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

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This might lead participants to believe that, as “experts”, the Investigators and therapists are working from
established scientific and medical principles.
This is in contradiction to the theoretical nature of the investigations being tested, ie. the Manuals do not
make clear that it is the validity of these theories that is being tested in the PACE Trial and that the
assertions in the Manuals have not been proven.
The PACE Trial literature is telling participants that Investigators and therapists know that what they are
saying is correct, when such is not the case, a situation that many people deem to be unacceptable.
In 1997, Michael Sharpe published his concept of cognitive behavioural therapy in which ‐‐ using CFS as an
example ‐‐ he described a cognitive‐behavioural approach to somatisation, which he concluded was: “the
basis for a new evidence‐based approach to psychosomatics” (Psychosomatics 1997:38:356‐362).
Sharpe maintained that: “Patients present with symptoms, but physicians diagnose diseases. In many cases,
however, no disease can be found….Such complaints are commonly referred to as somatization, somatoform, or
functional symptoms….they lead to a considerable, but largely wasted, expenditure of medical resources on clinical
investigations”.
Sharpe set out his concept of cognitive behavioural therapy, explaining that it was originally developed for
the treatment of depression and that it is based on a theoretical model of illness which assumes that (1)
illness is best understood using a broad perspective of biological, cognitive, emotional, behavioural and
social components and (2) these components interact to perpetuate illness.
In Sharpe’s model of “illness components”, it is important to note his interpretation of the biological
component: “Standard biomedical investigations are typically negative in CFS. This does not mean that the illness
has no biological basis and a number of physiological abnormalities have been identified. These include
decreased physical fitness or ‘deconditioning’ ”.
There is no mention of organic pathology in Sharpe’s model of the perpetuation of CFS, thus in his
model, biological abnormalities extend only to loss of physical fitness and do not allow for pathogens
such as viruses.
According to Sharpe, “An important implication of this model is that psychological and social factors are
regarded not only as consequences of the biological disturbance but also as causes of the disturbance”.
Sharpe’s reasoning is thus circular: according to him, the effects of a cause can be the cause of the cause.
This statement by Sharpe may alert readers to the fact that normal standards of thought, science and logic
appear to have been suspended in relation to their model of “CFS/ME” (which claims that biological,
psychological and social factors all interact to perpetuate illness), because what is not explained is that these
factors cannot suddenly start interacting only when people become sick ‐‐‐ they must be operating all the
time in nature, so how can they be the cause as well as the consequence of illness behaviour?
Such a concept appears to be what has been described by a Professor of Neurology as “psychobabble” that
lacks all scientific merit and should be totally rejected (“ME:PFS: Diagnostic and Clinical Guidelines for
Doctors”; ME Association, 1991).
Of even more concern is that the Wessely School’s beliefs about ME/CFS appear not to have advanced with
the progression of medical science over the last twenty years.
Regarding CBT treatment for CFS, Sharpe concluded: “If the described model is valid, changes in relevant
cognitions and behaviours should facilitate normalization of physiology and speed recovery”.