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ME -Prof Bleijenberg & lasting harm
ME -Prof Bleijenberg & lasting harm - 24.05.2005 06:49

Prof. Bleijenberg (psychologist) was - together with Prof. Van
der Meer - one of the first followers of the controversial
*Wessely-School*, which alleges that ME is a psychiatric
behavioural disorder, which is perpetuated by aberrant illness
beliefs and personality, despite the abundance of well
documented ME/CFS research in peer-reviewed medical
journals, indicating pathological, multi systemic dysfunction.


~~~~~~~~~~~~~~~~~~~~~~~~~~~~




Prof. Bleijenberg (psychologist) was - together with Prof. Van
der Meer - one of the first followers of the controversial
*Wessely-School*, which alleges that ME is a psychiatric
behavioural disorder, which is perpetuated by aberrant illness
beliefs and personality, despite the abundance of well
documented ME/CFS research in peer-reviewed medical
journals, indicating pathological, multi systemic dysfunction.

From the start of the *fatigue* clinic in Nijmegen in 1991 they
have used flawed criteria, which suppress the true severe
symptomatology and emphasize *chronic fatigue* as the primary
symptom.

They are the leading authors of the worst CFS report ever written
in the medical history:

*Chronic fatigue syndrome* - by the Health Council of the
Netherlands, which can be found at:
 http://listserv.surfnet.nl/scripts/WA.EXE?A3=ind0503E&L=me-net&P=69896&E=2&B=---583083060-707284150-1113903638%3D%3A1779&N=cfs_advice.pdf&T=application%2Fpdf


The prominent researcher Leonard A. Jason et al says in the
study *Chronic Fatigue Syndrome: The Need for Subtypes*
(Neuropsychology Review, Vol. 15, No. 1, March 2005), that the
*model* of the Nijmegen University could not be replicated. This
is a proof of my former statement, that the report of the Health
Council of the Netherlands is based on swindle:


"......Typical of the purely psychogenic explanations for CFS is a
research group from the Netherlands (Vercoulen et al., 1998),
who believe that individuals with CFS attribute their symptoms to
physical causes, are overly preoccupied by their physical
limitations, and do not maintain regular activity.

According to this model, these factors cause individuals with
CFS to be functionally impaired, implying that the central
problem with patients experiencing this condition is a
psychosomatic preoccupation with one’s fatigue.

When Song and Jason (in press) tested this model, it fit
only with the chronic fatigue participants who had
psychiatric reasons for their fatigue. The fact that this
model could not be replicated with either the CFS group or
those with medical reasons for their chronic fatigue
suggests that CFS and chronic fatigue due to psychiatric
causes are not the same conditions...."



Jan van Roijen



``````````````````````

From:




Prof. Bleijenberg CBT study
~~~~~~~~~~~~~~~~~~~~~~~~~~~
(post M.E. Awareness Week 2005)




From: The Webmaster & Caretaker Team, ME Free For All.


To: All Members of ME Free For All
with permission to forward & repost.



----- Original Message -----


Subject:
Re: Prof. Bleijenberg CBT study
(post M.E. Awareness Week 2005)



Dear Professor Bleijenberg and colleagues,

For M.E. Awareness Week (8 - 14 May 2005), this year, our
principal theme at ME Free For All (related site:
www.mefreeforall.org), was "M.E. Centres of Attention", focusing
on the controversial and potentially harmful treatments offered in
the newly established specialist M.E. centres around the country
(see e-mail pasted below).

An article about your work, together with a case study of Saphira
van den Dam, was published on BBC News Online at
 http://news.bbc.co.uk/1/hi/health/4084631.stm.

In a follow up, I have offered freely for publication a critique of
your work, in particular and that of other researchers, in general,
which recommends Cognitive Behaviour Therapy and Graded
Exercise and I am sending a copy to you for your attention and
for right of reply if you choose.

Fundamentally, I am concerned that, until we distinguish between
M.E. and chronic fatigue states, progress towards a definitive
diagnostic test, treatment and cure will be impeded.

I do hope that, whatever the differences in our opinions and
conclusions, you agree that my analysis has been accurate,
objective and professionally courteous.


Yours sincerely
Dr John H Greensmith
Editor, ME Free For All
(www.mefreeforall.org)
e-mail:  info@mefreeforall.org
36a North Street
Downend
Bristol
BS16 5SW
United Kingdom


[Cc: Professor Gijs Bleijenberg, Professor of Psychology, Expert
Centre Chronic Fatigue, University Medical Centre Nijmegen,
Netherlands. With permission to translate, freely forward and
repost.]


Letters to the Editor.


Recent Research by Professor Gijs Bleijenberg et al (2004), at
the Expert Centre Chronic Fatigue, in Holland, claiming that
people with Chronic Fatigue Syndrome or M.E. can be helped
with Cognitive Behaviour Therapy and, subsequently, Graded
Exercise is controversial, questionable, based on some fragile
and unwarranted assumptions and demonstrates the need for
root & branch re-thinking of valid and reliable experimental
research design in this often poorly controlled field of study.

Firstly, all researchers need to come off the CFS/ME fence and
posit either that:

(a) M.E. is not a separate illness from all those other
conditions subsumed under the umbrella term Chronic
Fatigue Syndrome (CFS) and may always be used
interchangeably and synonymously, or that

(b) M.E. is a distinct illness, varying along a continuum of
severity, whether it is given the name Myalgic
Encephalomyelitis, where there is evidence of
inflammation of the brain and spinal cord, or Myalgic
Encephalopathy, where the same symptoms of
exhaustion, muscle pain, cognitive dysfunction etc. are
not accompanied by such evidence.


Most desirable, for all concerned, would be a definitive
diagnostic test for M.E., as well as for each of the other illnesses
currently considered together and good quality research is
desperately needed here. Continuing research with all illnesses
lumped together does not compare like with like, both within and
amongst experiments and the findings will be, at least, diluted
and, most likely, fatally flawed to be of any generalisation value.


In addition to losing the opportunity to differentiate clearly
between these groups of patients, Professor Bleijenberg,
secondly, makes a fundamentally shaky assumption that the
trigger of the illness (often but not always a virus) has now
passed, rather than that it may be dormant, persistent and/or
recurrent; or some other, as yet unthought of, possibility.


Thirdly, Professor Bleijenberg (as well as other researchers in
their work) may offer a false dawn to people with M.E. Whereas
Cognitive Behaviour Therapy (CBT) may be of help to some
people with an illness in which fatigue is a principal symptom
and who have a negative attitude to their illness, it may be of no
value to people with M.E., who have no such negative feelings.
Nor is it true to say that if CBT does no good, it will do no harm.
For veteran M.E. sufferers, it may be the latest disappointment in
a long line of treatments, which had looked promising, that
proves the last straw.


Furthermore, Professor Bleijenberg asks M.E. patients to take a
risky gamble for high stakes when he suggests, after CBT,
Graded Exercise. Certainly, some exercise is necessary, for
even the most severely affected patients, to prevent them seizing
up but research and painful experience has shown that stepping
up activity, in incremental stages, irrespective of the patient's
health at the time (notwithstanding reassurances that therapists
understand the limits and apply restraint), leaves many more
people with M.E. worse, than it helps, sometimes irrecoverably
so.

Amongst this disarray of poor experimental design and practice,
ME Free For All (www.mefreeforall.org) urges the suspension of
such research programmes with the equivocal acronyms PACE
(Pacing, Activity, Cognitive behaviour therapy, a random
evaluation) and FINE (Fatigue, Intervention by Nurses
Evaluation) until the underlying research rationale is more solid
and some more basic epidemiological and physiological
research has prepared the ground.

It is better to have no treatment at all than one that does you no
good and might do you lasting harm.



Yours sincerely

Dr John H Greensmith
Editor, ME Free For All
(www.mefreeforall.org)
e-mail:  info@mefreeforall.org.
36a North Street
Downend
Bristol
BS16 5SW



~~~~~~~~~~

- E-Mail: j.van.roijen@chello.nl
 

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