Cognitive behavioural therapy for MS-related fatigue explained: A longitudinal mediation analysis, 2018, van den Akker et al

Didn't read the whole thread and hope I'm not interrupting a discussion (in this case just ignore me).

Just saw that a group of German BPS-guys together with Rona Moss-Morris (UK) are studying the same topic since 2011: "A brief psychodynamic-interpersonal intervention for fatigue in MS".

The German Professor of Psychosomatic Henningsen even mentions in the description that his experience with CBT for ME ("his work on the use of psychodynamic-interpersonal approaches in somatically inexplicable body complaints" --> this is what he calls ME on the same page) was of help for this study.

http://www.psychosomatik.mri.tum.de...chotherapie/brief-psychodynamic-interpersonal
 
petrichor said:
I've seen two CBT psychologists that specialized in CFS, and they only focused on managing, not denying.
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Even with this how can they possibly help you, you are the one using your body surely its common sense how to manage your own body not a rolled out "treatment".

Surely its the patient who should be teaching the "therapist" how its works.
 
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large donner said:
Even with this how can they possibly help you, you are the one using your body surely its common sense how to manage your own body not a rolled out "treatment".

Surely its the patient who should be teaching the "therapist" how its works.
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I'm not sure I can express this the way I want to. The reason for CBT is apparently to learn to manage your life etc. better. This automatically presumes that you aren't already doing that, and that really gets up my nose. It's the same as telling parents how to better manage difficult children when they are often doing the best job it's humanly possible to do. I think - I know - that I am managing my illness very well thank you. Being told to think about it this way or that by some young thing with half my life experience and, dare I claim, half my wisdom, gives me the complete sh**s.
 
oldtimer said:
I'm not sure I can express this the way I want to. The reason for CBT is apparently to learn to manage your life etc. better. This automatically presumes that you aren't already doing that, and that really gets up my nose. It's the same as telling parents how to better manage difficult children when they are often doing the best job it's humanly possible to do. I think - I know - that I am managing my illness very well thank you. Being told to think about it this way or that by some young thing with half my life experience and, dare I claim, half my wisdom, gives me the complete sh**s.
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I do think it can be good sometimes to have an objective other (not a friend or relation) to bounce ideas off when you're in distress. Sometimes its easier to think through problems in that situation and come up with positive solutions. Ideally, the person could also suggest some too. Plus, sometimes just talking to someone can ease distress. And in a session with a professional, you don't have to worry about burdening the other person with your problems. You can talk away and cry and shout if you like.

But that's about it, right? The rest is just bullshit. All that CBT stuff how your negative thought patterns are the problem and need to be corrected, its ridiculous and very obviously so when its being delivered by someone who has never had a major tragedy their whole life.

I don't know why people feel the need to make a distinction between CBT for CFS and the "much nicer" CBT that's offered to people with other illnesses. All these forms assume you are thinking the wrong way and need to be corrected. Whether its having negative thoughts that make your disease worse ("catastrophising"), like in MS, or negative thoughts that make you think you're sick when you're not, like in CFS, there's an overhwhelming paternalism about it all.
 
@oldtimer and @Woolie Can't say how much I agree!

The more I read about CBT, the more appalled I am by the whole concept. On the theoretical side, I have seen nothing convincing proving that thoughts and behaviors are causing psychiatric problems. On a more ethical side, none of the papers I've browsed acknowledged the extreme situations people are going through, be it the loss of beloved ones, rapes, having been abused as a child or coping with terrible diseases... The more shocking were those by Moss Morris about children with MS, where never once was it said that what's happening to them is one of the worst things children are faced with.

It just seems to be a patronizing process, led by people totally devoid of real empathy toward the people they are supposed to help.


Hopefully, in reality, what matters are the therapist's skills. Since being ill, I have been sent to several psychiatrists and psychologists, with a psychoanalyst (Yeah I'm in France) or CBT background. I've been lucky, they all listened to me, never tried to eagerly apply an abstract theoretical framework upon me and all said that my problems had nothing to do with psychiatry.
 
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Spot on @Woolie I’ve got a brilliant counsellor I’ve had for many years pre ME diagnosis. She is an agenda free sounding board for any issues/decisions I’m facing and gives me a safe place to vent feelings that aren’t easily discussed with family and friends - eg if the feelings are about their behaviour or attitude or are too painful to repeatedly share with them. I feel very lucky to have this support and sad that people generally in the U.K. are getting fobbed off with fourth rate follow the manual CBT instead of professional counselling.
 
Woolie said:
I do think it can be good sometimes to have an objective other (not a friend or relation) to bounce ideas off when you're in distress. Sometimes its easier to think through problems in that situation and come up with positive solutions. Ideally, the person could also suggest some too. Plus, sometimes just talking to someone can ease distress. And in a session with a professional, you don't have to worry about burdening the other person with your problems. You can talk away and cry and shout if you like.

But that's about it, right? The rest is just bullshit. All that CBT stuff how your negative thought patterns are the problem and need to be corrected, its ridiculous and very obviously so when its being delivered by someone who has never had a major tragedy their whole life.

I don't know why people feel the need to make a distinction between CBT for CFS and the "much nicer" CBT that's offered to people with other illnesses. All these forms assume you are thinking the wrong way and need to be corrected. Whether its having negative thoughts that make your disease worse ("catastrophising"), like in MS, or negative thoughts that make you think you're sick when you're not, like in CFS, there's an overhwhelming paternalism about it all.
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Yes, I have a friend who needs to talk everything through - at length! - in order to sort her thoughts out. It suits her personality. Being intensely private and introverted, I have never found that talking to a stranger about private things makes me feel any better - just extremely uncomfortable. I've found that patience and time bring clarity and reveal solutions - or whether there are none. It never fails. Definitely horses for courses I think.

The formulaic kind of CBT that prescribes rote solutions reeks of sham and scam, as if a lot of psychologists looking for a reason to exist suddenly came across this great little sideline, as you said, in catastrophizing and negative illness thinking. And of course it appeals to NICE and politicians because it's cheap and quick.
 
Personally I think listing CBT as a treatment for specific illnesses is as unethical as picking a faith based belief and telling people to have sessions with the spiritual person within that belief.

That's totally down to individuals if they chose to do that but it should not be a prescribed treatment.
 
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