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

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“ ‘I don’t take the British point of view that CBT is the one thing you can do to effectively treat ME/CFS’ says
(Professor) Klimas.
“Dr Lapp agrees. ‘In my opinion CBT is widely but unfairly maligned because of the British approach, which
presumes that ME/CFS has no organic basis and is therefore contradictory to current science. This type of CBT
assumes somatic symptoms are perpetuated by errant illness beliefs and maladaptive coping’.
“ Dr Bell (says) ‘It won’t suddenly make patients better’.
“Dr Peterson says he’s ‘not convinced of the efficacy of CBT’ ” (CFICS Chronicle Special Issue: The Science &
Research of CFS: 2005‐2006: 52‐53).
Australia:
“Many (CBT/GET) studies have significant refusal and drop‐out rates, which may reflect on the acceptability of the
treatment regimens” (Royal Australasian College of Physicians Australian National Guidelines, M J Aust
2002:65:176 (8 Suppl):S17‐S55).
Canada:
“Exercise programmes must be entered into cautiously as clinical studies have indicated that symptoms worsened in
approximately half of the ME/CFS patients” (Canadian Guidelines on ME/CFS, produced by Health Canada
Expert Medical Consensus Panel; JCFS 2003:11(1):7‐115).
New Zealand:
“GET may cause relapses and is therefore potentially harmful” (New Zealand Guidelines Group: Report to the
Ministry of Health, November 2003).
The UK Chief Medical Officer’s Working Group Report
The UK Chief Medical Officer’s Working Group Report of 2002 on “CFS/ME” recorded concerns about GET:
“Existing concerns include the view that patients have a primary disease process that is not responsive to or could
progress with graded exercise. Substantial concerns exist about the potential for harm. No other treatment
received such negative feedback” (4.4.2.1:46‐47).
Unremitting concern
This concern is un‐remitting: nine years ago (in June 2000) the Medical Advisor to the ME Association wrote
in the charity’s Newsletter “Perspectives”: “The ME Association receives far more complaints about graded
exercise regimes than any other management issues. Consequently, we are now informing our members that
they should consider taking legal action against the health professionals concerned when an inappropriate
‘exercise prescription’ causes a relapse”.
In a keynote lecture at the ME Research UK international research conference held on 25 th May 2007 in
Edinburgh, Dr Eleanor Stein from Canada, a psychiatrist with a dedicated ME/CFS practice, denounced the
Oxford criteria, which she said “could describe almost anybody. I do not believe that studies which use the Oxford
criteria can be generalised to patients with ME/CFS”. She also said it is very clear that ME/CFS patients have “a
host of physiological abnormalities that cannot be explained by psychiatric, attitudinal or behavioural hypotheses”.
Stein was outspoken: “I would never in my practice use the Wessely model of cognitive therapy. I find it
disrespectful to try to convince somebody they don’t have an illness that they clearly have”.