BPS attempts at psychologizing Long Covid

[It's M.E. Linda]

Actually - just had an update - we offered them a call and they have yet to come back to us!

But they are on on your radar, and that’s good!

 

[rvallee]

Looks like the RACGP is very committed to making the worst possible mistakes to their worst possible extent and aggressively learning nothing from comparable experience that both does not exist and also can be drawn upon.


GPs and hospitals to tackle ‘long COVID’ together

https://www1.racgp.org.au/newsgp/clinical/gps-and-hospitals-to-tackle-long-covid-together

She told newsGP ‘mild’ cases of the virus should be renamed ‘non-hospitalised’ cases, given the longer-term damage to heart, lungs and brain seen in a minority of survivors, as well as the more common issues such as fatigue, breathlessness, brain fog, difficulty undertaking exercise, and even psychological symptoms resembling PTSD in those who were in intensive care.

‘It’s very hard to know how to go about preventing long COVID. It’s really very disconcerting,’ Professor McLaws said.

While there is limited evidence on symptoms and treatments specifically for long COVID, clinicians have drawn on the experience of survivors of the closely related SARS-CoV-1 coronavirus which also triggered post-viral fatigue and other issues.

‘Everyone is pushing for more collaboration between primary and secondary care and this is a great chance for us to do that,’ Dr Miller said. ‘This will be a very interprofessional space.

‘GPs are well placed to provide psychological support and to refer off for formal support if necessary.

‘We based this pathway on the first SARS, which also had [post-viral] breathlessness, fatigue and psychological distress,’ he said.

‘What we have found is that symptoms are often out of proportion to physiological abnormalities,’ he said.

‘At the moment, it’s a data-free zone as to whether interventions make any difference to long-term outcomes. No one can say,’ he said.

I love that post-viral illness is both successfully handled but also completely data-free.

‘It’s terrific the PHNs are going to provide a GP-centric holistic model to assess these patients as individuals,’ he said.

But, is it? The very thing that has been a total catastrophic failure in decades of practice? That's "terrific"? According to who?

He recently treated patients with severe fatigue, sleep and mood disturbances and heart palpitations, a combination suggesting both PTSD and chronic fatigue. Such patients represent the extreme end of the spectrum, he said, having often come out of intensive care with lung scarring and/or cardiac abnormalities as well as deconditioning.

‘Some seem to simply not have fully recovered from a virus, with their main problem being a lack of energy. They just don’t have as much petrol in the tank,’ Associate Professor Irving said.

‘For these patients, we can reassure them they don’t have lung scarring or cardiomyopathy or a neurological syndrome, and to suggest it is likely that time will heal them.’

‘Young people aged 20–39 now represent 40% of cases in Australia. That’s a very large group. We don’t want them going into middle age with chronic ill health.

You don't want to do what you've already done and continue to do in regular practice? Why? Would it be bad? Because it clearly is. You are doing this right now, though. And think it's bad. But also you have this under control. You've known about "post-viral fatigue" for a long time and have effective treatments but also this is brand-new and you have nothing useful, except for the decades of failure in practice, which exist when asked but also have never existed.

Hey, it's not as if the government had recently released a report affirming the complete failure of 2 decades of this ideological framework in practice. No, instead let's do all the same mistakes again. Yes, this is the smart way of doing things. It can't fail, nothing can when you simply don't give a damn about results.

 

[Kalliope]

ETA: It worries me a bit that Preben Aavitsland, epidemiologist and management and Staff for Infection Control and Environmental Health at Norwegian Institute of Public Health liked this tweet. He's a main expert in media during the pandemic.

ETA: He retweeted himself and added

 

[rvallee]

Ah, the cherry-picker has logged on and has things to say.

What a weirdo. Shame on Norwegian medical authorities to enable this ridiculous charlatan.

 

[chrisb]

Should we make allowances for the fact that English is not his first language, and he may not understand the implications of "risk factor"?

 

[rvallee]

Should we make allowances for the fact that English is not his first language, and he may not understand the implications of "risk factor"?

From his past ramblings, I think this is the implication he means here. That attitude and belief in recovery is literally the main determinant and making it something to fear would create more cases of severe psychological distress, that if no one talked about it there would hardly be any cases.

Dude is waaaaay far gone.

 

[Snow Leopard]

Should we make allowances for the fact that English is not his first language, and he may not understand the implications of "risk factor"?

No.

 

[James Morris-Lent]

Surely we can count on assiduous good faith terminology police such as M Sharpe and S Wessley to remind our man that the only option other than 'physical' attribution is to resort to supernatural etiology. This sort of thing will scarcely do from noted presumptive rational thinker H Vogt.

 

[rvallee]

Whatever the hell this is supposed to be... I skimmed through and this is basically someone liking the sound of their voice and sprinkling biopsychosocial! way too many times. Not about long Covid but we all know how this eventually works out. This is completely useless ego-jerking.


A Biopsychosocial Framework for Recovery from COVID-19

http://insight.cumbria.ac.uk/id/eprint/5684/3/BPS Recovery Framework C19 - V5 FINAL.pdf


Again the BPS ideology is entirely about money and reducing services. It's the only goal. Always has, always will be.

Over time, the use of BPS approaches at practice, organisational and national levels could reduce the reliance of communities and individuals on state services, but this will take a significant investment. With public attitude in favour of equitable solutions and re-investment in education, health and social care, this could be the moment to achieve significant improvements in social justice, enabling all to feel and function better than before the pandemic.

 

[Snow Leopard]

I skimmed through and this is basically someone liking the sound of their voice and sprinkling biopsychosocial! way too many times.

It is surprisingly superficial, with a lack of depth on understanding why people's needs aren't being met and and as a consequence, a lack of specific solutions proposed. The conclusion about "reduce the reliance of communities and individuals on state services" is not justified based on their study. One could easily conclude the opposite, that there are people in need who lack the resources to meet their needs who need additional (needs-specific) support.

The mention of "social justice" is rather strange as it only occurs in the conclusion and they don't explain what the mean by this, or why "reduced reliance on state services" would lead to increased social justice!?!

 

[Sean]

The conclusion about "reduce the reliance of communities and individuals on state services" is not justified based on their study.

Certainly hasn't worked with the BPS approach to ME/CFS.

 

[Kalliope]

New opinion piece by Henrik Vogt and Andreas Pahle.

Can research show that organic damage can explain all the symptoms in people who have had covid-19? No. In many of those who today report strong, lasting symptoms, doctors do not find anything wrong with the body. In many cases, it is unclear whether they actually had covid-19. But no matter: Even where there is significant physical damage, the perspective we raise is important in rehabilitation.

There is no distinction between "physical" and "mental". The health problems we address also cause physical changes. Fear has its own biology with changes in various physiological systems. Chronic stress as well.

Slik lager man oppskrift på uførhet
google translation: How to make a recipe for disability

 

[Sean]

There is no distinction between "physical" and "mental".

 

[rvallee]

Can research show that organic damage can explain all the symptoms in people who have had covid-19? No.

Wait, why do we spend billions on basic research when Henrik knows? All we need to do is ask him. Since he knows. He knows whether research is necessary or not. I'm sure he has an impressive track record of that. With arguments like that, who wouldn't be convinced?

It's quite something to demand and promote science while being called anti-science by people who are actually anti-science to the point of asserting that there is no point researching something because they already know the answer. The hubris is impressive.

 

[rvallee]

There are, in fact, many differences. They are, in fact, completely different things.

The basis of science, the early days of actual science work, was categorization and classification. Is X the same thing as Y? What is X? And if it's not the same as Y, why?

And here these loons are basically like:

 

[rvallee]

The GET manual used in the PACE trial says otherwise.

But I get that they are making it up as they go along. So this time it's about fitness, then it's about cognitions. In reality they don't have a viable theory.

Literally don't even have a hypothesis. When asked, they just pretend it's not a valid question. And these people are taken seriously. Absurd.

 

[Rick Sanchez]

Well either they don't know any better because they haven't done their homework, or they're deliberately lying.

They are deliberately lying. These people don't believe in anything other than the advancement of their own careers. I can still remember the details of exams I had 15 years ago, there's no way they don't remember the details of their 5 million pound study which was based on the idea that patients were suffering from deconditioning or false beliefs about their own illness. There's also no way they wouldn't remember that 'pacing' was included in the study as a sort of control group? With the puprose of showing that the patients preferred strategy of 'pacing' did not lead to recovery unlike their bogus treatments.

At this point I am also absolutely certain that the only reason they really engage with patients online is an attempt to bait poor mistreated patients into behaviour that can be characterized as harassment or threats. This is done to further advance their career, by having a narrative of being poor victims, or to attempt to convince people like Paul that these ME/CFS patients are crazies and not to be listened to, regardless of their arguments.

Honestly, we're really lucky to have people like Robert who are able to engage in a civil and convincing manner with these hacks, which reflects well upon our community.

 

[Snowdrop]

Apologies as I'm off on one of my tangents with regard to the thread.

With regards to post #189 (pg 10) I'd like to go back to that as I was thinking about this document from Margaret Williams:

http://www.margaretwilliams.me/2007/non-existence-of-bps-model.pdf

MW writes in the text:

McLaren’s recurrent theme is that some psychiatrists repeatedly invoke Engel’s biopsychosocial “model” and that they accept without demur (or references) that it is a reality, when nothing could be further from the truth.

McLaren asks: “Why do these intelligent people (ie. psychiatrists), their reviewers, their editors and, above all, their readers, continue to pay homage to something that does not exist?”

Wessely School psychiatrists, however, are certain that their own beliefs and their reliance upon the biopsychosocial model are right.They have built their careers upon it, so they must be right.

Here's a link to some of McLaren's thinking:


Also, related to this I am constantly getting confused by the differences between the bPs conceptions of mind/body and everyone else. It seems to me that both groups view the mind/body as one entity but bPs go too far with mind as locus of conscious control?

 

[Leila]

They are deliberately lying. These people don't believe in anything other than the advancement of their own careers. I can still remember the details of exams I had 15 years ago, there's no way they don't remember the details of their 5 million pound study which was based on the idea that patients were suffering from deconditioning or false beliefs about their own illness. There's also no way they wouldn't remember that 'pacing' was included in the study as a sort of control group? With the puprose of showing that the patients preferred strategy of 'pacing' did not lead to recovery unlike their bogus treatments.

At this point I am also absolutely certain that the only reason they really engage with patients online is an attempt to bait poor mistreated patients into behaviour that can be characterized as harassment or threats. This is done to further advance their career, by having a narrative of being poor victims, or to attempt to convince people like Paul that these ME/CFS patients are crazies and not to be listened to, regardless of their arguments.

Honestly, we're really lucky to have people like Robert who are able to engage in a civil and convincing manner with these hacks, which reflects well upon our community.

This is exactly what it looks like to me. I was familiar with his background and role in ME history but have only been following his public communication for the last couple of months.

He's provoking and laying baits for "crazy patients" to attack him and I wonder what his threads look like to people like Paul Garner that are fairly new to this.

Geradas video, where she's using that soft, pseudo understanding voice gaslighting the patient into harming herself gives me the creeps.

They both remind me of nurse Ratched from "One flew over the cuckoo's nest".

 

[Sean]

Why does he bother to make such a fool of himself?

Because he is not as smart as he thinks he is, has nothing solid to back his case, and is getting desperate as reality closes in.

At this point I am also absolutely certain that the only reason they really engage with patients online is an attempt to bait poor mistreated patients into behaviour that can be characterized as harassment or threats.

Yep. Sharpe's Twittering is exactly that.