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

[Jonathan Edwards]

I just googled and the dictionary says "physical or mental effort". Unless you are talking about BPS-type effort preference, effort in everyday sense means expending energy.

No it doesn't. People know what effort is even if they have no idea what 'expending energy' might mean. Expending energy is just a lay metaphorical term anyway for 'doing stuff'. The lay sense of energy is something like 'brio' - feeling full of beans. You don't expend that, even if at the eend of a marathon it is gone. We wil get nowhere if we talk of energy in this colloquial way.

 

[Jonathan Edwards]

Does agency or consciousness/subconsciousness play role in PEM? The answer would be a resounding no if you ask patients.

ANd how are they to know, and it is nonsequitur anyway. It is not that consciousness causes PEM. If exertion causes PEM then using the term in its usual meaning means that after consciously making an effort to do stuff you get payback. I am imagine that most patients would fully agree with that. It also covers mental exertion, which is presumably always conscious.

 

[Jonathan Edwards]

I think that's why we should stick to purely physical definition of exertion so as not to open it to misinterpretation.

But there isn't one. We can use up tons of calories without an 'exertion'. If the idea is to stick to use of calories then we need to change the term.

BUT the term comes from lived experience of exertion in the sense of trying to do stuff as far as I am aware. Lived experience cannot come from measuring calories because 99.9% of people haven't done that.

And we have absolutely no evidence for it being the use of calories that actually causes the reaction. So we would be flying entirely in the dark.

 

[Jonathan Edwards]

And As Trish has said this all belongs on another thread where we have already been through all this.

 

[poetinsf]

Similarly you can't stop your neurons from firing, they always fire. One has to be careful with arguments such as "PEM is a consequence of spending calories or neurons firing". One ends up in the vague BPS land very quickly without any meaning.

I'll repeat what I said to @Utsikt since I think it is important: PEM is not the consequence of exertion. Rather, it is your low tolerance to the exertion that causes PEM. Hence it is also called exercise intolerance.

 

[poetinsf]

Some posts may be moved. We have a PEM discussion thread if you want to continue.

Is there an easy way to do this? I personally don't mind discussion turning to a different topic, but it would be great if someone can move them. Otherwise, I'll come back tomorrow and do copy-paste of my new replies to PEM thread.