Some of you M.E. Peeps may have heard that the One Click Group is taking NICE to court over the latest guidelines about M.E./CFS.
Recently, Ann Robinson (no, not that one with the ginger hair and curled lip) wrote an article in The Guardian: Sick, mad or bad? saying that she cannot she what is wrong with the guidelines which suggest that CBT and GET (Graded Exercise Therapy) will be beneficial to PWME.
What's wrong with that idea is that CBT is a method through which one is supposed to be able to retrain the thought processes behind certain activity. It is used in a variety of contexts and with people with a variety of conditions.
Now, CBT may be useful in the sense that, for those who are having difficulty in adjusting to a restricted existence, they may gain insight into ways in which they might adjust to their plight. However, having been offered and accepted my GP's kind offer of CBT 5 years ago, I found that the therapist put great emphasis on ways in which she thought I could retrain my thinking processes to overcome my fatigue, pain, disorientation and muddled thinking. Now, if those aspects of myself had been psychologically based ---e.g. if I was clinically depressed and, as a result, the body was willing but the spirit weak, and I therefore found everything just too much effort, this may have worked. What she failed to understand was that I was not depressed and that the spirit was all too willing to get up and get on with whatever I desired but my body was weak and unwilling to let me. That's why PWME are so cross and agitated and frustrated about the idea that CBT can help them.
Similarly, the notion of GET is based around the fact that one is kind of 'out of condition' and if one can only motivate oneself (which again implies the idea that the problem is in the mind) to get up and get out, incrementally increasing the amount of activity, then one will eventually reach a state of nirvana where the idea of doing the London Marathon is all tickety boo.
Once again, when muggins was very, very poorly 6 years ago, muggins was persuaded to try this 'therapy' by my GP. Silly really ---I should have known better and my body was telling me to listen to it but no, I thought the GP must know better. He's such a nice man and so quietly spoken. He means well. He means well but he so deluded. I'm sure that my months of trying to walk further, walk faster made matters worse. This outcome is not unusual and GET has been shown to make people with M.E. worse --- not just in the short term but in the long term and sometimes permanently.
So, Ann Robinson, that is what is wrong with the Guidelines --- they are balderdash and not only that but they perpetuate the notion that
a) if only PWME would get up off their fat arses and TRY and
b) get over the prejudice about 'therapies' and the nuanced implication that they (PWME) are, in some way, mentally ill,
then they would get better and could go back to work.
This doesn’t help anybody and if you look at the Ann Robinson article via the link above and the message board that links to it you will read the most astonishing tripe and bigoted nonsense about PWME from all sorts of people. Thankfully, dear NMJ has put the point of view of PWME forcefully and told these twits a few home truths.
And another thing whilst talking of bigots and being misunderstood......
The proposed reform of Incapacity Benefits will most likely make people like me feel even more judged, intimidated and harassed than we do already. Only last year I was repeatedly asked to go for a Personal Capability Assessment at my local DWP office. I can only reach this town (11 miles away) on my very best day (few and far between and what any normal person would judge to be a 'sofa day')and this request was during the summer holidays when things are at their most hectic and I struggle every day.
I refused and refused until, in the end, my GP sent a letter and miraculously I received a phone call from the DWP telling me that I need not go and they would not contact me again for 3 years. They had not understood my condition or contacted the GP first and they had not understood the strain their type of persistence puts upon people who are already struggling to exist.
Last week, my friend who lives opposite was asked to attend the same office for a PCA. He is the same age as me, ( not that old) ,has a chronic heart condition, has recently become profoundly deaf and cannot walk further than abut 10 metres (with the aid of a stick) without being breathless and having to sit down. In all honesty he probably has about 5 years of life left if he's lucky. His own GP and Consultant have told him so and whilst he tries to adjust to this fact he is harassed to go for the PCA. In fact when he got there, the assessing doctor spent no more than 3 minutes with him and said it was ridiculous to even think about him working.... Yet still the pen pushers at DWP made him go.
The new assessment that comes with the reforms next October will, apparently, assess you for what you can do rather than what you cannot do. For example:
Can I use a keyboard and answer the phone and take a message ?
Yes I can do both.
Can I walk more than 30 metres?
Yes sometimes.
What none of these assessments ever seem to assess is how often, how regularly and consistently you can do any of these things ---particularly when you have a condition like ME/CFS, which fluctuates, day to day, minute to minute. They never take into account that inorder to do quite ordinary things like go to the Co-Op in the car two miles away, buy a loaf of bread and come back might entail a slow and steady preparation and a over an hour's rest afterwards. They also never seem to think about the notion of returning to work within the context of a life rather than as an activity in itself.
For example, on a good day I might manage to work for a morning (desk bound/sitting down sort of job) but which morning that is can vary. Presumably an employer would wish me to specify which morning I would show up for work but I never know from one day to the next how ill I'll feel ---so who will want someone who can be so unreliable /
If I was assessed as being able to return to work (even on a part-time basis) on the basis of my ability to use a keyboard and answer the phone, and that was all I had to do then I might be able to return to work but that doesn't take into account the actaul businees of working within the context of my life. There is still a house to run, children to care for, shopping to be done etc etc. It's the everyday existence stuff that takes whatever energy and wit I have. Holding that together is more than enough without adding to it by going out to ork as well. I cannot do it all. And what’s the betting that if I did return to work and into a job supplied by the DWP (so that they could tick a box and make their figures look good) that it would be a dead end job completely alien to my experience and expertise?
In the end, my suspicion is that a lot of this is down to money, politics and big business. It suits both the Government and the Insurance industry, who are in sway to each other, to uphold the Psychiatric Lobby who insist that M.E/ CFS is psychological rather than neurological. If it's psychological it's fixable by drugs or therapy, wizardry and mind bending and then we can all go back to work and save the Government and the Insurance the bother of paying out for what is due to us: us, who paid our taxes and contributions, who set up insurance plans and paid our premiums, who often went on working trying to pretend everything was all right when it wasn't and wanted and want desperately to be well and get back to a normal fulfilling life where we're not dependent and spending our time defending ourselves. The savings the Government and Insurance Industry think they might make would be better spent of proper Biomedical research and care instead of money making and ego building
12 comments:
I havent read the links yet; I will follow them next.
Cusp, this was a really well written post and all of your arguments / reasoning / points that you make I absolutely agree with.
I personally am against CBT btw. It probably is good for some people in some particular situations. But even for depression I think it is limited. I dont think CBT addresses root causes in such instances.
Great post!
Thanks Kahless. I was afraid it was a bit of a rant but it's all so frustrating. Actually the PCA business is particularly annoying for people like my friend because anyone with common sense (let alone a doctor) can see he has no chance of getting back to work and yet he's constantly hassled. He's having a hard enough time as it is in coming to terms with what has happened to him in the last 2 years and doesn't need this game of cat and mouse.
As for CBT, well it has its uses but they are limited and the DWP sell it like some kind of bloody cure-all. They even suggested it to my friend when what he needs is some space and quiet to sort HIMSELF out.
My two experiences with the DWP capability assessment still leave me seething whenever I recall them. Perhaps all I needed to do was refuse to go?
Well done cusp for keeping the torch alight when so many of us just can't. And to your friend too over at the Guardian site. What a load of ignorant bigots.
hey cusp - when CBT and GET fails to cure PWME, what will be next, lobotomies for us all?
i suggest that those who remain convinced that ME is a psychosocial illness are forced to havce CBT until their minds are changed.
a shame they can't experience the illness themselves, that's the only way they will be convinced. wish they could all have it for 24 hrs.
Great post - sorry to have got to it late. I wonder if you have thought of sending this off to a newspaper. It deserves a wider readership and would be helpful to many PWME.
An absolutely spot on blog post.
Hi Signs. Good to see you back ... you seem to be resurfacing a little I've left you in peace for the last while. Thanks for your praise: most honoured whenit comes frome Mrs. Waywithwords ;-) I suppose I could submit it to the local paper. Never considred it.
Hi Rachel. Welcome and nice to see you here. I've lurked many a time at your place and admired your drawings. Thanks for your kind words.
CBT is rarely the answer for most things it's just that Richard Layard has the ear of the government and is convincing them that is a cure all for everyone.
It's not.
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It saddens me to see that the situation in the UK with ME/CFS is possibly even worse than here in Australia. When I finish my masters, I plan to launch a campaign regarding the CFS situation in the direction of my local member, who was just elected Prime Minister a bit over a week ago. He seems like a caring man, but I guess we shall see.
I would encourage you to send your letter to any publication you can think of who might publish it...good luck!
Thanks for your support Amanda
Great post, did you see that some Australians, oops, have just said they can cure ME with, yes, with exercise. Don't know who they are, as the article in the paper only mentioned the Uni of Perth.
It wasn't mentioned that ME is actually made a lot worse by GET or exercise therapy so the research was clearly not done with ME patients.......
So not only was it a worthless article from a reporter who hasn't done any homework at all, but the same applies to the people at the Uni in Perth.
So great to see that you did this great blog on silly therapies that are useless etc.
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