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

326
iv) CBT/GET encourage patients to ignore symptoms and therapists will not encourage ʺparticipants to listen
to their bodyʺ, rather, they will encourage them to ʺconsider increase symptoms (sic) as natural response to
increased activityʺ
v) CBT will ʺexplore unhelpful thoughtsʺ and ʺfear avoidance, and anxiety related to CFSʺ.
The corollary is that the participantʹs fatigue and other symptoms are the result of deconditioning, anxiety,
fear avoidance, unhelpful thoughts and do not result from physical disease, with the inescapable
conclusion that ME/CFS is considered a psychological disorder. Indeed, the Manual teaches therapists how
to manage participants who believe they have a physical disease and how to persuade them that this is not
the case and to dissuade them from seeking further medical attention.
The ʺCBT Model of CFS/MEʺ as it is explained in the CBT Manual for Therapists adduces other factors, often
risible and contradictory, as contributing to the ʺmaintenanceʺ of the participantʹs ME/CFS. These include:
• ʺbeing too busyʺ (p 17)
• ʺbeing too inactiveʺ (p 17)
• ʺfear of activityʺ (p 47)
• ʺworking excessively hardʺ (p 81)
• welfare dependency:
• ʺbeing on benefitsʺ (p 51)
• ʺbeing in receipt of benefitsʺ (p 92)
• ʺif a participant is in receipt of benefits, or income protection (IP), this may inadvertently lead them not to
push themselves too hard.ʺ (p 97) ʺEvidence from research trials has indicated that patients who are in
receipt of benefits or permanent health insurance do less well than those who are not in receipt of them. In
reality, benefits and IP can help patients financially in the short term, but prove to be an obstacle to getting
better in the long termʺ (p 99)
• adopting the sick role:
• ʺsometimes relatives and friends do more than may be required, e.g. all of their shopping, cleaning, cooking,
resulting in increased dependence of the person with CFS/MEʺ (p 44)
• believing that ME/CFS is a physical disease:
• ʺa purely physical attribution of illness may be a block to overcoming their CFS/MEʺ (p 48)
• ʺ[belief in] an ongoing virusʺ (p 63)
• work or relationship issues (p 34):
• ʺattitudes of family and friendsʺ (p 12)
• ʺinadequate housingʺ (p 50)
• ʺfinancial difficultiesʺ (p 50)
• ʺ meeting people sociallyʺ (p 97)
• ʺ being responsible for the running of the home, their work, paying billsʺ (p 97)
• ʺlost their confidence in their ability to do a variety of things, e.g. travelling alone, meeting new people etcʺ
(p 97)
• and, perhaps most bafflingly, concerns about ʺnot being good enoughʺ (p 101).
ME/CFS is thus presented as a ʺconditionʺ (not a disease) that can be caused both by doing too much and by
doing too little; by working excessively hard but also by being dependent on welfare.