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

I don't think we learned much. As I said to David Tuller yesterday—and others may disagree, but this is my personal opinion—I think there's enough biomedicine and biology in Pariante's work for it to be taken seriously. Any work on brain inflammation and central fatigue may prove important to ME/CFS, even if to just a subset of patients. I certainly don't lump him in with the likes of Chalder and Crawley, who are not serious scientists.
 
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InitialConditions said:
I don't think we learned much. As I said to David Tuller yesterday—and others may disagree, but this is my personal opinion—I think there's enough biomedicine in Pariante's work for it to be taken seriously. Any work on brain inflammation and central fatigue may prove important to ME/CFS, even if to just a subset of patients. I certainly don't lump him in with the likes of Chalder and Crawley, who are not serious scientists.
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My concern would be that his support for, and his misrepresentation of patient's concerns about, CBT for ME would suggest that he would be open to interpreting any biomedical results that he might find into that framework. The results of his work might prove to be useful; his interpretation of it, possibly not so much.
 
Pariante 2:19 to 2:39
More or less repeats his arguments from the article.
Goes on and on about personalised treatment/ help with management. pacing, pushing at your limits gently etc etc. Seems to think that the NHS clinics are getting it right with their usual mix of therapists to provide this personalised help.

He argues that it's important for psychosocial approaches to be included in all research studies of Long Covid.

He also made what to me seems a very superficial statement that as far as the body and brain are concerned psychological stressors and infections have exactly the same effect on the body and brain - ie stimulating the immune system, so from that he seems to deduce that ME/CFS and Long Covid can be treated by psychosocial treatments.

The interviewer says her mother has ME/CFS and has experienced clinicians and friends saying it's all in her mind. Pariante tried to dismiss this as belief from over 50 years ago. He didn't acknowledge that it's still going on.

The interviewer was very respectful and didn't challenge him at all.
 
He's right that psychological stress isn't good for ME/CFS, as it isn't good for many other conditions. Maybe I'm wrong, but I don't think that anyone has challenged the idea that psychological stress can be bad for ME.

The problem is this ambiguity with whether that's treated as a central perpetuating mechanism of ME or whether it's just something seen as a factor as it is in many other conditions, including physical ones. He isn't making that clear, isn't talking about evidence for what he's saying, and keeps talking about various analogies and comparisons which basically amount to truisms.

It's a bit of a dogs breakfast, which is frustrating, because although he seems like a nice and respectful guy, that all makes it hard to have a good dialogue with him.
 
Trish said:
Pariante 2:19 to 2:39
More or less repeats his arguments from the article.
Goes on and on about personalised treatment/ help with management. pacing, pushing at your limits gently etc etc. Seems to think that the NHS clinics are getting it right with their usual mix of therapists to provide this personalised help.

He argues that it's important for psychosocial approaches to be included in all research studies of Long Covid.

He also made what to me seems a very superficial statement that as far as the body and brain are concerned psychological stressors and infections have exactly the same effect on the body and brain - ie stimulating the immune system, so from that he seems to deduce that ME/CFS and Long Covid can be treated by psychosocial treatments.

The interviewer says her mother has ME/CFS and has experienced clinicians and friends saying it's all in her mind. Pariante tried to dismiss this as belief from over 50 years ago. He didn't acknowledge that it's still going on.

The interviewer was very respectful and didn't challenge him at all.
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There was an interview/story with Helland from the Norwegian Competence Center, where she said something along the lines of "Some people only hear psychosocial when we talk about the biospychosocial approach". I could have given her the benefit of the doubt that she also included healthcare workers in this, but then she went to say that we now know that illness is influenced by many factors, and we must treat it holistically or something similar. IE, the healthcare workers know what this means, but patients misunderstand.

Sorry, no. Some healthcare workers really do believe it's psychosocial, supported by the type of statements such as the one above.
 
petrichor said:
He's right that psychological stress isn't good for ME/CFS, as it isn't good for many other conditions. Maybe I'm wrong, but I don't think that anyone has challenged the idea that psychological stress can be bad for ME.

The problem is this ambiguity with whether that's treated as a central perpetuating mechanism of ME or whether it's just something seen as a factor as it is in many other conditions, including physical ones. He isn't making that clear, isn't talking about evidence for what he's saying, and keeps talking about various analogies and comparisons which basically amount to truisms.

It's a bit of a dogs breakfast, which is frustrating, because although he seems like a nice and respectful guy, that all makes it hard to have a good dialogue with him.
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I have never found psychological stress bad for my ME. I have had nights when I could not sleep for worry, but that is universal with extreme stress even if you don't have ME.

My symptoms depend on how much I do whether life is good or bad.
 
InitialConditions said:
I don't think we learned much. As I said to David Tuller yesterday—and others may disagree, but this is my personal opinion—I think there's enough biomedicine and biology in Pariante's work for it to be taken seriously. Any work on brain inflammation and central fatigue may prove important to ME/CFS, even if to just a subset of patients. I certainly don't lump him in with the likes of Chalder and Crawley, who are not serious scientists.
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He seems to straddle both. But he needs to pick a horse and soon because everyone still clinging to the wrong horse will find themselves to be entirely irrelevant before they get a chance to get back in the barn.

Association with the ME-BPS world is the same as being associated to HIV deniers in the AIDS world. It's as clear as it gets. That stink won't come off.
 
Trish said:
The interviewer says her mother has ME/CFS and has experienced clinicians and friends saying it's all in her mind. Pariante tried to dismiss this as belief from over 50 years ago. He didn't acknowledge that it's still going on.
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And that disqualifies him as a serious person. Being unable to acknowledge reality always should be.
 
When Pariante says (2:22 in the BBC interview) that it is the same effect on the body, whether you suffer grief or a virus, that is a misleading exaggeration.

I've had experiences with grief (divorce because I was ill, death of parents) and it never put me in bed (I have primarily fibro). I experienced pain, but it was the emotional pain specific to grieving, and ultimately of limited duration. I knew my body to be in good condition during those times.
 
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InitialConditions said:
I don't think we learned much. As I said to David Tuller yesterday—and others may disagree, but this is my personal opinion—I think there's enough biomedicine and biology in Pariante's work for it to be taken seriously. Any work on brain inflammation and central fatigue may prove important to ME/CFS, even if to just a subset of patients. I certainly don't lump him in with the likes of Chalder and Crawley, who are not serious scientists.
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but he (Pariante) is very tight with SW and a lot of his work is on depression. All of the bPS group are just dying for something that 'proves' the correlation between ME and depression.
 
Sly Saint said:
but he (Pariante) is very tight with SW and a lot of his work is on depression. All of the bPS group are just dying for something that 'proves' the correlation between ME and depression.
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I think they'd have found that correlation by now if it existed. Pariante's talk at the 2018 CMRC conference included reference to the finding of low cortisol levels in ME/CFS patients and he then compared it with high cortisol found in depressed patients.
 
Tbh the fact that he is reduced to fighting a rearguard action so blatant and pathetic is a sign that we’re making progress. They’ve fallen back very far from their original position in the 1990s (there is no disease, CBT/GET is curative) to now saying that CBT is somewhat helpful as an adjunct treatment whose mechanism action is placebo.
 
Trish said:
psychological stressors and infections have exactly the same effect on the body and brain - ie stimulating the immune system
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Well, that would be drivel - pure psychobabble. Pariente has done some meaningful biological studies but he seems to have no idea in terms of overall theoretical framework. Personalised treatment is bullshit, as we know. I have n'tween the presentation but it is no good being half a scientist.
 
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