Fear conditioning as a pathogenic mechanism in the postural tachycardia syndrome, Norcliffe-Kaufmann et al, 2022

I think this illustrates the issue very well. Medicine having defined anxiety through physical symptoms that have been attributed to anxiety, literally means that basically anything that activates the autonomic nervous system is automatically defaulted to anxiety.

Completely circular, like someone following a trail of their own breadcrumbs and the breadcrumbs of their predecessors through a maze.

And they literally argue that they're on the right track because: look at all the breadcrumbs! There are so many breadcrumbs, they say, as they take out a fistful of breadcrumbs to add onto the track of breadcrumbs. They never make it out of the maze, because they're following the trail of their predecessors and refuse to go beyond the track, as it's all they're allowed to do. Amazing.

https://twitter.com/user/status/1545398244167098372

 

Unfortunately the FND vultures already have their eyes on relatively well understood neurological conditions such as Parkinson’s as if anyone shows any variability, fatigue, mood disturbances or any of the other signs they believe to indicate functional aspects then their illness has a significant functional component are fair game for CBT, ACT or which ever acronym is currently in favour.

 

I had to do my own diagnosis for my chest pain. When the standard tests for heart attack showed I wasn't having one - and this happened several times - I was eventually asked if I was "anxious" and I said no. I could tell I wasn't being believed.

At the same time this was going on I also had a GI bleed that had been going on for several years. Eventually (it took three hospitals to find it) I had what was described as a "giant polyp" removed which had very fragile blood vessels. I discovered eventually that my GP records suggested that I was seeking treatment for piles (which I wasn't - the blood was much too dark for that) which was why nobody was taking it seriously.

In the end I had to fix my own low iron and low ferritin. It took nearly two years because I absorbed iron poorly, and during that time my chest pain reduced and reduced. I no longer get it now. If you look at links for anaemia the fact that it can cause chest pain and tachycardia is barely mentioned. It certainly isn't given any prominence. I didn't exactly diagnose the cause of my chest pain. I paid for testing, saw I had low iron and ferritin, started fixing that, and ended up fixing the chest pain in the process, as an added bonus.

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Iron deficiency and dysregulation

 

I had my OI under control, more or less, but the last few months I have nearly fallen many times and actually fell twice, once leaving a large bruise on my forehead. Yes, I fall forward, common in OI. I want to add I don't know for sure it was OI, but I am sometimes more vigilant than I used to be. I also completely forget a lot, which is when I am most likely to nearly fall.

These kinds of findings, presuming they are accurate on the questionnaires, cannot determine the direction of causality. An alternative explanation, basically the opposite of their main claims, can easily be constructed. We fall and have problems, of course we get anxious (more focussed) to at least a small amount after this happens a number of times. Not getting anxious/focussed would be more of a psychological problem than getting anxious is. So of course we pay attention, and adrenaline goes up (not read the study so not sure how reliable I consider this), and of course we are more vigilant, if we can be. If the thesis and antithesis are both supported by the same data, it raises the possibility of logical fallacies. In any case they fail to prove their hypothesis.

As has been pointed out already here, we are more concerned after we have a history of problems. It does not fit their claimed hypothesis. In my own case I am much more likely to fall or nearly fall if I am not paying attention. Oh dear, now they will say my subconscious was doing it for me?

Also could someone explain to me how a psychogenic problem can cause cardiac arrest during a tilt table test? I had to be revived when I had one in the 90s. Fortunately I was tested in a hospital, and it was run by my cardiologist at the time.

 

This drivel is, sadly, gaining immense traction. It’s so gut wrenching to see how gleefully pseudoscience is embraced by medical professionals. The simplicity is too seductive I suppose. Anyway, when patients inevitably fail to improve via CBT, we can just attribute it to a lack of motivation and keep on failing upwards.

 

This is actually a teaching moment about the flaws in medicine. A single mediocre study of no merit whatsoever, and you have physicians declaring from this single mediocre study how it proves the condition is psychogenic. That's all it takes for them, good enough to make life and death decisions about millions. Since it obviously can't be falsified and it's so easy to pretend this is valid by not caring about outcomes ("my patients seem to get better" is all it takes), it can sustain itself indefinitely as long as no one checks anything, which is already the default.

Some facts require a mountain of evidence to be accepted. For others, a doodle on a napkin is more than enough, actually it would take a mountain of evidence for people to stop believing in it. Nothing to do with the facts themselves or their complexity, even less to do with the patients themselves, it's all about what can be concluded from it. The current model of evidence-based medicine simply does not work for anything that isn't a single acute event. It's simply a popularity contest that has no issues validating prejudices and often makes things far worse than doing nothing, which is usually very hard but here is basically the norm.

A radical new approach is needed, this one doesn't yield anything useful while allowing complete nonsense to not only pass through, but be greased up and polished explicitly to be carried ahead of actual useful findings. It may be the most counterproductive system currently in use, and I include old kludged up Cobol mainframe systems from the 1960's in this, at least those work.

This is alternative medicine with alternative medicine standards but given the power and legitimacy of science-based medicine. You couldn't build a worse system than this if you tried your hardest to build one.

 

If someone has access to the article, could you send me the PDF version please?

 

Let us presume that some kind of anticipatory tachycardia is happening. Its still jumping to conclusions to conclude its a bad thing or causal. It could still be reactive. The brain knows what is coming, and tries to prepare. It might be a very good thing, not a bad thing.

 

Twitter thread exploring the issues with this paper

 

Odd. Not entirely surprising. Still odd. I'm not even sure how that makes any sense, other than in seeing only patients with mild issues, they can "succeed" at anything because it probably doesn't matter. For all the talk about clinics exploiting patients with untested treatments and pseudoscience, there is a serious issue with having allowed it to be commonplace in healthcare.

https://twitter.com/user/status/1547283689138176001

 

Wow, that's um... quite the list of exclusions.

 

Trial By Error: Is POTS a “Functional Psychogenic Disorder”? Yes, According to NYU Research Team
https://www.virology.ws/2022/08/03/...-disorder-yes-according-to-nyu-research-team/

 

I think your fear for the outcome of the wet tissue is causing this unreasonable thought process of yours, I'm sure a short course of AI-delivered CBT will be sufficient to correct that for you....