ME -Prof Bleijenberg & lasting harm ME -Prof Bleijenberg & lasting harm - 24.05.2005 06:49
Prof. Bleijenberg (psychologist) was - together with Prof. Van der Meer - one of the first followers of the controversial *Wessely-School*, which alleges that ME is a psychiatric behavioural disorder, which is perpetuated by aberrant illness beliefs and personality, despite the abundance of well documented ME/CFS research in peer-reviewed medical journals, indicating pathological, multi systemic dysfunction. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Prof. Bleijenberg (psychologist) was - together with Prof. Van der Meer - one of the first followers of the controversial *Wessely-School*, which alleges that ME is a psychiatric behavioural disorder, which is perpetuated by aberrant illness beliefs and personality, despite the abundance of well documented ME/CFS research in peer-reviewed medical journals, indicating pathological, multi systemic dysfunction. From the start of the *fatigue* clinic in Nijmegen in 1991 they have used flawed criteria, which suppress the true severe symptomatology and emphasize *chronic fatigue* as the primary symptom. They are the leading authors of the worst CFS report ever written in the medical history: *Chronic fatigue syndrome* - by the Health Council of the Netherlands, which can be found at: http://listserv.surfnet.nl/scripts/WA.EXE?A3=ind0503E&L=me-net&P=69896&E=2&B=---583083060-707284150-1113903638%3D%3A1779&N=cfs_advice.pdf&T=application%2Fpdf The prominent researcher Leonard A. Jason et al says in the study *Chronic Fatigue Syndrome: The Need for Subtypes* (Neuropsychology Review, Vol. 15, No. 1, March 2005), that the *model* of the Nijmegen University could not be replicated. This is a proof of my former statement, that the report of the Health Council of the Netherlands is based on swindle: "......Typical of the purely psychogenic explanations for CFS is a research group from the Netherlands (Vercoulen et al., 1998), who believe that individuals with CFS attribute their symptoms to physical causes, are overly preoccupied by their physical limitations, and do not maintain regular activity. According to this model, these factors cause individuals with CFS to be functionally impaired, implying that the central problem with patients experiencing this condition is a psychosomatic preoccupation with one’s fatigue. When Song and Jason (in press) tested this model, it fit only with the chronic fatigue participants who had psychiatric reasons for their fatigue. The fact that this model could not be replicated with either the CFS group or those with medical reasons for their chronic fatigue suggests that CFS and chronic fatigue due to psychiatric causes are not the same conditions...." Jan van Roijen `````````````````````` From: Prof. Bleijenberg CBT study ~~~~~~~~~~~~~~~~~~~~~~~~~~~ (post M.E. Awareness Week 2005) From: The Webmaster & Caretaker Team, ME Free For All. To: All Members of ME Free For All with permission to forward & repost. ----- Original Message ----- Subject: Re: Prof. Bleijenberg CBT study (post M.E. Awareness Week 2005) Dear Professor Bleijenberg and colleagues, For M.E. Awareness Week (8 - 14 May 2005), this year, our principal theme at ME Free For All (related site: www.mefreeforall.org), was "M.E. Centres of Attention", focusing on the controversial and potentially harmful treatments offered in the newly established specialist M.E. centres around the country (see e-mail pasted below). An article about your work, together with a case study of Saphira van den Dam, was published on BBC News Online at http://news.bbc.co.uk/1/hi/health/4084631.stm. In a follow up, I have offered freely for publication a critique of your work, in particular and that of other researchers, in general, which recommends Cognitive Behaviour Therapy and Graded Exercise and I am sending a copy to you for your attention and for right of reply if you choose. Fundamentally, I am concerned that, until we distinguish between M.E. and chronic fatigue states, progress towards a definitive diagnostic test, treatment and cure will be impeded. I do hope that, whatever the differences in our opinions and conclusions, you agree that my analysis has been accurate, objective and professionally courteous. Yours sincerely Dr John H Greensmith Editor, ME Free For All (www.mefreeforall.org) e-mail: info@mefreeforall.org 36a North Street Downend Bristol BS16 5SW United Kingdom [Cc: Professor Gijs Bleijenberg, Professor of Psychology, Expert Centre Chronic Fatigue, University Medical Centre Nijmegen, Netherlands. With permission to translate, freely forward and repost.] Letters to the Editor. Recent Research by Professor Gijs Bleijenberg et al (2004), at the Expert Centre Chronic Fatigue, in Holland, claiming that people with Chronic Fatigue Syndrome or M.E. can be helped with Cognitive Behaviour Therapy and, subsequently, Graded Exercise is controversial, questionable, based on some fragile and unwarranted assumptions and demonstrates the need for root & branch re-thinking of valid and reliable experimental research design in this often poorly controlled field of study. Firstly, all researchers need to come off the CFS/ME fence and posit either that: (a) M.E. is not a separate illness from all those other conditions subsumed under the umbrella term Chronic Fatigue Syndrome (CFS) and may always be used interchangeably and synonymously, or that (b) M.E. is a distinct illness, varying along a continuum of severity, whether it is given the name Myalgic Encephalomyelitis, where there is evidence of inflammation of the brain and spinal cord, or Myalgic Encephalopathy, where the same symptoms of exhaustion, muscle pain, cognitive dysfunction etc. are not accompanied by such evidence. Most desirable, for all concerned, would be a definitive diagnostic test for M.E., as well as for each of the other illnesses currently considered together and good quality research is desperately needed here. Continuing research with all illnesses lumped together does not compare like with like, both within and amongst experiments and the findings will be, at least, diluted and, most likely, fatally flawed to be of any generalisation value. In addition to losing the opportunity to differentiate clearly between these groups of patients, Professor Bleijenberg, secondly, makes a fundamentally shaky assumption that the trigger of the illness (often but not always a virus) has now passed, rather than that it may be dormant, persistent and/or recurrent; or some other, as yet unthought of, possibility. Thirdly, Professor Bleijenberg (as well as other researchers in their work) may offer a false dawn to people with M.E. Whereas Cognitive Behaviour Therapy (CBT) may be of help to some people with an illness in which fatigue is a principal symptom and who have a negative attitude to their illness, it may be of no value to people with M.E., who have no such negative feelings. Nor is it true to say that if CBT does no good, it will do no harm. For veteran M.E. sufferers, it may be the latest disappointment in a long line of treatments, which had looked promising, that proves the last straw. Furthermore, Professor Bleijenberg asks M.E. patients to take a risky gamble for high stakes when he suggests, after CBT, Graded Exercise. Certainly, some exercise is necessary, for even the most severely affected patients, to prevent them seizing up but research and painful experience has shown that stepping up activity, in incremental stages, irrespective of the patient's health at the time (notwithstanding reassurances that therapists understand the limits and apply restraint), leaves many more people with M.E. worse, than it helps, sometimes irrecoverably so. Amongst this disarray of poor experimental design and practice, ME Free For All (www.mefreeforall.org) urges the suspension of such research programmes with the equivocal acronyms PACE (Pacing, Activity, Cognitive behaviour therapy, a random evaluation) and FINE (Fatigue, Intervention by Nurses Evaluation) until the underlying research rationale is more solid and some more basic epidemiological and physiological research has prepared the ground. It is better to have no treatment at all than one that does you no good and might do you lasting harm. Yours sincerely Dr John H Greensmith Editor, ME Free For All (www.mefreeforall.org) e-mail: info@mefreeforall.org. 36a North Street Downend Bristol BS16 5SW ~~~~~~~~~~ E-Mail: j.van.roijen@chello.nl |