BPS attempts at psychologizing Long Covid

We need to talk about Long-Covid

Dr Andy Siddaway on the key role of psychologists in research, service design, and interventions.

https://thepsychologist.bps.org.uk/volume-35/march-2022/we-need-talk-about-long-covid

A response to this article has been posted here, CBT Watch - blog

 

Literally the #2 complaint I see in long haulers on the issue of psychologizing LC, right after all the gaslighting and harmful psychologizing, is how they cannot get any help for mental health exactly because of all the gaslighting and decades of failure psychologizing chronic illness. They cannot find therapists who actually understand this issue, only therapists who perpetuate it.

People with LC are begging for the chance to have actual meaningful support, secondary to actual medical treatment, and they cannot find it because of all the delusional thinking about re-attributing the psychological effects of chronic illness as their cause.

The main failure of de-medicalizing a disease is that everyone suffering from it cannot get any medical help and suffer more as a consequence. The secondary failure is that they are suffering psychologically for it, for which they cannot get any help or support since de-medicalizing is a systemic process that affects all aspects of healthcare.

All this reveals is that psychology is completely unable to assess what it does, while showing the same of medicine. Talk about making two birds completely non-credible with one magical healing crystal.

 

That about 'nutshells' that one (in a nutshell. : in a very brief statement). Bravo.

 

Long Covid sufferer, Gez Medinger, is again promoting quackery on youtube:

https://www.youtube.com/watch?v=RF1mEWx_wd4

 

His Twitter thread promoting his video.

Includes this statement
"To be clear - this is a discussion of *one* possible link between a stressed autonomic system & LC related dysautonomic symptoms. It does not imply there is a psych causal component - LC has proven biomedical pathology. Nor is it exclusive -simply a poss contributing factor."

Dr Asad Khan has retweeted it, saying "I have wondered about this as well… hasn’t gone down well with some commenters but it is interesting at the very least."

and Diane O'Leary joining in the debate, arguing that promoting this concept isn't a good idea

 

Yes!

Also agree with the above comments on Gez Medinger's latest video. I like (and follow) both interviewer and interviewee, but... I think they've all stepped on a landmine here. The discussion around this quickly becomes unhelpful. We know this is biological. I know it, you all know it. They should know it, but somehow they still buy into elements of mind-body nonsense. I and others have probably said this before but you can put all of humanity on the spectrum of too chill <-> too excitable (or similar descriptors) and claim that's the cause. I also defy anyone to live without episodes of physical and emotional trauma.

As antidote, here's a very good thread from today.

https://twitter.com/user/status/1521978182609555457

 

He also promoted the Gupta programme at one point (no doubt receiving a kickback from Gupta for doing so). He is well-meaning, but clearly isn't very sceptical or scientifically literate.

ETA: I've added a critical comment under the video.

EDIT: it looks like he's already deleted my comment. No wonder all the comments are positive from people claiming to be Type As and suffering from trauma. What an echo chamber.

 

I watched Gez’s video which features a psychologist with long covid. Interestingly neither of them talked about trauma or the so-called Type A personality type he advertised this session with.

A lot of talk about parasympathetic nervous system and re-stabilising the sympathetic nervous system with breath work, meditation, expensive vagal nerve stimulation machines and some new concept that all fatigue is from being in an immobilisation state and the developer of this theory has made an a audio app that will apply the right frequencies via music to your brain that clinicians can pay a license to use on their patients. She intimated this was the cause of dysautomnia, so just another reiteration of the stress theory….

Some of the mental health advice was sound from my POV as a retired psychiatrist (basically mindfulness, anxiety and emotional regulation concepts)

ETA - sorry have been watching the wrong video!!! (Cognitive dysfunction - has same pic of her when googled her) This review is from his one with Dr Sally Riggs on “five psychological strategies to help with Long covid” now watching the right one while sitting with my anger waiting for it to dissipate before commenting again….

 

Yes, this is the perennial problem for Twitter and its short-form. Let's hope Elon improves it without breaking it. In the meantime someone agreed with you @Trish and asked for a thread unroll. Try this:

https://threadreaderapp.com/thread/1521978182609555457

 

Gez recently defended the video and position on the grounds that it’s resonating with a majority of long Covid sufferers. He couldn’t contemplate that his Twitter respondents weren’t: (a) representative of a majority of Long Covid sufferers, and (b) a representative of a cross section of long Covid patients. Selection bias must not be adequately taught any longer.

As far as I’m concerned, Gez is Paul Garner going the speed limit.

 

This might be pointless to say but I expect that to some extent GM's point of view comes directly from where he can make money from holding that POV. Money is a great motivator. Throwing reality under the bus then becomes easy.

 

Maybe he isn't.

Maybe he'd like to be transparent about it.

 

Yes, thanks for pointing that out! I have watched the short video now…. More on the Polyvagal Theory (aka the Stress Theory) so basically a rehash of the BPS/psychosomatic model. The problem is these ideas about arousal and anxiety are related to significant trauma from a psychiatric perspective. She is discussing CBT models so everything is in a thought, feeling, behaviour paradigm.

Type A personality is a pop psychology term and played little role in my training in personality development, disorders and treatment. It angers me that he is using a BPS trope which has been disproven many times. The relationship to predisposing you to illness and trauma is speculative and unproven and interestingly many people with these qualities are seen as “successful” and society rewards them by giving them influence and power.

It is his personal journey and I can relate (having seen the other video on his emotional experiences in the psychological strategies video) that he may have experienced trauma and while dealing with the maelstrom of emotions that come with having a life-changing illness, that similar emotions arising from trauma may have become important to attend to and wishes to treat the trauma to help in his recovery but I am not convinced it will solve the biological effects of covid.

I wonder if his review of published “evidence” and patient research is in his newly published “Long Covid Handbook” or if he is preparing this chapter for the next one….The BPS brigade will be rubbing the hands in glee!

 

In the days of ME a disproportionate number of sufferers were teachers, health care workers, and women with young children. It was thought that these were all people who often interacted with those who had infections and who found it difficult to rest adequately when they themselves had an infection.

From this it came the idea that adequate recovery time lowered the risk of getting ME. Wessely took this and twisted it to a Type A personality and made it a moral failure.

I think that many longcovid people are also ones who could not rest but pushed themselves to get back to normal life but this is different from being Type A in a way they are not well enough informed about the politics to realise.

 

Predictably, the Medinger trauma narrative is being gleefully cited by a slate of actors, including those with ties to the functional neurological domain.

Once this genie gets out of the bottle, it’s impossible to contain. I feel like the only thing that can forestall it is definitive biomedical literature. Hopefully, the Nath paper will generate positive coverage.