MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

14
The above list is by no means comprehensive but merely gives an overview of documented abnormalities
seen in ME/CFS that can be accessed in the literature, all of which is available to the Wessely School.
ME/CFS has been defined in the Canadian Guidelines (2003), which have been adopted internationally and
are the best aid to the diagnosis of ME/CFS but which the Chief Investigator Peter White insists should not
be used in the UK (see below), perhaps because they are unambiguous:
‘The question arises whether a formal CBT or GET programme adds anything to what is available in the
ordinary medical setting. A well‐informed physician empowers the patients by respecting their experiences,
counsels the patients in coping strategies, and helps them achieve optimal exercise and activity levels
within their limits in a common‐sense, non‐ideological manner, which is not tied to deadlines or other
hidden agenda”.
In its 2007 Clinical Guideline 53 on “CFS/ME”, the National Institute for Health and Clinical Excellence
(NICE) specifically recommended that the Canadian case definition of ME/CFS should not be used in the
UK. NICE based its decision on a small number of mildly positive clinical trials by the Wessely School,
while devaluing evidence from scientific studies and patients’ own evidence. ME/CFS is the only physical
condition for which behavioural modification is the primary (indeed only) management approach in a NICE
Guideline. The MRC declines to fund biomedical studies, yet the cost of implementing the Wessely School
regime in the UK is £3.75 million annually, in addition to non‐recurrent costs of £26.45 million
(Breakthrough, MEResearch UK, Spring 2008).
There is no cure for ME/CFS
According to the Chief Medical Officer’s Working Group Report on “CFS/ME”, there is no cure (CMO’s
Working Group Report: January 2002: 4.4.2.2:48) so it is misleading of the MRC PACE Trial Principal
Investigators to imply otherwise and to try to achieve their aim by using techniques of persuasion in an
attempt to control the mind of participants by constantly bombarding them with language that seems to
misinform them.
For the Principal Investigators to state that full recovery is possible with CBT/GET, as Professor Michael
Sharpe asserted (“There is evidence that psychiatric treatment can be curative”. BMB 1991:47:4:989‐1005) and as
Professor Peter White – using “the General Practice Research Database to show that social factors affect prognosis in
CFS” ‐‐ unambiguously asserted (“recovery from CFS is possible following CBT….Significant improvement
following CBT is probable and a full recovery is possible”. Psychother Psychosom 2007:76(3):171‐176),
implying that patients can recover from ME/CFS if they would only follow the psychiatrists’ recommended
regime of CBT/GET, seems to offer false hope: the recovery statistics simply do not support such a belief.
To imply otherwise would seem to be overt misrepresentation of the significant body of peer reviewed
published biomedical science.
However, in their 2007 paper Knoop, White et al appear oblivious and confidently state: “The first clinical
implication of the present study is that a therapist delivering CBT can tell the patient that substantial improvement is
likely and that full recovery is possible. By communicating this, the therapist can counterbalance factors that lower
the expectations of the patient. Examples of such factors are a negative attitude of certain patient advocacy groups
towards behavioural interventions or an oversolicitous (sic) attitude of others in response to CFS. There is empirical
evidence that lower expectations of patients have a negative influence on therapy outcome”.
This belief may explain the instructions in the PACE therapists’ Manuals for the need for repeated “positive
reinforcement”.
In the same 2007 paper, White’s definition of “recovery” is curious: