BEHAVIOR fear, anxiety. IS REASONABLE. but it would be fair if it were not in place. To overcome it. I suggest to realize fairness and merelakanya to achieve a less anxious and fearful lagi. http ://klinikpsikis.com /understanding-anxiety-anxiety / there described as a state of anxiety about the fair

Professor Simon Wessely of the Institute of Psychiatry claims that 'randomised controlled trials' remain 'the gold standard of evidence' but doesn't mention that this strong statement can only truly be the case where trials are placebo controlled, properly blinded and properly randomised.

Even then, the results cannot be generalised completely, and may even apply only to the trial subjects under the particular trial conditions, and not to the population at large.

There seems to some confusion about the nature of RCTs at the Institute of Psychiatry.

Writing about his own and others’ CBT 'trials', Professor Wessely's colleagues at the Institute of Psychiatry, Professor Trudie Chalder and Dr Mary Burgess, CBT therapists who are pivotally involved alongside Prof Wessely in a repetitive, redundant, unblinded non-randomised (in the true sense) non-placebo-controlled CBT 'trial' at the taxpayers vast expense (PACE - funded by the Department of Work and Pensions & MRC), claimed about the trials apparently underwriting and justifying the PACE trial, in their 2005 book "Overcoming Chronic Fatigue" :

"The effectiveness of CBT in treating CFS has been evaluated in three well-conducted research studies undertaken since the 1990s. All three were conducted as randomized controlled trials; that is, trials in which there are more than one treatment group, and participating patients DO NOT KNOW which group they are in. CBT was found to produce better results than the other treatments with which they were compared."

How could participating patients NOT know which group they are in, and why would CBT therapists Prof Chalder and Dr Burgess make such a claim about trials, comprehensively slated by knowledgeable professionals in various journals, about a situation where there are in fact no ‘other treatments’ ?

It's surely problematic enough in real medical research where there's enough biological variability to skew results rendering them invalid, even with double blinding, proper randomisation and placebo controls, but the problems must become insuperable, if not intractable, where these RCT requirements are ignored in a situation where there's no objective measures, no clean diagnosis, a reliance on the treacherous self-reports of subjects glad of some, if not the only attention they’ve ever had, vulnerable subjects who can be easily manipulated no matter how unintentionally, and an extraordinary pressure on the trialists and hence participants to get the results the DWP obviously want, from a trial costing the taxpayer millions.

Worse , the trialists have already decided what the results of this 'trial' will be in advance (see NHS Plus).

Of course, fatigue is a signal that something is wrong and logic dictates you find what’s wrong and treat that, not the signal there’s something wrong. There are no strawberry shortcuts, whatever the DWP hope.

Gold standard?

"archiecoch" wrote about the PACE trial's lack of credibility.

What about the mountain of uncontrollables and uncontrolled for
variables being swept under the grubby middle aged DWP carpets of this
seeming CBT show trial?

There are no plausible mechanisms you can check and nothing being
objectively measured. It's worse than trials in homeopathy or astrology.

The PACE trial is bound by the Helsinki Agreement and requires "fully"
informed consent, in addition to participants fully understanding the
implications and "aims" of the trial.

Fully informed consent including a complete understanding of the trial's
implications could not have been sought, otherwise there would be no
trial participants and no trial, obviously.

Jonathan Rutherford's article "New Labour, the market state, and the end
of welfare" contains important information about the "aims" of some of
the people who have "designed" and are now running this trial (Sharpe M,
Wessely S and Aylward M)
http://www.lwbooks.co.uk/journals/articles/rutherford07.html

I guess one would really have to figure out who was on the ethics
committee, how well informed and exactly how independent they actually were.

It should really be very thoroughly and independently investigated by
the appropriate international authorities.

Otherwise it's a predetermined Pyhrric victory for the aficionados of
CBT for "CFS" (the M.E deniers), and a huge loss to society as more
research money goes down the drain and a quarter of a million people
affected by M.E. in this country are condemned to remaining physically
ill every day of their lives, often very severely.

Professor Wessely asks - 'is this really a sly scheme simply to reduce the staggering costs of disability benefits?' - and immediately provides a very straightforward and unambiguous confirmation that this is indeed precisely the case.

'The answer is no, not directly' - i.e. - the answer is yes, indirectly.

Professor Wessely's colleagues were directly - 'involved in developing guidelines for the Department of Health on the management of CFS for Occupational Health Physicians' - and were both directly and indirectly involved with a NICE guideline on CFS.

'One staff member' - has been - 'conducting workshops and lectures on the cognitive behavioural treatment (CBT) of CFS all over the UK' (RV5 Better treatments for Chronic Fatigue Syndrome - South London and Maudsley NHS Trust).

A 'key finding' of their NHS Plus guideline was that - 'Cognitive behavioural therapy and graded exercise therapy have been shown to be effective in restoring the ability to work in those who are currently absent from work'.

For their NHS Plus guideline they elected to mine SD Ross et al's ready-made review - "Disability and Chronic Fatigue Syndrome" - 'as the basis for [their] systematic review' .

While SD Ross et al. had already concluded (Arch Inter Med 2004) that - 'No specific interventions have been proved to be effective in restoring the ability to work' - Professor Wessely had also concluded ( JAMA 2001) that he and his colleagues' CBT and exercise ideas for 'CFS' were not 'remotely curative'.

The costs to the taxpayer must be simply 'staggering' as yet more experiments are carried out on members of public to 'prove that' - rather than 'evalute if' - CBT works for CFS (and everything else).

Meanwhile scientific research into the causes and cures of disease must inevitably suffer as a direct consequence.

After reviewing the 'best research' literature on the subject Professor William M Epstein provided direct insight into this disturbing social phenomena when he wrote in 2006 ('Psychotherapy as Religion' - Nevada University Press) that - 'CBT appears to be the favored contemporary choice of psychotherapy, eclipsing psychodynamic and behavioral treatments as American society intensifies its preference for personal responsibility over social responsibility, exaggerating an already exaggerated heroic individualism... for all its deficiencies, (CBT) has not inspired effective clinical practice... the best research offers no credible evidence of any successful psychotherapy for any condition. In just this way, both the theory and the practice of CBT are social languages, that is, "schemas" of social meaning, a Wittgenstein language-game, a universe of discourse. Failing as science, cognitive theory and cognitive-behavioral treatments become interesting as social phenomena of belief - it is fascinating to speculate why contemporary culture accepts the metaphysics of CBT rather than behavioral therapy or psychodynamic therapy, or for that matter Christian Science, colonic irrigation, or phrenology'.

Interestingly enough, the lead investigator of the PACE trial, a Proffessor Peter White, spoke on You and Yours recently.

He said; "Like many, many illnesses if I have something going on in my brain, such as thinking at the moment, that is a physical process happening in my brain and therefore if I have a feeling or a thought it is physical, it's not entirely psychological".

A kind of NewLabour's Freudian slip.

The "something going on" in his brain he likens to "many illnesses".

He seems to suspect, albeit unconsciously, that his thoughts are a bit diseased.

Feelings and thoughts are psychological but mainly physical, he infers, out of convenience, trying to publicly avoid suggestions that he thinks ME is psychological and his methods are psychological, both of which are the case of course.

But you can typically have a physical thought and a psychological feeling, as you do !

Take your pick, follow your whim, or in this case, the money.

You wouldn't fly in an aircraft with a pilot exhibiting this degree of confusion.

But then they tend to have regular check ups of both body and mind.