An audit of 12 cases of long COVID following the lightning process intervention examining benefits and harms, 2025, Arroll et al

Arroll leads a unit that provides education resources for New Zealand GPs. He is very influential in NZ medicine. He and the Royal NZ College of GPs have been aggressively promoting the Lightning Process for years.

RNZCGP GoodFellow Unit MedCases CPD Sept 2023: Chronic fatigue syndrome/myalgic encephalomyelitis
This thread has details about Arroll. The attached letter in that post was written by me to the RNZCGP. Despite numerous followups, I have had no reply. Making a complaint to the NZ Health and Disability Commission was on my list of things to do today.

And now, Arroll is clearly going all in. The RNZCGP has also promoted the LP again, since my letter.
 
Last edited:
@Hutan
If you write about the paper, you might also want to attack the claim of ‘independence’ in the review. If I understand correctly, there is only one LP-instructor in NZ, Jenny Oliver. You’ve written about their connection here:

Edit: I finished reading the thread. There are many more connections from your comments.

Hutan said:
Bruce Arrow replied to Ros Vallings' very tame suggestion that the Lightning Process wasn't an ME/CFS treatment with this, coauthored with the NZ champion of the Lightning Process, Jenny Oliver:
Click to expand...
https://www.s4me.info/threads/rnzcg...gue-syndrome-myalgic-encephalomyelitis.35342/
 
Last edited:
The journal is the Journal of Family Medicine and Primary Care. I thought it might not be a well regarded journal, but it seems to be relatively well known.

I didn't see a way to submit comments - has anyone found how that is done?
 
To my comment on PubPeer, I'm thinking of adding this. I also didn't yet include it, but they say "two complaints about therapist approaches", but as far as I can tell from the "qualitative study", Reme 2012, the negative comments were generally gathered from multiple participants, not necessarily just those two who did not improve.

----

Regarding prior evidence, the paper says this about the NICE guidelines:
The Bristol study reported no harm from the intervention, yet NICE controversially downgraded its evidence rating due to the report stating no harm. Instead, they quoted a qualitative study of 9 adolescents and 3 parents. The results from the qualitative study were very optimistic about the LP other than two complaints about therapist approaches.
Click to expand...

This mischaracterizes and understates the reasoning provided by NICE [2] for recommending not to use the LP:
[...] some negative experiences were reported around the confusing nature of the educational component, the intensity of the sessions, the secrecy surrounding the therapy, the approach of some therapists which led to feelings of pressure and blame and dishonesty about the success rate.The committee were particularly concerned around the secrecy of the Lightning Process and the lack of public information on the components and implementation of the process. The committee discussed concerns that the Lightning Process encourages people to ignore their symptoms and push through them and this could potentially result in harm for people with ME/CFS. The committee noted they had made clear recommendations on the principles of energy management and this is at odds with the principles of energy management in the guideline. In addition, the committee were aware that some children had been told not to discuss the therapy with their carer or parents. The committee agreed this was an inappropriate and harmful message to give to children and young people. The committee considered these findings were applicable to adults as well as children and young people and therefore, the committee decided to make a recommendation not to offer therapies based on the Lightning Process for ME/CFS.
Click to expand...
 
forestglip said:
To my comment on PubPeer, I'm thinking of adding this. I also didn't yet include it, but they say "two complaints about therapist approaches", but as far as I can tell from the "qualitative study", Reme 2012, the negative comments were generally gathered from multiple participants, not necessarily just those two who did not improve.
Click to expand...
It’s paywalled. Do you have access?
 
Our experience with such complaints is that there can be confusion regarding the viewpoint of an occasional therapist with limited interpersonal skills with the LP intervention.
Click to expand...

I'm confused about how a therapist might have limited interpersonal skills.

Our study also of twelve participants found no harms. In the Bristol trial, no harm was reported; the participants in our audit also reported no harm.
Click to expand...

The authors are sounding a little desperate.
 
Last edited:
The senior author wrote the following letter to the BMJ in 2019: What keeps corporate power hidden from doctors? —

McKee and colleagues draw attention to corporate strategies that serve shareholder interests at the expense of public health. These effects are often obscured by sophisticated marketing and public relations. Of particular interest is why so many of us, including doctors, fail to recognise this common pattern. We are part of the problem, so we need to understand this “blindspot” and its determinants to guide management.
Click to expand...

as a species we are notably poor at recognising our vulnerability to persuasion. Complementing this lack of insight, we doctors like to think that our clinical decisions are based on scientific rationality, and marketers reinforce this vanity with carefully curated “evidence,” often coupled with images that appeal to our healing role. Seeing ourselves as rational prescribers, we rankle at suggestions that we are influenced by marketing. But, somewhat ironically, denial of vulnerability is itself a key risk factor for being influenced.
Click to expand...

As with vulnerability to persuasion, we are also better at recognising conflicts in our colleagues than ourselves. This blindspot also plays a role in distorting the medical literature, as can be seen from authors’ disclosures that downplay relationships, financial and otherwise, with for-profit corporations. The tendency to sanitise our links to vested interests is hard to resist.
Click to expand...
 
Financial support and sponsorship
This study was funded by the University of Auckland Research Fund for Professor Bruce Arroll.

It would be interesting to find out if the funding described above is a discretionary pot allocated to Bruce Arroll, or if he had to make an application specific to this “study”. If the latter, is the application publicly available or would it be possible to get a copy of the application via an OIA request?
 
Wrote this to add to the above bit about harms:

It is also unclear what the paper means when it says "two complaints" about therapist approaches. There were far more than two aspects of the LP that were criticized by patients in the "qualitative study" [3], some of which presumably were aspects of the protocol itself and not specific to therapist approaches, including:
- Sessions being too long
- Full treatment protocol being too short
- Lack of followup support
- A feeling of confusion and disorganization
- A feeling of therapists being too controlling and not open to critical questions
- "Normative pressure to be happy all the time and not express any negative feelings, which they found difficult"
- Encouragement to not talk to anyone about the LP, resulting in patients feeling "kind of alone"
- "Inducing guilt if no recovery"
- "The cost"
Click to expand...

Edit: I'd also add this:

It is possible that they mean only two patients had complaints. In this case, the authors may be assuming that only the two patients who did not report improvement had complaints, but this is not specified in the referenced study.
Click to expand...
 
Last edited:
Nightsong said:
The other aspect of this (which I don't think is discussed in the paper) is that LP quacktitioners themselves are apparently sometimes selective about which clients they take on - I think we've encountered stories where they only accept patients who have a psychological view of their illness or insist that patients be in some way minded to accept their intervention. I wonder how many patients were excluded from undergoing the LP because of these factors? And the other salient phrase is "completing treatment" - how many dropped out of the "treatment"?
Click to expand...
Indeed it's somewhat funny that the conclusion calls for randomized controlled trials when they there is no possibility of randomization since it's heavily selected.

Among 500 other giant red flags.
 
You must log in or register to reply here.
Back
Top Bottom