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

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“plausible” (if true, how is someone to know which thoughts to trust and which to distrust?), and “difficult to
switch off”. The authors then inform participants that: “Initially it can be difficult to detect your ‘unhelpful’
thoughts. After all we are not used to focusing on what we are thinking about” (but the authors have just informed
participants that these thoughts are “difficult to switch off”).
The Manual then moves on to “What are thinking errors?” and “Why do I need to identify unhelpful thinking
patterns?” and participants are informed that they should “stand back and dissect the thought” so that they
would be “one step closer to coming up with helpful alternatives”.
It is striking that there is no room in this model for existing helpful thoughts, even though virtually every
ME/CFS sufferer initially believed that they would improve and they continue to spend precious resources
(financial and physical) seeking amelioration of their suffering. As is obvious from the internet, it is rare to
find a patient with ME/CFS who does not strive to remain positive against overwhelming odds, but none of
this is featured in the authors’ own model, nor is it even acknowledged by Burgess and Chalder.
Participants are instructed on “How to challenge your unhelpful thoughts” by “detecting possible thinking errors or
distortions” and by “finding evidence that does not support them”. Inevitably, participants must keep a ”new
thoughts diary” and are instructed that they must ”follow the guidelines carefully”.
Participants are given a list of “Points to bear in mind when tackling unhelpful thoughts” which include being
told to “remember that there is no right or wrong way of thinking” (what then, is the point of this Manual? It has
used endless pages informing participants that they have “thinking errors”).
Section 2 (“Tackling unhelpful assumptions and core beliefs”) tries to modify participants’ core beliefs and it
exemplifies the unwarranted psychologisation of “CFS/ME”.
The underlying assumption is that participants can recover once the “blocks” that reside in their thoughts
and behaviour have been overcome by correct thinking, including correcting their “personality traits”.
“Below is a list of things that may be influencing your progress (all of which have been addressed earlier in the
intervention):
“1. Fear about increased activity making you worse. Worry about …taking the risks that are necessary to help you
overcome your CFS/ME” (participants are warned that they have to take risks to “overcome” their CFS/ME,
yet they are assured that CBT and GET are safe; if so, why might they pose risks?).
“2. Having extremely high personal standards” (this informs the participant that being a perfectionist is a block
to recovery; there is no proof that this is true, but it is stated as a proven fact and it might undermine the
self‐confidence of the participant); “avoiding new activities” (how does this block recovery from ME/CFS?).
“3. In receipt of benefits or a permanent health insurance” (participants are informed that they may feel trapped
by their benefits or insurance policy payments into not trying hard enough to get better).
“4. Having another illness on top of your CFS/ME” (how does a participant distinguish between “real” pain
caused by another illness ‐‐ and therefore “allowed” ‐‐ and the pain caused by ME/CFS that is to be
ignored?).
“5. Conflicting advice or being in receipt of different kinds of therapy/diets. There are health professionals who would
suggest that you need tests or should try different types of treatment, this can lead to confusion” ‐‐ this seems
dangerous advice given by Burgess and Chalder (behaviour therapists who are not medically qualified): it
not only tells the participant not to trust other health professionals but it dissuades participants from
seeking medical care. This may be a serious breach of ethics.