Hooper on Wessely -- Part 3

Conclusion

In defiance of the extensive published evidence that ME/CFS and other disorders mentioned above are not psychosomatic, Professor Wessely's unremitting insistence that they are in reality but one single behavioural disorder seems indefensible.

In April 2000 an Opinion from a leading Queen's Counsel (who is a member of the House of Lords) was obtained about Professor Wessely's dogma on ME/CFS. That Opinion is concise:

"On the document you have sent me there is an overwhelming case for the setting up of an immediate independent investigation as to whether the nature, cause and treatment of ME as considered by the Wessely School is acceptable or consistent with good and safe medical practice. There is substantial doubt as to whether such could be the case. It is, of course, open to patients (and) their parents to seek Judicial Review".

In her letter of 2nd September 2003 to Professor Szmukler referred to above, the Countess of Mar wrote:

"Through his prolific output Professor Wessely has introduced his personal beliefs into the UK medical literature and those beliefs are aimed at changing the perception of ME/CFS held by both medical and lay people. Through the shortcomings of the peer-review system, his personal beliefs have become medical doctrine, effectively turning patients into victims".

Without doubt, there is substantial evidence in the public domain that Professor Wessely himself has carried out an unremitting campaign of denigration of ME sufferers. One of the most notorious was his involvement with a poll run by the British Medical Journal in 2002 in which doctors were asked to vote on what they considered to be "non-diseases". It is understood that it was Professor Wessely himself who nominated ME. Along with big ears and freckles, ME was duly voted a "non-disease" that should be left medically untreated.

It must be due in large part to such disgraceful antics and to the fact that Professor Wessely and other members of the Wessely School are Government advisers on "CFS" that people with ME/CFS are suffering politically-driven health discrimination which is contrary to the Disabled Discrimination Act.

There is a broad body of informed opinion - national and international -- that Professor Wessely belittles other peoples' work without addressing the issues. For a detailed exposition of the tactics of dismissal used by the Wessely School, see "The Mental Health Movement: Persecution of Patients? A Consideration of the Role of Professor Simon Wessely and Other Members of the 'Wessely School' in the Perception of Myalgic Encephalomyelitis (ME) in the UK. Briefing Paper for the House of Commons Health Select Committee" by Malcolm Hooper et al http://www.meactionuk.org.uk/SELECT_CTTEE_FINAL_VERSION.htm

Apart from the Wessely School's own studies, there is little published evidence to support the notion that CBT actually works in ME/CFS, and their own studies have been the subject of criticism on the grounds that many of their studies are deemed to be methodologically flawed, principally because of the authors' selection bias (i.e. they are not studying cases of true ME/CFS, but are then claiming that their results relate to ME/CFS).

For many years Professor Wessely has achieved considerable coverage of his views in the UK media on topics ranging from dental amalgam, "blaming mummy for a bad tummy" "the power of the placebo", "how long should a sick leave last?", bogus miracle cures, and total allergy syndrome to RSI (repetitive strain injury), so the national press coverage of the apparently exponential increase in rates of psychosomatic disorder and the alleged efficacy of CBT is substantial, with Professor Wessely being frequently quoted in the broadsheet newspapers.

Also, due in no small measure to Professor Wessely's apparent control over what gets publicly funded on ME/CFS (perhaps due his previous positions on three MRC Boards and to the fact that "Wessely School" members hold influential positions at the MRC) and what gets published on ME/CFS in the UK (perhaps exercised through his position as a member of the Scientific Advisory Panel to the Science Media Centre which was founded in 1999; it is funded by pharmaceutical companies and operates like a newsroom to promote the views of industry and to launch fierce attacks against those who question them), the medical journals frequently publish highly uncritical assessments of CBT which focus on the few studies which support its use, whilst ignoring those controlled trials which did not find CBT to be effective (and which warned about the dangers of exercising beyond fatigue).

This matter is the subject of an article entitled "A Subgroup Analysis of Cognitive-Behavioral Treatment Studies" by Fred Friedberg (JCFS: 1999:5: 3-4:149-159; co-published simultaneously as "Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical and Basic Science Research (ed) Roberto Patarca-Montero, Haworth Press Inc. 1999).

Friedberg, clinical professor in the Department of Psychiatry at the State University of New York, made the following cardinal points:

"Several studies of graded activity-oriented cognitive behavioural treatment for (ME)CFS, all conducted in England, have reported dramatic improvements in functioning and substantial reductions in symptomatology.

"On the other hand, cognitive behavioural interventions conducted in Australia and the United States have not found significant improvements in functioning or(ME)CFS symptoms.

"Furthermore, descriptive studies of CF (chronic fatigue) patients in England, the US and Australia suggest that the (ME)CFS population studied in England shows substantial similarities to depression, somatization or phobia patients, while the US and Australian research samples have been clearly distinguished from primary depression patients and more closely resemble fatiguing neurological illnesses".

Professor Friedberg notes the "widely divergent clinical presentations" and he notes specifically that because all the apparently successful CBT studies have all been conducted in England, a replication of these findings in a well-designed US study would be necessary before a general recommendation for CBT could be made.

Professor Friedberg's paper was published almost a decade ago, yet Professor Wessely's influence in the UK remains undiminished.

In a paper dated 8th March 2008 entitled "The Year of No Compromise" Greg Crowhurst, a health care professional whose wife is one of the most severely affected ME/CFS sufferers in the UK, said the following:

"This is a simple summary of the inferred messages underpinning the psychiatric paradigm, currently being heavily promoted in the UK".

Although written specifically in relation to ME/CFS, the summary applies equally to all disorders designated by Wessely et al as being "medically unexplained" which these psychiatrists assert are Functional Somatic Syndromes (FSS), including the disorders outlined above. These "Wessely School" psychiatrists in fact believe that ME/CFS, FM, IBS, non-ulcer dyspepsia, pre-menstrual syndrome, chronic pelvic pain, atypical chest pain, "hyperventilation syndrome", tension headache, temperomandibular joint pain, globus syndrome and multiple chemical sensitivity are but one single psychiatric disorder (Lancet 1999:354:936-939).

Crowhurst's summary exactly captures the situation in the UK:

"The recommendations:

q· do not investigate ME/CFS patients

q· do not provide special facilities for ME/CFS patients other than psychiatric clinics

q· do not offer special training to doctors about the disorder

q· do not offer appropriate medical care for ME/CFS patients

q· do not offer respite care for ME/CFS patients

q· do not offer State benefits for those with ME/CFS

q· do not conduct biomedical research into the disorder

The tactics:

q· the wreaking of havoc in the lives of ME/CFS patients and their families by the arrogant pursuit of a psychiatric construct of the disorder

q· the attempts to subvert the international classification of this disorder from neurological to behavioural

q· the propagation of untruths and falsehoods about the disorder

q· the building of affiliations with corporate industry

q· the insidious infiltration of all the major institutions

q· the denigration of those with ME

The practices:

q· the attempt to make "ME" disappear in a sea of chronic fatigue

q· the refusal to see or acknowledge the multiplicity of symptoms

q· the ignoring and misinterpretation of the biomedical evidence

q· the suppression of published findings

q· the vested interests

The impact:

q· the arresting and sectioning of protestors

q· the silencing of ME patients, through being given a psychiatric label

q· the suppression of dissent

q· the labelling of ME patients as the "undeserving sick", as malingerers

q· the forcible removal of sick children and adults from their homes.

"It is poignant how an institutionally supported prejudice against people with ME has arisen, based on nothing more substantial than supposition and opinion, carefully disseminated.

"You have to be very careful how you discern the truth; it is an important issue in the corporate wall of collusion surrounding the physically sick people who have ME.

"We have to be very clear about what is the truth about ME and what is either deliberate, naive or ignorant misinterpretation or misrepresentation. The impact of the above strategy on peoples' lives is catastrophic".

Crowhurst's article can be accessed at www.metrainingco.org.uk

As noted by Hooper et al, the malign influence of Wessely School dogma extends throughout Government departments, throughout the NHS, and even extends to the Judiciary, with one Claimant being told at a High Court Hearing that "Judges regard ME as psychological self-indulgence". One Local Health Board will only fund treatment for ME/CFS where the focus is CBT/GET. A spokesman for Grampian NHS Trust is on record in 2003 (disturbingly, this was a year after the publication of the UK Chief Medical Officer's Working Group Report) as stating "ME is not a condition we recognise or treat" (see "Illustrations of Clinical Observations and International Research Findings from 1955 to 2005 that demonstrate the organic aetiology of ME/CFS" http://www.meactionuk.org.uk/Organic_evidence_for_Gibson.htm  ).

The damage perpetrated on those with ME/CFS by Wessely School adherents cannot be quantified. The Wessely School argument that syndromes like ME/CFS cause "unnecessary expenditure of medical resources" has been criticised by a leading US researcher for its pernicious public policy implications (Lancet, 11th December 1999:354: number 9195).

In the UK, patients with ME/CFS, particularly children, have suffered gross and barbaric abuse and persistent denigration as a consequence of the beliefs of Wessely School psychiatrists who are attempting to control the national agenda for this complex and severe neuro-immunological disorder and who by their words and deeds have wreaked havoc in the lives of many ME/CFS patients and their families by their arrogant pursuit of a psychiatric construct of the disorder in clear defiance of the clinical and scientific evidence of the organic nature of ME/CFS.

There have been persistent and frequently covert attempts by these psychiatrists to subvert the international classification of ME/CFS, with destructive consequences for those affected.

It seems that Professor Wessely is accountable to no-one for his role in determining UK Government policy that the disorders mentioned above do not exist as discrete entities and that such patients should be "managed" by psychotherapy.

Instead, in return for his decades of denigration of patients (for actual quotations from his work see "Quotable Quotes about ME/CFS" available from the charity Invest in ME at 01603 - 701980) and for his denial and dismissal of the published evidence that he is wrong, and for all the seemingly consequential suffering and despair arising from his personal beliefs, Professor Wessely has been lauded and honoured.

On 27 August 2003, Dr George Szmukler, Dean of Psychiatry, Institute of Psychiatry, King's College Hospital, London, wrote to the Countess of Mar about Professor Simon Wessely: "Professor Wessely must be judged one of the most outstanding researchers in the UK, and indeed internationally. Professor Wessely has been awarded a Research Medal by the Royal College of Physicians specifically for his work on CFS and he has served on many prestigious scientific committees, further attesting to the high regard in which he is held by the scientific community".

Not everyone - including doctors and medical scientists from around the world -- shares that view.

http://www.meactionuk.org.uk