Healthcare Hubris - blogs on the biopsychosocial model by Joanne Hunt

This prompted me to conduct an unscientific Twitter survey:

 

The results are in. At least 2 people said they clicked “decreased them” accidentally.

https://twitter.com/user/status/1640521636561448961

 

The importance of some pacing is even recognised in, for example, the PACE Trial manuals for CBT and GET. The denial of supports (payments, disability aids, disability accommodations, etc.) that is recommended by leading BPS proponents actually makes careful pacing and energy management (even combined with graded activity/exercise) impossible or almost impossible for many if not most patients. Their views basically get in the way of patients’ health.

 

I thought this made some good points. I think the points about the Science Media Centre could have been strengthened by linking to their often very biased press briefings particularly older ones (e.g. IIRC the one for the PACE Trial in the Lancet was very uncritical).

 

Nudge theory in action.

It’s behavioural ‘psychology’ (the psychology being that of the person doing it as it’s basically using reward and punishment to control and ‘condition’ others)

of course all the policies as such were part of that ‘close down options for any other behaviours such as pacing’

which is why the death rate for ME or anyone who ever had a similar label should always be being tracked for something others like to claim ‘doesn’t kill’ but certainly can be made impossible to live with and that vicious cycle of them being further punished for being injured by harm done them by others etc.

 

For what it's worth, this is a post I've written about this in case of interest to anyone who mightn't have read it yet:

https://listserv.nodak.edu/cgi-bin/wa.exe?A2=CO-CURE;bfa29c62.2304C&S=
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[The author has a number of peer-reviewed publications on this and related topics]

Media silence on the politics driving 'one of the biggest medical scandals of the 21st century' by Joanne Hunt https://www.healthcarehubris.com/po...-biggest-medical-scandals-of-the-21st-century

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Tom comments: There are a few slightly "difficult" words in this but I think it should be understandable for people who, say, finished high school/secondary education or equivalent. My impression was it gets a bit easier to read as it goes along

https://www.healthcarehubris.com/po...-biggest-medical-scandals-of-the-21st-century

To give an idea of what are the practical implications of the philosophies of the people being complained about read, for example, "A Selection of points the Barts CF Service made during the NICE Guidelines for CFS / ME" and all the supports Peter White's service wanted to deny patients <https://web.archive.org/web/2021081...g-the-nice-guidelines-for-cfs-me-tom-kindlon/ >

Another example is how people with connections to the disability insurance industry such as Peter White often recommend that patients not be given disability payments.

Peter White has also done work for the Department of Work and Pensions which could influence state benefits. Discussed here: "How payments from insurance companies might potentially bias proponents of CBT and/or GET for ME/CFS (such as the PACE Trial investigators)" <https://www.s4me.info/threads/how-p...fs-such-as-the-pace-trial-investigators.8066/>

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Some extracts:

"The ever-growing elephant residing in newsrooms across the country (arguably, across much of the globe) is that the neglect of conditions such as ME/CFS – and increasingly long Covid - can be traced back to the interests of academic-clinicians (largely, UK psychiatrists), together with their associates in the income protection insurance industry and government, all of whom claim to work in the best interests of disabled people. Here, ‘best interests’ transpire to be depriving disabled people of a financial safety net through taking away state support, denying them basic social accommodations and appropriate biomedical care, whilst forcing them to undertake harmful psychosocial ‘rehabilitative’ healthcare interventions and exposing them to psycho-coercion masquerading as welfare-to-work policies."

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"In other words, by re-positioning a medical condition as ‘psychosocial’ (allegedly caused by a person’s maladaptive psychology, and therefore amenable to psychosocial ‘healthcare’), eligibility to long-term benefits and private income protection is precluded, and the state saves on medical care."

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"Whilst these agendas potentially impact all chronic illness, the target has historically been conditions that are clinically ‘contested’, since (oft politically induced) uncertainty creates a space where iniquitous political agendas are allowed to take centre stage. ME/CFS is perhaps the best example of this, a blueprint for the systematic social and epistemic marginalization of many other chronically ill and disabled patient groups under increasing austerity."

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"the PACE trial sought to prove that the researchers’ favoured interventions - cognitive behavioural therapy (CBT) and graded exercise therapy (GET) - were effective in ‘treating’ ME/CFS. ‘Sought to prove’ seems a fair representation; beyond numerous design problematics and the clear political agenda (get people off benefits, preclude income protection pay-outs and push people back into work), methodological jiggery pokery ensued when it became clear that the results were not going to meet researchers’ expectations."

 

• Joanne Hunt
• 3 days ago

Who is lobbying whom? Addendum: An eminent abuse of power
https://www.healthcarehubris.com/post/who-is-lobbying-whom-addendum