Catastrophizing, time to ditch the term? - ME/CFS Skeptic blog

Turtle · Sep 6, 2024

ME/CFS Skeptic said: ↑

There were also a couple of studies on catastrophizing by the research team of Jo Nijs. They have a background in pain research so that is probably why they had an interest in the concept.

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But because catastrophizing was (in one of the two studies) related to the duration of climbing, the authors interpreted this as follows:

"Before a physical activity, patients seem to assess how fatigued they will become and adjust the way they perform the activity accordingly."

So even when a patients with ME/CFS are pacing, as they should, they are blamed for catatastrophizing and kinesiophobia.

To me that is just healthy thinking and acting by the patients.

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Dolphin · Sep 6, 2024

Arnie Pye said: ↑

I have always assumed that the blaming and demeaning about pain comes about because healthcare professionals think they would be better than me at dealing with the pain I have and they consider me to be weak and contemptible.
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I remember Ellen Goudsmit once suggesting that the CBT model for ME/CFS treats us as if we are super wimps.

bobbler · Sep 7, 2024

ME/CFS Skeptic said: ↑

There were also a couple of studies on catastrophizing by the research team of Jo Nijs. They have a background in pain research so that is probably why they had an interest in the concept.

In two of their studies, patients had to estimate how much fatigue they would have following stair climbing. They had to climb two floors of stairs (4× 8 steps, height/depth 19.5 cm) and then to descend to their starting position. If catastrophizing is important in ME/CFS, one would expect that patients anticipated the fatigue to be significantly worse than they actually experience after the stair climbing. But this was not the case. In the first study the patients almost perfectly estimated their fatigue while in the other they slightly underestimated it.

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But because catastrophizing was (in one of the two studies) related to the duration of climbing, the authors interpreted this as follows:

"Before a physical activity, patients seem to assess how fatigued they will become and adjust the way they perform the activity accordingly."

Sources:
Influence of symptom expectancies on stair-climbing performance in chronic fatigue syndrome: effect of study context - PubMed (nih.gov)
Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study - PubMed (nih.gov)
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That is so frustrating. I'm trying to work out whether my frustration is clouding this at all but to me it feels like how on earth can they get away with that twisting of the interpretation into a win-win for them and no-win for patient. They seem determined that whatever result happened they had an answer for why it went back to that same presumption of mind-behaviour but a rather nonsense form which seems to resemble more everyday bigotry than the 'say what you see' scientific observation is supposed to involve.

Sean · Sep 7, 2024

hibiscuswahine said: ↑

Also to have a catastrophic thought is not catastrophising. Having a fear response to an unknown stimuli is normal and often life preserving. Some would say that considering all options around a situation, positive and negative, is healthy problem solving.

As previously said, by many others, having a realistic assessment of one's life and the ability to change it, is more useful in the long run as one prepares for various life possibilities.
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Exactly.

Very pleased and grateful you chose to stay here and keep contributing your invaluable insight and experience.

hibiscuswahine said: ↑

People can be optimistic of themselves as a person, but pessimistic about their ability to control their illness (especially with ME when there are no known effective treatments and an illness that can flare up for no known reason or for some uncontrollable reason - infection, various environmental stressors (family, economic, random events etc), a new medical illness developing etc etc.
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I would call that realistic, based on very hard earned lessons.

The persistent failure to account for (actual) context by the psychosomatic club, including their influence of their own prejudices, is one of the most serious in this whole sordid story.

bobbler said: ↑

That is so frustrating. I'm trying to work out whether my frustration is clouding this at all but to me it feels like how on earth can they get away with that twisting of the interpretation into a win-win for them and no-win for patient. They seem determined that whatever result happened they had an answer for why it went back to that same presumption of mind-behaviour but a rather nonsense form which seems to resemble more everyday bigotry than the 'say what you see' scientific observation is supposed to involve.
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All roads lead to psychosomatic, even when it doesn't, seems the distinguishing characteristic of the psychosomatic contribution, certainly for ME/CFS, and everything else stuffed into the PPS/MUS/FND/etc categories.

The single most important fact about human psychology is that we largely see what we want to see, and there are no worse offenders than the psychosomatic club.

(For the record, I do not dismiss the concept or possibility of psychosomatic influences, in general. But the field is clearly in a deep methodological and ethical cesspit entirely of its own making at this stage of its history, and virtually none of its claims can be taken seriously yet, let alone be safely allowed to be unleashed upon patients lives.)

Utsikt · Apr 9, 2025

hibiscuswahine said: ↑

(unfortunately, therapists who only subscribe to the school of positive psychology but also one of the most popular theory in current day society, seem to have their own cognitive distortion that positive thinking is the "best" way of thinking, when many other schools of thinking would say otherwise)
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What is the school of ‘positive psychology’? Is that really a thing? It sounds like a sciencey disguise for toxic positivity..

Midnattsol · Apr 9, 2025

Utsikt said: ↑

It sounds like a sciencey disguise for toxic positivity..
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You're right on the mark there.

Arnie Pye · Apr 9, 2025

If doctors want to continue using this idea of pain catastrophizing by patients in a questionnaire there should be a second part to it with questions for the doctor and what their attitude is to the patient.

hibiscuswahine · Apr 9, 2025

Utsikt said: ↑

What is the school of ‘positive psychology’? Is that really a thing? It sounds like a sciencey disguise for toxic positivity..
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Yes it is a thing but likely to also be the basis of toxic positivity which I especially see in the wellness industry. It was not part of mental health practise when I was working a decade or so ago. Taken over by pop psychology and thousands or people who have become "health coaches" (cough - grifters).

https://en.wikipedia.org/wiki/Positive_psychology

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