Thursday, 30 March 2006

Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists

Assessment and Treatment of Patients with ME/CFS: Clinical Guidelines for Psychiatrists

I’ve been meaning to post the above link to Dr Eleanor Stein's guidelines for a while. I also came across an article on the guidelines by Angela Kennedy, which I'll include at the end.

Some people maintain that psychiatric care is a curative treatment for ME/CFS. It's heartening to see others in the profession publishing documents that skewer this misguided and unscientific notion, outlining an evidence-based approach that is respectful and supportive of patients, rather than being fixated on curing their alleged illness beliefs.

Seriously. I know who has weird illness beliefs when it comes to ME/CFS, and it ain't the patients.

I’m still mired in payback, so I won’t say more today, except that my favourite quote from this document is:

"The best antidepressant for patients with ME/CFS is improved physical health and quality of life."

My oath it is.

Here's the article:

Australian Psychiatrist Eleanor Stein has recently published a paper about the assessment and treatment of patients with ME/CFS: Psychiatry Overview.

In this article, written with the support of authors of the Canadian Guidelines, Dr Stein writes about ways in which doctors can empower and advocate for patients, recognises ME/CFS as a multi-system potentially disabling medical disorder and presents a compelling argument for the use of the Canadian Criteria as a diagnostic tool. She delineates the psychological problems CAUSED by the effects of the disease (including the social and material inequalities and impact on quality of life), and demonstrates some of the flaws of the psychiatric paradigm of ME/CFS. She states unequivocally: "ME/CFS is not a psychiatric disorder".

It is inevitable that such a sensible, empathetic, truly evidence-based, patient-centred approach to such a serious illness by a psychiatrist will be contrasted to the approach of the proponents of the Psychiatric Paradigm, known colloquially as the Wessely School. Their approach is well-documented, and the stark difference all too obvious, by their own words, only SOME examples of which are documented in the Marshall and Williams collation "Denigration by Design" (1999), and the Hooper et al document "The Mental Health Movement: Persecution of Patients".

The way in which Stein writes about patients in the above paper is starkly different to the discursive constructions of patients employed by proponents of the psychiatric paradigm throughout their literature: where Stein writes about patient suffering, and quality of life issues, and patient autonomy and empowerment, proponents of the psychiatric paradigm charge patients with hypochondria, malingering, stupidity and/or hysteria, among other things. They attempt to deprive ill people of social and financial support that they need, and foist inappropriate psychological treatments and dangerous exercise regimes upon them. By their use of language and by their flawed methodology, they cultivate a culture of ignorance about this illness, and present personal, biased (and often prejudiced) opinions as if they were facts, even though they have been made aware of the flaws in both their research and reasoning about this illness.

The above charges are supported by large amounts of evidence, and this evidence is damning.

When articles such as Stein's appear, questions cannot help but arise for the ME/CFS community and those with associated conditions, adversely affected by the psychiatric paradigm: HOW can there be such discrepancy in approaches? WHY do proponents of the Psychiatric Paradigm write about patients in such frank contemptuous language, so consistently and relentlessly? HOW do they manage to ignore the huge amount of evidence demonstrating organic illness and the glaring flaws in their own beliefs, their own evidence?

These are essential questions that just will not go away and will need to be accounted for eventually. In the meantime, articles such as Eleanor Stein's work here must make for very uncomfortable reading for those of her psychiatrist colleagues who run with the Wessely School.

Angela Kennedy,
The One Click Group

http://www.theoneclickgroup.co.uk


3 comments:

  1. Hi. I also have ME and am currently having a relapse and live in carlisle, UK. I also have just started a blog!
    ReplyDelete
  2. i'm unsure how this comment thing works as am new to blogging. I hope you get better soon and thank you for postuing this useful link. The UK are currently having a trail based on the psychiatric model which is perceived as unhlepful by many.
    ReplyDelete
  3. Thanks for your comments Marianne, and sorry it's taken me so long to reply. I'll have a look at your blog!
    I like the polite way you put it, 'the psychiatric model which is perceived as unhelpful by many'. I don't support the psychiatric model myself, I think it's disgraceful.
    ReplyDelete

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