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29 januari 2010

 

Studies in MEdical Sadism - 0 

 

    "The mild and the long-suffering may suffer forever in this world. As long as the patient will suffer, the cruel will kick."
     -- Sidney Smith
      "The only thing necessary for the triumph of evil is for good men to do nothing."
    -- Edmund Burke
    "A person may cause evil to others not only by his actions but by his inaction, and in either case he is justly accountable to them for the injury."
    -- John Stuart Mill, On Liberty

Three days ago I wrote about a Good article in The Times about ME and yesterday I was pleased to have seen two more, to which I gave the links. Here is a third good one that appeared today:

As it happens, this is by a sports journalist of the Daily mail, whose wife has ME. The Lynn he mentions is Lynn Gilderdale, also mentioned yesterday.


But my real subject of today is in the title - and the number 0 indicates that it is the beginning of what may be considerable series, quite possibly in both Dutch and English (though I will not put much Dutch in my English texts), and quite likely in various styles, moods, tones and vocabularies.

For the moment, I am mostly serious, with some mockery and anger smoldering under it.

Studies in MEdical Sadism - 0
 

1. Introduction
2. The text to be reviewed and the review
3. Provisos

1. Introduction

I have decided to spend some time and energy on Studies in MEdical Sadism, namely into the beliefs of the English psychiatric school that is associated with the names of messrs. Wessely, White, Sharp, Clare (and related schools of thought in America, as in the CDC), and that especially as regards ME, a disease that I now have for 32 years, since I was 28, and that has destroyed almost all my social and scientific chances, and has left me poor, discriminated and without help for all these years, except for minimal dole, with more than two decades of pain, while I have the best possible degree in psychology and an excellent degree in philosophy, and I had hoped, and indeed expected, in view of my undisputed intellectual brilliance, to be able to have a university career.

While messrs Wessely, White, Sharp, Clare etc. are not party to my falling ill on January 1, 1979, they are party to my not getting any help whatsoever, other than dole, in spite of being ill for 32 years, and that because they have during this time surrected and perpetuated the myth that ME is a psychiatric disorder, that should not be treated by medical specialists other than psychotherapists.

In my view, that is an insane idea, not because I am ill, but because of the sort of reasoning they employ; the great amount of malice they have spouted; and the many suicides and destroyed lifes they have caused or contributed to, while having no rational scientific evidence for their theories whatsoever.

Also, it is my own belief that by far the best scientific hypothesis for their actions with regards to ME (which they call CFS) is twofold: (1) They are trying to increase the market for psychotherapy of their kind, and it would be financially very pleasant for them and their colleagues to be able to treat physically ill people as if they were mentally ill, or at least also mentally ill and (2) they seem to me, who is a psychologist who also read a fair amount of psychiatry, quite possibly unconsciously, to be of a sadistic bend of mind. (Also, it is not unlikely some of them are simply mad, as psychiatrists often have been, history has shown meanwhile.)

In any case, my own hypothesis about their reasons to style me and 17 million other people suffering from the same or very similar symptoms as I do, namely as if I and they have a psychosomatic disorder, a somatoform disorder, a psychogenic disorder etc., while there in fact is good medical evidence of many kinds that many people with the symptoms of ME have a real and serious physical disease, and while the World Health Organization has since 1969 insisted that ME is a serious neurological disease, and since 1992 that it is NOT a psychiatric disorder, is at least as well-founded, as scientific and as rational about this handful of pretentious pseudoscientists as is their hypothesis that some 17 million people with ME, including myself,  do not have a physical disease but some strange psychic morbidity that is - they claim - caused by "dysfunctional beliefs".

And I am quite willing to discuss, in an objective court of law, the two alternatives as they stand:

Either I am mad and so are 17 million persons from allover the world, who complain of the same symptoms as I do, and who believe, as many of their doctors do, that they have a hitherto medically unexplained disease - or else this handful of professors of psychiatry is grossly incompetent or possibly unconsciously sadistic, and quite conceivably both.

Since I have little health and energy, I will spend the time and energy on Studies in MEdical Sadism piecemeal, and bit by bit, but indeed it is my contention that (1) there is such a thing as medical sadism, and I have seen rather a lot of it the last 32 years (in which I also have been happy to see quite a few very good doctors and professors of medicine and psychology) and (2) it ought to be made a special subject of study, by patients organizations, and also in schools of medicine, since (3) while the majority of medical doctors undoubtedly is bona fides and competent, this has evidently not been the case in psychiatry and psychotherapy since 1900, though there have been competent and honest psychiatrists as well, and (4) the position of any medical doctor, not only psychiatrists, though these are especially prone to it, is all too easily corrupted in the same way as politicians may be, and often are: "All power corrupts, and absolute power corrupts absolutely". (Lord Acton, 1895)

This then is the start on what may turn into a book or a Ph.D. of my Studies in MEdical Sadism a.k.a. Cognitve Psychological Therapy for Sadism in Psychiatrists and Psychotherapists. (Consultations may be given in my home, after payment of a suitable fee.)

For the moment I will be doing some light exercises based on a piece of text from

Kumar and Clark - Clinical Medicine

By Parveen Kumar, CBE, BSc, MD, FRCP, FRCP (Edin), Professor of Clinical Medical Education, Barts and The London, Queen Mary's School of Medicine and Dentistry, University of London, and Honorary Consultant Physician and Gastroenterologist, Barts and The London NHS Trust, London, UK; and Michael Clark, MD, FRCP, Honorary Senior Lecturer, Barts and The London, Queen Mary's School of Medicine and  Dentistry, University of London, UK

ISBN 0702027634 Paperback 1528 Pages 1283 Illustrations Saunders Published August 2005

that I found on the internet.

I start with a short overview of some of the techniques and tricks of psychobabble and - as I call it - psychosadism (albeit unconscious, if indeed it is, for the firm proof of which probably a combination of thumbscrews and truthserum are necessary, for trained professors of psychiatry seldom or never have excellent minds, but usually are very slippery, and very persistent in their delusions and quackery).

What one easily and often meets in their writings, especially about ME (or CFS as they call it, contrary to the medical doctors of the World Health Organization, according to whom, since 1969, the disease should be called Myalgic Encephalomyelitis or Encephalopathy, and is a neurological disease, albeit so far of unknown cause and etiology, which also, since 1992, is NOT a psychiatric disorder), are the following pecularities, idiosyncracies, fallacies, and abuses, among others:

- doubletalk cultivated ambiguities of language of many kinds, calculating at seeming to say one thing while conveying another
- lack of quantification studious avoidance of quantifying terms like "all", "many", "some", "60 percent" in preference for unqualified nouns: "Patients", "Doctors" etc.
- may, can, could, might all the vagaries, ambiguities, innuendos, uncertainties and unclarities these English terms fall prey to
- pseudoterminology definitions and redefinitions of terms that sound like science but are mere prejudice
- insinuation, defamation manifold discriminations and denigrations of patients by all manner of insinuations and defamation, dressed up as "psychiatric science"

Next, readers innocent of real science should know at least the following two points

- materialism real science (physics, chemistry) is materialistic in outlook: There are no spirits, souls, angels or divinities (in science, regardless of the religious beliefs of the scientist)
- scientists most real scientists who have looked into psychiatry or psychology consider these subjects not real sciences
- science the practical test of a real science is that it allows the creation of technological artefacts that exist and work without any belief in them.

Here it should also be noted that in fact over the last 100 year most of the teachings of various schools of psychiatry, e.g. about the causes of depression, schizophrenia, stomach ulcers and homosexuality have been scientifically refuted, generally not by psychiatrists who perpetuated and defended their illusions, but by by biochemists, neurologists or brain scientists (who as a rule know much more of science and mathematics than psychiatrists, who tend to do bad in both).

There are three other points I should briefly mention before turning to the piece of psychiatric prose I am going to review:

- medical pretentiousness

Many doctors of medicine are quite pretentious folks, strongly convinced of their own excellence, power and merit. Personally, I am similarly inclined about myself,  and I have no problem if others are, and indeed I have met medical doctors who were very intelligent, very hardworking, very learned, and very moral. However, I have never met any psychiatrist or psychotherapist of whom I could honestly say the same, and most I spoke with seemed benighted fools to me, or best people with good intentions but no special intelligence - and here one should realize that the really good students in medicine rarely end up as a psychiatrist, that seems to be especially a specialism for such students of medicine who had some personal issues, and that just the same holds for psychotherapists (who usually started out as students of psychology with personal problems, of which I have seen and talked with quite a few).

- psychosomatics

The whole concept of "psychosomatic illness" is, from the point of view of a real scientist, a category mistake: There are not a body with a brain AND also a psyche, soul, mind or what have you: There just are a body with a brain, and some of the living brain's functioning appear as experiences to that brain only - and how this happens is, to this day, mostly a mystery, for which reason all psychiatric dogmatizing about "body AND mind", "the unconsciousness", "complexes, inhibitions, neuroses" and what have you must be verbal guesses with some slight foundations at best.

- financial interests of psychiatrists and insurance companies

One of the things professors of medicine including psychiatry are rarely willing to discuss honestly and with full disclosure of their personal interests are their ties to pharmaceutical or insurance companies, simply because (i) these ties may be financially very profitable (ii) these ties may make them appear biased in some of their public stances and (iii) it is not a rare event that some illegal hanky panky has been going on between professors or doctors of medicine and pharmaceutical or insurance companies.

2. The text to be reviewed and the review.

Apart from this and the next paragraph, the format of this section is that I quote the text of Clinical Medicine (as I found it on the internet), and I give my comments on the text by indenting them and make the text I quote blue. What I quote has been copied by somebody else, and I follow that in the order I have found it (except for the tables below) also without any excisions, but with correction of a few obvious typing mistakes.

The index entry for ME in Clinical Medicine directs the reader to the entry for CFS. There is a very small entry in the infectious diseases seciton under the heading Postviral/Chronic Fatigue Syndrome, which states "Studies have suggested that two-thirds of patients with a symptom duration of more than 6 months have an underlying psychiatric disorder".

This is a very dishonest entry in view of many studies which have not merely "suggested" but PROVED that many patients with the diagnosis of ME that was reached by exclusion DO have physical disorders, and in view of professor Malcolm Hooper's 2003 thorough refutation of the Wessel-White-Sharp-Calder school of - what I do like to call - sado-psychiatry, since I have been told now for 32 years, directly or by implication, that I am a malingerer or deluded, whilst I am a psychologist and a philosopher of science - that shows their "studies" and "suggestions" are simply pseudo-science.

We all have illness behaviour when we choose what to do about a symptom. Going to see a doctor is generally more likely with more severe and more numerous symptoms and greater distress. It is also more likely in introspective individuals who focus on their health.

This is manipulative prose, that is mostly innuendo and suggestion. First "We all" is a rhetorical move, not a scientific fact. Second, "illness behaviour" is pseudoterminology, that suggests there is some scientific concept of "illness behaviour", which there isn't. The second sentence is a waste of space, logically speaking, but leads up to the third that aims to suggest that especially "introspective individuals" - suggesting: neurotics - complain about the symptoms of ME, which is completely unfounded and arbitrary.

Abnormal illness behaviour occurs when there is a discrepancy between the objective somatic pathology present and the patient's response to it, in spite of adequate medical investigation and explanation.

Here the pseudoterminology introduced in the previous paragraph gets used, as if there must be some scientific notion of "Abnormal illness behaviour". There is not: It is insinuation that patients who complain about the symptoms of ME are "abnormal" (a term which is used to suggest "deviant", "disturbed", "deluded"). Also, this paragraph suggests - very dishonestly - that medical science is omniscient: That is, that if present medical science or a medical scientist (real or so called) does not know of a somatic explanation, it "therefore" can have no somatic explanation.

That's utter nonsense - what it implies is that you must be deluded and must have a psychiatric condition if medical science cannot yet provide a good scientific explanation for one's complaints. Also, this is precisely the way of - now defunct - Soviet psychiatry: Dissidents are insane because "there is a discrepancy between the objective" facts of socialist excellencies at "present and the patient's response to it, in spite of adequate medical investigation and explanation" of Marx's scientific socialism.

But applied to ME this is indeed what the ME-sadism school of psychiatry teaches and wants, and indeed it would be most convenient for psychiatric incomes, as it would be most welcome to insurance companies not to have to do anything for patients with ME except have them get cured from their delusions by a psychiatric nurse, for that is MUCH cheaper than doing real medical research into the possible somatic causes of their complaints, as it is also MUCH cheaper NOT to have to provide them with the things ill people do need, and have a legal and human right to.

FUNCTIONAL OR PSYCHOSOMATIC DISORDERS: MEDICALLY UNEXPLAINED SYMPTOMS

The title is literal doubletalk: Whereas there ARE many "MEDICALLY UNEXPLAINED SYMPTOMS" to claim that such symptoms are "FUNCTIONAL OR PSYCHOSOMATIC DISORDERS" is a doubletalking lie that only serves the interests of psychiatrists and psychotherapists in paid work, and the interests of insurance-companies in having to treat ill people as if they are ill in all those cases - and there are many - where there are  "MEDICALLY UNEXPLAINED SYMPTOMS".

One has NO right to "explain" what indeed is medically unexplained as if it is "functional" or "psychosomatic" - or if one has that right, e.g. as a psychiatrist or psychotherapist (out for income or money from insurance companies) others have the right to conclude that a perfectly valid scientific explanation for this stance of psychiatrists and psychotherapists is that in fact they are - unconsciously, of course - sadists out to get patients or money from insurance companies.

And indeed that is my hypothesis, for it it were otherwise these psycho-sadists would produce better science and better prose, and would at least not lie about the facts established about ME by real scientists (which the psycho-sadists lie about by systematically "forgetting to mention" these, whereas this is their scientific and moral duty).

`Functional' disorders are illnesses in which there is no obvious pathology or anatomical change in an organ (thus in contrast to `organic and there is a presumed dysfunction in an organ or system).

As I indicated "`Functional' disorders" is an intentional misnomer for "medically unexplained diseases and symptoms". To claim or suggest that what medical science has not yet explained properly in somatic, organic, biochemical terms is or could be "`Functional' disorders" is pseudo-science and word magic.

Also, from a really scientific point view - that is: one which does accord with the perspective of the real sciences physics and (bio-)chemistry, but not (necessarily) with the beliefs about science psychiatrists and psychotherapists have, who generally lack the mathematical talents to do or understand real science - (1) ALL illnesses are due to some "dysfunction in an organ or system", whether or not such a dysfunction has been found yet and (2) there is NO "mind" or "psyche" or "soul" IN ADDITION to a (possibly malfunctioning) brain. You may believe you have a soul, but that is not a scientific belief, but a religious one. In real science there just is the body, including the brain and its functioning - and the present day real knowledge about the human body is related to the body in roughly the manner medieval cartography is related to the real world: Accurate and helpful in some places, but full of unknowns.

The word psycho-somatic has had several meanings, including psychogenic, `all in the mind'; imaginary and malingering.

The word "psycho-somatic" is pseudoscience: It is based - if not used satirically - on the presumption that there is, next to the brain and the body, a psyche or soul. From a scientific point of view it is demonology.

The modern meaning is that psychosomatic disorders are syndromes of unknown aetiology in which both physical and psychological factors are likely to be causative.

No, in a textbook of clinical medicine that is a lie: For real scientists there are not "both physical and psychological factors" - there are ONLY physical factors... plus a lot of real ignorance about very many aspects of the body's and the brain's functioning, coupled to a lot of pseudoscience, psychobabble, and nonsensical terminology by all manner of would be healers, from astrologists to psychiatrists.

The psychiatric classification of these disorders would be somatoform disorders, but they do not fit easily within either medical or psychiatric classification systems, since they occupy the hinterland between them.

Again, "somatoform disorders" comes from the same psychiatric pseudo-scientific stables as "psychosomatic", and is pseudoscientific terminology. The valid terminology here is "medically unexplained, at present".

Next, if it is true that these terminological nephews and nieces of "demon-possessed"  "do not fit easily within either medical or psychiatric classification systems", one is once more reading pseudoscience. And indeed, what the professors of psychiatry who apparently wrote it probably do have in mind is that they would like to see that ALL or MOST diseases get reclassified as having BOTH a somatic and a psychological component, which enables their breed of pseudoscientists to cash in on any disease, by claims of their ability to cure - what they probably will style - "the inappropriate illneess behaviour" of patients, namely by massive doses of Cognitive Behavorial Therapy, well-paid of course, and preferably without any control.

Also, although the writers of this bad prose pretend to a knowledge of German, the "hinterland" does not lie "between" but "behind" ("hinter") something - so this is yet another abuse of words.

Medically unexplained symptoms and syndromes are very common in both primary care and the general hospital (over half the outpatients in gastroenterology and neurology clinics have these syndromes).

Indeed - which would suggest, at least to people intelligent enough to study physics rather than psychiatry or psychology - that there is very much that present day medical science can not yet rationally explain. And this is indeed the case.

But the authors are trickcyclists, and they manage to insinuate once again that "Medically unexplained symptoms" must somehow be "syndromes". (Presumably, their reasoning here is the same, though statistically and scientifically speaking much less well based than my own thinking about the many sick syndromes I could name that wrecked havoc in the minds of psychiatrists, that indeed all belong to precisely that one group of - niminal - scientists that have most madness and most suicides in their ranks.)

Because orthodox medicine has not been particularly effective in treating or understanding these disorders, many patients perceive their doctors as unsympathetic and seek out complementary treatments of uncertain efficacy.

This may well be strengthened, in quite a few cases on record, to "Because orthodox medicine has been remarkably ineffective in treating and misunderstanding these disorders" etc. Now, since it would seem to me that "unorthodox medicine" - whatever that may be, precisely - has not been particularly effective either in  "treating or understanding these disorders", it seems quite rational in principle of patients if they "seek out complementary treatments of uncertain efficacy", and the more so if what your doctor is telling you, politely of course, that in fact he has learned from the Handbook the text I review comes from, that one must be ("probably", "psycho-scientifically") a nutter if one has a medically unexplained disorder.

Examples of functional disorders are shown in Table 22.4.

Table 22.4

Functional or psychosomatic syndromes (medically unexplained symptoms)

`Tension' headaches
Atypical facial pain
Atypical chest pain
Fibromyalgia (chronic widespread pain)
Other chronic pain syndromes
Chronic or post-viral fatigue syndrome
Multiple chemical sensitivity
Premenstrual syndrome
Irritable or functional bowel syndrome
Irritable bladder syndrome

This is in various ways grossly misleading or a lie. First, the title should have been styled differently, e.g. thus:

Medically unexplained symptoms (a..k.a. as "Functional or psychosomatic syndromes" by pseudoscientists like psychiatrists)

Second, many real scientists would disagree about any of these entries under the heading "Functional or psychosomatic syndromes", and in fact, in the case of - what are called here - "Fibromyalgia (chronic widespread pain)" and "Chronic or post-viral fatigue syndrome" there is a lot of research by real scientists (that is, mostly and generally, although there are exceptions: not psychiatrists and not psychotherapists) that there are quite a few real pathologies in patients with the symptoms that belong to these diagnoses, all of which make it very probable that they have a REAL disease, which indeed is so far "medically unexplained " - and will remain "medically unexplained " till eternity if it is up to the pseudoscientists.

Because epidemiological studies suggest that having one of these syndromes significantly increases the risk of having another, some doctors believe that these syndromes represent different manifestations in time of `one functional syndrome', which is indicative of a somatization process.

This is improperly vague language: Whose "epidemiological studies"? How many? Presumably, precisely the psychiatric pseudo-science who wrote the present text. And what does "suggest" mean here? Anyway - the rest is indeed just pseudoscientific terminology, innuendo and insinuation.

Functional disorders also have a significant association with psychiatric disorders, especially depressive and panic disorders as well as phobias.

Note what happens if one rewrites this thus: "Medically unexplained diseases have a significant association with psychiatric disorders", precisely because psychiatrists are in their business to make money, although they disdain in their prose to indicate what they mean by "a significant association", or indeed what is a "psychiatric disorder".

And in this connection: Depression has been for decades a major source of income for hordes of psychiatric pseudoscientists - until Prozac and the later medicines appeared on the scene, and a few months of taking a serotonine-inhibitor cured hundreds of thousands or millions that had been till then carrying money in vain to Freudian, Jungian and other psychiatric pseudoscientists. And so called panic disorders and phobias are not so much "psychiatric disorders" as simply "medically unexplained", for the most part.

Against this view is the evidence that the majority of primary care patients with most of these disorders do not have either a psychiatric disorder or other functional disorders.

This is manipulative language, for it is simply a fact that "the majority of primary care patients", whatever their complaints "do not have either a psychiatric disorder or other functional disorders", especially since "functional disorders" is the modern equivalent of "possessed by demons".

What there is a LOT of  "evidence" for is that psychiatry and psychotherapy so far, for lack of adequate understanding of how the brain works, are wholly or for the most part pseudosciences, even if there are indeed sincere and honest psychiatrists and psychotherapists (although these too tend to be very shy about admitting their vast ignorance of how the brain works).

It also seems that it requires a major stress or a psychiatric disorder in order for such sufferers to attend their doctor for help, which might explain why doctors are so impressed with the associations with stress and psychiatric disorders.

This is mere tittle tattle, that in fact only conveys personal impressions in vague language.

Doctors have historically tended to diagnose `stress' or `psychosomatic disorders' in patients with symptoms that they cannot explain.

No, they have not, or only if you restrict history to no later than the 1950ies, when the notion that stress might cause disease was popularized by Selye. And even then: It is quite immoral and irrational for "doctors" to offer diagnoses of "symptoms that they cannot explain": They should honestly say they cannot explain it, and not reason along the line "If I - evidently great medical omniscient genius that I am - cannot explain symptoms, THEREFORE there cannot be an unknown disease that causes it, so THEREFORE it must be psychosomatic".

History is full of such disorders being reclassified as research clarifies the pathology. A recent example is writer's cramp (p. 1233) which most neurologists now agree is a dystonia rather than a neurosis.

This seems to me to be malicious lying or misrepresentation: What "History is full of" is the finding of real somatic causes (as in: stomach ulcers, schizophrenia, depression, autism, homosexuality) for very much that up to then was considered a "psychiatric disorder" by the psychiatric pseudoscientists (who must have received billions for pretending to be able to treat what I just listed) if not a case of demonic possession.

And the example given - writer's cramp  - is probably willfully sarcastic.

Chronic fatigue syndrome (CFS)

This is a - n intentional - psychiatric misnomer of a serious organic disease that should be called ME, until the real cause has been identified.

There has probably been more controversy over the existence and aetiology of CFS than any other functional syndrome in recent years.

An important part of the reason for this is that there have been a number of psychiatrists and psychotherapists, also all without the requisite knowledge of real science, have been insisting for decades, against the rulings of the WHO that insists since 1969 that ME IS an organic disease of unknown aetiology and since 1992 that it is NOT a psychiatric disorder, that ME "is" a psychiatric disorder, in spite of much and variegated excellent evidence by many real scientific researchers of many organic pathologies in many patients with the symptoms that go with the name ME.

Rather than admitting their own ignorance the pseudos of psychiatry kept insisting that ME "is psychosomatic" ("somatoform", "psychogenic"), although they have NO independent evidence for this. And rather than furthering objective scientific research by real scientists, the pseudos of psychiatry - who don't do real science, and therefore have much more time than real scientists - have overtaken scientific and political committees that oversee the spending on medical research, and have blocked the funding of research by real scientists into the cause or causes of ME. They did this by the sort of prose and stances that I am reviewing, that is by insinuation, double talk, defamation, slander, and falsehoods about the evidence real scientists HAVE found relating to ME.

This is reflected in its uncertain classification as neurasthenia in the psychiatric classification and myalgic encephalomyelitis (ME) under neurological disorders.

Well.. the "psychiatric classification" like the concept and term "neurasthenia" are simply pseudoscience. Again, the reader must keep in mind that, until the Wessely-White-Sharp-Clarenden-Reeves school of pseudos started their campaign (whether to further the incomes of psychiatrists, or whether paid by insurance-companies who don't want to support patients with yet another real disease, or whether moved by their own sadistic malice), the medical majority was on the side of the WHO, according to which the disease is a real and serious neurological disorder, with many known signs and symptoms of real pathology in its patients.

There is good evidence for this syndrome, although the diagnosis is made clinically and by exclusion of other fatiguing disorders.

This is again a fine example of the technique of disinformation by the writer of this prose. First, the term "syndrome" is often used in medical science where there is only a set of interrelated symptoms (that collectively are the syndrome) and no medical explanation as yet, for which reason to speak of "good evidence for this syndrome" is a case of abuse of language, if not outright stupid. Second, the "good evidence" that ME exists is not produced "clinically", but stems from research laboraties and real scientists, who have found rather a lot of positive evidence that ME is a real and serious organic disease. Third, the diagnosis is NOT made "by exclusion of other fatiguing disorders", but much more simply and relevantly "by exclusion of other disorders", for one may have symptoms that go with ME (and not just "fatigue") and yet may have another organic disease.

Its prevalence is 0.5% in the UK, although abnormal fatigue as a symptom occurs in 10-20%.

This is doubtful, as long as there is no good causal explanation of ME. Also, it is not said what the "10-20%" are percentages of, but if this is taken as suggested, namely in all UK patients with any kind of disease, it is clear that "abnormal fatigue" is NOT a symptom that is very useful to diagnose ME. And indeed, the best two symptoms to diagnose ME seem to be (1) that good standard medical checkups have verified that the complaints of the patient are not caused by any known disease and (2) that the patient has post-extertional malaise, which means that one does not recuperate at all or very slowly from doing a little too much, even if this little too much is very little for healthy people.

What I find pretty sickening, meanwhile, is that the writers of this this medicalese pseudoscientific prose know these facts at least as well as I do, but refuse to reveal them in a Handbook of Clinical Medicine. This is palpably and culpably dishonest and unscientific, and harms patients and there human and civil rights.

It occurs most commonly in women between the ages of 20 and 50 years old.

I think this is the first factually true statement without manipulation, if indeed it is without this last dishonesty. In any case, some 20% are men, and the agegroup of 20-50 covers a large percentage of the population.

The cardinal symptom is chronic fatigue made worse by minimal exertion.

No. The cardinal symptom is chronic exhaustion that does not go away with resting, that is with post-exertional malaise.

The fatigue is usually both physical and mental, with associated poor concentration, impaired registration of memory, irritability, alteration in sleep pattern (either insomnia or hypersomnia), and muscular pain.

Let me note as a psychologist that these are NOT the sort of complaints neurotics or psychotics have or had. And let me note as a psychologist who has had this disease, or at least its characteristic and defining symptoms, for over 30 years now, that I spend mostly in bed, in the dole, without any help, that there are some 17 million people who are ill with these symptoms, who mostly developed precisely these symptoms, and no others, without having any knowledge of ME (by any name, also): Most simply fell ill with some flu-like disease, often Epstein-Barr, as in my case, and never got well.

The name myalgic encephalomyelitis (ME) is decreasingly used within medicine because it implies a pathology for which there is no evidence.

This is a lie. Psychiatrists of the pseudo-scientific schools like to call it "Chronic Fatigue Syndrome" because this makes it very much easier to misrepresent patients with ME as if they are malingerers or at best psychosomatic wimps, but reputable real scientists do not do such things - and also know that the name ME is based on some evidence, and such evidence as there is for a neurological disease of the brain (which is what the name) has not been refuted or undermined.

Aetiology

Functional disorders often have aetiological factors in common with each other (see Table 22.5), as well as more specific aetiologies.

If  "Functional disorders" are mostly a dishonest attempt by pseudoscientists to misrepresent real diseases that sofar are not medically explained, it is clear that "aetiological factors" and "specific aetiologies" are likely to come from unscientific attributions, word magic, insinuations etc.

For instance, CFS can be triggered by certain infections, such as infectious mononucleosis and viral hepatitis. About 10% of patients with infectious mononucleosis have CFS 6 months after the infectious onset, yet there is no evidence of persistent infection in these patients.

Since when are psychiatric disorders "triggered by certain infections"? Since when is "no evidence of persistent infection in these patients" - which besides is a conscious lie by the writer: There is evidence of "persistent infection", if the patients are properly investigated by real scientists - evidence for a persistent psychiatric disorder?

Those fatigue states which clearly do follow on a viral infection can be classified as post-viral fatigue syndromes.

Surely they "can be" thus "classified". But that is not the question: They also can be classified as being possessed by demons, or whatever else you please, including "somatoform disorder". In any case, here we see another case of word magic: Since indeed it is true that viral infections are normally accompanied by feelings of being tired, the psychiatric pseudos conclude that "therefore" these "can be classified as post-viral fatigue syndromes".

Note the subtle insinuation of "syndromes" here - and indeed, the same trickery can be done with any disease, and if "fatigue states" are the symptom used, any disease can be "shown" in this way to lead to all manner of "post-viral fatigue syndromes" then one can be pretty sure all manner of psycho-therapeutical witch-doctors will want to give their insurance-paid therapies against it.

Other aetiological factors include physical inactivity and sleep difficulties.

This is a psychitaric way of putting the cart in front of the horse while pretending to be rational: If one is ill, on generally also suffers from "physical inactivity", and if one's illness includes "sleep difficulties" one will find it more difficult to get rid of feeling tired. But these are then not "aetiological factors", as the pseudo scientist who wrote this suggests, but simply consequences of being ill.

And indeed the game of the pseudo scientist who wrote this, and his co-workers, is to insist that the consequences of being ill are to be redefined, restyled, reclassified, and renamed as "symptoms of somatization disorder", because these patients then can be given hefty doses of Cognitive Behaviour Therapy, which brings bliss to the face of a therapist of it, when paid.

Immune and endocrine abnormalities noted in CFS may be secondary to the inactivity or sleep disturbance commonly seen in patients.

This is again disingenuous psychiatric sadism: What the the pseudo scientist who wrote this seeks to insinuate, by such clever allpurpose words as "may" is that somebody in which a real scientist has shown "immune and endocrine abnormalities", as has happened many times, which does explain why the patient feels miserable, is inactive and has sleep disturbances, in fact ("may") cause these "abnormalities" himself or herself, namely by .... unsavoury beliefs that the disease is physical, and by inactivity and sleep disturbance.

What the pseudos "forget to mention", as they always "forget to mention" any scientific finding that contradicts their nonsense, is that nobody has ever shown that one - in real fact, and not just in psychiatric insinuation - that "inactivity and sleep disturbance" in healthy persons can cause the immune and endocrine abnormalities that have been found in persons with the symptoms of ME, by real scientists.

Mood disorders are present in a large minority of patients, and can cause problems in diagnosis because of the large overlap in symptoms.

Actually, this is subtly falsified in two ways: First, mood disorders are present in any group of patients who have a disease for years on end, and who see their chances on a decent and normal human life and career disappear in pain, while being steadily defamed and denigrated by the psychiatric pseudos. Second, the incidence of mood disorders amongst people with ME, seems to be remarkably small, in the few cases this has been seriously investigated.

These mood disorders may be secondary, independent (co-morbid), or primary with a misdiagnosis of CFS. The role of stress is uncertain, with some indication that the influence of stress is mediated through consequent psychiatric disorders exacerbating fatigue, rather than any direct effect.

This is mostly twaddle without cognitive value ("may be", "is uncertain1").

Management

The general principles of the management of functional disorders are given in Box 22.7.

This is witchdoctor-medicine if there are no "functional disorders" other than as "medically unexplained diseases", as is the case. And to suggest that one KNOWS the proper "Management" of "medically unexplained diseases" seems criminal incompetence and quackery to me. I'll arrive at Box 22.7 in a moment.

Specific management of CFS should include a mutually agreed and supervised programme of gradual increasing activity.

What stinks here is first the innocuous sounding "mutually agreed and supervised": At least in England it turns out that if you dare not to agree, and indeed try to resist to sign your rights away, you'll get serious trouble with the supervisor, and may loose your dole or benefits. In other circumstances, any similar procedure is called "blackmail". Second, it FORCES people in a "programme of gradual increasing activity", which is, it seems to this psychologist of nearly 60, based on psychiatric needs to hurt or harm, but not on any good science.

Indeed, to my mind it all sounds like applied sadism, and that especially in view of the standing ruling of the WHO that ME is (i) a neurological disease and (ii) is NOT a psychiatric condition. Hence, if some psychiatrists can effectively force you to exert yourself in a disease in which it is known since 40 years at least that precisely that will exacerbate your symptoms, you have almost as clear a case of abuse of power, medical sadism, and attempts to harm and hurt ill people as one could think of, outside the Lubjanka and Pol Pot's prisons.

Finally, it has meanwhile been shown, also in the medical literature, that the programs "of gradual increasing activity" do no good and considerable harm. I would advice everyone who is forced to this by threats that one else looses one's dole or benefits, that one records all names, addresses, personal details and whatever else may help to prosecute these people who do this to one for damages, medical malpractice, incompetence, unethical behavior and intentional malice.

However, few patients regard themselves as cured after treatment.

This is again a misrepresentation: Very few "regard themselves as cured after treatment", and indeed the few who did say so may have been too frightened and too much pained to say otherwise, just to escape being physically maltreated. Also, few have reported any improvements in their condition, and to the few who did the foregoing applies. Finally, many have reported a worsening of their symptoms and an increase in pain.

It is sometimes difficult to persuade a patient to accept what are inappropriately perceived as psychological therapies' for such a physically manifested condition.

This is sadistic doubletalk of frightening dimensions, but is cleverly done: These therapies of enforced exercise are not psychological but physical, and they are sadistic when enforced upon people who are ill. And the conditions these patients suffer from are "physically manifested" because they are physical.

 Antidepressants do not work in the absence of a mood disorder or insomnia.

As every beginning student of medicine should know. So what is the purpose of saying it here is unclear.

Now to Box 22.7:

Box 22.7 Management of functional disorders

Again "functional disorders" = "medically as yet unexplained illnesses".

The first principles is the identification and treatment of maintaining factors (e.g. dysfunctional beliefs and behaviours mood and sleep disorders)

This is as Torquemada would argue: Since you have the wrong dysfunctional beliefs, you will get more treatment/torture - and if you dare to protest, or indeed as much as say that you are ill, this is taken as a sign that you still indulge in "dysfunctional beliefs".

Communication

Explanation of ill-health, including diagnosis and causes

I am a psychologist and a philosopher. I have this disease for 32 years. These are not "Explanations": these are malacious lies, that only serve the pleasures of medical sadists or the incomes of those who are so indifferent to other people's suffering that they wish to force ill people to do physical exercises, if they are not gross and culpable incompetence.

The "diagnosis and causes" I have read in this Handbook of Cilinical Medicine are scientifically incompetent, morally sickening, and legally most dubious (and should be completely forbidden).

Education about management (including self-help leaflets) .

As above - with the addition that all psychiatric cant and sadism also pays the canters and sadists very well indeed.

Stopping drugs (e. g. caffeine causing insomnia, analgesics causing dependence)

This again is medical sadism: If you have very little energy, caffeine gives at least a little more. No doubt I drink too much coffee, but this is because I get no help whatsoever, so I am forced to try to clean my house and do the shopping as well as I can. As to analgesics: It is sick and a clear symptom of a sadistically diseased brain to deny a person who is in pain to take a painkiller, on the spurious argument that this may be "causing dependence".

Rehabilitative therapies

This is another piece of Orwellian double talk: Terminology that far from subtly suggests one is a criminal. Similarly, in Holland I have learned over the last six years that I am supposedly "socially unintegrated" because I am ill, for which reason I should take part in forced "courses of social integration" that will cost the taxpayer 5000 tot 10.000 euro in money - just for me alone - to the phoneys and loonies that are supposed to "socially integrate" me - and that in a society in which I have been discriminated for 32 years, because I have "an unexplained disease", whereas all manner of junks, even those who do not have the Dutch but the German or Belgian nationality, could all these years get all manner of very costly help for years on end, simply because in their blood there is evidence that they shoot heroin, and in my blood there isn't.

Cognitive behaviour therapy (to challenge unhelpful beliefs and change coping strategies)

Cognitive behaviour therapy is word magic, pretentuous nonsense and fraudulent pseudo science. NO ONE knows how the brain generates experience, and ALL who claim to understand the human mind have little more to offer than a web of words and guesses.

The term "unhelpful beliefs" should be read as "politically/psychiatrically incorrect beliefs": They are simply such as deny that the psychiatrist or his nurses that are maltreating and denigrating one are competent or moral. "Coping strategies" again is psychobabble for having one's habits upset on purpose by some nurse of doubtful motivation, small brain, and conformist inclination, who is simply following orders.

Supervised and graded exercise therapy for approximately 3 months (to reduce inactivity and improve fitness)

This is sick sadism when imposed on anyone who has good reason and good evidence to believe he or she is ill, as almost anyone with ME has, for most persons with ME were healthy and productive socially well-adjusted persons until they fell ill, and most persons with ME have since they fell ill suffered huge financial losses ("opportunity costs"), and have had no chances whatsoever to lead anything resembling a normal life.

Pharmacotherapies

Specific antidepressants for mood disorders,analgesia and sleep disturbance .
Symptomatic medicines (e.g. appropriate analgesia, taken only when
necessary)

Apparently, when one is a psycho-sadist, one can have everything both ways, and indeed that is a technique the leading psycho-sadists knowingly indulge in. Anyway, the rub is of course in  "appropriate analgesia, taken only when necessary": WHO is going to decide what is "approprate" and when it is "necessary"? A psychotherapist who became psychotherapist because he had sadistic parents, an unhappy youth, and many personal ills to avenge on ill people who cannot defend themselves? Or the only person in the universe who can  really feel his or her pains, namely the patient?

Prognosis

This is poor without treatment, with less than 10% of hospital attenders recovered after 1 year. Outcome is worse with increasing age, co-morbid mood disorder, and the conviction that the illness is entirely physical.

More malicious nonsense: The prognosis of people with ME is also poor with treatment, and the treatment outlined here may be life-threatening to some. That mood disorder is "co-morbid" (and e.g. not a direct consequence of not being helped at all while being subjected to the kind of pseudo scientific evil utter nonsene I am reviewing) is an unjustified assumption. Finally, "the conviction that the illness is entirely physical" IS the conviction (1) of virtually all patients (who are free enough to dare speak their minds) and (2) of the vast majority of medical doctors who are not psychiatrists.

Obviously there ARE diseases medical science as is cannot explain; obviously people with ME may, in vast majority, have such a disease; obviously there IS a lot of real scientific evidence that many people with ME DO have many pathologies healthy people do NOT have; and indeed it is also obvious that some people who believe they have ME have something else; obviously there also will be a few who are mad who claim they have ME (in a very small minority); and obviously, if one has ME and depends on the heaven that is called English dole, one either is really ill or else a  masochist. (And for psychobabblers I add that with so many people with the symptoms of ME the chances are that 99.99% of those in the dole with ME are really ill.)

Finally, I turn to another table of psychobabble:

Table 22.5 Aetiological factors commonly seen in functional disorders

I note again that "functional disorders" is psycho-sado-speech for "medically unexplained diseases" (as "disorder" is again a clever bit of Orwellian terminology, possibly suggested by a lawyer), while "Aetiological factors" are NOT "commonly seen in functional disorders", for there are no such things in "medically unexplained diseases".

Predisposing

Perfectionist obsessional and introspective personality

Seems to me nonsense, and without any good statistical foundation. (The term "good" is inserted because the psychobabblers these day have become quite handy - since the computer can do the statistics they don't really understand anyway - in dressing up their nonsense as if it has some "evidence based" grounds, while these "evidence based" nearly always happen to be the pseudoscience of their psychobabbling colleagues.)

Also, note that this is yet another psychiatric way of denigrating persons who do think about the nonsense psychiatric babblers spout about ME: "O, you must be an introspective obsessive compulsive!".

Childhood traumas (physical and sexual abuse)

Personally, my guess is that the psycho-sadists have introduced this to guarantee easier access for themselves to the media. As far as I know there is no good statistical evidence for this whatsoever.

Similar illnesses in first-degree relatives

This is true and false at the same time. It is true, because ME - especially if it starts with a viral infection - has been shown to occur in patches. And my former wife and I both fell ill with Epstein-Barr in Januaru 1979, and never got over it. It is false, because the trickcyclists include it in a table of "Aetiological factors commonly seen in functional disorders".

Precipitating (triggering)

Does the modern education British doctors these days receive make it necessary to give elementary dictionary-definitions in a Handbook of Clinical Medicine? Anyway... there is a none too subtle difference: And "precipitating" involves a rapid descend, fall, or decline; while "triggering" at least suggests causation. In any case:

Infections

Indeed, and it seems the majority of persons with ME started their disease with some sort of infection (which indeed also may be the case in those where this seemed otherwise). In any case: Since when is a psychiatric disorder caused by an infection? Since this helped psychiatrists and psychotherapists find patients!

Chronic fatigue syndrome (CFS)

This is just nonsense - the concept of "Chronic fatigue syndrome" is nonsense (psychobabble, pseudoscience), and the inclusion of it in a table of "Aetiological factors commonly seen in functional disorders" is a disingenuous lie, without any good statistical support.

irritable bowel syndrome (IBS)

Psychologically traumatic events (especially accidents)

Curious and curiouser... but psychobabblers out for patients are capable of many misrepresentations.

Physical Injuries ('fibromyalgia and other chronic pain syndromes)

See under "Psychologically traumatic events (especially accidents)" and "Chronic fatigue syndrome (CFS)".
Also, it must be either a major new finding or a major new lie that "especially accidents" and "Physical Injuries" are "Aetiological factors commonly seen in functional disorders". When I studied psychology, I wasn't taught this. And indeed it seems bilge to me.

Life events that precipitate changed behaviours (e.g. going off sick)

In other words: According to this Handbook anything whatsoever can be among "Aetiological factors commonly seen in functional disorders". But I am sure insurance companies love this nonsense: If you are "going off sick", the psychobabblers will impute a "functional disorder" to you, so that they can conclude that what keeps you from working is merely your "dysfunctional beliefs", for which - OF COURSE! - the insurance company does not need to pay. And while treating you as a fraud and malingerer and while stealing your human rights for help with a disease, they have o so cleverly avoided telling you you are a fraud and malingerer: You have "dysfunctional beliefs" and a "functional disorder". And as far as the insurance company and their psychobabblers are concerned, you might just as well or better be dead.

Incidents where the patient believes others are responsible

First, this is somewhat subtle psychobabble for "paranoia", I fear. Second, it allows the psycho-sadist who deals with you to play games along the line that you with your "dysfunctional beliefs" refuse to take responsibility for your life. Therefore, you are to blame. (And don't you dare to say "No": That's more sick dysfunctional belief from a worthless wimp like you!) Therefore "society" a.k.a. the insurance company (the psycho-sadist has been working for since decades) will not pay your medical costs.

"And so it goes...".

Perpetuating ( maintaining)

Again, as under "Precipitating (triggering)", these are not synonyms - and I suppose, like very much in the prose I am reviewing, is intentional ambiguity to perpetuate, maintain, precipitate and trigger confusion and unclarity, since these are the forces that help the pseudo-scientists.

Inactivity with consequent physiological adaptation (CFS and 'fibromyalgia').

Again the victim is blamed: If you are ill you are inactive, and to claim you are or remain ill because you are inactive is to twist things around without evidence, except of incompetence or sadism in the writers.

Avoidant behaviours multiple chemical sensitivities (MCS) CFS

I don't know much by MCS, but fail to see why this may not play a real role in quite a few real diseases, whether to to perpetuate, maintain, precipitate or trigger it, if the vast majority of those in power believe the earth is warmed up by human activities. For it certainly is true that over the past 50 years enormous amounts of chemicals of very many kinds have become part of the biosphere, that have never been there before.

As to "Avoidant behaviours": That is of course in the eye of the beholder i.e. up to psycho-sadist who mistreats you: However you behave that does not fit his dysfunctional beliefs, he may style it "avoidance".

Maladaptive illness beliefs (that maintain maladaptive behaviours)

This again is up to the psycho-sadists' discretion - and whatever you believe about your illness he does not believe ipso facto "must" be "maladaptive".

(CFS)

Whether this entry is correct I don't know (as I am copying of a copy) but again it seems that the diagnosis of CFS can be "Perpetuating ( maintaining)" the having of CFS.

Excessive dietary restrictions (`food allergies')

This is a tricky formulation: "Excessive" is always wrong, and while `food allergies' stands between quotation marks, no doubt to suggest that it is all a "dysfunctional belief", in fact there are food allergies. However, I do not know of any good scientific investigation into their role in ME.

Stimulant drugs

This is unclear, since "Stimulant drugs" is unclear. Are we speaking of caffeine, benzedrine, cocaine? I doubt more than a very small percentage of persons with ME will take anything stronger than caffeine, for fear of the consequences (namely: if you exert yourself, e.g. by using amphetamines, it is very likely you will be struck by heavy post-exertional malaise). It would be interesting to see good scientific research on the effect of known stimulants of people with ME, if only because all would be helped much by a relatively innocuous stimulant, at times such a thing may come in handy.

Sleep disturbance

Here we have one of the rare moments the writers write the truth without admixture of lies, insinuations, doubletalk, innuendo, or suggestion - except that they have suggested several times that people with ME should be deprived of analgesics and of sleeping pills

Mood disorders.

As under Sleep disturbance

Somatization disorder

I must take it that "Somatization disorder" is a "Perpetuating ( maintaining) factor" in ... "Somatization disorder", so presumably what the psychobabbler who wrote this must have meant is that one "Somatization disorder" leads to another. Well, nonsense and absurdities often lead to more nonsense and absurdities.

Unresolved anger or guilt

Three of the very nice things about psychiatry, that undoubtedly attracts many a (n unconscious) sadist to it is that a psychiatrist has very much power over his patients and that he can always accuse them of believing or desiring anything whatsoever, if not consciously than unconsciously. O, and the third nice thing about psychiatry, for psychiatrists, is that it is NOT a REAL science at all: Nobody knows how the brain manufactures experience, so psychiatrists cannot be refuted, and claim and pretend what they please.

And the pseudo-science of psychiatry is divided into many mutually contradicting schools of thought, in which there even may be found a few decent, sincere, rational psychiatrists (usually with very few illusions about their fellow psychiatrists). Here I merely suggest that the real sciences have three things that the modern pseudo-sciences lack, with a few individual exceptions: Real sciences are not divided in many competing schools - there may be differences, but not about the fundaments, as in psychiatry, psychology and sociology; real sciences lead to a real technology that works completely regardless from your beliefs - pseudo-sciences like most schools of psychiatry and religion only "work" for the faithful; and real sciences are done by real scientists of great or considerable intelligence - in comparison with which psychiatrists, psychologists and sociologists almost invariably look like poor fools. (See the writings of Richard Feynman, or the writings of the philosopher of science Grunbaum on psychiatry, or the whole debate of some 25 years ago on the many frauds of Freud.)

Unresolved compensation

This is another of the favourite psychiatric/psychotherapeutic games: You must be compensating! And don't you dare discuss what the psychobabbler is compensating, or he'll tell you you suffer from "dysfunctional beliefs"!

3. Provisos

The present text is a first effort, and may take some reviewing, for which I don't have the fitness just now.

As I have indicated, my source for the blue text is under the last link. Also, part of my background is the following, copied from three days ago, and all well worth reading by anybody interested in ME, psychology, psychiatry, philosophy of science, the morals of and motives of psychiatrists, or rational thinking:

1. Anthony Komaroff

Ten discoveries about the biology of CFS (pdf)

2. Malcolm Hooper THE MENTAL HEALTH MOVEMENT:  
PERSECUTION OF PATIENTS?
3. Hillary Johnson

The Why

4. Consensus (many M.D.s) Canadian Consensus Government Report on ME (pdf)
5. Eleanor Stein

Clinical Guidelines for Psychiatrists (pdf)

6. William Clifford The Ethics of Belief
7. Paul Lutus

Is Psychology a Science?

Short descriptions:

1. Ten reasons why ME is a real disease by a professor of medicine of Harvard.
2. Long essay by a professor emeritus of medical chemistry about maltreatment of ME.
3. Explanation of what's happening around ME by an investigative journalist.
4. Report to Canadian Government on ME, by many medical experts.
5. Advice to psychiatrist by a psychiatrist who understands ME is an organic disease
6. English mathematical genius on one's responsibilities in the matter of one's beliefs:
   "it is wrong always, everywhere, and for anyone, to believe anything upon
     insufficient evidence
".
7. A space- and computer-scientist takes a look at psychology.


Maarten Maartensz

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