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

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• “….Tell the participant that you will look forward to working with them over the coming months” (more
false empathy, because the therapist must first engender “trust”)
“Donʹts …..
• “…Challenge the participant about their illness attributions” (ie. the therapist must not tell the
patient the truth about their own beliefs, namely that “CFS/ME” is a mental disorder).
Page 39 of the Manual instructs therapists to ask participants about occupation, benefits, and any income
protection (IP) policies they may have; whilst it is understandable to seek demographic information and to
enquire about occupation, asking specifically if a participant is on benefits and if they have IP is highly
unusual and appears to reveal the motives behind the PACE Trial.
Page 43 of the Manual directs therapists to ask specifically if a participant belongs to an ME organisation,
which again seems to reveal the PIs’ motives, since the Wessely School believe that membership of such an
organisation militates against recovery.
Page 45 of the Manual (and throughout) focuses on “fatigue”. There is no mention of cardinal ME
symptoms, as these do not feature in the Wessely School model. Instead, therapists must establish if there is
“phobic anxiety”, or if the patient feels “tense”, or if there are any situations in which the patient feels
“uncomfortable, e.g. in supermarkets”, or if the patient has suffered from “panic attacks”.
Managing Participants who believe they are physically ill:
It seems that the PIs recognised that there could be significant problems maintaining the engagement of
participants who believed they had a physical disease and therefore the therapists were provided with
specific instructions on how best to manage them.
Page 47 of the Manual provides the Wessely School’s beliefs about this issue in a section entitled: ʺBeliefs
about the cause of the illness and why it is persistingʺ:
“Exploring the participants’ beliefs about their illness is essential before you discuss the CBT model for CFS/ME. It is
vital that you incorporate their own beliefs into the CBT model that you discuss with them so that they feel that their
opinions matter and have been taken seriously”: how is it possible for a therapist to incorporate a participant’s
beliefs into the “CBT model” if the participant’s beliefs are at variance with the assumptions of the model?
It would appear that therapists are being instructed to solicit the beliefs of participants “so that they feel their
opinions matter and have been taken seriously”, but it seems that participants’ opinions do not matter and are
not taken seriously because the therapist is instructed to change them. It is reasonable to question how
seriously the beliefs of a participant are taken when the purpose of therapy is to change any beliefs that
the therapist has been taught are a barrier to recovery.
“Participants will have been diagnosed with CFS/ME, but it is important to ask them what they feel has caused their
problems and what they feel is keeping their illness going”: if a participant does not think that their problems are
caused by ME (or by “CFS/ME”), then what are they doing in the PACE Trial?
“It is useful to gain an impression of their strength of belief in the cause, particularly if they feel that it is caused by
something physical, e. g. a virus. If a participant is convinced that their CFS/ME is caused purely by something
physical, e.g. an ongoing virus, you will need to carefully address their beliefs during the course of CBT to
broaden rather than directly challenge causal attributions”: these ambiguous instructions seem aimed at
displacing the participant’s rational belief that a virus may be causing their symptoms, yet the authors of the
Manual have no evidence that a virus is not implicated and ignore the evidence that viruses are implicated.