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

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.

The drawback seems to be cost effective often simply means coming out of a different budget or cost centre rather than actual value for money.

Denial of social care and housing for example might result in keeping the budget for that down or arguing that you are being efficient by not letting numbers creep up.

Relatively small amounts of money on a talking therapy, even if it achieves naff all, and you can claim to be "investing" money in healthcare.

Although giving people the support that's needed might actually cost less in the long term.
 
Jo, I have to say these are really rather extreme examples!

I am sure these are not unusual. Meddling with people's ideas about their motives seems to me inexcusable. People regularly get told that their problems are due to early family life. That can very easily destroy the family.

I grew up in a circle of North London left wing intellectuals that included some very famous names in psychotherapy and psychoanalysis. In later years my parents realised just how mad their friends had been. Our own family had a brief experience of 'family therapy' and all of us realised just how manipulative and self-serving the psychotherapist's approach was. We had the sense to terminate after one or two sessions.

Psychotherapy is potentially really nasty stuff. There was an interesting play a few years back going in to why Freud originally proposed all the stuff about repressed childhood experiences. It did not reflect well on Freud himself. The suggestion was that the whole theoretical construct arose as a side effect of abusive behaviour in the history of the Freud family - but nothing repressed, just straight misery from abuse. I didn't know whether or not to take it seriously but it rang true.
 
omg.



Cue flashbacks to absolutely the worst sessions I've ever had! I had no idea. And neither do they, it seems. :rolleyes:

Brilliant -- I'm probably being inappropriate but the comment re the unnecessary surgical experience was hilarious --- I think he'd make a good straight man/stooge --- someone tell him he's wasted in medicine --- after Newsnight he should contact Alan Bennett
 
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 has a fleeting feeling that the presenter (Deborah Cohen) may have used that "trick" lawyers are supposed to use - when the other side are making your case for you, just shut up and let them - in this case Paul Garner. I think @Jonathan Edwards may have suggested that medical professionals are not taken in by this stuff (unless it's useful).

The two female Doctors may actually have been much more of a challenge - they talked about helping patients and research showing promising results. Problem is we an be fairly sure that "fatigue scores" are the old baseless subjective outcome measures (questionnaires).
 
When I asked him on Twitter when he had changed his mind about the Exercise review being "shite", he blocked me rather than answer the question. Maybe I should have asked him privately if I really wanted to know...
:jawdrop:

What a very scientific way to deal with this! First I was on the fence about his story with long covid, and tried to see him as someone misguided by his own experience and projecting it on others, like so many people tend to do, but this attitude with the blocking is hard to explain...
 
I has a fleeting feeling that the presenter (Deborah Cohen) may have used that "trick" lawyers are supposed to use - when the other side are making your case for you, just shut up and let them - in this case Paul Garner. I think @Jonathan Edwards may have suggested that medical professionals are not taken in by this stuff (unless it's useful).

The two female Doctors may actually have been much more of a challenge - they talked about helping patients and research showing promising results. Problem is we an be fairly sure that "fatigue scores" are the old baseless subjective outcome measures (questionnaires).

Well, one would like to make excuses and believe this was intended to be a friendly treatment but not at the cost of ignoring reality IMHO the impact of the entire report did include the controversy but its geshtalt impact was pro GET and the entire thing was derailed by dropping the vax/antivax bomb into a playground full of children which was very emotive, a complete non sequitur and IMHO very irresponsible. With friends like this we dont need enemies. They basically used ME/longcovid as a bogey man to push vax but did not give ME a fair treatment in relation to longcovid.

Longcovid has not been around long enough to say who among those afflicted has a truely chronic, unrelenting condition. IMHO most, like Garner, probably dont and good luck to them, I dont want anyone else to have this disease if they can avoid it. Those who have it need to be treated appropriately.

I feel the emphasis on ME was very askew. The most important thing missing from the detail as far as I am concerned was that PWME are a minority subset of all people with infection difficulties and likewise the number of people with longcovid who also have ME/CFS is probably a minority. The rest, probably a majority, probably recover normally albeit slowly and at some point these people probably can benefit from exercise. The problem is we must not get these people mixed up with people who have ME/CFS. We dont have a basis for telling them apart or for telling all longcovid patients who are trying to recover not to exercise, we should however warn that a minority may have a chronic condition for which GET would be counterproductive, so they are believed and supported, not driven to continue harming themselves with GET.

The treatment portrayed the ME community representative (Dr Charles Shepherd) as assuming that all people with longcovid have a chronic ME/CFS like condition which I doubt was his intent, his 15 mins was clearly hacked down to a couple of mins by the editor and context lost in the process no doubt.

We have yet to do the science to establish who has longcovid, how many for how long and how many among them have an ME/CFS syndrome. We have not even characterised ME CFS yet sufficiently to detect it with a test but that is what we need to distinguish who should do GET and who should not.

I agree medical professionals in the know will read between the lines and probably already know about the contention but your average licence fee payer without prior experience or biological education will take away the idea that clinicians think GET is best and vax your kid or they might get leprosy ME/CFS.
 
I has a fleeting feeling that the presenter (Deborah Cohen) may have used that "trick" lawyers are supposed to use - when the other side are making your case for you, just shut up and let them - in this case Paul Garner. I think @Jonathan Edwards may have suggested that medical professionals are not taken in by this stuff (unless it's useful).

The two female Doctors may actually have been much more of a challenge - they talked about helping patients and research showing promising results. Problem is we an be fairly sure that "fatigue scores" are the old baseless subjective outcome measures (questionnaires).
Is it just me, or does Deb Cohen remind anyone else of Philomena Cunk?
 
Psychotherapy is more than just harmless buffoonery. It is harmful for people with actual brain diseases like mood disorders (not talking about the worried well who just need someone supportive to chat with) and should be regulated. Imagine having a biological problem in the brain and someone is telling you it's caused by your family relationships. It's also a financial burden, especially the non-CBT psychodynamic approaches where therapy can go on for YEARS. Some people have wasted so much money on these scammers that they could have used to buy another house their kids would inherit instead of lining the pockets of scammers. At the very least, their research and efficacy claims should be held to the same standard by regulatory agencies as somatic treatments.
 
Well, one would like to make excuses and believe this was intended to be a friendly treatment but not at the cost of ignoring reality IMHO the impact of the entire report did include the controversy but its geshtalt impact was pro GET and the entire thing was derailed by dropping the vax/antivax bomb into a playground full of children which was very emotive, a complete non sequitur and IMHO very irresponsible. With friends like this we dont need enemies. They basically used ME/longcovid as a bogey man to push vax but did not give ME a fair treatment in relation to longcovid.

Longcovid has not been around long enough to say who among those afflicted has a truely chronic, unrelenting condition. IMHO most, like Garner, probably dont and good luck to them, I dont want anyone else to have this disease if they can avoid it. Those who have it need to be treated appropriately.

I feel the emphasis on ME was very askew. The most important thing missing from the detail as far as I am concerned was that PWME are a minority subset of all people with infection difficulties and likewise the number of people with longcovid who also have ME/CFS is probably a minority. The rest, probably a majority, probably recover normally albeit slowly and at some point these people probably can benefit from exercise. The problem is we must not get these people mixed up with people who have ME/CFS. We dont have a basis for telling them apart or for telling all longcovid patients who are trying to recover not to exercise, we should however warn that a minority may have a chronic condition for which GET would be counterproductive, so they are believed and supported, not driven to continue harming themselves with GET.

The treatment portrayed the ME community representative (Dr Charles Shepherd) as assuming that all people with longcovid have a chronic ME/CFS like condition which I doubt was his intent, his 15 mins was clearly hacked down to a couple of mins by the editor and context lost in the process no doubt.

We have yet to do the science to establish who has longcovid, how many for how long and how many among them have an ME/CFS syndrome. We have not even characterised ME CFS yet sufficiently to detect it with a test but that is what we need to distinguish who should do GET and who should not.

I agree medical professionals in the know will read between the lines and probably already know about the contention but your average licence fee payer without prior experience or biological education will take away the idea that clinicians think GET is best and vax your kid or they might get leprosy ME/CFS.

Entirely reasonable --- specifically I think you're correct i.e. the average licence payer/viewer will not have realised that Paul Garner was talking s--t. Yea the issue of vaccinating children was a strange one to link - surely the issue is whether it helps to end the pandemic --- keep people safe (including the children themselves).
Long covid may be many illnesses and one might be the same as the illness some people with ME/CFS have. Why try to read across unless you've got to a point where nothing else explains a specific case of Long covid - in that instance it looks like ME/CFS.

Rushed response.
 
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.

Yip from memory Jaime Seltzer said that "these approaches (BPS) don't work so why waste money on them"?
 
He appears to have changed his mind after his life-altering phonecall with a certain Norwegian Lightning Process coach:

Should look at this; started to scan:
"synthesise evidence" - looks like a pretty accurate summary!

"YOU ARE A COORDINATING EDITOR OF THE COCHRANE REVIEWS THAT COLLECT EVIDENCE TO INFORM HEALTHCARE DECISIONS, DID YOU FIND ANYTHING USEFUL THERE?" to misquote @Caroline Struthers "no, they were all shite"

https://www.gavi.org/vaccineswork/being-hit-cricket-bat-doctors-battle-long-covid
 
Moved post

There's a new paywalled editorial by Hanne Kjöller in DN today (Sweden's largest morning paper), about Paul Garner and Minna Johansson's BMJ blog articles.

Det går att respektera lidande som inte kan förklaras medicinskt
https://www.dn.se/ledare/hanne-kjol...ra-lidande-som-inte-kan-forklaras-medicinskt/
Google Translate said:
A lot of resources have been invested in looking for biomedical explanatory models for suffering that could not be medically explained. Imagine if the doctors instead were to ask themselves what makes patients more or less ill. [...]

The narrative about postcovid includes the successful person who loves his job, exercises and is healthy. The successful physician and professor of tropical medicine, Paul Garner, was a perfect fit. Three months after his infection last spring, he suffered severely from shortness of breath, fog, strange skin phenomena, fatigue and arrhythmias.

On social media and in my email box, there are several who referred to Paul Garner as "proof" that the disease is strictly medical. It is based on some strange assumptions: that doctors - unlike "ordinary people" - have a body that functions separately from all the factors that affect the rest of us (such as stress, anxiety, fear, sadness). So some people are either body (doctor/researcher) or soul (hysterics/imagination). Not - like all of us - both.

Furthermore, the assumption is based on the fact that the morbidity that is now spreading looks the same for everyone. Since Paul Garner obviously had several objectively verifiable symptoms (such as arrhythmia), the conclusion is that this is a physical illness. To 100 percent.

Today, no one in postcovid groups refers to Paul Garner. In the blog version of the scientific journal BMJ, he tells how he, with the help of a Norwegian psychologist, who recovered from ME themself, learned that our unconscious defense against injury and infection sometimes sets off false alarms. That a malicious cycle, with autonomous responses (not regulated by will, such as pulse and blood pressure), is triggered. And that tracks in the brain are drawn like tire marks in clay. Garner learned to redraw these tracks. He stopped scanning his symptoms and reading stories about others as well as interacting in patient groups on Facebook. Now he's healthy. Which, of course, made the video an overnight sensation.

 
Moved post.

Oh for goodness sake. Does anyone really believe that someone who has recovered from post viral symptoms is evidence of some sort of miracle mind over matter cure?

Haven't they heard that lots of people with physical symptoms post virally get better in a few months? Or that people with all sorts of physical illnessess get better without magical thinking.

The whole story is looking more and more idiotic.
 
Moved post

There's a new paywalled editorial by Hanne Kjöller in DN today (Sweden's largest morning paper), about Paul Garner and Minna Johansson's BMJ blog articles.

Det går att respektera lidande som inte kan förklaras medicinskt
https://www.dn.se/ledare/hanne-kjol...ra-lidande-som-inte-kan-forklaras-medicinskt/
Sten Helmfrid has commented on the article (behind the paywall).
Google Translate said:
Of course, it was only a matter of time before Hanne Kjöller would bring up the story of Professor Paul Garner, who to great fanfare recovered from postcovid after a few months of illness.

Previous studies of post-infectious fatigue syndrome show that two thirds of those who have been ill for three months and a quarter of those who have been ill for six months are no longer ill after one year.

Although there are still questions about the similarity between postcovid and other post-infectious fatigue syndromes, the existing evidence thus indicates that no willpower or special insights are needed in the body's alarm system to recover. Many patients recover without us understanding why they are getting well.

The problem with the proponents of the aforementioned false alarm theory - I assume that Kjöller and Garner are referring here to the Norwegian doctor Dr. Vegard Bruun Wyller - is that the only scientific test of the theory has turned out negative. There are also no clinical studies that show an objective improvement for patients after psychological treatment according to Wyller's model or other biopsychosocial theories.

It is unfortunate that DN lends its editorial page to the unilateral glorification of theories that lack scientific support.
 
Moved post

There's a new paywalled editorial by Hanne Kjöller in DN today (Sweden's largest morning paper), about Paul Garner and Minna Johansson's BMJ blog articles.

Det går att respektera lidande som inte kan förklaras medicinskt
https://www.dn.se/ledare/hanne-kjol...ra-lidande-som-inte-kan-forklaras-medicinskt/
It's remarkable that almost every factual detail is wrong or framed slightly incorrectly to fit the narrative. Quite expected but still remarkable.
 
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