Some of you, reading the article in the Handbook I wrote on CFSi/ME & Cpni, know that I'm not a fan of Cognitive Behavior Therapy (CBT) for fibromyalgiai and chronic fatigue/ME. I believe that what originally began as trying to provide better coping tools has been coopted by the medical establishment's tendency to blame the victims of disease for their own disease when medicine is impotent in helping these serious disorders.
So, on seeing Dr. Teitelbaum's report of a study in the Netherlands exposing the harm created by CBT for CFS/ME patients, I had to bring it to our readers attention. Below Dr. Teitelbaum's summary and the link to his excerpt from the research report translated from the Dutch.
Majority of ME/CFS Patients Negatively Affected by Cognitive Behaviour Therapy?
A recent pilot study (Koolhaas, et al., 2008, Netherlands) reports that only 2% of ME/CFS patients are cured by CBT, while the greatest share (38%) are adversely affected—most reporting substantial deterioration. It is especially notable that employment and education are negatively affected. This is in sharp contrast to the claims of psychiatrists and the Dutch Health Council that 70% of patients improve. Previous studies have also ignored or denied the negative effects of CBT on ME/CFS patients. The pilot study, recently published in the Dutch medical magazine, Medisch Contact, concludes that the previously reported claims of 70% improvement in ME/CFS patients receiving CBT are vastly overstated and misleading.
The following summary is from page 4 of the Dutch-language study.
Cognitieve gedragstherapie bij het chronische vermoeidheidssyndroom (ME/CVS) vanuit het perspectief van de patiënt, Drs. M.P. Koolhaas, H. de Boorder, prof. dr. E. van Hoof
Date: February 2008
ISBN: 978-90-812658-1-2
You also have to watch out
You also have to watch out for inappropriate criteria used to select the subjects: the tendency among the "stinking thinking" crowd is to say "anyone with fatigue lasting more than 6 months" or something equally inclusive. Then, although they've trashed the 10% of the participants who actually have CFSi/ME, they can report that they've "cured" the rest.
Virtually all the CBT/GE studies are flawed in this way.
Ron
On CAPi for CFS starting 01/06 (NE Ohio, USA)
Currently: doxyi & zithi -- continuous; metronidazolei -- 5 days on, 9 days off.
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What worries me is that
What worries me is that this is becoming the "standard of care" in a lot of hospitals for CFSi/ME, because it is "scientific." Physicians reading these boutique University studies are clueless about the flaws in the research methodology, but impressed that they are published in peer reviewed journals. Therefore they must be accurate, especially if they agree with ones unconscious bias that there must be something mental wrong with "those people." Arrrgh! Don't get me started... too late!
CAPi for Cpni 11/04. Dx: 25yrs CFS & FMSi. Currently: 300mg BID Roxithromycin, Bactrim DS 2x/day, Tinii 1000mg/day pulses; Vit D2000 units, T4 & T3
The use of CBT is
The use of CBT is controversial in the ME community in the UK. My own view is that the psychiatric lobby - rather than the psychotherapeutic community - has a lot to benefit from promoting CBT. As it means they get all the grant money for their institutions i.e. their livelihoods. I have seen and done the questionnaires and they are mostly about getting you to admit that you have obsessional or neurotic views about your illness and this is what is preventing you from getting well.
Recently the RSM protest group did a letter to the Royal Society of Medicine critisising CBT. The protest group pointed out how psychiatrists think that people with ME have "abnormal illness beliefs" and that they are frightened to do anything because they think it will make them more sick. Such 'therapists' believe that these "false beliefs" make the patient avoid activity "unreasonably". They also believe the patient wants to occupy "the sick role" to achieve secondary psychosocial gains of not having to work or shoulder their normal burden of being a parent (make anyone angry that last part?).
My principal personal objection, having experience "CBT", could be put in the very elequoent nutshell provided by the protest group letter dated April 2008, that it:
"undermines our experience in being able to manage our own illness and presumes that we do not want to get better or that we have psychological blocks, phobias, anxieties and other psycholgoical problems as opposed to a genuine physical debility. It also assumes that we are not credible witnesses in the case of our own illness - which is degrading, humiliating and offensive."
Sorry don't know how to do links. if you are interested, i guess google "RSM Protest Group" for the full letter.
Blackfoot
M.E./CFSi 20 years, intermittent. Wheldon Protocol - Started NACi and supplementsi Sept 2007. Doxyi and Roxy full dose by Dec '07. First Flagyli pulse January 2008.
Here's the link for the RSM
Here's the link for the RSM Protest Letter
I've heard that neurologists are the least likely of any specialty to get any further training once they're licensed.
This gives a glimpse of their attitude toward their work, I think.
Ron
On CAPi for CFSi starting 01/06 (NE Ohio, USA)
Currently: doxyi & zithi -- continuous; metronidazolei -- 5 days on, 9 days off.
Get the research results you paid for: support Open Access