if people are telling you your wording can be interpreted in a different way than you say you intended then you need to tighten the wording so it is unambiguous.
I don’t agree with the things that are not programs. There is no evidence for this either.I don’t really understand why BHC insists on talking about ‘programmes’. If they had been content to talk about strategies for managing stress, about how mindfulness, affirmations and breathing exercises under individual supervision can benefit these patients, it would have been different.
Yes, you are right about that. I was mostly thinking that the possibility to customize for the individual that BHC is talking about is basically non-existent if they participate in a program compared to getting help managing stress in an individual treatment relationship.From the conclusion of post 3 from @MittEremltage
I don’t agree with the things that are not programs. There is no evidence for this either.
I don’t think there is much evidence for individual treatment relationships either, but it’s probably more widely accepted.Yes, you are right about that. I was mostly thinking that the possibility to customize for the individual that BHC is talking about is basically non-existent if they participate in a program compared to getting help managing stress in an individual treatment relationship.
This is what I think is so risky when it comes to people living with PEM.
- You are taught that you are not ill, but that your brain is stuck in an unfavourable state that you can restore with the help of brain training.
- You should focus on everything except your symptoms.
- But at the same time, you are encouraged to trigger symptoms by stepping outside your comfort zone, and this is a prerequisite for the brain to be able to recover.
- You should consciously put yourself in an elevated emotional state (here, for example, is a person who shows how to do this by forcing laughter) reduce any discomfort.
- It is about increasing activity and getting your body used to a new level of activity.
I cannot understand how you can do this and at the same time follow the recommendations in the BHC clinical guide.
The guide contains a lot of information about post-exertional malaise (PEM). My understanding is that BHC places great emphasis on PEM being an undesirable condition that should be avoided.
Thank you for setting out the arguments as always in such clear and through way.The Bateman Horne Center's recommendation on brain retraining goes against their own guide - in today's post I'll show how.
Link Part 4: Why the recommendation by BHC is risky and contradictory (part 4)
Thank you!Thank you for setting out the arguments as always in such clear and through way.
I cannot understand how you can do this and at the same time follow the recommendations in the BHC clinical guide.
The guide contains a lot of information about post-exertional malaise (PEM). My understanding is that BHC places great emphasis on PEM being an undesirable condition that should be avoided.
I've had this thought too, because their claims make no sense right now. I'm wondering if one person wrote about PEM, and then somebody else (who doesn't believe in PEM) wrote about neurplasticity programmes. Then a third person (who knows nothing about PEM or DNRS but is supported by AI) is doing the answering.It is like there are two different people writing their stuff, who never talk to each other.
As a patient rep working closely with biomedical researchers here in the Netherlands, I can confidently say they do see signs of real damage in the body and the findings align with what we see elsewhere. Yes, it's preliminary, for the moment unpublished, and the research is still developing, but dismissing it just because the studies are small doesn’t mean there’s nothing there. That kind of thinking is both problematic and misleading.I know its a big leap to accept there might be nothing physically wrong with your body but there isn't actually any replicated evidence that has found anything wrong in M.E so it's not a false assumption. Real symptoms, yes, but no actual damage found.
That depends on how widely you’ve looked for evidence. But in the context of ME/CFS it holds true because the basic research has barely been done. DecodeME will make their arguments moot regardless, if the results are positive.I know it's a cliché, but the only thing I can say is: absence of evidence isn’t evidence of absence.
This. It would be ok to diagnose comorbid anxiety and treat it in a way that does not risk the patient getting PEM. Mainly through meds and a therapist that truly understands PEM (which most don't so that might still be a bad plan).I do think there are some people who might already be on the path to recovery, improving, or maybe more prone to "catastrophizing" — and they could maybe benefit from some of the brain retraining techniques.
In the sense that graded exercise therapy and pacing up are essentially equivalent.Just to flip this around a bit: don't we have evidence from PACE that CGT is not effective for ME/CFS? Isn't this CGT approach to ME/CFS pretty much the same as what's being call brain retraining here?
The PACE theoretical model for CBT, which it has one, despite PACE pretending to be a 'pragmatic' trial, is explicitly a fear avoidance (whatever that means) model based on the same ideas. To be fair, "brain retraining" is a completely fluid idea that means whatever one wants it to mean in whatever context they need it to mean that thing. Like Feng-shui. And it's as scientific as "detoxifying". Actually, has even less evidence for it (toxins are definitely bad for us).Just to flip this around a bit: don't we have evidence from PACE that CGT is not effective for ME/CFS? Isn't this CGT approach to ME/CFS pretty much the same as what's being call brain retraining here?
Unfortunately, the BHC’s comment is mostly a repetition of what they said in our previous dialog and they do not touch at all on the fact that the recommendation on brain training strongly contradicts their own guide. It is disappointing to see that an institution that otherwise so clearly stands up for both science and patient safety ends up this far off the mark when it comes to delineating itself against potentially harmful pseudoscientific methods.