Loading ...
Sorry, an error occurred while loading the content.
 

ACT: Part 2/3: THE MENTAL HEALTH MOVEMENT: PERSECUTION OF PATIENTS?

Expand Messages
  • ownermeinformuk
    ACT: Part 2/3: THE MENTAL HEALTH MOVEMENT: PERSECUTION OF PATIENTS? Two illustrations of the implementation of Wessely School policy Out of the many known
    Message 1 of 1 , Jan 11, 2004
      ACT: Part 2/3: THE MENTAL HEALTH MOVEMENT: PERSECUTION OF PATIENTS?

      Two illustrations of the implementation of Wessely School policy

      Out of the many known cases of patients being persecuted as a result
      of the implementation of Wessely's policy on ME, just two are
      mentioned here: details of many others have been put before the
      Chief Medical Officer, who has made it known that he receives more
      letters about ME than on any other medical issue. There are
      numerous records relating to this matter in Hansard (both Lords and
      Commons) and on 23rd November 1999, the House of Commons Select
      Committee on Health produced its Report looking at adverse clinical
      incidents, unexpectedly poor outcomes to treatment, failures in
      medical care and poorly-performing doctors: that Committee took
      representations from at least eight people about ME.

      1. The case of Ean Proctor

      In 1988, a formerly healthy 12 year old boy named Ean Proctor from
      the Isle of Man had been suffering from ME since the autumn of 1986;
      his symptoms included total exhaustion, feeling extremely ill,
      abdominal pain, persistent nausea, drenching sweats, headaches,
      recurrent sore throat, heightened sensitivity to noise and light and
      loss of balance; he was also dragging his right leg. In 1987 his
      condition had rapidly deteriorated; he had gradually (not suddenly
      as may occur in hysterical disorders) lost his speech and was almost
      completely paralysed (which lasted for two years). He had been seen
      by Dr Morgan-Hughes, a senior consultant neurologist at the National
      Hospital in London, who had reaffirmed the diagnosis of ME and
      advised the parents that ME patients usually respond poorly to
      exercise until their muscle strength begins to improve; he also
      advised that drugs could make the situation worse.



      Although he did not obtain his MRCPsych until 1986, during one visit
      by the Proctors to the National Hospital in 1988, Wessely (then a
      Senior Registrar in Psychiatry) entered the room and asked Ean's
      parents if he could become involved in his case; desperate for any
      help, they readily agreed. Wessely soon informed them that children
      do not get ME, and unknown to them, on 3 June 1988 he wrote to the
      Principal Social Worker at Douglas, Isle of Man (Mrs Jean Manson)
      that "Ean presented with a history of an ability (sic) to use any
      muscle group which amounted to a paraplegia, together with elective
      mutatism (sic). I did not perform a physical examination but was
      told that there was no evidence of any physical pathology.I was in
      no doubt that the primary problem was psychiatric (and) that his
      apparent illness was out of all proportion to the original cause. I
      feel that Ean's parents are very over involved in his care. I have
      considerable experience in the subject of 'myalgic
      encephalomyelitis' and am absolutely certain that it did not apply
      to Ean. I feel that Ean needs a long period of rehabilitation
      (which) will involve separation from his parents, providing an
      escape from his "ill" world. For this reason, I support the
      application made by your department for wardship".



      On 10 June 1988 Wessely provided another report on Ean Proctor for
      Messrs Simcocks & Co, Solicitors for the Child Care Department on
      the Isle of Man. Although Wessely had never once interviewed or
      examined the child, he wrote "I did not order any
      investigations..Ean cannot be suffering from any primary organic
      illness, be it myalgic encephalomyelitis or any other. Ean has a
      primary psychological illness causing him to become mute and
      immobile. Ean requires skilled rehabilitation to regain lost
      function. I therefore support the efforts being made to ensure Ean
      receives appropriate treatment". Under his signature, Wessely
      wrote "Approved under Section 12, Mental Health Act 1983".



      In that same month (June 1988), without ever having spoken to his
      parents, social workers supported by psychiatrists and armed with a
      Court Order specially signed by a magistrate on a Sunday, removed
      the child under police presence from his distraught and disbelieving
      parents and placed him into "care" because psychiatrists believed
      his illness was psychological and was being maintained by an "over-
      protective mother". Everything possible was done to censor
      communication between the child and his parents, who did not even
      know if their son knew why they were not allowed to visit him.



      In this "care", the sick child was forcibly thrown into a hospital
      swimming pool with no floating aids because psychiatrists wanted to
      prove that he could use his limbs and that he would be forced to do
      so to save himself from drowning. He could not save himself and
      sank to the bottom of the pool. The terrified child was also
      dragged out of the hospital ward and taken on a ghost train because
      psychiatrists were determined to prove that he could speak and they
      believed he would cry out in fear and panic and this would prove
      them right. Another part of this "care" included keeping the boy
      alone in a side-ward and leaving him intentionally unattended for
      over seven hours at a time with no means of communication because
      the call bell had been deliberately disconnected. The side-ward was
      next to the lavatories and the staff believed he would take himself
      to the lavatory when he was desperate enough. He was unable to do
      so and wet himself but was left for many hours at a time sitting in
      urine-soaked clothes in a wet chair. Another part of the "care"
      involved the child being raced in his wheelchair up and down
      corridors by a male nurse who would stop abruptly without warning,
      supposedly to make the boy hold on to the chair sides to prevent
      himself from being tipped out; he was unable to do so and was
      projected out of the wheelchair onto the floor, which on one
      occasion resulted in injury to his back. This was regarded as a
      huge joke by the staff.



      In a further medical report dated 5th August 1988 for Messrs
      Simcocks, Wessely expressed a diametric opinion from that of Dr
      Morgan-Hughes, writing: " A label does not matter so long as the
      correct treatment is instituted. It may assist the Court to point
      out that I am the co-author of several scientific papers concerning
      the topic of "ME"..I have considerable experience of both (it) and
      child and adult psychiatry (and) submit that mutism cannot occur (in
      ME). I disagree that active rehabilitation should wait until
      recovery has taken place, and submit that recovery will not occur
      until such rehabilitation has commenced....it may help the Court to
      emphasise that.active management, which takes both a physical and
      psychological approach, is the most successful treatment available.
      It is now in everyone's interests that rehabilitation proceeds as
      quickly as possible. I am sure that everyone, including Ean, is now
      anxious for a way out of this dilemma with dignity".



      Ean Proctor was kept in "care" and away from his parents for over
      five months.



      Although this took place in 1988, such brutality is still happening
      in the UK: the continued barbaric "treatment" of sick children by
      certain psychiatrists who profess to specialise in ME was the
      subject of a Panorama programme transmitted on 8th November 1999 and
      was profoundly disturbing (a videotape recording is available).
      Nothing seems to have been learnt from the appalling case of Ean
      Proctor and there is no question that children with ME continue to
      be forcibly removed from their parents and home; this issue was
      raised by Dr Nigel Speight, a consultant paediatrician at the
      University Hospital of North Durham with 20 years experience of
      children with ME, who in April 1999 reported to the Chief Medical
      Officer's Working Group on "CFS/ME" that the frequency of
      psychiatrists diagnosing the parents of children with ME as having
      Munchausen's Syndrome by Proxy now amounted to an epidemic. Jane
      Colby, Executive Director of The Young ME Sufferers Trust (TYMES
      Trust) says "To have your sick child taken from you, to be
      suspected of damaging them yourself, just when they most need your
      care, is an appalling experience".





      2. The case of Child X: Some ten years after her own nightmare
      experience, Mrs Proctor answered a knock at her door on the Isle of
      Man and was surprised to find herself confronted by a police officer
      who had been directed to question her by the Metropolitan Police.
      Although at the time she did not know it, another child with ME in
      southern England was being threatened with forcible removal from his
      home if his parents did not agree to his being admitted to a
      psychiatric hospital: in an effort to protect the child from
      inappropriate treatment and medical harm, his father had
      surreptitiously taken him abroad. When police officers broke into
      the house, it seems they found Mrs Proctor's name and address and
      she was therefore suspected of assisting the boy's parents in his
      disappearance and of harbouring him, which was untrue. Believing
      his son to be safe, the father returned to the UK where he was
      arrested and sentenced to two years imprisonment, a sentence he was
      happy to endure, thinking that his son was safe. However, the
      child's mother was then targeted and threatened with imprisonment if
      the boy was not handed over to a particular psychiatrist at a
      Teaching Hospital. The physically sick child was forced to spend
      seven months under the "care" of this psychiatrist and was subjected
      to "active rehabilitation", during which time his condition
      deteriorated considerably. He is now severely ill and terrified of
      health professionals.



      The lengths to which these psychiatrists who have focused their
      careers on "eradicating ME" will go in order to obtain parental
      obedience, and the control they wield, is extremely disquieting.



      Professor Wessely, though, seems to be curiously affected by
      elective amnesia over the compulsory removal of children with ME
      from their parents: his involvement with the wardship of Ean Proctor
      is incontrovertibly established, yet in a Channel 4 News programme
      on 26th August 1998 in which the case of Child X was being
      discussed, when asked by the presenter Sheena McDonald if there can
      ever be a case for the coercive approach in situations involving
      forcible removal of a child with ME from the parents, Wessely stated
      (verbatim quote) "You know very well I know nothing about these
      cases" and when Sheena McDonald asked "So you would agree that
      unless there is criminal abuse, there is never a case for a coercive
      approach to take children away from parents?", Wessely replied
      (verbatim quote) "I think it's so rare. I mean, it's never happened
      to me". Despite this denial on national television, there is
      unequivocal evidence that Wessely had been personally involved in
      Ean Proctor's wardship and that he had advised the local authorities
      to take the action they did. (Copies of Wessely's letters and
      reports and a videotape recording of the Channel 4 News item are
      available).


      The formal international classification of ME by the World Health
      Organisation


      Although formally classified by the World Health Organisation in the
      International Classification of Diseases (ICD) as a neurological
      disorder since 1969 (currently to be found at ICD-10: G93.3),
      Wessely School psychiatrists have succeeded in a gradual but
      consistent distortion of the clinical entity ME, by denying its very
      existence and by subsuming it within the heterogeneous label
      of "CFS". The term CFS was first coined in the US in 1988 and at
      the time, it was indicated that it was intended to replace the older
      term ME or to be considered equivalent to it, but Wessely School
      psychiatrists have increasingly equated "CFS" with other chronic
      fatigue states (especially neurasthenia) which are formally
      classified in the ICD as Mental and Behavioural Disorders (ICD-10
      F48.0).



      It is important to be aware, however, that ME remains classified as
      a neurological disorder in the ICD (with CFS listed as an
      alternative term for ME) and that the WHO has confirmed it has no
      plans to re-classify the condition as a psychiatric disorder.


      Current Government policy concerning ME/CFS



      Whereas the American Medical Association has issued a Statement
      addressing the fact that basic laboratory tests are insufficient for
      ME/CFS patients because it is known that routine screening is normal
      in 90% of such patients and that more complex investigations (such
      as immunological assays, nuclear medicine screening and gene
      expression profiling) are essential to demonstrate the underlying
      biological and physiological basis of ME/CFS, in the UK current and
      future policy dictates the non-investigation of ME/CFS patients
      other than by routine screening; it dictates that no special
      provision or facilities other than psychiatric clinics need be
      provided for the care of ME/CFS patients; it dictates that no
      special training for doctors about the disorder is necessary; it
      dictates the denial of appropriate medical care; it dictates that
      there is no need for respite care (and commissioning officers are
      advised accordingly); it dictates that State benefits for those with
      ME be withdrawn unless patients agree to psychiatric intervention,
      whereupon (as for all psychiatric disorders) a lower rate of benefit
      is payable; it approves the use of Court Orders for the compulsory
      removal from their home of both children and adults with ME under
      the auspices of the Mental Health Act if patients decline
      psychiatric intervention and it dictates that no biomedical research
      is necessary into the disorder and that such research should not be
      publicly funded by Government bodies.


      What is ME and is it the same as Chronic Fatigue Syndrome (CFS)?



      Myalgic Encephalomyelitis (ME): ME is not a new disorder; there are
      many reports in the medical literature spanning at least 70 years
      and in April 1978 the Royal Society of Medicine accepted ME as a
      distinct entity. It is a serious and complex disorder which can
      affect virtually every major system in the body, with neurological,
      immunological, cardiovascular, respiratory, hormonal,
      gastrointestinal and musculo-skeletal manifestations.



      The cardinal features of ME are post-exertional muscle fatigability
      (this bears no comparison with ordinary "tiredness" or "fatigue" or
      TATT ("tired all the time", which is a feature of many psychiatric
      disorders); profound malaise; intractable muscle pain in specific
      groups of muscles (myalgia); variability of symptoms from day to day
      and even from hour to hour, and chronicity.



      Non-psychiatric research into ME is impressive. It is funded in the
      UK almost entirely by small charities such as MERGE
      (www.meresearch.org.uk) but not by the larger charity Action for ME,
      which has now chosen to support Government policy and as a result
      has received significant Government funding, This research deals
      with scientific facts, not with beliefs, and there is an ever-
      increasing body of evidence from international centres of excellence
      of a variety of biomarkers for ME, some of the most significant
      being inflammatory markers. The following evidence exists:



      neurological deficits - these are demonstrated by nuclear medicine
      techniques such as SPECT scans (single photon emission computed
      tomography, a type of radionuclide scanning) and MRS scans (magnetic
      resonance spectroscopy) which demonstrate cerebral hypo-perfusion,
      and PET imaging (positron emission tomography) which shows brain
      areas of hypo-metabolism



      endocrine dysfunction - there is evidence of disturbance of the HPA
      axis (hypothalamic-pituitary-adrenal axis) and of central adrenal
      insufficiency, with evidence of an impaired stress response in that
      both the right and left adrenal gland bodies are reduced by over
      50%, indicative of significant adrenal atrophy



      immune dysfunction - there is abundant evidence of an unusual and
      inappropriate immune response, with evidence that changes in
      different immunological parameters correlate with particular aspects
      of disease symptomatology and with measures of disease severity



      vascular disturbances - there are specific disturbances peculiar to
      patients with ME/CFS, characterised in particular by orthostatic
      intolerance (this is not the same as postural hypotension, stated by
      some psychiatrists to be related to de-conditioning). There is
      evidence of very extensive damage to the endothelium which lines all
      blood vessels; it was found to be swollen and stiffened as a result
      of severe damage: damage of this kind would compromise the blood
      supply to the deep capillary beds in all tissues, including nerve
      cells



      mitochondrial abnormalities in muscle - there is convincing evidence
      that ME/CFS patients reach exhaustion more rapidly than normal
      subjects. The use of 31P NMR (31P nuclear magnetic resonance) has
      now provided positive evidence of defective oxidative capacity:
      oxidative activity involves production of ATP (adenosine
      triphosphate, the main energy releasing source of the cell) which
      can be seen and monitored in tissues. The findings show that there
      is a continued loss of post-exertional muscle power (giving an
      additional loss of power), with delayed recovery for at least 24
      hours, whereas sedentary controls recovered full muscle power after
      200 minutes. Further evidence shows that some ME/CFS patients have
      persistent enterovirus within skeletal muscle tissue; these are also
      findings consistent with delayed recovery of muscle power after
      exertion.



      There is also evidence of increased neutrophil apoptosis (programmed
      cell death) in ME, whilst evidence of higher levels of TGF b1
      (transfer growth factor beta 1), indicative of a persistent viral
      infection or of a toxic state has been presented at international
      conference proceedings on ME/CFS.



      In health, the cells of endothelium that line every blood vessel of
      every organ and which provide the all-important blood-brain barrier
      have tight cell junctions that prevent many compounds from crossing
      these membranes. Some chemicals are known to open these normally
      tight cell junctions, allowing free transport of compounds that are
      toxic to the central nervous system. When the gut wall, for
      instance, has increased permeability, the opioid peptides
      (casomorphin and gliadomorphin) which would normally be excluded are
      absorbed into the blood stream, giving rise to diffuse
      symptomatology and systemic dysfunction. Hypersensitivity reactions
      are common in ME/CFS patients, especially to cow's milk and gluten,
      as well as to many medicinal drugs, particularly to anti-
      depressants. The compromised gut facilitates the development of a
      gut dysbiosis which in turn can give rise to autoimmune disease,
      with very significant and chronic damage to health.



      Studies from both Israel and the US have shown that ME/CFS has
      components of autoimmune disease: immunohistochemistry has shown a
      high percentage of reactors in these patients as in patients with
      lupus (another autoimmune disorder) which is a known overlap
      condition.



      Studies performed in the US on ME/CFS patients have shown prominent
      RNA not observed in normal controls. RNA bands so far sequenced show
      homology with human genes which are noted for their tendency for
      gene rearrangement under severe physiological stress: environmental
      stresses which researchers are investigating include the frequent
      and well-documented linking of this disease with food and chemical
      sensitivities. In the UK, a pilot study (funded by a small charity,
      the CFS Research Foundation) has found changes in 50 or so genes in
      patients with ME/CFS, from which it can definitely be concluded that
      many of the genes that show up are involved with the immune system.



      The exhaustion experienced by patients is extreme, being described
      in the Journal of the American Medical Association in the following
      terms: "The disabling weakness and exhaustion that a patient with
      (ME) CFS experiences is so profound that "fatigue" is probably an
      insult" (J. Cuozzo: JAMA 1989:261:5:697).



      Other distressing symptoms commonly arising in the more severely
      affected are:



      · multi-systemic dysfunction including vertigo,
      dysequilibrium and ataxia



      · difficulty with swallowing (choking fits are not uncommon
      and both adults and children may require tube-feeding) and voice
      production (particularly if speaking is sustained)



      · episodic cardiac pain indistinguishable from myocardial
      infarction (heart attack) and segmental chest wall pain



      · pancreatitis



      · frequency of micturition, including nocturia (bladder and
      bowel control may be insecure)



      · pronounced vascular disturbance (leading for example to
      an
      inability to use the fingers and to the "ME headache")



      · inability to stand unsupported for more than a few
      moments
      with the ability to walk only very short distances, requiring the
      use of a wheelchair



      · difficulty with simple tasks such as climbing stairs and
      dressing



      · difficulty with breathing, with sudden attacks of
      breathlessness requiring the administration of oxygen (lung function
      studies have demonstrated a significant reduction in all parameters
      tested)



      · in females, ovarian-uterine dysfunction is not uncommon,
      whilst in males, prostatitis and impotence may occur



      · cognitive impairment may be profound



      · hair loss is a recognised and documented finding



      · an adverse reaction to medicinal drugs, especially to
      anaesthetics, is virtually pathognomonic.





      American and Australian research has shown that the quality of life
      in this disorder is lower than for any other chronic illness group
      apart from terminal cancer and that the quality of life is uniquely
      disrupted on all levels.



      A major report by an ME charity (Severely Neglected: ME in the UK;
      Action for ME, March 2001) found that 77% of sufferers experienced
      severe pain; over 80% had felt suicidal as a result of the illness;
      70% are either never able, or are sometimes too unwell, to be able
      to attend a doctor's clinic; 65% (ie. nearly two out of three) have
      received no advice from their GP on managing this illness; 80% of
      those who are currently bed-ridden by ME report that a request for a
      home visit by a doctor has been refused, and many people do not
      receive the State benefits to which they are clearly entitled.
      (This report is apparently no longer used by Action for ME, who have
      seemingly now joined forces with the Wessely School in endorsing
      psychiatric interventions).



      Suicide rates are very high, not necessarily because patients are
      psychiatrically disturbed, but because the unavoidable isolation and
      the physical suffering are simply unbearable without adequate
      support. The losses are many, including loss of career, loss of
      marriage, loss of ability to be self-supporting and loss of
      independence. Although frequently told that they do not look ill,
      patients may be severely incapacitated and quite unable to fend for
      themselves. Their suffering is compounded if, as is often the case,
      their means of financial survival by way of State benefits is
      withdrawn because of Wessely's dictum that ME is a "non-disease"
      (see below). Many patients are simply too sick to be forced to
      attend psychiatric units and to participate in
      compulsory "management strategies" which involve exercising, but if
      they fail to attend, they are deemed not to want to get better and
      their State benefits are withdrawn because of Wessely's dogmatic
      advice to Government that ME is nothing more than an "aberrant
      illness belief". There are many such known cases, including those
      in which ME patients have been threatened with being sectioned (ie.
      compulsorily detained under the Mental Health Act) unless they
      comply with psychotherapy.



      In his Testimony before the US FDA Scientific Advisory Committee on
      18th February 1993, Paul Cheney, Professor of Medicine and Director
      of the Cheney Clinic, North Carolina and one of the world's leading
      experts on ME/CFS, testified as follows:



      "I have evaluated over 2,500 cases. At best, it is a prolonged post-
      viral syndrome with slow recovery. At worst, it is a nightmare of
      increasing disability with both physical and neuro-cognitive
      components. The worst cases have both an MS-like and an AIDS-like
      clinical appearance. We have lost five cases in the last six
      months. The most difficult thing to treat is the severe pain. Half
      have abnormal MRI scans. 80% have abnormal SPECT scans. 95% have
      abnormal cognitive-evoked EEG brain maps. Most have abnormal
      neurological examination. Most have evidence of T-cell activation.
      80% have evidence of an up-regulated 2-5A antiviral pathway. 80% of
      cases are unable to work or attend school. We admit regularly to
      hospital with an inability to care for self".



      In the February 2000 issue of the American Journal of Medicine,
      Anthony Komaroff, Assistant Professor of Medicine at Harvard,
      summarised key points in an Editorial:



      "Many controlled studies have compared patients with age-matched and
      gender-matched healthy control subjects. The evidence indicates
      pathology of the central nervous system and the immune system.
      There is considerable evidence from different investigators, using
      different techniques and different groups of patients, of a state of
      chronic immune activation. In summary, there is now considerable
      evidence of an underlying biological process in most patients
      (which) is inconsistent with the hypothesis that (the syndrome)
      involves symptoms that are only imagined or amplified because of
      underlying psychiatric distress. It is time to put that hypothesis
      to rest".

      As long ago as 1994, Professor Paul Levine from the US National
      Cancer Institute stated "the spectrum of illnesses associated with a
      dysregulated immune system must now include (ME)CFS" and the Centres
      for Disease Control now take the disorder so seriously that it has
      been designated a "serious legitimate diagnostic Priority One
      disease of public health importance".



      In the UK, the very existence of ME is denied: psychiatrist Simon
      Wessely advises that ME is a "non-disease" and he has personally re-
      classified CFS as a mental disorder in UK reference manuals (see
      below). He asserts that the disorder exists only because
      of "artefacts of medical specialisaton" and he advises that such
      disorders "should not be dignified by their own formal case
      definition and body of research" (Functional somatic syndromes: one
      or many? S Wessely, C Nimnuan, M Sharpe Lancet 1999:354:936-939).





      What is CFS?: In the 1980s in the US (where there is no NHS and
      most of the costs of health care are borne by insurance companies),
      the incidence of ME escalated rapidly, so a political decision was
      taken to rename ME as "the chronic fatigue syndrome", the cardinal
      feature of which was to be chronic or on-going "fatigue", a symptom
      so universal that any insurance claim based on "tiredness" could be
      expediently denied. The new case definition bore little relation to
      ME: objections were raised by experienced international clinicians
      and medical scientists, but all objections were ignored. In 1991 in
      the UK, Wessely and Sharpe were amongst a group which produced their
      own criteria for "CFS" and this definition became known as the
      Oxford criteria. In 1994 these same psychiatrists were instrumental
      in yet another revision of the criteria known as the CDC or the
      Fukuda criteria because they were produced under the auspices the US
      Centres for Disease Control. Of great significance is the fact that
      both the Oxford and the CDC criteria specifically include
      psychiatric conditions which are known to feature
      prolonged "fatigue" or "tiredness" and, crucially, they specifically
      exclude all physical signs from the case definition of CFS,
      including the signs of neurological disease which had been noted in
      the ME medical literature for many years. Thus the quite specific
      neuro-immunological disease ME became subsumed within the
      heterogeneous label of "CFS".



      This marked a turning point in the "eradication" of ME by
      psychiatrists and of the campaign to designate CFS as a "mental"
      disorder.



      Are both camps studying the same disorder?



      Disconcertingly, the editors of both the CMO's Report of January
      2002 and the Medical Research Council's subsequent document setting
      out its preferred strategy for the direction of future research
      in "CFS/ME" (released on 1st May 2003, the editor being Dr Chris
      Watkins, whose position at the time was MRC Programme Manager for
      Research on Mental Illness) persistently refused to heed repeated
      calls for accuracy: when draft copies of both Reports were studied,
      the same important error appeared in both documents and was pointed
      out but was deliberately retained in the final version of both
      reports. That error relates to the classification of ME and of CFS
      in the ICD and it reads:

      "Currently, CFS and ME are classified as distinct illnesses in the
      World Health Organisation's International Classification of
      Diseases" (CMO's Report 2002:1.4.1).



      As this error was pointed out to the editors of both reports long
      before they were published, it cannot have been an over-sight that
      the error appeared in the final versions of the reports and it may
      well have been expedience on the part of the Wessely School
      psychiatrists who dominated both reports (see below).



      This error is easily shown to be erroneous: CFS is clearly listed at
      G93.3 as a term by which ME is also known, whilst other syndromes of
      chronic fatigue are listed under Mental and Behavioural Disorders at
      F48.0, a category from which ME/CFS is expressly excluded by the
      WHO. Moreover, the WHO has confirmed that it is "unacceptable" for
      the same disorder to be classified in two different places and does
      not accept this to have occurred.



      It is necessary to be aware that the patients studied by Wessely are
      largely obtained from either his own 1991 Oxford criteria or from
      the 1994 CDC criteria which he helped to develop, neither of which
      selects those with ME.



      It is increasingly accepted that it is inappropriate to synthesize
      results from studies of this illness which use different definitions
      to select study populations (A Comparison of Diagnostic Criteria.
      Jason et al: Evaluation and the Health Professions: in press
      December 2003), but Wessely is well-known for using the
      terms "fatigue"; "chronic fatigue"; "CFS" and "ME" interchangeably,
      even though they may represent totally different patient
      populations. He has been stringently criticised for this in, for
      example, the Quarterly Journal of Medicine (QJM 1997:90:723-727),
      where Hedrick succinctly pointed out his mischaracterisation of the
      facts and noted that it is unacceptable for him to summarise a wide
      variety of studies, in this case drawing conclusions across seven
      studies which were based on different patient populations -- from
      simple fatigue of 30 days to severe chronic fatigue of decades -
      without addressing the adequacy of the analysis performed. (In his
      article, Wessely even left out findings from cited studies which did
      not support his own pre-determined conclusions). To quote
      Hedrick: "Studies and review articles on psychiatric factors and
      CFS need to be subject to the same standards of scientific inquiry
      as studies investigating organic factors, lest the theoretical
      stance of the researchers / authors turns out to be the most
      powerful predictor of results".



      Wessely is always at pains to point out that only "patients" refer
      to the disorder as ME and that those with superior knowledge (ie.
      doctors) refer to it as "CFS".



      Until the issue of case definition is accurately addressed and is
      beyond doubt, it seems to serve Wessely's purpose very well indeed
      to ensure that clinical obfuscation continues to abound around ME
      and CFS.



      The published views of the Wessely School on ME



      Wessely continues to be overtly patronising in his encounters with
      ME/CFS patients whilst continuing to mock and denigrate them in
      print and in his behaviour with his colleagues, where those with ME
      are the subject of his ill-concealed ridicule and contempt, as
      exemplified when he gave the 9th Eliot Slater Memorial Lecture at
      the IOP on 12th May 1994 (of which an audiotape recording exists).
      The title of his lecture was revealing: "Microbes, Mental Illness,
      The Media, and ME: the Construction of Disease".



      The sheer cumulative extent of Wessely's denigration of ME patients
      as set out in his published works over 16 years has to be read for
      oneself to be believed.



      For convenience, attached as an appendix to this document is a short
      compilation of referenced quotations from the published works on
      ME/CFS of both Simon Wessely and Michael Sharpe, which speak for
      themselves.



      Extracts from many of Wessely's published papers from 1987 to 1999
      have been compiled in two spiral-bound volumes for ease of access
      and are available at cost price on request (see Further Reading).



      Wessely is well-known for his published views on ME. One of the
      best known dates from 1993 when, together with Anthony David, he
      wrote in the Lancet (Lancet 1993:342:1247-1248) in unmistakable
      terms: "The inclusion in the tenth revision of the ICD of benign
      myalgic encephalomyelitis under Diseases of the Nervous System seems
      to represent an important moral victory for the self-help groups in
      the UK (but) neurasthenia remains in the Mental and Behavioural
      Disorders chapter under Other Neurotic Disorders. Neurasthenia
      would readily suffice for ME. Applying more stringent criteria for
      CFS in the hope of revealing a more neurological sub-group succeeds
      only in strengthening the association with psychiatric disorders".
      What is strange is that the authors seemed not to know that in 1993,
      ME had already been classified under Diseases of the Nervous System
      for almost a quarter of a century.



      Wessely believes that "There lies at the heart of CFS, not a virus
      or immune disorder, but a distortion of the doctor-patient
      relationship" (Chronic fatigue syndrome: an update. Anthony J
      Cleare Simon C Wessely. Update 14th August 1996:61-69).



      In another paper, Wessely claims that ME exists "only because well-
      meaning doctors have not learnt to deal effectively with suggestible
      patients" (Psychological Medicine 1990:20:35-53).



      Wessely concluded his major Review of the Post-viral Fatigue
      Syndrome (yet another ICD term for ME/CFS) in the prestigious
      British Medical Bulletin by citing medical comments on patients
      between 1880 and 1908, with the clear implication that such
      descriptions apply equally well to today's ME sufferers: "always
      ailing, seldom ill; a useless, noxious element of society; purely
      mental cases; laziness, weakness of mind and supersensitiveness
      characterises them all; the terror of the busy physician" (BMB
      1991:47:4:919-941).



      In one medical textbook, Wessely wrote about ME/CFS patients
      that "the description given by a leading (doctor) at the Mayo Clinic
      remains accurate: 'the doctor will see that they are neurotic and he
      will often be disgusted with them' " (Chronic fatigue and myalgia
      syndromes. Wessely S. In: Psychological Disorders in General
      Medical Practice. eds: N Sartorius et al Hogrefe & Huber 1990)



      In relation to patients with ME/CFS in a paper on "medically
      unexplained symptoms", Wessely states " Patients with functional
      somatic symptoms are generally viewed as an unavoidable, untreatable
      and unattractive burden" (Patients with medically unexplained
      symptoms. Alcuin Wilkie Simon Wessely. British Journal of Hospital
      Medicine 1994:51:8:421-427).



      Such has been Wessely's "help" to ME/CFS patients over the last
      sixteen years of almost supreme reign over their fate that they are
      frequently abused by busy physicians whose views are based upon the
      misinformation with which they have been targeted and bombarded by
      the journals and the medical trade press (over which Wessely exerts
      so much editorial control) to the virtual exclusion of opposing
      views. Busy practising clinicians rarely have time to study the
      international medical literature which presents a very different
      picture.



      Wessely's own literature output is prodigious; he has authored well
      over 200 papers, so it is necessary to be aware that a database
      search on "ME/CFS" is dominated by his publications and that he
      promotes himself as a world expert in "medically unexplained
      symptoms", a category in which he and his adherents firmly
      place "CFS"; it is easy, therefore, for the uninformed and
      disinterested to be misled about what is actually known and
      published in (non-UK) peer-reviewed journals about ME/CFS.



      Wessely does not hesitate to refer to himself as a medico-legal
      expert, in one instance claiming "I frequently act on behalf of
      CFS/ME sufferers in their dealings with insurers (see below for his
      involvement with insurance companies) and the courts ---indeed, I
      was the principal expert witness in two recent medico-legal cases
      concerning CFS. In the first, the sufferer was awarded £160,000
      and
      the second £320,000. These are the only two cases of their kind
      in
      the UK". The published response pointed out that in the two cases
      to which Wessely referred, he was one of three medical expert
      witnesses in both cases and the £320,000 was an out of court
      settlement. The £162,000 was awarded in the High Court in December
      1992 but was withdrawn by three appeal court judges who accepted
      Wessely's testimony that the plaintiff (a diagnosed ME sufferer)
      was "suffering from at least some degree of psychological disorder",
      evidence which was given without Wessely ever having examined the
      appellant. In claiming that there were only two such cases in the
      UK, Wessely was misleading, to say the least: in reality, at that
      time seven similar cases either had been or were going through the
      British legal system. (CFIDS Chronicle Spring 1994:14-18 and Summer
      1994:77-79).



      Wessely is ceaseless in his efforts to discredit ME and its hapless
      sufferers: in early 2002, at his instigation the British Medical
      Journal ran a ballot asking doctors to vote on which diseases they
      considered to be "non-diseases" which are best left medically
      untreated: Wessely proposed ME. Along with ear-wax accumulation,
      nail-chewing and freckles, ME was voted a non-disease, and in April
      2002 both broadsheet and tabloid newspapers ran banner headlines
      proclaiming "Obesity and ME are not diseases, say doctors". He
      appears indifferent to the fact that the stigma of having a "non-
      disease" could not fail to make things worse for sufferers;
      certainly it is the case that since the BMJ poll, many more ME
      patients have been removed without notice from their GP's list, in
      one specific case, a very sick ME patient was brusquely informed
      that "This practice does not treat non-diseases".



      As a direct result, an unknown number of ME patients are simply left
      to suffer and die at home without any medical care or support.



      Illustrations of Wessely's influence over the national perception of
      ME/CFS



      The WHO Guide to Mental Health in Primary Care: Wessely's
      determination to eradicate ME as a legitimate medical disorder seems
      never to cease. In 1997 he deliberately included ME in the WHO
      Guide to Mental Health in Primary Care. This Guide, available to
      all GPs in the UK, was produced by the UK WHO Collaborating Centre
      at the IOP, so it legitimately bore the WHO logo. However,
      Wessely's covert re-classification of ME was effected without the
      approval of the World Health Assembly and the WHO has confirmed in
      writing that what Wessely published about the classification of ME
      in the UK Guide to Mental Health in Primary Care did not carry WHO
      approval, stating: "It is possible that one of the WHO Collaborating
      Centres in the UK presented a view that is at variance with WHO's
      position". When on 18th August 2003 the Countess of Mar wrote to
      Wessely's Dean at the Institute of Psychiatry (Professor George
      Szmukler) raising concerns about the erroneous inclusion of ME as a
      mental disorder, his reply of 27th August 2003 failed to address the
      issues raised and instead consisted of a paean of praise for
      Wessely, describing him as "one of the most outstanding medical
      researchers in the UK, and indeed internationally (and he) has been
      awarded a Research Medal by the Royal College of Physicians
      (specifically for work on CFS). The Institute of Psychiatry has
      every reason to have confidence in the quality and integrity of
      Professor Wessely's research". It later transpired that the Dean
      had co-edited a psychiatric text book with Wessely's wife, also a
      psychiatrist and a Senior Policy Adviser to the Department of Health.



      The NHS Information Authority (NHSIA): this is a body which was set
      up in 1999 to disseminate approved information throughout the NHS.
      The fact that the WHO so unequivocally distanced itself from the UK
      Guide to Mental Health in Primary Care did not prevent Government
      Ministers and the NHSIA from relying upon the Guide in their own
      database of mental disorders, both as a source of information from
      Ministers to Members of Parliament and also for distribution
      throughout the entire NHS, with dire results for ME sufferers. In
      various letters to MPs, the Parliamentary Under Secretary of State
      for Health (Stephen Ladyman MP) refers to the UK Guide to Mental
      Health in Primary Care as "the WHO Guide", mistakenly conveying the
      notion that he was referring to a Guide produced by the WHO itself
      in Geneva (whereas he ought to have been referring to the UK WHO
      Collaborating Centre at the IOP) and stating about the
      Guide "Although WHO were initially keen to use the
      term 'neurasthenia', they eventually decided to call the
      section "Chronic Fatigue and Chronic Fatigue Syndrome (may be
      referred to as ME)". In one letter dated 29th August 2003, Stephen
      Ladyman provided false information for Dr Liam Fox MP, erroneously
      stating that the current version of the ICD classified CFS in two
      different places: "as Neurasthenia / Fatigue Syndrome in the mental
      health chapter (F48.0) and as Post Viral Fatigue Syndrome / Benign
      Myalgic Encephalomyelitis in the neurology chapter (G93.3)". This is
      quite unacceptable, because, as mentioned above, the WHO itself has
      confirmed that this is not the case, and that ME/CFS is expressly
      excluded from F48.0. It took until 2003 before "patient power"
      finally succeeded in securing an erratum on the website of the Royal
      Society of Medicine (publishers of the Guide) but to date (December
      2003), the NHSIA has still not corrected its website and continues
      to classify ME/CFS as a mental disorder.



      The House of Commons Library: it is known that MPs are provided
      only with information on ME/CFS which endorses a psychiatric
      aetiology, in particular with a Research Paper prepared for MPs by
      Dr Alex Sleator of the Science and Environment Section of the House
      of Commons Library (98/107, December 1998) which is simply a re-hash
      of the discredited Joint Royal Colleges' Report of 1996 (see
      below). Many letters exist from MPs which testify to this. This is
      despite the fact that medical textbooks, papers, journals and
      international conference reports which demonstrate an organic basis
      for the disorder are known to have been placed in the House of
      Commons Library for the use of MPs. It has been ascertained that
      the information supporting an organic basis has been removed to the
      Library archives, so unless an MP was sufficiently well informed to
      know what s/he was asking for by name, it is difficult for them to
      access such material.



      The Official Secrets Act: During the life (1998-2002) of the Chief
      Medical Officer's Working Group on ME/CFS, members were ordered not
      to discuss the deliberations and were even threatened with the
      Official Secrets Act (documents available). If the psychiatric
      lobby which dominated that Working Group is so confident that they
      are right, why the need to force the suppression of opposing views
      by resorting to threats of prosecution under the Official Secrets
      Act in a Working Group that had nothing to do with State security
      but was supposed to be acting simply in the best interests of sick
      people? This is in marked contrast to the "Key working principles"
      set out in the first Briefing Note of March 1999, which states "The
      Group must have maximum 'transparency' ie. as much information about
      its activities to be distributed as possible to all potential
      interested parties".



      The Media: The UK national newspapers frequently run headlines such
      as "ME's mainly in the mind---Study reveals yuppie flu can be cured
      by positive thinking" (Daily Express, 5th January 1996, about one of
      Mike Sharpe's studies) and "ME is just a myth, sufferers told"
      (Sunday Telegraph, 20th November 1994, about the conclusions of 150
      British psychiatrists attending a pharmaceutical conference in
      Jersey). On 5th May 1996 the Daily Express carried an article by
      Jonathan Miller from America, which ran with the headline "Chronic
      Bandwagon Disease" in which he referred to CFS as "Completely
      Fictitious Syndrome".



      Medical Trade Journals: The medical trade magazines (widely
      distributed free to doctors, especially to GPs and to hospital
      libraries by the drug companies) have made a point of promoting
      psychiatric interventions for those with "CFS" and of mocking and
      denigrating sufferers from ME/CFS in a way they would not dare do
      about patients with multiple sclerosis or other neurological
      disorders, yet ME is formally classified by the WHO as a
      neurological disorder. For example, on 1st April 1994 "GP Medicine"
      carried a bold banner headline proclaiming "GPs despise the ME
      generation"; on 12th January 1995 "Doctor" magazine ran a feature
      called "Bluffer's Guide" by Dr Douglas Carnall, in which he
      wrote "Modern bluffers prefer the term chronic fatigue syndrome..if
      they really insist on a physical diagnosis tell them chronic fatigue
      syndrome is a complex disorder in which multiple biopsychosocial
      factors are mediated via the anterior hypothalamus ---in other
      words, it's all in the mind. Or, if you're feeling tired, you could
      always refer"; "Doctor" magazine also ran a quiz by Dr Tony
      Copperfield (known to be the pseudonym of a GP in Essex) in which
      GPs were asked to choose from four possible answers to the
      question "What would be your initial response to a patient
      presenting with a self-diagnosis of ME?" The correct answer
      was "For God's sake pull yourself together, you piece of pond
      life". One of the worst and most damaging examples was published on
      20th October 2001 in "Pulse" in a series called "Choices for the
      new generation of GPs". The item on which three GPs provided their
      approach was entitled "ME patient with litigation history demands
      inappropriate therapy" and the approach provided by Dr Mary Church
      (this is her real name: she is a Principal in a practice in
      Blantyre, Scotland and most disturbingly of all, she is a member of
      the British Medical Association medical ethics committee) was
      particularly contemptuous but is not untypical: "Never let patients
      know you think ME doesn't exist and is a disease of malingerers.
      Never advise an ME patient to make a review appointment. At the end
      of the consultation, I say goodbye, not au revoir. Always refer ME
      patients to a local expert. It's a wonderful way of passing the
      buck". Although some of these items are doubtless intended to be
      amusing, it is not appropriate for a doctor to write with such
      contempt about any illness, physical or psychiatric, which ruins
      lives and quite frequently causes death, and these items are
      damaging because they lend credence to what many doctors privately
      admit they still believe (ie. Wessely's view that ME does not exist
      and that "CFS" is a psychiatric disorder).



      Disgraceful treatment of ME patients: On Sunday 15th June 2003,
      Clare White, a woman in her early 60s (a graduate who taught French
      during her professional academic career but who has been severely
      affected by ME for many years) was taken ill: being unable to
      contact her GP (because the surgery had only an answering machine
      telling patients to telephone NHS-Direct) she was forced to
      telephone 999 for an ambulance. She was taken to the A & E
      Department of a flagship London hospital in great distress,
      suffering from acute renal colic and vomiting. On arrival she was
      seen by a very helpful, polite, considerate and conscientious junior
      doctor who examined her and found that she had many abnormalities,
      including blood in her urine. He asked her if she had any other
      diagnosis, so she told him she suffered from ME. He started to
      organise various investigations, including an IVP (intravenous
      pyelogram), informing her of what was proposed. The woman then
      heard him discussing her case with a more senior colleague just
      outside her cubicle and was dismayed to hear the senior doctor
      instruct the junior doctor to do nothing because ME was
      a "personality" problem which did not need further investigation.
      She definitely heard this said very clearly. The junior doctor
      repeated forcefully that the abnormalities he had found had nothing
      to do with ME and that she needed investigating. The two doctors
      had a heated argument, the outcome being that the junior doctor,
      although clearly very angry, was pressurised into not investigating
      further. In her own words, "a stop was put on the works". To his
      credit, the junior doctor, who was visibly uncomfortable, arranged a
      wheelchair and ambulance transport for the woman to be taken home.
      She lives alone and has no-one to look after her. The pain has now
      spread to the bladder region but she is receiving no medical care
      and no social support. No-one wants to know and no-one cares.



      Medical Insurance: In December 2003 a professional woman telephoned
      SAGA with a view to taking out private health insurance; she was
      asked if she suffered from any chronic physical disorder, to which
      she replied that she suffered from ME. The reflex response of the
      clerk was "Oh, that's not a physical disorder".


      Illustrations of Wessely's influence over the international
      perception of ME/CFS



      Wessely's influence is not restricted to the UK; of many available,
      just two illustrations (one from Australia and New Zealand and one
      from Canada) are presented here.



      The Australian CFS Report 2002 (Chronic fatigue syndrome: Clinical
      practice guidelines ---2002. Report of a Working Group convened
      under the auspices of the Royal Australasian College of Physicians.
      Medical Journal of Australia 2002:176: S17-S55). This Report
      virtually echoed the UK Joint Royal Colleges' Report of 1996 and was
      comprehensively condemned as seriously flawed. One typical review
      is that of Dr Abhijit Chaudhuri, DM, MD, MRCP(UK), Clinical Senior
      Lecturer in Neurology, University of Glasgow and Consultant
      Neurologist who specialises in ME/CFS: "This document contains many
      flawed statements and observations (and) the accounts appear biased
      and inaccurate. I have deep concerns about the selectivity of the
      literature review. The document has over-emphasised the behavioural
      model and has failed to review the appropriate literature on the
      neurology. The paper has devoted much of its clinical discussion on
      the comparison of psychiatric disorders with CFS. The quality of
      references and review on the neurological aspect of CFS is very
      poor, with omissions of research carried out by international groups
      in the past three or four years. The cited references show a skewed
      representation of a group of psychiatrists. The guidelines show a
      preference for cognitive behaviour therapy and graded exercise
      therapy and ignore criticisms and the flawed designs of the trials
      upon which their success has been claimed. Many areas of the text
      appear highly opinionated in favour of the psycho-behavioural model
      of CFS. The document cannot be recommended since it does not
      reflect the cumulative base of knowledge on CFS".



      Notwithstanding intense international criticism, it was this same
      Australian Report that formed the basis of the MRC's 2003 Report on
      the direction of future research in ME/CFS from its Research
      Advisory Group (see below).



      A Canadian reference book: Whiplash and Other Useful Illnesses (a
      medico-legal reference book by Andrew Malleson, published in 2003 by
      McGill-Queen's University Press, Montreal and London). This
      supposed reference book is one of the worst in existence and is a
      shameful display of ignorance on the part of its author. He cites
      Wessely in his references and in the chapter headed "Finessing
      Whiplash: Copycats and Fashionable Illnesses" vents his undisguised
      venom on ME/CFS patients :



      "Somatizers had dropped neurasthenia like a hot brick, Fatigued
      somatizers needed a new diagnosis (so) they developed "chronic
      fatigue syndrome" (CFS) in North America and "myalgic
      encephalomyelitis" (ME) in the United Kingdom. Chronic fatigue
      syndrome has gone from strength to strength. In Britain in the mid
      1950s, an apparent viral illness featuring muscle pains and severe
      fatigue hit 292 members of the staff at the Royal Free Hospital in
      London. The illness was well-publicized by the media and, in a
      familiar pattern, people all over the country soon came down with
      it; many are still doing so. The Royal Free epidemic was first
      christened "encephalomyelitis" but because no-one died, the illness
      was re-named "benign myalgic encephalomyelitis". Its victims soon
      dropped the "benign" so the condition is now known simply
      as "myalgic encephalomyelitis". Shorter comments "The disease label
      alone was a triumph of the longing for organicity over science".
      At the end of the 1980s, conventional medicine focused on the
      acquired immunodeficiency syndrome of AIDS. AIDS left its victims
      in a chronic state of exhaustion. In the typical way that
      fashionable illnesses have of acquiring serious-sounding pathology,
      CFS quickly incorporated this concept. The chronically fatigued
      promptly renamed their illness "chronic fatigue and immune
      dysfunction syndrome (CFIDS), a condition satisfactorily endowed
      with all the pathological glamour of AIDS, but respectable. From
      the medico-legal point of view (lists produced by itemizers of
      symptoms) are a goldmine. They provide lawyers with symptoms over
      which they can litigate and healthcare practitioners with the
      ability to charge insurance companies for treating practically any
      symptoms of which a patient might choose to complain. Victims of CFS
      and ME, like the neurasthenics before them, are mostly young to
      middle-aged women from the middle and professional classes.
      Epidemics of ME, CFS (and) environmental hypersensitivity do not
      occur in the industrially underdeveloped countries. Fashions and
      affluence go together. Before the days of the welfare state, only
      the well-off could afford a fashionable illness, although as
      sickness benefits and compensation payments have made the luxury of
      pseudo-illnesses more accessible, these illnesses have trickled down
      the social pyramid. I have used the word "victim" to designate the
      sufferers of fashionable illnesses. I have done so deliberately,
      because these sufferers are quick to adopt the victim role. They
      often see themselves being harmed by members of the medical
      profession who inflexibly refuse to recognize the validity of their
      suffering. As well-educated members of the middle and professional
      classes, these victims are often vocal advocates for their own
      anguish. Despite their fatigue, literate victims of fashionable
      illnesses have displayed inexhaustible energy writing, arranging
      meetings and proselytising on behalf of their particular fashionable
      illness. Victims aim much of their copious literature at the
      unbelieving doctors and their callous disregard for such illnesses
      (because) in order to provide compensation or support, insurance
      companies and government social services require medical validation
      of the illness. Some doctors, perhaps out of a sense of scientific
      integrity, out of bloody-mindedness, or even, as the claimants for
      fashionable illnesses sometimes maintain, because of payments from
      insurance companies, refuse to validate these pseudo-illnesses.
      Responsible members of the medical profession have difficulty
      providing authentication when no evidence of any disability exists".



      Andrew Malleson was born and brought up in England but is now a
      psychiatrist with Toronto University Health Network; he is also
      psychiatric consultant to the Canadian Government Occupational
      Health and Safety Agency; his particular interest is in the uses and
      abuses of illness, especially illnesses that are intentionally or
      unconsciously feigned. He has done medico-legal work for the last
      15 years.



      Malleson seems entirely unaware of a well-recognised problem in
      modern medicine, namely, that medicine does not listen to patients
      any more, nor does it pay any regard to symptoms: it only respects
      laboratory results. Clinical practice (the very foundation of
      medicine) is now ignored. In a nutshell, there is a current
      misconception that evidence-based medicine means laboratory-based
      medicine, wherein objective clinical observation is accorded lower
      evidential weight than laboratory measurements. If no cutting-edge
      laboratory investigations are to be permitted (as is currently the
      case for ME/CFS patients), then the politically desired status quo
      will prevail and the advancement of medical science will continue to
      be actively obstructed by corporate control.



      Tactics of denial



      It is not only upon ME/CFS patients that Wessely School
      psychiatrists seek to impose their preferred but unproven
      psychotherapy regimes; other related conditions for which these
      particular psychiatrists promote their own regime include almost any
      syndrome for which medicine does not yet have an explanation of the
      exact, confirmed pathoaetiology, for example, fibromyalgia, multiple
      chemical sensitivity, chronic low-dose organophosphate poisoning,
      Gulf War syndrome, pre-menstrual tension, irritable bowel syndrome,
      and atypical chest pain. Psychiatrists of the Wessely School deny
      the physical reality of all these conditions, asserting that they
      are all one and the same psychiatric condition. (In the case of
      irritable bowel syndrome (IBS), it has now been shown not to be
      a "psychological" disorder at all: American researchers have
      demonstrated molecular alterations in serotonin signalling in the
      gastro-intestinal tract and that IBS is caused by altered gut
      biochemistry).



      In relation to Gulf War syndrome, Wessely claims that Gulf War
      veterans have a three-fold increase in somatoform disorders: despite
      the fact that in the UK alone, over 500 formerly healthy, tough
      young men have died, Wessely denies the existence of any such
      syndrome and has advised the Ministry of Defence that one of the
      biggest risk factors for a soldier to develop ill-health following
      deployment to the Gulf is the fact that s/he knows another deployed
      person who has developed a similar illness.



      Denial of the known and available evidence



      Denial of existing evidence is currently popular by those who see
      themselves as "revisionists", and such people are extremely
      dangerous, as they seem to believe that they and their like-minded
      colleagues alone have the prerogative to define reality.



      On 29th April 2000 Channel Four transmitted a programme
      entitled "Denying the Holocaust" which revealed the tactics used
      by "deniers" of the truth (in that case, the reality of the
      Holocaust).



      Whilst in no way comparing the suffering and atrocities imposed upon
      Holocaust victims with the suffering imposed upon those with ME/CFS
      by doctors who do not believe in it, it may nevertheless be salutary
      to examine the similarities in the tactics and methods used
      by "deniers" and "revisionists" of whatever discipline.



      Referring to David Irving (the subject of the lengthy legal action
      involving Penguin Books and Professor Deborah Lipstadt, who was also
      the subject of the programme). Lipstadt branded Irving "one of the
      most dangerous of the men who call themselves revisionists". The
      narrator said "familiar with (the).evidence, he bends it until it
      conforms to his ideological leanings and political agenda".



      Such allegations have been made about Wessely in relation to what he
      publishes about ME/CFS.



      Tactics used by "deniers" were identified in the programme as
      including the following:



      manipulation, distortion, deliberately portraying things differently
      from what is known, falsifying facts, invention, misquotation,
      suppression, illegitimate interpretation, political re-modelling,
      exploiting public ignorance and intimidation.



      Deniers take liberties with facts, and what is omitted is often more
      significant than what is included.



      A falsifier uses many different means but all these techniques have
      the same effect ---falsification of the truth and denial of reality.



      Other tactics include the following :



      a.. deniers aggressively challenge others' views, claiming that
      others have no proof, and challenge them to validate the established
      facts and to produce proof to standards specified by the deniers
      themselves but to which they do not require their own "evidence" to
      subscribe


      o deniers claim that "pressure groups" are active against them and
      are attacking both them and the truth


      o deniers claim that there are "orchestrated campaigns" against
      them


      o deniers agree, prepare and organise as a matter of policy a
      systematic strategy amongst themselves


      o deniers show a readiness to jump to conclusions on every occasion


      o deniers endeavour to rationalise their own ideology and for
      their own ideological reasons they persistently and deliberately
      misrepresent and manipulate the established evidence


      o deniers fly in the face of the available evidence


      o deniers engage in "complete deniability" which has nothing to do
      with genuine scholarly research.




      Tactics of denial used in relation to ME/CFS as a physical disorder



      Revisionism and denying known evidence in medicine is nowhere more
      apparent than in the case of ME/CFS, and the choice of Government
      medical advisers is a matter of great economic impact.



      To policy makers and physicians in a cash-strapped NHS, the
      advantages of denial must seem attractive. The last thing needed is
      a disease which threatens the health of hundreds of thousands if not
      millions world-wide, so accepting advice which promotes the view
      that the condition in question is neither new nor particularly
      disabling (and that the disorder is largely self-perpetuated) makes
      instant economic sense, especially if the advice also recommends
      that granting state benefits to those affected would be not only
      inappropriate but counter-productive.



      In ME/CFS, denial is directed at undermining the experience and
      expertise of doctors who hold different views from Wessely School
      psychiatrists.



      In medicine, denial ought to be very rare due to the peer-review
      system, but in the case of ME/CFS, many peer-reviewers and editors
      of journals appear to share the same views as the deniers, so that
      articles and research papers which show a lack of objectivity and
      which misrepresent the existing literature and which make
      unsubstantiated claims abound, with the consequence that readers are
      deliberately misled.



      In the UK ME/CFS literature (mostly as a result of the assiduous
      activities of psychiatrists of the Wessely School), there is
      evidence of a systematic attempt to deny the severity of the
      symptoms, the role of external causes and the nature of the
      illness. Such is the profundity of articles, reports and research
      papers produced by this group of psychiatrists that there is now a
      widespread belief that ME/CFS is not a disorder which requires money
      to be spent on specialist tests or on expensive virological or
      immunological research, let alone on long-term sickness benefits.



      It may be informative to compare the tactics of denial listed above
      as identified in the TV programme with a selection of methods and
      tactics used by those engaged in denial activity relating to ME:



      o Deniers consistently ignore existing evidence which contradicts
      their own preferred theories: they disregard evidence, they
      misconstrue findings, they distort figures and they speculate.


      o Deniers apply a double standard to the evidence --- they support
      their own claims with a select choice of studies, with flawed
      research (ie. with research which has been shown to be flawed in the
      medical literature), and with a mass of generalisations, whi<br/><br/>(Message over 64 KB, truncated)
    Your message has been successfully submitted and would be delivered to recipients shortly.