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Is a problem with the historic debate between the medical illness model and the social model of an external imposition of handicaps that we do not fit neatly into either, or rather we fit into both? ME is both an ongoing active illness that requires medical treatment and active rehabilitation...

I would agree, that this was initially true for the first ten years or so, but over time new symptoms have appeared. Each successive major relapse sees new symptoms including food sensitivities, orthostatic intolerance, chostochondritis, different patterns of cognitive impairment, etc.

The thing I currently notice is novel on line activities. I can mange familiar activities like ordering groceries, but struggle with novel activities or activities that I have not do for some time such as renewing my blue badge or ordering a passport. Subjectively the same amount of time online...

I agree this is an important distinction and one I often fail to make. For me it most obvious with orthostatic intolerance (OI), which when at its worse results in headaches, fatigue, brain fog, dizziness, etc within a few minutes. With orthostatic intolerance I have to stop what I am doing at...

I also have IBS and food intolerances that post date the onset of my ME. The IBS varies with my ME; it is both a symptom of PEM for me and also triggered by food stuffs that I am intolerant too.

Interestingly I regard my eczema as a symptom of my ME. It did not begin until after the onset of my ME and gets worse when my ME is worse.

My orthostatic intolerance worsens with PEM.

l wonder if this is because people are only now recognising the significance of orthostatic intolerance.

Historically and in fiction the supposed signs of ‘psychosomatic illnesses’ overlap with the signs of ‘malingering‘ and potentially include: - doesn’t make medical/scientific sense, eg paralysis when there is no evidence of nerve damage - involves voluntary actions, but not reflexes, eg...

My understanding is that some long Covid suffers do experience PEM that looks very similar to that experienced by people with ME. So though Covid can produce symptoms that do not overlap with ME it is likely that a percentage of long Covid suffers do look like fitting into definitions of ME...

A step forward but it is a shame they did not mention the possible symptom of post exertional malaise as an indicator that exercise might be contra indicated.

When still working I did a lot of evaluation of training sessions for disabled clients and for carers, both professional and lay, including mixed groups of clients and carers, looking variously at attitudes to communication disability, imparting specific information and developing specific...

This is not a comment on the ME post specifically, but rather a general response to the debate on charities use of volunteers versus paid staff. Though I understand that contributors and supporters want as much value for money as possible, I think it is important that the ME charities model...

In relation to myself, when I have pain that has no obvious external stimuli I have often wondered what my pain threshold is. Am I more sensitive to pain than pre onset or am I more habituated to pain? Subjectively with idiopathic pain it is impossible to know as there is no objective yard...

I note that the title implies that ‘functional‘ and ‘medically unexplained‘ are in some way equivalent or interchangeable. How many unevidenced assumptions are subsumed in this title? (Prizes for the correct answer to the nearest hundred)

Is there any unambiguous evidence that conversion disorders exist beyond the imagination of psychiatrists, psychologists and psychoanalysts and those patients they manage to convince? Did it grow out of the bizarre sexually repressed imaginations of nineteenth century Vienna as much of Freud’s...

@Trish, thank you for the hard work and energy that went into this. The final draft reads really well. Let’s hope sufficient numbers of the right people read it and take it seriously.

Just so Prof Crawley isn’t feeling left out, in some of her press interviews she suggests that with CFS biomedical problems associated with the brain can be corrected by her repertoire of behavioural interventions: Unfortunately she only gives vague suggestions in press interviews but nothing...

Yes, though it is about CBT, for the BPS crew there has always been an overlap between GET and CBT and as @Barry points out there is a GET component to this manual.

I have not yet fully read this Manual, but, beyond the need to comment on many specific points that I will hopefully later return to, it interesting that the overall tone and content is, as already been pointed out, an unfailingly positive presentation of hopeful assertions as evidenced...