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Preprint: The Rise And Fall Of The Wessely School, 2021, Marks

Discussion in 'PsychoSocial ME/CFS News' started by Andy, Jun 10, 2021.

  1. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Abstract

    The Wessely School’s (WS) approach to medically unexplained symptoms, myalgic encephalomyelitis and chronic fatigue syndrome (MUS/MECFS) is critically reviewed using scientific criteria. Based on the ‘Biopsychosocial Model’, the WS proposes that patients’ dysfunctional beliefs, deconditioning and attentional biases cause illness, disrupt therapies, and lead to preventable deaths. The evidence reviewed here suggests that none of the WS hypotheses is empirically supported. The lack of robust supportive evidence, fallacious causal assumptions, inappropriate and harmful therapies, broken scientific principles, repeated methodological flaws and unwillingness to share data all give the appearance of cargo cult science. The WS approach needs to be replaced by an evidence-based, biologically-grounded, scientific approach to MUS/MECFS.

    https://psyarxiv.com/jpzaw/

    Blog post from David Marks repeating the abstract, https://davidfmarks.com/2021/06/10/the-rise-and-fall-of-the-wessely-school/
     
  2. Trish

    Trish Moderator Staff Member

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  3. Trish

    Trish Moderator Staff Member

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    I've started reading this document. It's over 100 pages.

    This bit on page 15 could do with some corrections:

    Can someone tell David Marks about S4ME and tell him MERUK and MEPedia are not patient forums. And OMF is not the only research organisation. If he is going to list ME organisations he needs to be better informed.
     
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  4. Andy

    Andy Committee Member (& Outreach when energy allows)

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    Well he follows the S4ME account on Twitter, so he must have some awareness of us.

    I can't see any way to comment on the preprint itself, but comments are possible on the blog, and he's obviously on Twitter.

     
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  5. Hutan

    Hutan Moderator Staff Member

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    Actually Ron Davis is chair of OMF's Scientific Advisory Board, which is different to chairing OMF.
    wholistic > holistic

    Some particularly nice bits (I'm not very far into it yet)
    Interesting use of the 'Wessely School' - perhaps that is a good term to use as we consider his legacy.
     
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  6. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    It's been in use for a while
    https://me-pedia.org/wiki/Wessely_school

    (Joan Crawford [psychologist] often refers to it)
     
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  7. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    I think he is a member (although he hasn't posted)
    @DFM
     
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  8. chrisb

    chrisb Senior Member (Voting Rights)

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    I find it interesting that David Marks appears not to have found reference in the works of the WS, Waddell and Aylward to Arthur Cott and his Behavioural Medicine Unit at St Josephs Hospital, Hamilton, in association with McMaster. I was beginning to think I had just not looked hard enough.
     
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  9. Hutan

    Hutan Moderator Staff Member

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    I should add that I appreciate David Marks' contribution to the challenging of PACE and MUS in general. And his effort in putting this document together - I am sure it will make a difference.

    Although this sentence about the prevalence of MUS is true (ie one source does give that estimate), I think it's a shame to let that idea of MUS illnesses really accounting for so much primary care resources stand without some skepticism being expressed.

    There is inadequate evidence for the twin peaks idea.

    Hmm, it is technically true that multiple researchers have demonstrated marked biological changes in immune and endocrine systems. the problem is, each researcher seems to have demonstrated a different biological change. I don't think we have enough evidence on the immune and endocrine fronts say that 'marked biological changes' of the immune and endocrine sort have been reliably identified.


    . I find this a bit odd, a description of PEM that is very likely to have people mis-understanding the severity of the illness.
     
    Last edited: Jun 10, 2021
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  10. Keela Too

    Keela Too Senior Member (Voting Rights)

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    That’s quite some read!
     
  11. chrisb

    chrisb Senior Member (Voting Rights)

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    I don't think it can be right that Aylward introduced Wessely to BPS thoughts. The two letters in the National Archives from, from memory, 1992 and 1993 do not suggest that sort of relationship at that time. Meanwhile the 1989 paper on CBT abd GET suggests other sources. There was already a well established school recommending these methods.
     
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  12. Hutan

    Hutan Moderator Staff Member

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    The International Consensus Criteria?
    I think Chapter 2, which describes MUS and ME/CFS could use some editing. It gets tangled up in whether ME and CFS are different, and the details of the criteria. I don't think a lot of the information is really needed to address the topic indicated in the title - I think it will result in readers without knowledge of ME/CFS being confused, (edit) and many people with knowledge of ME/CFS wondering what basis there is for suggesting ME and CFS are different.

    I'm done for the day, but am looking forward to reading chapter 3, The Wesselyan Psychosomatic Theory, tomorrow.
     
    Last edited: Jun 10, 2021
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  13. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    I am looking forward to reading the article in full, but wonder if there is a danger in using phrases like the ‘Wessely School’ as it suggested a stronger coherence of thought amongst the BPS advocates than actually exists.

    Are we in danger of doing what the members of the Wessely School regularly resort to, setting up a straw man argument to knock down? Obviously challenging the Wessely belief system is necessary, but may not be sufficient to successfully challenge the BPS approach to ME. I have great respect for the scholarship of those here tracing the roots and development of the theories underpinning the BPS approach, but I suspect what ties it together is not an adherence to any specific theoretical model, but rather an blind adherence to CBT and exercise, with a readiness to disbelieve/disrespect their patients/client group.

    Taking out the core Wessely ‘beliefs’ is important, but this alone will not stop them, as illustrated by their response to the draft NICE guidelines, seeking to hang onto CBT and exercise under different guises.
     
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  14. JohnTheJack

    JohnTheJack Moderator Staff Member

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    Someone who helped him has already mentioned this.
     
  15. chrisb

    chrisb Senior Member (Voting Rights)

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    I tend to agree but I think the "Wessely school" has been used for a long time. Was it initiated by Margaret Williams?

    I prefer "Maudsley/Oxford schools", at least until we get to the bottom of how they came to be developing the same ideas at the same time. Both seem to be developments of the "McMaster" (can I call it that or should it be "McP(h)erson"?) School, which dealt more generally with MUS rather than CFS.
     
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  16. rvallee

    rvallee Senior Member (Voting Rights)

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    Maybe alongside his Spiked editorial labeling most 9/11 illness as mass hysteria or the government's apology over his mishandling of the Camelford poisoning also as mass hysteria.

    He never owned up to any of it, hasn't stopped repeating the same failures. The psychiatrist who called mass hysteria, and people just keep listening to it every damn time, broken clock and all.
     
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  17. DFM

    DFM New Member

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    Thank you everybody who has commented on 'THE RISE AND FALL OF THE WESSELY SCHOOL'. The tendency to nitpick is always helpful but substantive comments are also most welcome.
     
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  18. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    They are experts in a treatment. A treatment in need of an ailment to cure. Sadly, ME/CFS is not that ailment and, unfortunately, it doesn't look like the treatment does all that much for anything else. Except cause harm - that's what it does most effectively.

    Criticisms of that treatment must be shot down, the critics smeared and gaslighted because these guys have staked their careers on this treatment, not on ME. They are not disease experts, if they were then they would have recorded harms and be interested in hearing what patients who have been harmed have to say, rather than trying to silence them.

    Anything else, such as allegience to BPS and philosophies that have gone before, are just to borrow the illusion of authority for the treatment they designed that doesn't work.
     
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  19. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    Looking forward to reading this essay -- alongside the blog articles by Healthcare Hubris (link posted on the forum here) that seem to cover a bit of a similar topic from another angle. (?)

    It would be much easier for me to read if it had a table of content, though, even if without page numbers.

    @DFM, I wonder if it's possible to add a table of content to the preprint or here on the thread?

    (Once again, apologies for just popping in.)
     
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  20. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    The actual text is around 63 pages, the rest are references and tables referred to.

    I note also that quite early on there is a link to Unrest on Youtube;
    I think this is an unauthorised upload of the film (the subtitles are in spanish) so am not sure of the potential copyright issues.
     
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