Why the BPS people think the way they do

[Hoopoe]

They see ME/CFS as something like a psychological disorder. If you have a psychological disorder, the only cure is to understand how your own behaviour and thoughts are causing the problems in your life. That's why therapy emphasises taking personality responsibility (instead of blaming something or someone else). This is not easy but it can be done and genuinely help the person, if a psychological disorder is the problem that they have.

However, this approach is harmful if the person is not actually causing the problems in their life, or in the context of ME/CFS, the symptoms through your own behaviour and beliefs. It leads to the person being told that they're doing something wrong when that is not true. It leads to blame, self blame and self doubt that do not lead up to to an eventual resolution, only to demoralization, adding another layer to existing problems. It distracts from searching for ways to live better with the illness and wastes time and energy.

What we patients here often call psychologization is applying this psychological disorder framework to an illness, and then being blind to the fact that it is not working. I suspect this is because the people working in this field tend to have a personal life story where taking personal responsibility was lifechanging in some way, so they're enthusiastic about this. Chronic illness is also difficult to understand for those who have not experienced it so it's easy to misinterpret it. And if you have a hammer, everything looks like a nail.

Is taking personal responsibility good? Yes, but it's important to acknowledge that we do not have power over all things in our life. This is also not easy to accept, and it's helpful so that one can focus one's efforts on the things that can be done and changed.

 

[Utsikt]

I don’t think we’ll get very far if we try to figure out why someone believes what they believe. We’ll have a hard enough time figuring out what they actually believe because they tend to be quite inconsistent depending on which topic they are talking about.

 

[rvallee]

I don’t think we’ll get very far if we try to figure out why someone believes what they believe. We’ll have a hard enough time figuring out what they actually believe because they tend to be quite inconsistent depending on which topic they are talking about.

Yeah, there is basically no thinking involved here, and it's very obvious. The very ideas they espouse aren't even coherent, it's a toddler level belief system. Fluid beliefs, no less. The last respectable belief system featuring magic grounded in science, aka pseudoscience.

It's just humans being foolish as usual, but unrestrained by, frankly, any norm, because it's all fluid beliefs no one can even think could be wrong, because the implications are equivalent to having committed millions of ritual sacrifices. Which sounds really bad, because it is.

 

[Peter T]

I blame Plato and his idea of the Heaven of Forms. At a simplistic level such as the mathematical formulation a triangle as a two dimensional shape is an abstract idea that that has no existence in the real world, so for it to have meaning triangles, squares and other shapes must somehow exist in a postulated heaven of forms.

Tie this in with how the human brain processes information, we are prone to think that if we can formulate an idea it must some how exist in a more real sense than observational data or deductive reasoning. This is the type of thinking that lead to the medieval Catholic Church’s Inquisition or Stalinist Russia’s placing the idea of Collectivisation above the resultant hundreds of thousands of deaths.

The idea of such as psychogenic illnesses relates to Freud’s idea of hysteria. Freud’s early monograph ‘On Aphasia’ was a brilliant critique of neuropsychological modeling of human behaviour that raised issues with experimental and scientific observation that we still have not fully answered. However Freud’s solution was to throw out the baby with the bath water and replace science with personal belief and literary invention. Such magical thinking is outside the proper realm of science but it is enormously attractive to an awful lot of people. Without it we would not see psychogenic explanations as the default when medicine does not yet have scientific answers nor would lotteries be such a successful way of generating income for their organisers.

You could perhaps argue that social contagion is much more likely to be seen in ideas of psychogenic illnesses amongst clinicians and researchers than amongst individuals displaying somatic/bodily symptoms.

[edited to correct some typos]

 

[MrMagoo]

The problem is that BPS fits with the cultural hegemony, which makes it easy to perpetuate as people are primed to accept that healthy = good and so good=healthy, I am good and I am healthy, I must be healthy because I am good.
This is why people have an absolute fit if they exercise and eat well but get any kind of disease because it’s not supposed to happen to them, they did everything right etc. They're not a benefits blagger with a big tv who sits round smoking etc.

 

[Hoopoe]

I don’t think we’ll get very far if we try to figure out why someone believes what they believe. We’ll have a hard enough time figuring out what they actually believe because they tend to be quite inconsistent depending on which topic they are talking about.

Avoiding telling the truth while dropping hints is the approach for psychological disorders because people cannot instantly accept that they are the reason for their problems. They have to gradually accept that and see it for themselves.

The BPS people have been trying to apply a similar approach to ME/CFS, trying to "help" patients discover that they are causing the illness themselves through their thoughts and behaviours.

 

[V.R.T.]

Avoiding telling the truth while dropping hints is the approach for psychological disorders because people cannot instantly accept that they are the reason for their problems. They have to gradually accept that.

The BPS people have been trying to apply a similar approach to ME/CFS, trying to "help" patients discover that they are causing the illness themselves through their thoughts and behaviours.

This is precisely the technique that was used on me. Ironically, the psychological fallout of realising that I fell for it and it destroyed my life has made my mental health worse than it ever was before. And it was pretty bad before!

 

[Hoopoe]

This is precisely the technique that was used on me. Ironically, the psychological fallout of realising that I fell for it and it destroyed my life has made my mental health worse than it ever was before. And it was pretty bad before!

Something similar happened to me. I didn't have difficulty accept the message that I was flawed because I believed in myself. I tried so hard to become a better person, which meant ignoreingmy symptoms as much as possible, but they kept getting worse. I struggled to accept that I was getting worse. The psychiatrist even believed getting worse was a good sign, that I was working properly on myself.

When I stopped trying to ignore them, accomodating them instead, I felt better, but was socially marginalized because people were influenced by the psychiatrist to believe that it was my personal responsibility to get better. I also had to endure all the pain of unnecessary self-doubt, blame, feelings of worthlessness, etc. that came on every time I needed to stay at home to rest.

The mental health cure was a real mental illness inducer. I entered therapy with a minor problem, two years later, every single aspect of my life was much worse than before. It was mainly the illness getting worse but the bad therapy added additional layers of harm and dysfunction when it could have had a stabilizing effect.

 

[bobbler]

There is a lot intertwining here.

One other issue is that there are certain personality types eg narcissism type related things who do not take responsibility and believe themselves above having to do so. In fact pushing the received wisdom that's OK 'because they can't be changed'. Although of course that's another mis-sell because as soon as society starts making it not an advantage to be that way that most on that spectrum immediately update their behaviour - its about bystanders and systems rewarding it and being lazy short-term to the detriment of longer-term. By them selling the illusion of 'can't beat em so join em'. And each year that makes it harder to be the moral one who then does decide to be a good guy etc.

In this way I guess the bps/hysterical women/freud stuff is like an anti-fable in the sense that Aesop's fables were selling morals through stories and this is people who are trying to use a warning/threat to stop others judging their behaviour switching to use a fable pretending the person with the bruise is the problem and not them, like there is some third way.

And I don't think we can underestimate the pushing of this as being one of the main factors because so many like to argue rhetorically and be antagonistic and rewrite and reframe in their own heads and the only reason they believe in all of this is because it works for them. It is just calling the other person mad and putting a foot on their neck/behaving badly towards someone, and for some reason allowed to be acceptable in today's day and age if you call it a 'belief' even when coercion-control/pyshcological techniques to injure in other areas is finally being recognised as equivalent in injury as doing it physically.

And I've started with this point because we often duck it but there are a few types who love the hysterical woman/oversensitive/didn't hit them that hard and this type is the number 1. They are into the Freud nonsense because it works for them as a weapon. But also because something else in them teaches them to find ways to think others are inferior to them ergo justifying their self-first attitude.

Somehow in current times we are at a point where people are being lied to that this aspect is the one thing that can't be compromised on and therefore all structures must assemble around their wants/needs rather than addressing their faults to reduce harm to others etc.

The net result being that the impact of their behaviour is normally consequences to others. And they see that those receiving said consequences should take responsibility for their own damage, rather than the 'doer'.

And everyone just bounds around some fallacy as if these people can be avoided or something so more fool you for hanging around with them or putting yourself in harms way or whatnot.

More people than I realised are just weird and won't 'help' someone even where it is no skin off their nose, just for the sake of it, when they aren't disabled themselves or anything just think or have been taught it as a behaviour or maybe even realise it is to do with seeing life as a zero-sum game so don't help anyone because they are competition, or maybe they are just mean. I don't get it.

When you imagine that you have this middle-lot/majority in society who aren't those most vulnerable, picked-on, needing others to work around a specific limitation [or exclusion - some things are people being different and its just that society chose to prioritise servicing one over the other] but also aren't high in the spectrum of narcissism but can choose how much they prioritise their own needs vs make a society work then they are effectively in different generations of 'society' then the ones 'choosing between' where that balance lies as to whether you include and are accepting of those more vulnerable or go with dog-eat-dog survival of the fittest (which of course is a mislead because it isn't 'the fittest' it is those who fit an artificially created idea of what is 'valued', such as being able to stand for an hour or turn up at 9am rush hour being more important than not shouting at people for no reason) as a model.

And most seem to have decided of recent times and for some forever that it is easier to tell of the victim than it is to get themselves in the bad books of the person who might be vindictive.

They want to pretend that doesn't make them morally wrong and wrecking society by not doing their duty as a citizen or bystander and pretending that 'teaching the victim to cope with that happenning all the time because they aren't going to step in once to say it isn't acceptable' as if 'being bullied' is now 'anxiety' works for them.


How does this relate to medicine and ME/CFS? Well I don't think it is any coincidence that those who are illest get treated the worst, and would be the most work and the 'treatment is consideration' at the moment rings out.

Combine that with a health service that has use an accounting approach to pretend each person passing through it has equal time needs based on the easiest/cheapest to deal with and even the most dedicated person who is an 'over and above' type has that much spare.

And if someone sees that being dedicated then they instead want to nick that to direct at something else - 'if you can do overtime to help that ME patient not die then you can sort out those files I'm behind with instead'.

 

[Mij]

The top personality traits of psychologists are openness and conscientiousness, according to AI Overview.

Being "too" open and conscientious can manifest as intellectual rigidity and an inability to adapt or compromise? I have never been able to have a rational discussion with one on X when describing ME/CFS.

 

[bobbler]

The top personality traits of psychologists are openness and conscientiousness, according to AI Overview.

Being "too" open and conscientious can manifest as intellectual rigidity and an inability to adapt or compromise? I have never been able to have a rational discussion with one on X when describing ME/CFS.

There are a lot of people who have studied psychology, and chosen very different types of courses some of them it seems - it used to be as a proper BPS (British Pyshcological Society) a deliberately broad-based qualification you had to do in order to progress and yet there seem to be different routes now, and a lot of psychology positions that do not require studying psychology just the 'doing' rather than 'what is useful content' sometimes.

And then you have to divide up that whole lump of psychologists into those who have been attracted to 'CFS' and hasn't done a broad background but fixated themselves eg on CBT of a certain type, when you've only a small minority who even go into the 'clinical psychology' side which is substantially different in methods and the like to cognitive psychologists, organisational psychologist, social psychologists, neuropsychologists, and so on. These are all different 'schools' of thought and methods and approaches too.

I could well imagine that even if personality profiles weren't tosh that the two groups would/could be completely different in personality type. there is a certain type who would have been attracted into a sector that only offered paid jobs to those who would enforce behavioural 'psychology' ie punishment-reward onto people. It wasn't like there were any jobs I'm aware of where the NHS was paying for eg a psychologist to support someone very ill with ME/CFS in a normal actually help their mental health way.

And I think like BACME I keep saying I keep assuming the 'B' stands for behavioural and were attracted to roles 'motivating those with false beliefs' and yet those who are OTs, nurses elsewhere might be the type focusing on actually making the environment suitable because eg they had a family member with MS or Parkinsons or whatnot.

I do think there is - just haven’t had the energy to add yet - other reasons/types that the psychosomatic ideas feed into and the conscientiousness sounds like it makes sense from a few angles

 

[shak8]

The top personality traits of psychologists are openness and conscientiousness, according to AI Overview.

Being "too" open and conscientious can manifest as intellectual rigidity and an inability to adapt or compromise? I have never been able to have a rational discussion with one on X when describing ME/CFS.

Openness as a personality trait---I think openness in a psychotherapist is a professional stance (in their training, therefore they are socialized in the profession to be open) to prod clients to verbalize their fears and troubling feelings.

Openness can be masking tactic, hiding one's true feelings. Openness implies trusting. It could also be an indicator of a lack of experience or knowledge--a sort of cluelessness.

I have one kid who doesn't censor his feelings when he should---he was born that way. He is the most "open with his feelings kid I have ever worked with" said his childhood therapist.

The word "openness" is not very definitive.

 

[DigitalDrifter]

If by BPS you are including the average GP, then the truth is that they don't really fully believe in the awesome power of the mind. It's just some charade they go along with because they need a way of labelling the patient as malingering, or a hypochondriac. They're taught to give patients the "we're not saying your symptoms aren't real" line to placate them and avoid getting in to arguments. It offers them plausible deniability if you report them to the GMC or medical board. They can just say it's the awesome power of the mind, we thought the patient was somatizing / having a nocebo effect to their negative beliefs about exercise. That way they get away with dismissing your symptoms as mostly not real and certainly non deteriorative.

Ask yourself why doctors believe Psychosomatic explanations upon such low quality of evidence.

 

[MrMagoo]

The top personality traits of psychologists are openness and conscientiousness, according to AI Overview.

Being "too" open and conscientious can manifest as intellectual rigidity and an inability to adapt or compromise? I have never been able to have a rational discussion with one on X when describing ME/CFS.

Why would there be a top personality trait though? It’s a job like any job, and a range of people will study for it and progress in it. A personality trait isn’t requisite for the role, and even if it were, we all know lots of examples of people who don’t seem to be in the right line of work. From teachers who hate kids through to HCPs who hate sick people.

 

[Hoopoe]

I have one kid who doesn't censor his feelings when he should---he was born that way. He is the most "open with his feelings kid I have ever worked with" said his childhood therapist.

Neurotypicals tend to prefer harmony over sincerity. The harmony is constructed by putting on a mask to hide one's true feelings and thoughts, making an effort to conform to group consensus, and displaying various behaviours intended to reduce to reduce tension and reassure each other that everything is okay.

The other day I was asked why I didn't come to the hiking group last week and I said because I didn't feel like it without hesitation. That provoked laughter (a social signal to reduce interpersonal tension) because it was considered borderline insensitive. The good social skills response would have been to reassure them that I value their company and cite a good reason for not coming or making one up. But in reality the group isn't that important to my life and I had other things I wanted to do more that day and didn't feel like explaining. In other contexts my behaviour would have been interpreted as rude.

A neurotypical person will often intuitively know what the correct behaviour is in a context, but they are often not good at explaining why or explaining how rules change with the context. That's presumably because they developed an intuitive sense for these things at a young age.

There aren't only negatives, sometimes the autistic honesty is very appreciated by others and it is useful to form deep authentic connections.

 

[Creekside]

Do they believe their theories, or is BPS simply a system for always being successful despite not doing anything? If you Fire an arrow and then place the target so that the arrow is in the center, you can brag about your amazing ability to always hit the center. BPS fires their arrow, adjusts the target as necessary, and gets paid for "hits in the center". Somehow, they've managed to convince the powers that be to accept this success. I expect that some know that their work is nonsense, but it's all too easy to convince some gullible people to be devoted followers.

Think of how successful astrology is, despite it being nonsense. BPS is just reworked astrology, and people can make money at it.

 

[MrMagoo]

Do they believe their theories, or is BPS simply a system for always being successful despite not doing anything? If you Fire an arrow and then place the target so that the arrow is in the center, you can brag about your amazing ability to always hit the center. BPS fires their arrow, adjusts the target as necessary, and gets paid for "hits in the center". Somehow, they've managed to convince the powers that be to accept this success. I expect that some know that their work is nonsense, but it's all too easy to convince some gullible people to be devoted followers.

Think of how successful astrology is, despite it being nonsense. BPS is just reworked astrology, and people can make money at it.

Again, it’s reinforced by society. They are doing “good” work and they are “good” people, middle to upper class, working in the NHS with the less fortunate.

 

[Creekside]

Again, it’s reinforced by society.

Yes, that's why it's successful. I suppose this sort of scamming is simply evolution: there are resources to exploit, and organisms have figured out a successful way to exploit them and avoid the defenses. Cowbirds are an example of this.

If you want to counter this sort of scam, you need to improve the defenses of the targets. If you managed to educate the gullible better, the scammers might be less successful.

 

[DigitalDrifter]

https://www.theguardian.com/science/2016/jan/07 - Click upon treatment wars for the below quote (There are other interesting articles there).


“People who say CBT is superficial have just missed the point,” said Trudie Chalder, professor at the King’s College Institute of Psychiatry, Psychology and Neuroscience in London, who argues that no single treatment is best for all maladies.

 

[Sean]

The psychologisation of everything continues on without restraint.