Webcast: (Medically Unexplained) Physical Symptoms: A Scientist Practitioner Approach June 8 Trudie Chalder

Medicine without science looks every bit as bad as it sounds.

This is textbook pseudoscience, it could basically form the basis of a course on what quackery in action looks like, an ideal case study. And as is common with BPS stuff it's not really that problematic that someone pushes woo like this, it's that it is actually taken seriously by the broader profession and the gatekeepers of science, used in actual practice with vulnerable people who get toyed with for the sake of ideology. That's what's impossible to understand, there is literally nothing there, it's entirely a belief system with zero substance. It's just stuff that makes them feel good because they literally never check whether any of it works and no one provides any oversight or accountability.

It's the ethical bankruptcy of it all, the complete recklessness about real-life consequences. I have nothing but contempt for the people who defend and promote this stuff. I pity the quacks themselves, they can't help themselves and are just sad people living in a self-delusional fantasy. Those whose job is to guard against this and choose to suspend all their responsibilities to give prominence to this junk, however, will be on the receiving end of very vexatious litigation in the future. There is absolutely no excuse for this, not anymore, not ever, there is no defending this after decades of disaster.

I need a drink or six after that. It's like a window into madness, the origin point of a nightmare imposed on millions. By choice. Knowingly. I don't get it. Such is the banality of evil.

 

that will be interesting....... assuming that it is actually sent.

Did you know any of the other participants?
Shame you couldn't have an open discussion about the talk.

Thanks for 'taking part' and reporting back.

eta:

I'm guessing she's refering to this:
https://www.s4me.info/threads/patte...ndrome-2020-chalder-sharpe-white-et-al.15313/

 

Ha; she's got another one coming up.........

https://maudsleylearning.com/insights/braincast-webinar-series/

(I see they've also 'done' SW; I haven't watched it)

Edit:
Braincast webinar with Trudie Chalder on 20th July 2020.
Direct link to video posted by @Esther12 here:
https://www.s4me.info/threads/cogni...20-goldstein-chalder.15251/page-4#post-273682

 

Excellent summing up.

All manner of things I was going to quote regarding the absurdities of TC's approach to science, but then gave up!

Just one thing comes across to me loud and clear: How on earth does someone so incapable of critical thinking ever become a scientist, and a highly influential one at that? It's mind boggling.

 

Is it even legal to run clinical trials if you lack the necessary qualifications? Else she might turn to brain surgery next, given she might think it a logical progression from her current work.

 

Digging a bit deeper - and it gets murkier:

Deary et al. (2007) dreary paper bases the autopoietic model of CBT for MUS on:

Lang, P. J., Melamed, B. G., & Hart, J. (1970).
A psychophysiological analysis of fear modification using an automated desensitization procedure.
Journal of Abnormal Psychology, 76(2), 220–234. https://doi.org/10.1037/h0029875

In Exp. I with 29 female undergraduates, an apparatus designed to administer systematic desensitization automatically was as effective as a live therapist in reducing phobic behavior, suggesting that effective desensitization is not dependent on a concurrent interpersonal interaction. An extensive psychophysiological analysis of the desensitization process showed that Ss' fear signals are associated with an increment in autonomic arousal, and that repreated presentation of fear items is accompanied by reduction in autonomic activity. Heart rate levels, responses, and degree of habituation to fear stimuli appeared related to success of desensitization. In Exp. II with 5 male and 15 female Ss, the anxiety hierarchies developed for desensitization yielded autonomic gradients, when the items were presented as visualized scenes, that varied with fear content and reported clarity of visualization. Results support the view that desensitization modifies autonomic, as well as gross motor and verbal responses, through learning. (APA PsycInfo Database Record (c) 2016 APA, all rights reserved)

So, in theory: pwME and other MUS's can be desensitised via CBT/GET then..... Easy peasey - this is like treating a straightforward phobia - should be no problem showing that to be possible / doable using actimeters! So, if that's true I'd be absolutely fantastic at getting pwME back on their feet in no time at all. Straightforward really.... except it's not - because Deary et al is a load of tosh!

 

In a sense, their work is a test of whether the avoidance behaviour (of more than low activity levels) in ME/CFS can be unlearned or not. It can't be unlearned because it's not an irrational fear (ie. fear without basis in reality). Increasing activities will reinforce the behaviour because of the bodily feedback that signals it is harmful. This is also how patients learn the behaviour in the first place.

 

Indeed re the unlearning behaviour. However, they go a step further and declare that the feelings / sensations that signal harm / pain etc are the patient's misinterpretation of benign bodily sensations - a phobic response. Phobias are straightforward to treat via cognitive changes - updating a person's thinking about the thing they fear along with experiential dares to try out new thinking in places or near where their feared place/thing is. i.e. extinguishing a severe spider phobia or fear of going over bridges, for example.

So, in essence CBT for MUS to overcome a fear of the pain following movement (kinesiophobia) and activity would be straightforward to do and to demonstrate objectively.

As you rightly point out what pwME experience is not an irrational fear - the debility following flare ups in ME can be overwhelming and disastrous - and last for weeks, months, years and in some cases for decades. That can be objectively and independently verified from patients and their families. Not acknowledging this fact undermines people's sense of reality and is a not very pleasant way to bull people - gas-lighting by another name.

 

As far as I am aware Dr Clare Gerada, Wessley’s wife, said she felt v ill for the few days she had it but recovered quite quickly. I would not be surprised this will confirm to her that people can easily get better after viral illness and those of us who don’t have some psychological factor that is maintaining the illness. Utter nonsense of course.

 

@Joan Crawford, thanks for the write up, depressing as it is. Noting the webcast advert refers to chronic fatigue, may I ask in this webinar does Chalder refer to chronic fatigue or chronic fatigue syndrome? Thank you.

Today I have put up elsewhere on this forum Goodelf’s further two blog posts on their Untangling the MUS Web series. It’s worth reading Goodelf’s MUS series which examines how MUS has been promoted across the NHS using a key MUS study by Nimnuan, Hotopf and Wessely in 2000 as evidence of high rates of MUS. This study was split into two papers and MUS proponents cite the second paper only as showing high rates of MUS. Yet they don’t share that the first paper of this study showed high misdiagnosis rates for MUS.

Link here https://www.s4me.info/threads/how-b...sled-the-medical-community.14908/#post-265988

 

Trudie referred to CF and CFS and used the terms interchangeably. She doesn't differentiate between any of the MUS - CF, CFS, FMS, IBS.... All the same to her in her mind. Which makes sense if she believes her CBT model that pwMUS's symptoms are all the mis-attribution of benign bodily sensations and are autopoietically (self generated) from within largely as a result of trauma - remembered or otherwise. She sees the MUS's as being more of a function of the medciual department that people are diagnosed within - e.g. IBS in gastro, CFS in infectious diseases clinics, NEAD/DS in neruo etc. It baffles my head thatt she can sit in front of people talking about their difficulties and symptoms and not hear the differences.....

The Good Elf's blogs are fantastic. Helped me as I wasn't aware of the 2000 paper till they pointed this out to me. Eye opening.

One of many beefs I have with MUS is the risk of misdiagnosis. To not bring in the data from 2000 paper to inform the process -especially NHS / IAPT processes and risk is shocking.

 

You mention trauma as cause of MUS. Is that really what they believe? They don't mention that in their explanations I believe.

If so then their belief system is even more Freudian than I thought, just cleverly disguised.

 

In a word yes. They believe psychological trauma causes patients to malfunction so that they misinterprete benign bodily sensations as being signs and symptoms of disease / I'll health. Pure Freud And this conditioning makes patients frightened basically to be well. Have you read the Deary et al (2007) paper? The cbt model of MUS?

Trudie talked about one PATIENT yesterday who didn't recall trauma until she spoke to her mum who mentioned some event before she lost childhood amnesia. So, there you go. Bingo. Cause of her MUS

TC et al fail to explain or demonstrate the mechanism or process by which psychological trauma is transferred, for want of a better word, into disease, debility, symptoms and so FORTH. It's just assumed to be obvious......

They also fail to grasp that it is perfectly normal to experience adversity and distressing experiences and not develop such. Or to have ME etc with no or largely straightforward lives. It is common to struggle psychologically and developmentally after significant trauma. But that's different and when the impacts are explained to people they find it intelligible and are often helped by understanding themselves and their relationships better. Often that reduces psychological distress. Makes not one jot of difference to pain levels in pw FM. However, patients can often manage themselves better, more confidently, pace themselves better, and with less reliance on opiod medication and so forth. That I see regularly and I've educated our pain consultants to encourage pain patients to get help with troubling trauma reactions. Context is vital here. This is often really helpful in helping people to have more psychological resources to manage their condition well. That is what good psychological care should look like. Not fiddling about in people's past for a 'trauma' to pin pain and symptoms on

 

@Joan Crawford it is great to have you here commenting, what you say makes so much sense. Thank you

 

@Joan Crawford, very! Thanks for confirming that Chalder uses CF and CFS interchangeably.

 

I haven’t watched it but someone today shared another online teaching module on MUS that took place this month. In the video they apparently cite the 2001 Nimuan, Hotopf, Wessely paper as proof of high rates of MUS with no reference to the 2000 sister paper that showed high rates of MUS misdiagnosis.

https://www.youtube.com/watch?v=SOzaZMvzCpk

 

So basically its all Conversion disorder. So why keep making up names, 'creating/inventing' syndromes/disorders other than to 'pacify' the patient (as they appear to be doing with FND).