Private eye Medicine Balls column, 10 December 2016: ‘ME campaigners don’t ignore CBT and GET… but they do challenge the science’ Private eye Medicine Balls column, 25 November 2016: ‘ME cluster bomb’ [Written by ‘M.D.’, the nom de plume of Dr Phil Hammond and reproduced by the ME Association]:
The Eye received many supportive letters for stating in the last issue that CFS/ME (chronic fatigue syndrome/myalgic encephalopathy) has biological causes, but also some criticisms.
As one doctor put it: “Every illness has a physical, psychological and social component, and limiting diagnosis or treatment to only one aspect of someone’s illness is likely to lead to a much poorer outcome. This ‘triple diagnosis’ applies to any disorder you care to consider, although obviously in varying proportions. The one exception seems to be CFS/ME where any suggestion that there might be a psychological or social component leads to criticism. That cognitive behavioural therapy (CBT) is the only treatment which has repeatedly been shown to have any benefit is conveniently ignored.”
ME campaigners don’t ignore the fact that CBT and graded exercise therapy (GET) have been shown to work in randomised controlled trials and are endorsed by lofty scientific institutions such as the Cochrane Collaboration and NICE, but they do challenge the science.
The PACE trial, set up to compare the effectiveness of the four treatments for CFS/ME, has caused particular controversy and activists have had to fight to gain access to sue of the data which they are re-analysing to determine if claims about the efficacy of GET and CBT have been over-stated. For the PACE researchers to accept any such re-analysis would require it to be published as a credible peer-reviewed journal with independent analysis that is free from bias. It is a long and complex process.
M.D. agrees that the split between mind and body is unhelpful, and there are indeed physical, psychological and octal elements in all illnesses, either as causes or consequences. But it was doctors who initially dismissed a physical basis for CFS/ME, and as a consequence insufficient attention and resources have been given to doing large scale biological nutritional and genetic studies that might provide alternative treatments to the non-drug options currently on offer.
