which may be contingent upon their remaining unwell. Gradual recovery may therefore pose a threat of financial loss. ")
From: Functional somatic syndromes: one or many? S Wessely C Nimnuan M Sharpe Lancet 1999: 354: 936-939
"Functional somatic syndromes pose a major challenge to medicine. Those symptoms are associated with unnecessary expenditure of medical resources.")
From: Responding to Mass Psychogenic Illness. Editorial: Simon Wessely The New England Journal of Medicine 2000: 342: 2: 129-130
"To the majority of observers, including most professionals, these symptoms are indeed all in the mind.")
"The term psychogenic illness’ and its predecessor ‘mass hysteria’ exemplify the problem. ")
“Such outbursts are nothing new. In ancient times we were beset by ghosts and demons. Even if they have been replaced by our contemporary concerns about invisible viruses, chemicals and toxins, the mechanisms of contagious fear remain the same. ”(“ Such outbreaks are not novel. In a previous era, spirits and demons oppressed us. Although they have been replaced by our contemporary concern about invisible viruses, chemicals and toxins, the mechanisms of contagious fear remain the same. ")
"A firm public message that certain symptoms are probably psychological in origin will probably help prevent their spread."
From: Chronic fatigue syndrome: Symptom and Syndrome Wessely S Annals of Internal Medicine 2001: 134: 9S: 838-843
"Social, behavioral and psychological variables are important in both chronic fatigue and chronic fatigue syndrome."
"Social, behavioral and psychological variables are important in both chronic fatige and chronic fatigue syndrome."
"There is no compelling evidence of abnormal neuromuscular fatigue in patients with Chronic Fatigue Syndrome."
"Compelling evidence of abnormal neuromuscular fatigability in patients with the chronic fatigue syndrome is lacking."
“Part of the desire to subdivide Chronic Fatigue Syndrome is driven by emotion. It is interesting to note how some who advance these arguments assume that 'their' disease (the one they are suffering from, the one they are researching or treating) falls into the category of physical illness with this division. "
“Some of the desire to split the chronic fatigue syndrome into subgroups is driven by emotion. It is interesting to note how some of those who advance this argument assume that ‘their’ condition (the one they suffer from, research or treat) will fall on the physical side of the divide. "
"The greater the number of symptoms and the greater the perceived disability, the more likely doctors will find psychological, behavioral, or social factors that contribute to the disease."
"The greater the number of symptoms and the greater the perceived disability, the more likely clinicians are to identify psychological, behavioral or social contributors to illness."
"If the Chronic Fatigue Syndrome didn't exist, our current medical and social system could force us to invent one."
"If the chronic fatigue syndrome did not exist, our current medical and social care systems might force us to invent it."
From: Chronic fatigue syndrome: an overview Hyong Jin Cho Simon Wessely Rev Bras Psiquiatr: September 2005: 27: 3: Sao Paulo
“Functional somatic syndromes refer to groups of symptoms for which there is no evidence of structural abnormalities. This includes the Chronic Fatigue Syndrome. "
“Functional somatic syndromes refer to groups of symptoms lacking demonstrable abnormalities of structure. They include chronic fatigue syndrome. "
"Perpetuating factors are of particular importance in understanding CFS."
"Perpetuating factors have particular importance in understanding CFS"
“Several factors have been reported to be related to perpetuation of CFS. This includes a fixed somatic assignment that can be associated with avoidance behavior in relation to physical training or activity. "
"Several factors have been reported to be associated with the perpetuation of CFS. These include a fixed somatic attribution, which may be associated with avoidance behavior related to exercise or activity. "
"Physical deconditioning as a consequence of reduced activity may contribute to towards greater experience of symptoms."
Quotes from Michael Sharpe:
ME. What do we know (real physical illness or all in the mind?) Lecture given in October 1999 by Michael Sharpe, hosted by the University of Strathclyde
“There is strong evidence that a disorder that appears to be the same caused similar concerns a hundred years ago (and) that it was thought that the causes were our concerns, the changing role of women Time are allergies and toxins. "(" There is very clear evidence that a condition which appears identical caused similar concerns a hundred years ago (and) the causes were thought to lie in the concerns of that time namely, the changing role of women ; in our time it is allergy and toxins. ")
“The vehemence with which many patients insist that their illness is medical rather than psychiatric has become one of the hallmarks of the condition. ”)
“Payers and health services with tight budgets are understandably reluctant to spend money on patients who will not die and for whom there is controversy as to whether their illness is 'real' (and who) do not deserve treatment in this sense." 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 do not fit into a scheme of objective physical illness and still refuse to be assigned to the category of psychiatric illness and accept this stigma remain the undeserved sicknesses of our society and our health care system.“ (“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. ")
From: Cognitive Behavior Therapy Michael Sharpe A Reserch Portfolio on Chronic Fatige. Ed: Robin Fox; published by The Royal Society of Medicine for The Linbury Trust, 1998
"The first application of cognitive behavioral therapy in chronic fatigue syndrome was made by Wessely and his colleagues, who postulated a vicious circle model of the perpetuation of chronic fatigue, in which the patient's beliefs about the disease lead to avoidance of activity and thus to chronic disability." ("The first application of CBT to chronic fatigue sydnrome was by Wessely and colleagues (who proposed) a vicious-circle model of the perpetuation of chronic fatigue whereby patients' beliefs about the illness lead to avoidance of activity and thus to chronic disability. ”)
"CBT helps patients to re-evaluate their beliefs (and) encourages them to change their behavior.")
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