My my this was indeed a rather "rattled" response from Dr Sharpe
to the
recent article by Margaret Williams and Eileen Marshall....
http://www.meactionuk.org.uk/UNUMProvident_Sharpe_and_CBT.htm
...but as is usual with these doctors they manipulate the language to fool
their readers...
Dr Sharpe said in his response...
<snip>
"I have repeatedly argued that patients with these condition(s) are
best
managed in a medical setting with a multi disciplinary resources."
</snip>
This means absolutely anything. A medical setting is a hospital, a doctors
surgery or anywhere doctors hang out (after all there is safety in numbers).
Multi disciplinary resources can mean absolutely anything to anyone yet
again.... A physiotherapist (following a Wessely arranged Graded Exercise
course), an occupational therapist (doing the same), a counsellor or a
psychotherapist applying Wessely et al's Cognitive Behavioural Therapy, a
GP
pushing it all along and a psychiatrist pulling the strings in the
background constitutes a mutli-disciplinary team.
Note how the neurologist, cardiologist, endocrinologist and the non
psychiatrically biased immunologist with one notable exception being AfME's
medical director as well as other specialists can be conveniently excluded
depending on the subjective views of those controlling the plight of the
patient regardless of any possible undiagnosed, uninvestigated and
potentially harmful underlying pathophysiology that is going systematically
ignored (such as a heart problem for example.)
Dr Sharpe then went on to say the following....
<snip>
" Much is made of an invited review I wrote for a Unum report on poorly
understood illness entitled "Trends and Health and Disability in 2002".
As the authors will know it is simply a fact of the current classifications
that
individuals with these conditions including CFS/ME would qualify for both
a
medical diagnosis and for a psychiatric diagnosis of somatoform disorder."
</snip>
Thanks to 15 years of hard work by Wessely, Sharpe and their colleagues this
may be the case because at every turn they have endeavoured to reclassify
ME/CFS as a psychiatric or psycho(somatoform) disorder (I site the case of
the manipulation of the WHO classifications G93.3 and F48.0). Somatoform
Disorders and other psychiatric disorders also have the status of a medical
diagnosis because as such a medical diagnosis is made by a doctor.
Perhaps Dr Sharpe is trying to mislead his readers into believing that
psychiatrists are no longer able to make medical diagnoses?
The fact is that the majority of the medical profession is now seeing through the claims of a very small group of opportunistic, exploitative psychiatrists who are at every turn overlooking all the pathophysiological evidence that consistently appears outside of it's own profession demonstrating clearly that ME/CFS is not a psychiatric condition of ANY kind as claimed by those few who exploit the classifications they themselves worked so hard toproduce for their own career ends over the last 15 years.
Take a look at just one example of recent research that psychiatrists would
not want you to know about....
http://my.webmd.com/content/article/63/72082.htm?z=1728_00000_1000_ln_05
As so many of us know here and elsewhere there are dozens and dozens of
examples appearing every week right around the world covering issues
directly relating to ME/CFS in nearly EVERY clinical speciality in medicine
that has absolutely NOTHING WHATSOEVER to do with the views or opinions of
psychiatrists.
During the last 2 decades, psychiatrists obsessed with ME/CFS have routinely
produced studies far more systematically biased than ANYTHING that Margaret
Williams or her co-authors have *ever* produced.
The "Wessely School" have attempted to convince their peers via
a worldwide
network of likeminded colleagues that ME/CFS is a "disorder" that
can be
treated and cured by CBT and Graded Exercise - claiming that ME/CFS is
predominantly the cause of faulty illness beliefs and muscle deconditioning
with only minor disturbances to the neuro-endocrine system to account for
any discrete biological abnormality. This is not surprising... this is the
ideology of psychiatry - to formulate a psychological construct for symptoms
they claim are "medically unexplained" or indeed "unexplainable".
On the other hand, Margaret Williams et al have simply been exposing the
massive disparity, the denigration applied by this profession and in doing
so have tried to balance the debate and counter the stream of well financed
and coordinated yet flawed pseudo-science.
Further more, thanks to the appalling state of the peer review system and
the inherent bias of the BMJ/Lancet along with other journals overseas, much
of this systematically biased research now increasingly described as "poorly
carried out" has been published and pushed upon the medical establishment
and the media in preference to *anything* that contradicts the views of the
psychiatrists themselves. After all, if you say something often enough and
in enough places - people start to believe it - to believe it to be true and
as a result it becomes fact.
As I've said myself having studied Psychology to "A" level, this
peer
reviewed "evidenced based" research wouldn't in most cases usually
make it
past an "A" level examination moderator due to the inherent and
artificially
created hetereogeniality of the study groups psychiatrists use in their
studies that use floored inclusion criteria - the criteria of choice because
after all it produces the results they need to prove their views.
As I've also pointed out, these studies never use any sort of adequate
patient numbers to make the outcomes conclusively significant. The fact that
severely ill patients were and are never selected (they often cannot get to
out patient clinics let alone participate in Graded Exercise and CBT because
severely affected people are too damn ill), the fact that those who drop out
of the studies (usually due to deterioration of health) are never followed
up. The fact that children have ever been investigated and the fact that sub-grouping
has never taken place (to create a better and more accurate inclusion criteria)
all lead the constant drip drip of research by psychiatry to be scientifically
floored and thus unreliable evidence.
Dr Sharpe is indeed allowed his right of reply but I know that after
everything he has said
about the issue of ME/CFS over the years and after
all that has been said by his collaborative colleagues, those that are well
aware of the current situation will see Dr Sharpe's recent response and
simply cast it aside because the views of psychiatrists in relation to
ME/CFS are fast becoming discredited, irrelevant and insulting to those who
read them.
Thankfully we know just who is misleading who......
Just as Psychiatry became "yesterday's profession" in relation
to Multiple
Sclerosis, Parkinson's Disease and Motor Neurone Disease so psychiatrists
involved with ME/CFS are fast becoming discredited by their own history,
their words and their actions and thus they are becoming "yesterday's
news"
in relation to their claims over ME/CFS.
ME/PVFS and CFS are all classified as neurological diseases by the World
Health Organisation and are listed under section G93.3
and as such these
conditions should be treated by neurologists as primary care specialists.
The World Health Organisation list them there for a reason - it is their
valued opinion - the opinion of the World Health Assembly and not the views
of a relative handful of psychiatrists on a mission with careers to further.
Any secondary psychiatric problems of someone with a G93.3
neurological
disease should be passed onto psychiatrists who should in theory only play
a
secondary supportive role just as they do such for people with MS, Arthritis
and HIV/AIDS amongst other equally debilitating diseases. Sadly though, there
isn't as much money in secondary care these days.
And then there is "Fatigue
Syndrome". On the other hand, "Fatigue
Syndrome" and ONLY "Fatigue Syndrome" is specifically classified
as a mental and behavioural disorder by the World Health Organisation and
is listed as such under section F48.0. People with non-specific Fatigue Syndrome
should by all means be seen by psychiatrists as primary care specialists...
this is the correct
speciality for treating mental and behavioural disorders.
(To the novice reader, any confusion over this situation has been created
by
the profession of psychiatry for the advantage of psychiatry.)
The WHO have no intention of reclassifying ME/PVFS/CFS for the next 8 years
AT LEAST despite efforts of members of the "Wessely School" to have
these
classifications changed but as people have seen, psychiatrists have already
done their best to do this reclassification here in the UK and without the
permission of the WHO in Geneva.
http://www.whoguidemhpcuk.org/
Perhaps the medical profession could do us all a favour, and untangle the
mess that the ME/CFS psychiatrists have created...
Perhaps you could separate out those with non-specific F48.0 "Fatigue
Syndromes" away from G93.3 ME/PVFS/CFS even if that does mean that Action
for ME and the ME Association lose a heck of a lot of members as a
result....
Sub-grouping might just be the way to remove psychiatrists from making
claims over the ME/CFS community because after all ME/CFS is primarily a
neuro-immune-endocrine and cardiac disease. Some people with ME/CFS also
need to see gastroenterologists, liver specialists and other specialists and
the common thread is - no one in the ME/CFS community is at present allowed
to be referred to ANY of these specialists that should be an integral part
of a real service to those with ME/CFS.
http://www.meactionuk.org.uk/Subgroups.htm
As a suggestion; (and I suggest this with the knowledge I gained in my
profession of diagnostic radiography) perhaps the best way to subgroup the
ME/CFS community would be by turning away from the discredited views of
psychiatry and turning instead to the rest of medicine and in doing so
listen very hard to what they have to say and employ their views by
investigating our symptoms using investigations they know are directly
relevant to our complex and debilitating symptoms using all the ground
breaking research such as that recently produced in the USA in relation to
LVF...
http://www.the-aps.org/press%5Froom/eb03/13.htm
...no matter how complex because as we know with any complex disease or
illness - if you only prescribe basic tests to exclude established
conditions, you will not diagnose anything other than nothing at all and
indeed nothing at all is something that psychiatrists can then go on to make
careers out of.
In relation to ME/PVFS and CFS, medically unexplained/unexplainable physical
symptoms are myths that need to be urgently addressed and set aside for hard
science and very soon.
Yours sincerely,
Stephen Ralph DCR(R) Retired.
24th April 2003
-=-=-=-=-=-=-
www.meactionuk.org.uk
Putting the "Action" at the heart of UK ME Campaigning...