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

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The authors summarise their advice as follows: “There is nothing to stop your body from gaining strength
and fitness…”; this is misinformation and is dishonest, dangerous and unethical; neither the authors of
the GET Manual nor the therapists can know this since appropriate investigations have not been carried
out on PACE Trial participants as part of the trial, and moreover it is untrue, as shown by the evidence in
Section 2 above.
Next come various diagrams “explaining” the “GET model” and “Feeling better with exercise”, which claim
that GET leads the body to “adapt positively” and so leads to “improved strength, fitness, flexibility, endurance,
achievement and focus”.
There is no mention of even the possibility that participants with ME/CFS may be unable to benefit from
aerobic exercise.
In the section “The Role of Your Physiotherapist”, participants are told that the physiotherapist’s job is to
“explain how GET helps people with CFS/ME”, but there is no evidence that GET does help people with
ME/CFS and it may not help. The physiotherapist’s job in the PACE Trial is also to “Encourage you to
maintain your positive gains”; this implies that “positive gains” will not only have occurred but will also be
maintained, when neither may be achievable for people with ME/CFS.
Such “positive reinforcement” may have the effect of blaming the participant who is unable to meet these set
goals and it may well result in despondency and in a sense of failure.
The next stage in the GET Manual covers “Getting to know the paperwork” and includes admonitions about
the need for the “Exercise questionnaire; goal sheets; physical activity and exercise diary; GET plans and progress
sheets; exercise records” etc. Participants are given more “positive reinforcement”: “These sheets can be a
powerful reminder of your progress”. There is clearly to be no toleration of a lack of progress by any
participant in the GET arm of the trial.
GET participants are next invited to express any concerns they may have about undertaking exercise. They
are to be asked:
“Apart from improving your chronic fatigue (sic), what other benefits of exercise interest you?” and fourteen extra
(guaranteed) benefits of exercise are listed.
Not only do the authors refer to “chronic fatigue” (which has nothing to do with ME/CFS), but this section
is structured in such a way as to be a statement, not a question, as no‐one could credibly answer negatively
about any of the following fourteen guaranteed benefits of GET:
“improved sleep; improved ability to do more activity; improved immune system; weight loss / control; prevention of
osteoporosis; a healthier heart; improved breathing / less breathlessness; improved body image and confidence; ability to
exercise with children / family; ability to exercise socially; feeling better in spirits; greater stamina; greater energy;
greater strength”.
This is followed by an example of a “CFS/ME” GET participant’s “Physical activity and exercise diary”, which
includes:
“MONDAY: 07.00: Woke up; shower, breakfast. 08 00: Dropped kids off at school. 09.00: Breakfast (sic – apparently
a typical CFS/ME participant on the GET arm of the trial has two breakfasts). Walked dog 15 minutes. 10.00 –
12.00: on computer. 12.00 Lunch. 13.00: visit from friends. 16.00: pick up kids from school. 17.00: TV. 18.00: TV.
19.00: Dinner. 20.00: TV. 21.00 TV. 22.00: Bed.
“TUESDAY: Woke up; shower. 08.00: Breakfast. Walked dog 15 mins. 09.00‐12.00: Work. 12.00: Lunch. 13.00 –
17.00: Work. 18.00: TV. 19.00: Dinner. 20.00: TV. 21.00: TV. 22.00: Bed”.