BPS attempts at psychologizing Long Covid

strategist said:
How can a person possibly think that we need to focus less on understanding the causes of long covid? It sounds crazy, but it sort of makes sense if she believes that she already has the answer. Presumably for her, long covid is psychosomatic symptoms that are really caused by stress, which aren't recognized as such.
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Hopefully she commits and does it all, LP and the rest, so she can understand how utterly ridiculous it is. Sometimes it takes getting slapped in the face by your own face-slapping machine to understand why people aren't buying your self-face-slapping machine.

Sad that this is a level of delusion, of commitment to cognitive dissonance, that would probably benefit from some counseling, but she could never get that kind of counseling because therapists are likely to believe the same stuff. Oh boy. Talk about getting your face eaten after voting for the face-eating leopard party.
 
Invisible Woman said:
I find it fascinating that this is exactly the argument that the BPS cabal have used against those of us who insist on searching for an effective treatment or cure - we are accused of wanting the status of being sick, victimhood absolving us of our responsibilities. Yet in my experience it's the fellow patients who cling to the BPS view who have seemed happiest to do just that.
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You can actually notice that with people who buy the FND model. They will often be very angry at people pointing out that it means hysteria, often saying "don't take that away from me". Literally an illness label, an identity. Literally the very thing the people pushing for FND claim we are doing, they are the ones actually doing that, by bullying it onto vulnerable people.

Seriously Stephen King level of madness. This is all so damn twisted.
 
rvallee said:
Literally the very thing the people pushing for FND claim we are doing, they are the ones actually doing that, by bullying it onto vulnerable people.
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I have seen that played out on Facebook pages so many times. Any attempt to express a different opinion, however carefully or politely & instantly the accusations of bullying and discrimination fly.

It's okay for them to label me, you or someone else. It's not okay for you to question that label in your own case. Let alone generally.

No reason, logic or discussion allowed. Unless your opinion conforms to theirs.
 
Ultimately the BPS ideas are about reassuring people that they have the illness under control and that there is a simple way forward. That's why they can be attractive.

And so long covid is turned into a stress reaction that will just go away if you take care of yourself and don't focus on symptoms. No research is needed, the answers and treatments are all already there, and you're special if you believe in BPS ideas. It's all very reassuring.

One would think that people who study and treat cognitive processes had more insight into this but apparently everyone has their blind spot.
 
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Shinygleamy said:
Ptsd has undergone a horrible transformation of recent years. It used to be a specific disorder caused by extreme out of the norm life ending events, soldiers at war, men from the piper alpha disaster. Then suddenly I noticed this year that every man and his dog has been given this diagnosis. From an celebrity who had a slightly shitty childhood, to a man who is gay (apparently it causes horrific trauma). This is life, this is not what ptsd used to be. I wonder who's benefiting from the massive widening of the criteria.
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I was unaware of this recent transformation. PTSD is a horrible thing, but if it's now being widened, one consequence is that those suffering from old-style PTSD will be taken less seriously and their suffering will be more easily dismissed.
 
TiredSam said:
I was unaware of this recent transformation. PTSD is a horrible thing, but if it's now being widened, one consequence is that those suffering from old-style PTSD will be taken less seriously and their suffering will be more easily dismissed.
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This dilution has also percolated to the broader culture, roughly the same way fatigue is over-used about things like pandemic fatigue, explicitly meaning "I don't want to anymore". I see it often used lightly, like "I got PTSD from that game our team lost" or whatever. People can have "PTSD" for being passed over for a promotion or other trivial nonsense. It has basically lost all relevant meaning, it can mean one of something or a million of another, zero respect for scale or context.

Words have power. Misusing words in an official capacity has terrible consequences. To allow for the continuation of psychosomatic ideology, many common medical terms have been stripped of all meaning and there are no easy words to replace them with, and even if it happened they would get diluted as well with time. This has been one of the worst consequences of the BPS/MUS/FND ideology. In many cases entirely new words will have to be invented simply because the original words have become so trivial that post-breakthrough it would be obvious that they need to change.

I don't know who, if anyone, takes charge of terminology in medicine but it appears to be a complete free-for-all and no one takes any responsibility for anything. This is orders of magnitude worse than one of the worst blunders in the history of engineering, that lander that crashed on Mars because of a mix-up in units. And medicine continues to commit to that failure, it would like NASA continuously crashing landers because the teams just continue to work with whatever units they want to and never communicate with one another.

And of course those word games are essentially at the center of the entire ideology, where they obsess over finding the right term and the perfect explanation, this combination of words that will make people get over their 'fear' of whatever. They will keep playing these games and eroding all meaning out of common clinical terms until the very last day. And this is why we can't have nice things, because people abuse language and authority for self-serving purposes in a system devoid of accountability or oversight.
 
When I was first diagnosed I remember rereading a book called "Battle For The Mind" by William Sargant which I found very helpful (not to be confused with a different book entitled "The Battle For The Mind" by Tim Lahaye which I have never read) in helping me to recognise the affects of stress in my own experience of 10 years undiagnosed with significantly disabling ME.

In the book Sargant describes observations and anecdotes about human behaviour and behavioural conditioning as well as deconditioning (not the physical sense of fitness) by stress, especially regarding shell shock as it was written soon after the second world war and he was involved with trying to treat victims of shell shock hence his interest.

PTSD like "shell shock" has entered common parlance to mean a state of stress and disorientation and the book made it clear there were differences in severity regarding the degree to which individuals could be affected.

However the other side of the coin is that stress is stress because people are people and stress affects us all similarly because it is part of our physiology and while causes of stress responses may seem to differ in severity it is in fact the depth of the individual's emotional response which governs how deeply they are affected by a stressor.

In fact the thesis of the book is a comparison of stress conditioning due to battle trauma and its treatment via hair of the dog techniques, with the deliberate use of stress in political indoctrination, techniques of torture and even religious conversion and transformation. He argues the same principles apply in each process but the purpose or lack of it is very different in each case.

I honestly feel our culture pays too little heed to the downside of negative stress and tries to push it as a virtue when it is not for everyone. I believe we should be kinder to ourselves and each other but there are positive aspects to stress for those who are healthy enough as it enables them to achieve certain goals. Its a proverbial double edged sword.

The problem with BPS theory is it makes assumptions about cause and effect regarding psychology and disease in ME which are unsubstantiated and have now been disproven by studies of inflammatory markers etc. Anyone who would take a catch all bucket diagnosis like CFS and stereotype all cases as having the same psychological condition is not being intellectually sincere in the first place, yet despite the heterogeneity of the patients a systematic review showed some consistent inflammatory markers in the selected experimental cohorts.

Regarding longcovid it is a potential hypothesis of the BPS variety that stress conditioning has lead to retaining an impression of symptoms or some such idea which has a competing hypothesis that longcovid is due to continuing immune responses and is what it looks like.

BPS proponents act as if they dont need to prove their hypothesis which is very unscientific but does not of itself disprove it. Testing the BPS hypothesis can be done by examining the inflammatory state of longcovid patients as was done for ME patients and I hope that kind of study will be forthcoming in due course. It is likely to be more coherent due to the greater homogeneity of the cohorts.

Then we will be in a position to compare longcovid and ME as well as give a verdict on BPS theory which would be unscientific of me to presume a priori. However should there prove to be positive proof of immune activity in longcovid and parallels between longcovid and ME then I think that will be very persuasive argument against BPS and also an important moment and opportunity for showing the world the true nature of much ME CFS since the world readily accepts that longcovid comes from a virus.

I hope that makes sense.
 
boolybooly said:
Then we will be in a position to compare longcovid and ME as well as give a verdict on BPS theory which would be unscientific of me to presume a priori. However should there prove to be positive proof of immune activity in longcovid(...)
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I fear they aren't going to find any particular proof of unusual immune activity, at least not any different to ME (which is already dismissed by most doctors).

If they actually cared about post-viral illnesses, they would have already have a system in place to study the epidemiology and immune correlates prospectively. We have been asking for this for years but they failed. The best we have is one of our own (Lenny Jason) who has repurposed his university student study of post-viral illness.
 
TiredSam said:
I was unaware of this recent transformation. PTSD is a horrible thing, but if it's now being widened, one consequence is that those suffering from old-style PTSD will be taken less seriously and their suffering will be more easily dismissed.
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That's what I feel. If you're putting life trauma in with extreme life or death events you're undermining the original ptsd diagnosis.
 
https://www.nursingtimes.net/news/r...alth-impact-of-covid-19-on-nurses-10-10-2020/

Great news everybody, Mr W is going to help nurses. Any nurses in the vincity better go and hide (This might be why he was asked for his opinion about long covid in the new statesman article?) It's worrying that they are announcing mental health studies on vulnerable groups like bame, and women. I think there will be a general undermining of their position. The first lot of money dolled out by the government for covid studies? Studies for the well! :facepalm:
 
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Snow Leopard said:
I fear they aren't going to find any particular proof of unusual immune activity, at least not any different to ME (which is already dismissed by most doctors).

If they actually cared about post-viral illnesses, they would have already have a system in place to study the epidemiology and immune correlates prospectively. We have been asking for this for years but they failed. The best we have is one of our own (Lenny Jason) who has repurposed his university student study of post-viral illness.
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I am just saying empirical science is the battering ram we need to knock down the door of the blaggers castle. We have to face that challenge and call their bluff.

Prof Leonard Jason's move to include longcovid in the EBV longitudinal is a great move. His other work is an example of good patient centered and well intentioned psychology, which I think we need to remember does exist.

There have been other glimmers, the ME CFS interleukin review did have a pro-empirical result and it turned heads. Lipkin's proteome work recently looked close to considering subtypes.

Subtyping is an essential prerequisite to tidying up the mess left behind by the pro-insurer self promoting blagger-psych lobby who, lest we forget, invented CFS as a bucket diagnosis defaulting to mental oriented therapy for financial and careerist motives, doing incalculable harm in the process.

I think longcovid is a distinct immune syndrome, not unlike my own, which is very likely to leave detectable characteristic traces. We wont know unless we look but its potentially a well defined and consistent subtype which needs attention on a large scale and can attract a lot of funding and we should be encouraging "our" researchers to go for it IMHO.
 
boolybooly said:
In fact the thesis of the book is a comparison of stress conditioning due to battle trauma and its treatment via hair of the dog techniques, with the deliberate use of stress in political indoctrination, techniques of torture and even religious conversion and transformation.
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Sorry, but I don't understand this sentence. Who is doing the stressing and conditioning, and who is being stressed and conditioned in this example?
 
Arnie Pye said:
Sorry, but I don't understand this sentence. Who is doing the stressing and conditioning, and who is being stressed and conditioned in this example?
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Well that is the question isnt it? The discussion around this illustrates the moral minefield which psychology represents.

There are five different stress related processes identified in that sentence which are addressed by Sargant in his book. Some are coercive and some are voluntary. He discusses how stress can be used as a weapon or as a tool.

Stress responses can involve strong memories of events associated with stressful experiences so stress can be used to condition people as in the case of coercive political indoctrination by totalitarian regimes of prisoners, such as the Uighur in detention in China today.

In the case of religion he discussed how people undergo voluntary or self initiated religious practices relating to conversion or transformation or reconditioning to follow a desirable precept such as repenting of their sins or changing their personality to become more peaceful by means such as fasting or social confrontation but there have also been forms of self torture practiced by ascetic sects in the past but (while respecting freedom to worship etc) these tend to be regarded as not particularly healthy or safe these days.

More pronounced stress responses identified in the book include collapsing into unconsciousness and a reversal or breaking of previous behaviour and personality and conditioning. Sargant argues this has had a place in trying to break battlefield conditioning in shellshock cases as a medical treatment. Stress induction as a medical treatment can include deliberately stressing or exciting the patient by invoking anger or discussing early sexual experiences, administering psychoactive drugs like methedrine (methamphetimine) or physical insult like electroshock therapy, so that is doctors acting on patients with the alleged intention of assisting their patients. It does involve a degree of detachment and cruelty which one finds a little disquieting but so does surgery, so morally it is about outcomes, can it help? In a few severe cases he suggests it can.

The same knowledge about stress reactions and stress induction techniques can be used by torturers to break the resistance of captives to interrogate them or to break their enmity e.g. the waterboarding torture scandal and concerns over Guantanamo etc.

Does that make sense ?

This is a problem, the science around human and animal behaviour is abused so readily. Trying to add to its potential for controlling others would pose the same moral difficulty as discovering atomic power, sooner or later someone was going to invent the atom bomb. The question is, is it worth it? Why would you do it, vanity? Is the human race ready for the truth about itself. I dont think so. Any knowledge we add to psychological theory might be used by doctors benignly but will also be used by totalitarian regimes and advertising executives and giant social media tech companies to exert their will over others. Its the same old problem of the Orwellian jackboot in the face of humanity. One does not want to give them bigger jackboots but one does want to level the playing field so one has to educate oneself to understand the techniques they already use against innocents like us. I am in no way condoning the deliberate use of this kind of knowledge, but it is out there already and people use and abuse psychological power already, its best the rest of us know about it. Stay safe.
 
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For me the role of psychology goes way beyond the good vs the bad.

There's the question of when is it appropriate - if for example you identify that childhood poverty might affect a person as they develop to adulthood then is it appropriate to simply focus on the psychology of the individuals in question or to look at causes of poverty and what can be done about that. Moving into the territory of sociology.

Psychology as a field has lent itself all too readily to victim blaming - in the case of poverty by looking at the type of person who is poor, or the type of person who is too ill or in too much pain to work. BPS was supposed to provide a more rounded view on that and did the opposite. They simply carried on victim blaming but under the pretence that social & medical factors were considered instead of simply ignored.

There is also the grading of evidence. There is some evidence, not always replicated, sometimes from underpowered studies, that some physical abnormalities have been found in some ME patients. This is ignored, dismissed & simply not disseminated through the medical profession. On the other hand, poor and misleading evidence from psychology trials that close inspection shows to be false is largely accepted and spread far and wide. So not only is the weight of evidence unbalanced, it is tipped in favour of psychology therapies.

That's without even discussing the nature of unfalsifiable hypothesis.

In addition, with notable exceptions, the vast majority of psychologists remain silent. Are they ignorant of the glaring problems in their chosen field, happy to go along with it if it keeps them in work or what?

Until some of these fundamental problems are addressed then I will continue to look very suspiciously at psychology in healthcare.
 
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