Interesting:
Salvatore Mattera, 21/12/2025:
"There's this thing called the "Born Free" protocol for Long COVID and ME. If you tried it and it made you feel better, great. But I find it quite problematic and possibly dangerous.
It's so long I can't do a full critique, but there's one part that stands out to me and sets off immediate alarm bells: His protocol has a section called "'Anxiety', isolation, and phobia" which is functionally similar to typical brain retraining programs.
He performatively attacks CBT and GET in an attempt to buy trust: "I anticipate there is a special place in hell reserved for clinicians who negligently misdiagnose ME/CFS patients with a purely psychological disease..." But in reality, he advocates for CBT and GET - he just doesn't call them that.
CBT becomes: "Daily Mantras," "Perceptual Recalibration," "Replacing Unhelpful Thoughts"
GET becomes: "Graded Stressor Exposure" and "Pacing" (but not real pacing - intentionally increasing activity)
Giving it a different name might fool some people, but it doesn't magically make it different.
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The text repeatedly acknowledges biological reality ("symptoms are NOT imagined - they're real, measurable") but immediately follows with:
"HOWEVER, HOW your nervous system INTERPRETS and AMPLIFIES those symptoms can change the entire trajectory of the illness."
"It's NOT 'in your head', it's 'through your nervous system'"
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This is sophisticated gaslighting. It says: "Yes, your biology is broken, but the REAL problem is your threat-detection system overreacting to your broken biology."
"The symptoms that we worry about the most may persist the longest. We give energy and life to things by paying attention to them."
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This is The Secret-style magical thinking. It suggests symptom monitoring itself perpetuates illness - which could lead patients to ignore PEM warning signs and cause permanent harm.
The Motorcycle Analogy: "If you look at the tree, you hit the tree" -- implying if you focus on symptoms, you cause symptoms.
For people with ME, "looking at the tree" (monitoring symptoms) is a survival mechanism to avoid crashes. Reframing this as "OCD-like" or neurotic is victim-blaming patients for being cautious about a disease that punishes exertion.
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The middle section throws together hyper-specific mechanisms (NLRP3 inflammasomes, P2X7, extracellular ATP, AgRP neurons) to intimidate readers into accepting a weak premise.
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Notice the logical gap:
Claimed mechanism: Stress → inflammation → symptoms
Proposed interventions: Mantras, exposure therapy, "trusting your body"
Where's the mechanism connecting positive thinking to inflammasome regulation? It's not there.
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To be clear, PEM is NOT caused by fear of exertion. An athlete with ME who loves exercise and has zero fear will still crash if they exceed their energy envelope. The disease mechanism doesn't care about mindset.
Encouraging patients to ignore symptoms and "trust their body" while increasing activity is dangerous advice that can cause lasting harm.
"People with strong ADHD and/or OCD-like traits are expected to have a more difficult time with this, as the subconscious hyper-focus and pattern-recognition traits can easily be fixated on the symptoms"
This pathologizes careful symptom tracking as neurotic behavior. But for ME, tracking symptoms is the medical intervention - it's how you pace, identify triggers, and avoid crashes.
I don't know about the rest of the protocol. If the vitamins work or what the deal is. But this section alone completely destroys my trust and makes me highly suspicious of everything else."
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helpforlongcovid.com
