Three part article on cognitive therapies, mindfulness, Garner etc., 2025, Long Covid Advocacy Substack article

Trish said:
Part 2:

Behind the Biological Veneer: A Closer Look at the BMJ, SIRPA and Garner’s Framing of Chronic Illness
The Weaponisation of Cognitive Therapies in Mind-Body Medicine

LONG COVID ADVOCACY
MAY 22, 2025
1
TL;DR


So far in Part One, we have explored mindfulness and meditation and the sociological, philosophic and pragmatic issues that arise with their unquestioning acceptance.

This article explores how cognitive therapies contribute to a dangerous medical paradigm for chronic illness. We shall focus on Paul, ‘he’s not the messiah, he’s a very naughty boy’, Garner’s opinion piece for the BMJ and his appearance at the SIRPA conference.

We examine the historical, rhetorical, and systemic forces behind mind-body medicine and how they obscure harm through compassion-washing, concept laundering, and misplaced optimism.

When chronically ill, one is presented, with a whole smorgasbord of cognitive therapies that promise to help and offer hope. This can include traditional CBT and mindfulness-based stress reduction; “third wave” therapies like ACT (Acceptance and Commitment Therapy) and MBCT (Mindfulness-Based Cognitive Therapy); brain retraining programmes; six-week digital recovery courses; yoga-for-trauma classes; “Your COVID Recovery” platforms; self-help books; and the ever-expanding catalogue of mind-body medicine. It’s a psycho-industrial complex.

Buckle your seat belts, this should be quite the ride…

More at link.
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That was pretty good. I can't understand how anyone can't see how this is exactly as wrong and disturbing as whatever RFK Jr has been selling his whole life, but this is just how powerful peer and cultural pressure can be, that it can lead to the medical profession embracing the exact kind of quackery they otherwise dismiss with extreme prejudice, seemingly with zero self-reflection. Decades of their lies led to his, guaranteed it. They made it too easy, a Trojan horse they literally commissioned themselves, and keep rejecting any demand to take it outside to burn it. Because they're inside it.

Human nature never changes. Outside of hard-to-achieve circumstances, a bunch of gullible apes who can be made to accept any lie, even the lie that two equal lies are completely different. Somehow.

Medicine has truly opened Pandora's box in recent years. The woo is spreading everywhere and infecting everything it touches. There is no actual difference between a large segment of the health care industry and the book The Secret, with the only distinction that one channels prosperity, the other vitality. They are one and the same, literally zero difference in the assertions, in the evidence, in everything except the who.

Because humanity really hasn't matured out of the old "it's who you know, not what you know". Facts, even science, don't really matter for the most part unless someone can make money from it, and even then it's because who you know will change. But the fact that this pseudoscience is just pseudoscience can't make anyone money, so it has no power. Whereas this pseudoscience, devoid of any actual fact, can and does make lots of people money, and so it has power.

Love the Amazen mindful booth. It's such a perfect image for this scam industry. It represents it all in a small package. The whole of it is contained in there. The emperor is completely naked in there. Don't go in there! There's a naked emperor, you fool!

The Ferengi*'s first rule of acquisition covers this perfectly:
Once you have their money, you never give it back.
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* A civilization in the Star Trek universe whose only ethos is greed and corruption, for whom cheating is good and lying even better
 
Eleanor said:
It's the same kind of style you see from any Youtube crank ranting about how the earth is flat or vaccines cause autism or whatever. But because he has some past professional eminence he gets treated as a non-crank.
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The problem is more that most medical professionals already have similar beliefs, and so need no convincing to accept this kind of bullshit, even when presented like some flat earth conference talk on youtube with 14 views.

I don't see how it could be done fairly, but doing a private assessment of random physicians asking them what they think of this slide, I think the % who wouldn't mostly agree with it would be depressingly low, definitely low single digit %. The vast majority would see nothing wrong with it. It takes a lot of work to do that, and that's neither part of their training nor their job.
 
Trish said:
If people promoting brain training methods want to help people with ME/CFS, the best thing they can do is raise funds for proper clinical trials of the methods, with all the ethical safeguards, objective outcome measures and control group with equipoise that would be required of a clinical trial of a drug treatment, just as Fluge and Mella did with Rituximab.
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One think I noted, and frankly this is very significant because most medical research funding is privately donated, is that although the ME/CFS community and allies have donated tens of millions in private funding for scientific research over the last few decades, the establishment pseudoscience version has not.

Psychobehavioral research is almost entirely funded through either government/academic funding, private institutes and, occasionally, single wealthy donors. Now, we do also have private wealthy donors who occasionally give large sums to fund some research projects, but there is little to no grassroots funding for it. Not from patients, current and former, not from professionals involved. They raise next to no money. Despite being the completely dominant paradigm.

So they won't be doing that. It's not as if there's anything to actually research here. Which I guess is probably one reason why so little is donated. How would more money be used? Yet another biased open label trial? One more among hundreds of identical ones? Yet another cheap attempt at using questionnaires with overlapping questions? Been done to death already. There's nothing left to research here, everything's been done a hundred times because it's a very small space to look into. Basically as small as an Amazen booth. You can simply look in there and see everything, naked emperor and all.

No, instead what we see from 'recovered' activists is that they jump straight to making money for themselves. All of them. They don't raise money for research or to help, they make businesses out of it. They know a good scam when they see one, and this one is easy to exploit, governments will literally assist them at it, and so will the medical profession.
 
Utsikt said:
But you said a version of Buddhism says you shouldn’t react.
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I meant react judgmentally/emotionally. Not doing anything is one response. Overriding instinctual/learned reaction is another.

Mindfulness is rather a simple concept that only requires observing without judging, and it can stand on its own. Both the medicalize version and the article make it more complicated than it is by linking it to meditation or different Buddhist practices.
 
poetinsf said:
Mindfulness is rather a simple concept that only requires observing without judging, and it can stand on its own. Both the medicalize version and the article make it more complicated than it is by linking it to meditation or different Buddhist practices.
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The article gives an explanation for why it is tied to other Buddhist practices - because Buddhists practitioner of mindfullness does not practice mindfullness in isolation.

And simple things can be very difficult to do, as I illustrated with my example on violent anger issues in an earlier comment. They can also have serious consequences.
 
poetinsf said:
Mindfulness is rather a simple concept that only requires observing without judging, and it can stand on its own.
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It may be simple to say, but it's not simple to do well, especially for people in the midst of serious illness and who are not accustomed to it as a regular practice. Describing it in simplistic terms skates over the challenges, effort needed and potential for harm.
 
I will never forgive mindfulness for robbing me of raisins.
With some barely-overcome disordered eating and ARFID issues I started to enjoy them as an adult. Then, when the NHS CBT and Psychotherapy failed to cure my ME I was directed to a practitioner who asked me to buy a book on mindfulness (years before it was trendy) an hour of chapter 1’s repeated introduction “consider the raisin” talking endlessly about thinking of its ways, using all senses, I have not eaten one since. I can’t bear to look at them. It destroyed all of my pleasure and faint coping strategies, and reminded me wholesale of all the ways that I don’t like them.
 
MrMagoo said:
I will never forgive mindfulness for robbing me of raisins.
With some barely-overcome disordered eating and ARFID issues I started to enjoy them as an adult. Then, when the NHS CBT and Psychotherapy failed to cure my ME I was directed to a practitioner who asked me to buy a book on mindfulness (years before it was trendy) an hour of chapter 1’s repeated introduction “consider the raisin” talking endlessly about thinking of its ways, using all senses, I have not eaten one since. I can’t bear to look at them. It destroyed all of my pleasure and faint coping strategies, and reminded me wholesale of all the ways that I don’t like them.
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I'm with you on that. I hate that raisin exercise.
 
Friendswithme said:
Thousands of recoveries from all kinds of chronic symptoms. I appreciate that is anecdotes but those people deserve to be believed.
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Everyone here is happy to believe they recovered if they say so.
That is a completely different thing from believing an attribution of recovery to a specific cause in terms of a specific therapy. We know that is high unreliable and that 'believing it' is the road to quackery. Hence having proper trials - once that are adequately controlled unlike PACE.

I was at the Round Table Discussion prior to the release of the NICE 2021 Guideline. Representatives of all Royal Colleges who objected to the Guidelines were there and given plenty of time to voice their views on why NICE had got things wrong. They had nothing to say. Peter Barry did not even need to defend himself. They could not think of any cogent objections. It was all posturing.
 
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Trish said:
There was no way pwME could influence the guideline.
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Unduly influence. Otherwise, an excellent comment.
Trish said:
It may be simple to say, but it's not simple to do well, especially for people in the midst of serious illness and who are not accustomed to it as a regular practice. Describing it in simplistic terms skates over the challenges, effort needed and potential for harm.
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Build a house. A simple concept, but requiring a whole truckload of skills, resources, time, and energy to do a decent job of it.
 
Utsikt said:
And simple things can be very difficult to do, as I illustrated with my example on violent anger issues in an earlier comment. They can also have serious consequences.
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Trish said:
It may be simple to say, but it's not simple to do well, especially for people in the midst of serious illness and who are not accustomed to it as a regular practice. Describing it in simplistic terms skates over the challenges, effort needed and potential for harm.
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Sorry for the late reply, I've been tied up with moving.

Just being mindful does not require a lot of effort or practice in my experience. You just need some awareness to recognize the situation and detach yourself from it. And it can prevent harm. Take a road rage for example. You could get stress out by misbehaving people and end up with PEM (I don't know the "violent anger issues" that @Utsikt was referring, I'm making this up). By simply observing it as a phenomenon rather than reacting, you can prevent PEM.

I remember a patient from an online group who was stressed by neighbor's noise. She ended up developing all kinds of suspicions and resentment that made her condition worse. Had she observed it simply as a phenomenon, she might have dealt with it more rationally. Or at least had less mental stress if she couldn't do anything about it.

Linking mindfulness to difficult meditation or traditional Buddhist practices and then writing it off it like throwing the baby with bath water.
 
poetinsf said:
Sorry for the late reply, I've been tied up with moving.

Just being mindful does not require a lot of effort or practice in my experience. You just need some awareness to recognize the situation and detach yourself from it. And it can prevent harm. Take a road rage for example. You could get stress out by misbehaving people and end up with PEM (I don't know the "violent anger issues" that @Utsikt was referring, I'm making this up). By simply observing it as a phenomenon rather than reacting, you can prevent PEM.

I remember a patient from an online group who was stressed by neighbor's noise. She ended up developing all kinds of suspicions and resentment that made her condition worse. Had she observed it simply as a phenomenon, she might have dealt with it more rationally. Or at least had less mental stress if she couldn't do anything about it.

Linking mindfulness to difficult meditation or traditional Buddhist practices and then writing it off it like throwing the baby with bath water.
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No worries, we’re not in a rush. I hope the moving is going well!
 
Andy said:
From the article,

Can anybody explain how these two things are connected?
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Jonathan Edwards said:
It's obscure but are they suggesting that when DecodeME reports the BPS people will have all sorts of new rhetorical comments to make about how they prove their position?
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They won’t need to claim that it proves their position, just that it doesn’t disprove their position or that it is consistent with their model. We hope and expect that the publication of the DecodeME results will lead to a lot of media coverage. For different results, it seems fairly straightforward to predict how the BPS enthusiasts will respond, so I think it may be sensible to prepare counter-responses to anticipated BPS claims. The potential downside to briefing the media with counter-responses before the BPS claims have been made is that it may draw attention to claims which may not otherwise have been reported.

[Edit: See How should biological researchers present their results about ME/CFS to the media - discussion thread]
 
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Robert 1973 said:
They won’t need to claim that it proves their position, just that it doesn’t disprove their position or that it is consistent with their model. We hope and expect that the publication of the DecodeME results will lead to a lot of media coverage. For different results, it seems fairly straightforward to predict how the BPS enthusiasts will respond, so I think it may be sensible to prepare counter-responses to anticipated BPS claims. The potential downside to briefing the media with counter-responses before the BPS claims have been made is that it may draw attention to claims which may not otherwise have been reported.
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Yes I think preparing counter arguments to respond with rather than bringing it up in anticipation is the way to go.
 
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