Comments concerning Dr. Ellen Goudsmit, Dr. Fred Friedberg, the cause of CFS and bad science.
I have recently become aware that some have interpreted my articles as evidence of Cartesian dualism, i.e. the notion that the cause of illness is either in the body or the mind. I am also aware that some believe that I am aligned with the school of thought which perceives CFS as having a single (biomedical) cause and that I am so fixed in that view that I would ignore and deny future evidence to the contrary. Dr. Fred Friedberg put it as follows: She (i.e. EG) is “so beholden to a rigid mind-body dualism - so much so that I suspect that she would never support a role for psychological factors in CFS, no matter what the evidence" (1).
As the BPS Code of Conduct requires its members to correct misrepresentation, I hereby note that I do not hold the views above. Those who have read my posts will undoubtedly know that I regard CFS as an umbrella term which covers a mixed population. In line with the CDC and respected scientists such as Prof. Jason, I suspect that the current definition selects different subsets of patients and that these subsets may well have different causes. Indeed, I have already stated that there is evidence that the definition of CFS also covers a group whose fatigue is the result of chronic stress, hence the low cortisol levels documented in some research. My articles not only recognise the complexity of CFS but I have often discussed the role of psychological factors as contributing to the experience of disability. Both the acknowledgement of psychological factors in the aetiology of subsets and the articles noting the damaging effects of uncertainty, anxiety, depression etc, are
inconsistent with Cartesian dualism.
What particularly baffles me about the claims is that I have written very little about the aetiology of CFS. This is because as a psychologist, I am not able to interpret genetic and immunological findings and am therefore unsure about their significance. Any comments about a likely biomedical aetiology in my articles represent the views of the relevant physicians, and I usually cite the source. The fact that I don’t have a personal view about the aetiology of CFS, but like others, discuss findings and speculate about subsets, is again inconsistent with the suggestion that I am convinced that CFS has a biomedical cause. Even in relation to post viral syndromes, I simply do not know what leads some to recover and some to remain ill (cf. Hickie et al, BMJ). Furthermore, I don’t know anyone who does.
Although I have written at length about the flaws in the CBT model and have questioned specific psychological explanations e.g. which attribute CFS almost entirely to maladaptive beliefs and behaviours, this does not mean that I totally reject a role for all psychological factors. It means that I am not persuaded by the CBT model. As noted above, I don’t know the cause of CFS and do not claim to know. I simply have not seen good quality evidence to implicate factors such as hysteria, misattribution and suggestibility. If this came to light, then I would follow normal procedure in science and acknowledge the research.
Perhaps those individuals who perceive me as promoting a specific theory have confused me with someone else?
It saddens me greatly that I am being portrayed as a follower of Cartesian dualism, a concept I consider to be overly simplistic and inconsistent with good science. Equally, I am deeply disappointed that any reader of my articles would conclude that I am so fixated on a biomedical aetiology, that I would drop my principles (I have long promoted the need for balance and fought the denial of evidence), and simply ignore sound evidence implicating psychological factors in the aetiology of CFS. I realise that a scientist may express a less than objective opinion of evidence as a result of consultancies with drug companies, a position of influence in a political party, or the need to sell a book, but in my experience, there is no money to be made, or political influence associated with, the opposition to the CBT model. Even if there was a potential for personal or financial gain associated with the promotion of a biomedical aetiology, I would not discard my scientific training
and breach two professional Codes of Conduct.
1. People wishing to know the source of the comments may contact me offlist. To name it here would provide free publicity for a publication which is not the aim of this post.
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