Embodied: The psychology of physical sensation (2015) by C. Eccleston

MSEsperanza

MSEsperanza

Senior Member (Voting Rights)
Embodied: The psychology of physical sensation
by Christopher Eccleston
Oxford University Press 2015
E-book: https://www.oxfordscholarship.com/v...o/9780198727903.001.0001/acprof-9780198727903

Chapter 6 about fatigue deals with "chronic fatigue" as identical with "Chronic Fatigue Syndrome"; promotes cognitive-behavorial model.

The experience of mental fatigue is explored; in particular, its function in disengaging attention from activities that have increasingly marginal rewards. The idea of fatigue as a switch toward more profitable activity is discussed.
Click to expand...

Also explored is the opposite of fatigue: what makes us feel vital, energetic, and able to persevere. Two people help narrate the experiences of fatigue: an ultra-running athlete who regularly runs over 100 miles, and someone living with chronic fatigue.
Click to expand...

https://www.oxfordscholarship.com/v...27903.001.0001/acprof-9780198727903-chapter-6

Google books: https://books.google.co.uk/books?id...ce=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

The author Christopher Eccleston is Senior Editor at Cochrane, Cochrane Mental Health and Neuroscience Network and Professor at the University of Bath Centre for Pain Research.

see the posts by @Peter Trewhitt and @Esther12 :
https://www.s4me.info/threads/which-cochrane-review-group.7459/#post-133033

https://www.s4me.info/threads/which-cochrane-review-group.7459/#post-133038

He co-authored the rather promising-sounding paper 'Let’s talk about pain catastrophizing measures' discussed here.

@Michiel Tack
 
Jonathan Edwards said:
Judging by the blurb for the book Ecclestone is an ignorant nutcase.
He also seems to be a senior editor at Cochrane.
Embodiment is about the biggest bullshit buzzword in study of the mind.

As to what logically valid conclusions one can draw from these premises I would not pretend to know.
Click to expand...

I like your expression, ignorant nutcase. Says it all.
 
Last edited by a moderator:
I'm still working my way through it, but in the introduction "the fallacy of resource depletion" the author discusses "ego depletion" which is one of those findings in social psychology that has failed to replicate. https://replicationindex.com/category/ego-depletion/

The process by which this is governed is the subject of much research, especially in sports performance. Physical fatigue is subject to the subtle interplay of expectations of exertion, experience, and central nervous system control. The exact operation of any central control over exertion is not known, but there is wide acceptance that the experience of fatigue occurs long before biological homeostasis is threatened. This is true for both physical and mental performance.
Click to expand...

Wow, it is clear this guy understands neither the neurology of exercise physiology, nor the basic biochemistry involved. Our cells are quite sophisticated, utilising multiple substrates for energy - the limitation is the kinetics by which this occurs - so performance rarely just stops, but rather, performance of the currently stimulated motor units becomes limited, requiring greater effort to stimulate more motor units to maintain the same performance over time. (with a similar analogue for mental exertion)

Marathon runners (one of the examples in the book) only use a fraction of their motor units at any one time at race pace. Similar Consider measurements of elite cyclists - who can peak out at 1500-2000w for <8 seconds, 800w for 30 seconds and over 400w for an hour. So for that hour where they are riding as hard as they can, they're still only utilising 20-25% of their maximal force. Notably over time, cyclists riding at above the lactate threshold (but below VO2Max - which is not limited by the muscle, but the cardiovascular system's ability to deliver blood to the muscle) will require more oxygen to maintain the same output, known as the VO2 slow component - as motor units fatigue, more motor units are recruited to maintain the same output. There is no oxygen steady state at a constant performance output.


Hence fatigue is an important part of of provocative system, namely it warns when it will require more effort to maintain the same level of output - this is evolutionary important, for if we are not warned in advance of a decline in performance then we might not be able to escape danger - or gain our next meal. The key point is our brain makes predictions about our output capabilities which are constantly calibrated by afferent feedback. Real world fatigue is not defined as a decline in maximal performance induced through twitch interpolation, it is requiring greater effort (nerual drive) to achieve the same level of force (or equivalently, concentration in terms of mental exertion).

Fatigue as motivation to change The question persists, then, of why fatigue emerges if it is not a signal of a limit reached or a resource spent. Fatigue is an aversive emotional response to the demand of continuing a task, and a desire to stop or switch away from that task. Whether the primary task is a simple vigilance game or one of deliberate self-control, fatigue functions to motivate change.
Click to expand...

This is nonsense. Fatigue is not an emotion, it is a warning that higher levels of effort are being expended for the same level of performance.

Fatigue grows as the opportunity costs of persisting with the same task grow. In this way fatigue functions to motivate people to switch to more profitable behaviours by reducing cognitive engagement.
Click to expand...

None of this is backed up by empirical study.

This has practical considerations for the organisation of work; for the design of tasks, especially simple and monotonous ones, for which the emergence of the desire to stop or avoid altogether is likely; and for the training of elite, highly skilled performance that requires one to control fatigue—to overcome the desire to stop.
Click to expand...

Wow. Of course in the real world, if fatigue increases, which is to say the effort required increases to a point at which it can no longer be maintained metabolically, then stopping is inevitable, regardless of one's motivation. ('hitting the wall' is one example)

Fatigue is not "urge to stop", and I think the author is stretching this concept to the point of nonsense.
 
Last edited:
Competitive cyclists took cocaine to stop fatigue and help them keep going. They often died because they used all their resources.

These ideas of fatigue keep using athletes who are fit way beyond the normal. Hunter gathers do not have to be fit enough to run marathons. If anything, in the average healthy person fatigue probably irons out "boom and bust" in their beloved jargon.

Just chose your facts to fit your idea, don't test your idea to see if it is correct.
 
Sadly, the general public love this type of approach to health. The recipe seems to be:

  • Take a complex interaction of complex systems that we presently know little about and ignore completely.

  • Replace with vague concepts that use 'cutting edge' buzzwords with no meaning (I now refer to this as goop)

  • Make sure that it all sounds wonderful to be a part of. I'm surprised no-one has coined 'health orgasm' as the term to use for this (unless they have)
Come to this approach for the health issue--stay for the warm fuzzies you get in feeling you are in control of everything that happens to your health.

If I had the ability to read all this stuff (not that I'd want to) I'd devise a goop scale.
5 'GOOPS' and you are deep in alternate reality.
 
I am really stunned by this, and have to share with you a few excerpts. Look at this bit where Eccleston slides so seamlessly between the (probable) physical causes of fatigue in CFS and the idea that its actually all about motivation.
The causes of CFS are unknown, but are likely to be varied, unlikely to be psychological in origin, and very likely to involve both central nervous and immune system dysfunction. Dantzer et al. (2014), attempting to combine neurological, immunological, and psychological studies of fatigue, as well as research with nonhuman species, remind us of the impact of illness on motivation. Sickness in general, they argue, causes lack of interest, failure to explore, and habit failure, all of which are immune-system mediated—evolved responses that function to promote withdrawal. Although preliminary, this view is motivational in the recognition that the defining feature of human fatigue is the interruption of behavior by signals to halt and withdraw, which in humans is verbalized as the growing dominance of thoughts to stop and switch.
Click to expand...
He argues that because fatigue in disease might have an adaptive value in helping the organism withdraw and heal, then fatigue is "motivational". That is, it isn't a straightforward consequence of depleted resources, but actually serves a function. He does not seem to understand that evolutionary functions are not the same as motives. The giraffe's long neck serves an evolutionary function, but it has nothing to do with motivation. Similarly, while fatigue in illness might have some benefits in some situations, these may not necessarily have anything to tell us about the mechanisms that give rise to it. Although "illness behaviour" might have some upsides in some situations, it probably had a huge downside too - when the neighboring tribe came charging into your village with machetes and whatnot, I'm reckoning those with a fever were unlikely to have been the ones who got away!

Then this:
Chronic fatigue patients appear to demonstrate a high level of self-criticism and negative perfectionism (Luyten et al., 2011). People are highly critical and demanding in a self-defeating pattern that fuels ruminating thoughts of failure, and so depression. This pattern can be self-perpetuating as people fail to reach unrealistically high targets, which reinforces a belief of personal inadequacy. Specific beliefs are that the fatigue is uncontrollable, likely to lead to catastrophic outcomes, and that further activity will lead to physical damage. All appear to play a part in maintaining a lack of engagement with activity (Lukkahatai and Saligan, 2013).

Other strong beliefs, perhaps fuelled by the social context of CFS as a contested illness, are beliefs about the causes of the disease and what needs to be done. Simply put: if one believes strongly that exercising is not only going to be fatiguing but that it will cause damage, then one is unlikely to exercise. Further, one is likely to consider anyone who is suggesting exercise to be at least unwise and perhaps unkind. Ironically, the person with CFS can appear to observers to be passive and resting. The opposite is normally true. People with fatigue tend to be actively ruminating about possible solutions, and often desperate for change, but may be engaging in self-defeating attempts to achieve unachievable solutions.
Click to expand...
Notice the word "ruminating", an explicitly negatively valenced word that describes recurring thought patterns that do not serve to address the problem in any productive manner.

then this on the PACE trial:
Some treatments attempt to work with these beliefs and help people make gradual and sustainable changes rather than sudden radical ones. ... A recent large trial published in The Lancet contrasted three different approaches to treatment based on different ways of thinking about fatigue. One treatment is based on the energy-resource model of fatigue I discussed earlier as a fallacy. Essentially, there is a dominant cultural view that fatigue is a signal of a depleted scarce resource, signaling that one should conserve energy and avoid exertion; instead one should use one’s body as a guide. The alternative treatments do the opposite; they work on the assumption that for those with chronic fatigue one’s body is an untrustworthy guide and should not be followed. The stop signals should be thought of as false alarms. CBT essentially seeks to shift people from fatigue-determined behavior to planful behavior in which one works toward meaningful valued goals according to how one has planned in advance, regardless of how one feels in the moment. This trial, the largest of its kind, showed that the treatments that are aimed at gradually increasing activity had better results overall than standard care, and were better than the treatment that proposed changing activity depending on how one felt (White et al., 2011). Part of the CBT approach is learning that the beliefs one has about fatigue, however sensible and internally coherent, may not be true, and, more importantly, may be unhelpful.
Click to expand...
There are many qualitative studies of what it is like to live with CFS .... Missing is any phenomenological study of what it feels like to live with this urge to stop. Is it the same or different as that experienced by the person continuing a repeated task with diminishing marginal returns? Is it the same as someone like Kerry, deliberately undertaking an extreme sport, working far beyond their limits, ignoring the desire to stop by focusing on a superordinate goal, and learning to reinterpret her body? Or is it nothing like those, but instead a constant base level of motivational drag, where the very thought of initiating action is quickly defeated?
Click to expand...
So apparently, PwMEs live with the constant "urge to stop"!

Now, what did Sarah say? exactly what you'd expect from a PwME:
Chris: Tell me about the most recent time you overdid it?
Sarah: One Saturday I was reasonably careful in the morning. I did some housework. I had an event on in the afternoon. I felt it was important to go. There were a lot of people there I knew but hadn’t seen for a long time so there was energy in talking to them. Then it got to four o’clock and I started to feel pain in my lower back, then a headache, then I started to feel slightly fluey. But I ended up leaving at five o’clock and I had a chore to do on the way home. And yes: I completely misjudged it and it was too much, unfortunately, and I then felt really poorly. So I got home and had to just lie down.

Chris: What are the thoughts when that happens?
Sarah: “Oh, my God, I am so stupid. Why have I done this? Oh, I can’t believe it.” I start planning. Yes planning, planning, which is not very restful. That is often how it goes when I have overdone it and I have been rather foolish about it. I should have been more careful. The feeling is like a profound exhaustion. Like my battery has just died. It is flashing on 1 percent. That is how it feels. I think that “I need to lie down this second.” I can’t think straight. I can just about hold a conversation. But it probably does not make much sense. I feel shaky.

Chris:Are you an expert on your body now?
Sarah: Yes, I am. So there is a judgment call about how much can you tolerate before you have to step in and take control. But, on the whole, my body is normally right. And I should listen to it. That has certainly helped me to improve. It is hard to listen to your body at first. It is partly cultural. You push on through. You go to work. You try harder. So at first I couldn’t understand why it wasn’t working. I was trying but was getting worse. I was pushing. So I just ignored it. I ignored all these symptoms and carried on anyway. But gradually I understood that I had to listen to my body.

Chris: So you trust the information your body gives you?
Sarah: Yes, that was a hard lesson to learn. I did not want to accept it. I absolutely did not. This is not who I am. To do so little is wrong, I believe. I am only young. I should be working full-time, I should be doing all the sport I want to do, that I used to do. And I should be going out with my friends. So I have had to learn. I have tried to push through. I have absolutely tried that. But it doesn’t work. I had to learn to listen to my body. If it is telling me that it is not just tired, that it is ill, then I had to stop. So now I am good at reading it.

Chris: It sounds like a life without spontaneity.
Sarah: There is almost no spontaneity. There can’t be. Everything is planned. Which is sad. It is probably not how I would choose to be. But it works. You kind of weigh it up. And now I don’t really worry about it too much. You know: it’s a trade-off.
Click to expand...

Sounds pretty reasonable. Anyone here could have written that. Look at what Eccleston concludes from it:
Sarah lives a planful life closely managing the boundaries of what is possible when there is the ever-present threat of severe fatigue. For her the idea of working through fatigue is something she tried that did not work. She has a close relationship with her body as a source of information that tells her what is achievable. Unlike Kerry, however, Sarah trusts the information her body gives her and tries to follow it. Like Kerry, Sarah is an expert on fatigue and motivation. The fatigue she describes is similar to Kerry’s: a strong urge to stop. The thoughts are hard, if not impossible, to ignore. She knows not to make hasty decisions and that being active and achieving is an important part of who she is, but it must be done now in the context of the threat of relapse from forgetting hard lessons learned.

......We can learn a lot, however, from those who live their lives in chronic and severe fatigue, whether deliberately by engaging in endurance sport, or non-deliberately in struggling with chronic fatigue syndrome. In the extreme cases, what is at stake is how far one can go in ignoring the urge, or, more accurately, the demand to stop and switch.
Click to expand...

Edited for typos and to finish one of my sentences!
 
Last edited:
Woolie said:
I am really stunned by this, and have to share with you a few excerpts. Look at this bit where Eccleston slides so seamlessly between the (probably) physical causes of fatigue in CFS and the idea that its actually all about motivation.

He argues that because fatigue in disease might have an adaptive value in helping the organism withdraw and heal, then fatigue is "motvational". That is, it isn't a straightforward consequence of depleted resources, but actually serves a function. He does not seem to understand that evolutionary fucntions are nto the same as motives. The giraffe's long neck serves an evolutionary function, but it has nothing to do with motivation. Similarly, while fatigue in illness might have some evolutionary benefits, this

Then this:

Notice the word "ruminating", an explicilty negatively valneced word that describes recurring thought patterns that do not surve to addres the problem in any productive manner.

then this on the PACE trial:

So apparnetly, we PwMEs live with the constant "urge to stop"!

Now, what did Sarah say? exactly what you'd expect from a PwME:


Sounds pretty reasonable. Anyone here could have written that. Look at what Eccleston concludes from it:
Click to expand...
I mean no disrespect, but that guy's an idiot. Somehow manages to miss 100% of the shots he takes. All the details are either completely wrong or so wrong as to be meaningless. Totally fictitious misrepresentation of PACE. Of course it's the same as the PACE authors' own misrepresentation, no surprise there. I guess we should call it a philosophical trial, rather than a pragmatic trial, then? Complete nonsense.

That fake-ass dialogue is nothing at all like my experience, absurdly trivial and superficial. I don't know where they come up with this stuff but I'd suggest putting down the crack pipe and pursue creative writing instead.
Sickness in general, they argue, causes lack of interest, failure to explore, and habit failure
Click to expand...
That's just goopy nonsense and frankly shows how utterly clueless they are about their own selected topic of expertise. Quacks like this guy know nothing of the experience of illness but because the only people who can contradict it, those being misrepresented as they testify to the experience, have been stripped of agency they just continue making stuff up, not knowing when to stop because they destroyed the feedback mechanism and created a mutual admiration society in which every claim gets a shiny participation gold stamp.
The fatigue she describes is similar to Kerry’s: a strong urge to stop. The thoughts are hard, if not impossible, to ignore.
Click to expand...
Completely made-up tripe. If there is one defining characteristic of illness, not freaking fatigue, it's completely poverty of thought, the mind just goes blank. Well, even blanker than usual. But they can make up fake-ass dialogue so nothing matters anyway.

This is completely embarrassing. It devalues expertise to allow people to simply make stuff up like that. Way beyond simple incompetence to have such nonsense published. Especially as if you go back well over a century you can find the exact same pseudoscience, with the exact same basis in "evidence" and the exact same set of beliefs underlying it.
 
This strong urge to stop thing.....

Anybody else have issues with that? I find when I have been overdoing it, especially if I overdo a little bit on a few occasions within a shirt period of time, I feel absolutely awful & like I could just drop in the spot, but also a weird compulsion to carry on.

It's like the cognitive function has dropped below the level needed for good decision making or maybe a final burn off of adrenaline.

Anyway it's the opposite of an urge to stop.

Stopping can sometimes take huge strength of will.
 
Invisible Woman said:
This strong urge to stop thing.....

Anybody else have issues with that? I find when I have been overdoing it, especially if I overdo a little bit on a few occasions within a shirt period of time, I feel absolutely awful & like I could just drop in the spot, but also a weird compulsion to carry on.
Click to expand...
Well, quite, and Sarah's narrative - which he inserts right there in the chapter - doesn't mention an urge to stop, but rather hard-earned knowledge about what's likely to cause kickback if she doesn't obey. Most of what she talks about is annoyance when she later has to pay the price for NOT stopping.

Its an amazing example of how someone can believe they've "listened" to a person's narrative, but really, they've just superimposed their own preconceptions onto it.
 
Woolie said:
Its an amazing example of how someone can believe they've "listened" to a person's narrative, but really, they've just superimposed their own preconceptions onto it.
Click to expand...

I had this with my usually very good consultant years ago when we were discussing cognitive issues.

I explained the usual stuff many of us are familiar with and he immediately said " ah yes problems with concentration ". I disagreed and repeated what I just said and he went "yes, concentration problems are very common".

I just looked at him and said "you do realize you're not listening to me, right?" He looked surprised and I pointed out my cognitive difficulties were primarily processing problems. Concentration fade was secondary as I expended more and more effort to process information.

He looked surprised, thought about it & then seemed to get it.

I think our difficulties communicating aren't always taken fully into account - we say something during an appointment, but they hear what they expect to hear. We don't always have the ability to put them right and so they assume.

The ability to actively listen without allowing your assumptions to filter what is heard is a rare skill it seems.
 
Invisible Woman said:
This strong urge to stop thing.....

Anybody else have issues with that? I find when I have been overdoing it, especially if I overdo a little bit on a few occasions within a shirt period of time, I feel absolutely awful & like I could just drop in the spot, but also a weird compulsion to carry on.

It's like the cognitive function has dropped below the level needed for good decision making or maybe a final burn off of adrenaline.

Anyway it's the opposite of an urge to stop.

Stopping can sometimes take huge strength of will.
Click to expand...
precisely, I never feel 'urge to stop' & I certainly don't think I need to stop, there is no stopping cognition. Once I've gone even a liitle too far, the fact that there is no cognition around it is precisely the problem... people will say to me afterwards why on earth did you carry on for that long? What on earth made you do that Jem? you know you cant do all that without payback why did you do it? And there is no answer other than 'because I have ME'. They assume we are constantly body watching for symptoms... if only I were! PEM would never occur. But it's precisely that when I have been mentally/physically active & am starting to overdo it, the signal recognition disappears & I become completely stupid, unable to respond appropriately to anything. If only I were having thoughts that said 'I need to stop now', or even 'I want to stop now' i'm sure I wouldn't ever crash. But by that time I am too cognitively impaired to work it out.

Which is basically what Sarah says - she "ended up leaving at 5pm & had a chore to do on the way home"

He is incapable of hearing. As has been said... they cant listen without superimposing their own preconceptions onto what is said. It drives me completely nuts.
 
You must log in or register to reply here.
Back
Top Bottom