Guardian: Long Covid is very far from ‘all in the mind’ – but psychology can still help us treat it - by Carmine M Pariante, April 2021

He says that a trial "requires a comparison with a dummy treatment, so that our expectations, positive or negative, do not influence the results."

I thought a control group was needed to separate what would happen over time without the new treatment from the effect of the new treatment especially regression to the mean.

If they don't realise that it could explain the pace trial where they gave the absolute value for the improvement with GET without subtracting the value from the control group.

 

Reminds me of something James Coyne said i.e. [from memory] you can use psychological therapies to help someone deal with the fact they have e.g. got terminal cancer but it's not a treatment for the underlying disease.

So in ME/CFS psychological therapies may be useful in helping you deal with your ill-health but they are not a treatment for the underlying illness. I'm reluctant to go that far* and it would be relatively easy to use objective measurements to see if the psychological therapy worked


*"There was no significant improvement on any of the [PACE] trial’s objective measures, such as numbers returned to work or levels of fitness". [https://journals.sagepub.com/doi/10.1177/1359105317703785]

 

Whilst being on that paper don't forget to say STOP when you are experiencing symptoms.

 

Yip and blue pills would be cheaper!

This suggests that the there was no (positive) response from CBT in PACE:
"There was no significant improvement on any of the [PACE] trial’s objective measures, such as numbers returned to work or levels of fitness."
https://journals.sagepub.com/doi/10.1177/1359105317703785

Still fits the "definition of a placebo is that it makes people say they are better---"!. So if you stick to unblinded studies, and only use questionnaires, then you get +ve results!

 

Does Carmine still serve on the CMRC executive board?

 

Blue pills can be quite pricy!

 

Excellent point @Snowdrop about parity of mental illness and physical illness regarding social assistance and disability insurance.

The BPS proponents often work assessing claimants for social service and private disability insurers. They seem to insist that mental illness should share the same importance as physical illness. And yet, companies they work for, private insurers, usually only deem mental illness important enough to receive 2 years of benefit coverage. Whereas, physical illness may be in line for longer coverage. It could follow that the very system BPS proponents work for stigmatizes mental illness by virtue of the fact there is often only 2 years benefit coverage for these claimants.

 

So can we regard the therapists as placebos? I think so. With their status, and in the case of PACE, considerable government funding, those administering, as well as the researchers themselves would, or could engender hope/positive anticipation.

And on another aspect of this, after time and money invested with a practitioner, I'm personally reluctant to say their treatment is crap. One can anticipate push back even if the critique is more diplomatic. In a power imbalance, pwME receiving benefits would more likely be positive about the therapy. Especially given the status of the therapists and researchers.

 

Did they do anything right in that study [PACE] -- they gave the absolute value for the improvement with GET without subtracting the value from the control group


EDIT - see @Jonathan Edwards comment:
"I don't think they did that in any meaningful sense. They stated the reported improvements in all groups. Both absolute and relative change were explicit - and both are relevant in interpreting a study. This is about the one thing that they did not get wrong - except perhaps maybe in press release gloss."

https://www.s4me.info/threads/guardian-long-covid-is-very-far-from-‘all-in-the-mind’-–-but-psychology-can-still-help-us-treat-it-by-carmine-m-pariante-april-2021.20332/page-2#post-341390

 

I think CMRC may be "morphing" as Stephen Holgate is stepping down - probably considering its role/direction/members for now.

 

I don't think they did that in any meaningful sense. They stated the reported improvements in all groups. Both absolute and relative change were explicit - and both are relevant in interpreting a study. This is about the one thing that they did not get wrong - except perhaps maybe in press release gloss.

 

It's even worse than this. Their belief system also includes the belief that negative feedback from patients can be safely ignored. After all, the illness is the result of negative thinking, therefore any negative feedback from patients is just a demonstration of the negative thinking that led to the illness.

 

This is where the power of placebo stuff comes from: Interview - All in the mind?
and here: Placebos: Honest Fakery

I don't doubt that it is possible to use "placebos" to help learn better coping strategies for pain etc, but it's hard work and it doesn't work for everyone.
It's also potentially counterproductive if it leads you to ignore important warning signs. That goes for mental health conditions too.

 

There seem to be never ending circles in BPS beliefs.

 

The denial of symptoms as real, is why I am concerned that symptoms related to a blood clot from a COVID shot will be, or have been dismissed.