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

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Given the length of this section in the CBT Participants’ Manual, it is noteworthy that the therapists’ CBT
Manual does not contain any similar “physiological” information but explains “CFS/ME” simply as the
consequences of “deconditioning” and “fear avoidance and anxiety related to CFS”. Indeed, page 18 of the
Therapists’ CBT Manual appears to contradict this entire section in the participants’ CBT Manual: “Although
it is acknowledged that lack of physical fitness may play a part in exercise‐induced symptom production, physical
fitness is not central to this conceptualisation of the syndrome”.
The “Physiological Aspects of CFS/ME” section begins with the following paragraph:
ʺMany people with CFS/ME are concerned that their distressing symptoms may be related to a disease that hasn’t been
detected. Others are concerned that a virus (if one occurred at onset) is still present or has caused physical damage to
the body” (ethically, the therapists should tell the participants that they do not believe any physical disease is
present, thus enabling participants to make an informed choice about whether or not to disregard their
symptoms or withdraw from the PACE Trial).
“ Intensive research has tried to establish whether disease, deficiencies or any other abnormal changes in the body may
explain the very distressing and debilitating symptoms experienced by people with CFS/ME. To date, it appears that
there is no one cause of CFS/ME” (by this wording, the authors impart their own interpretation of the research
and imply that there is no disease present; they fail to tell participants that they, as “experts”, have already
concluded that there is no ʺphysical” cause).
This section continues:
ʺOver time, reduced or irregular activity and increased periods of rest causes (sic) physical changes in the body. These
changes cause unpleasant sensations and symptoms that can be very distressing. It is important to point out that
these changes are reversible with physical rehabilitation and/or exercise” (there is no evidence that the
physical changes which occur in ME/CFS are reversible with rehabilitation and/or exercise; these are
Wessely School assumptions stated as fact and it seems dishonest to misinform participants in this way).
“Research has looked at the effects of rest in healthy people when they reduce their activities and many similarities
between people with CFS/ME and healthy inactive people have been noted” (how can “the effects of rest” cause
swollen lymph glands, nystagmus, hair loss or mouth ulcers?).
It seems that Mary Burgess and Trudie Chalder are doing their utmost to explain the “physical” problems
which they assume the participants will have read about as a consequence of deconditioning.
The authors then make assertions describing the effects of prolonged periods of inactivity on the body;
according to them, these include:
“Changes in muscle function
• “A decrease in the number of active cell mitochondria (tiny parts of the cell that act as a powerhouse)…the
reduction of cell mitochondria has also been found in healthy inactive people. These changes may account for
the feeling of a lack of power or energy in the muscles” (Burgess and Chalder imply that this is true for
participants, but they cannot know this because they have not performed muscle biopsies or
carried out mitochondrial testing on the participants)
• “As reduced activity leads to less efficient muscles, it is more difficult for the muscles to squeeze the blood
back to the heart causing blood to pool in the lower part of the legs” (whilst pooling of blood in the lower
limbs has been shown to occur in many ME/CFS patients, there is no evidence that it is the result of
inactivity)