Paul Garner on Long Covid and ME/CFS - BMJ articles and other media.

Long covid patients really don't have a clue.
Perhaps someone should provide them with a link to some of this info .

 

Psychiatry's loss was our loss! But yes, his appearance on Newsnight reminded me of @Jonathan Edwards "that will do nicely". If NICE were in any doubt, re what they were up against, then the Newsnight program certainly provided clarity.

 

The breath taking arrogance of it. Just because you've not seen, or recognised it happening yourself doesn't mean it's not a possibility.

If a therapy has a positive effect when implemented well to the right patient then given to the wrong patient and not done properly it can harm. It's either effective, or it's not and if it's effective then it's a two edged sword.

This pretension that a treatment can be both effective and harmless is an attempt by the therapist to abrogate responsibility for who they treat and how they treat them. By definition anyone with this level of disregard for the safety and well being of their patients shouldn't be permitted anywhere near patients.

It also highlights a total lack of understanding on the part of the therapist as to the true nature of the therapist - patient relationship. This is not an equal relationship. Great suffering and harm can be caused but the patient may not be in a position to tell the therapist of the harms caused. The harms may not even become apparent to the patient until long after the therapy has ended.

 

I was referred to a psychotherapist about 40 years ago. The woman I saw was intimidating. It was also clear that her inspiration was Freud and she used many of the stereotypes of a Freudian therapy session. I didn't lie on a couch, it was just a chair. But she sat there and said almost nothing in all the sessions I had with her. Eventually I realised, from the little bit she did say, that her sole purpose, as far as she was concerned, was for me to "accept responsibility" for everything that had ever happened to me. I imagine if I'd been mugged or assaulted or raped she would have tried to get me to take the blame. I eventually called a halt to this complete waste of time, and ended the sessions myself. I remember the woman was furious. I managed to escape from the therapy but actually felt worse than I did before I started.

 

Jo, I have to say these are really rather extreme examples!

I have found psychotherapy to be beneficial, but whether it's because I want to believe that or it really was, who knows? If it helped, I don't know if it was because of "therapy" or just because I met with kind, smart people who helped provide me with some insight into why I was doing this or that. .

 

I have experienced both good and bad psychotherapy. Good was MIND charity at the drop in center where I was volunteering. Bad was a new age astrology counsellor and aura manipulator! Well, you get kind of desperate enough to try anything when you are ill and undiagnosed for years on end.

ME counselling from Westcare was closer to the good end of the spectrum but I was very resistant to the idea of pacing at first, as others have said but I can now see it makes sense and does help. It took a decade of convalescence to recover from the mess I got into after a decade undiagnosed and the advice I received helped.

When I reflect on Garner's early involvement with psychotherapy it changes my perspective on why we needed to challenge Cochrane and this latest episode, as it indicates he was quite invested in psychology from the outset. It strikes me that when longcovid came along he had an interest in identifying as an ME patient and then becoming an example of the virtues of psychological therapy.

To be honest I think he must have had longcovid lite, not ME and yet wanted to frame the experience as recovery from ME by psychological treatment because he was already invested in that perspective and possibly was trying to oppose the justified challenge to Cochrane. So I think I do now view him as a BPS proponent.

I think there will be lots of people with short term longcovid, if that makes sense, who will recover but I dont think they will need to try LP / NLP to do it, just listen to their bodies and return to normal levels of activity gently as they feel able.

With this BBC thing I think we missed a trick and the BPS cabal spoon fed the BBC producers more than the ME lobby and the BBC producers swallowed their line. We are not professional media tamperers so I dont think we should blame ourselves but it does suggest we ought to consider something along the lines of outreach to media to provide contact with those researchers who we trust who are willing to talk about their work.

 

I'm sure there are some very good therapists who do help people. The issue I take with the whole field is the lack of any oversight or accountability.

When it comes to mental health it seems that any worsening on the part of the patient is automatically down to the patient being non compliant or a worsening of their condition despite best efforts of the mental health professional. There's very little by way of checks to see if the therapy itself or how it was delivered might have been responsible or at least played a part.

We're all familiar by now with the scandal of using mesh implants in surgical procedures & how hard patients had to fight even where there was physical evidence. With mental health treatment there is no physical evidence & any complaints or claims of harm done will often be seen as a manifestation of the underlying condition. Many of these patients are very vulnerable.

I'm afraid I've also known people who have been harmed by therapy.

Having worked with some big corporates I have also seen the provision of therapy in the workplace. I have seen it used as a get out clause where the employer tries to bully an employee and undermine their contractual rights and when they complain they are offered referral. As an industry it readily lends itself to all sorts of unsavoury tactics.

 

I'm willing to bet that the scientific trials that purport to show benefit from psychotherapy are as poor quality as those on CBT and GET in ME/CFS. Given his views on psychotherapy, perhaps it's not surprising Garner claims to be impressed by Cochrane's GET review.

Some time ago Coyne wrote an interesting post about a meta-analysis which showed that long term psychotherapy was no better than placebo. Maybe this is it.

 

Garner wrote to me in July saying that he thought the GET review was "shite"




Then he said this

 

He appears to have changed his mind after his life-altering phonecall with a certain Norwegian Lightning Process coach:

 

True.

He's also free to publicly state he's changed his mind and why if that were tye case though. He certainly can't claim he hasn't had the opportunity.

I would have nothing for respect for someone who, having publicly espoused on therapy or hypothesis, then publicly stated they'd changed their views as they gained new experience & insight or science moved forward. Interestingly the BPS cabal never do this - at best they are "misunderstood".

Science is change, it should be a progression and, unless one is working in a very slow changing field, people's understanding should change. That's not a weakness, it's a strength.

Provided you haven't pinned your entire career on a B(P)S hypothesis and can't backtrack because of self interest & political reasons.

 

Say, the more context is added to Garner's bizarre tales and the less they add up to something legitimate. Too many odd twists. I'm sure he had symptoms for a short period of time but other than that all the details are massively suspicious or just plain bizarre.

No wonder he fit well with the RecoveryNorway cult. Peas in a pod.

 

https://www.lstmed.ac.uk/about/people/professor-paul-garner

"
Research Grants (current)
GBP 7 million. Garner P, Waugh P, Young T. Research, Evidence and Development Initiative (READ-It), UK AID, 2018-2024. Project number 300342-104 "

https://www.evidence4health.org/

"
Norwegian satellite
The Norwegian Satellite of Cochrane Effective Practice and Organisation of Care (EPOC) was established in November 2006 to support the production of Cochrane reviews by authors in low- and middle-income countries (LMIC) that address health systems questions relevant to LMIC.

We are based in the Norwegian Institute of Public Health in Oslo, Norway.

With thanks to our funders Norad (the Norwegian Agency for Development Cooperation) and the Norwegian Institute of Public Health."
https://epoc.cochrane.org/norwegian-satellite


https://www.fhi.no/en/about/departm...ealth-technology-assessments/lillebeth-larun/

 

IMO both are fair statements. Psychotherapy is the wild west. And it's not just the therapy that can harm but the therapist may do harm as has been documented time and again when a therapist crosses the line taking advantage of a person when they are at their most vulnerable.

Psychotherapy I think is quite common (I'm guessing here) and there are all kinds of therapists out there. It just seems common sense to me that some number of them will not be overly competent while a few are extremely good.

I think also that sometimes people may find themselves in therapy when they have problems that require some other means of solving, social assistance etc that may alleviate some of their burden. I expect therapists probably are unlikely to send people away saying they can't help either even when that becomes obvious.

I also think that if we want to get to the centre of arguing against BPS therapies for everything we need to make an accounting of why they are NOT 'cost-effective'. As that seems to be all that really matters to anyone with the power to do anything.