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

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.

 

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.

 

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

 

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...

 

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...

 

He's taking debating tips from Trish Greenhalgh then?

 

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.

 

Is it just me, or does Deb Cohen remind anyone else of Philomena Cunk?

https://www.youtube.com/watch?v=MUM89s4N2BQ

 

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.

 

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.

 

I don't think he is interested in dialogue anymore with anyone other than his new BPS friends.

 

Yip from memory Jaime Seltzer said that "these approaches (BPS) don't work so why waste money on them"?

 

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/

 

Sten Helmfrid has commented on the article (behind the paywall).

 

It's remarkable that almost every factual detail is wrong or framed slightly incorrectly to fit the narrative. Quite expected but still remarkable.