Talk:Simon Wessely/Archive 2

Archive 1

Archive 2

Summary

The value of the Gibson report was discussed at length. It was argued that this report is not a reliable source for this particular article. Information on specific cases of myalgic encephalomyelitis / chronic fatigue syndrome was shared. It was furthermore argued, that Simon Wessely's role in a controversy regarding the classification and treatment of ME/CFS should be clarified in the article. Potentially appropriate sources were mentioned:

• [1] David A, Wessely S, "Chronic fatigue, ME, and ICD 10", Lancet 1993:342:1247- 1248, where the authors claim that the WHO was wrong to classify ME as a neurological disorder under G93.3, post-viral fatigue syndrome.
• [2][[3] Song, S, Jason, LA, "A population based study of CFS experienced in differing patient groups. An effort to replicate Vercoulen et al.'s model of CFS", Journal of Mental Health, 2005, 14, 3, 277-289, where the authors show that the data do not support Vercoulen's model, which is based on Wessely's views:

"In part, due to the lack of a biologic marker, several theorists have proposed psychogenic approaches for understanding CFS (Wessely, Hotopf & Sharpe, 1998). For some, CFS was assumed to be a psychologically-determined problem (Manu, Lane, & Matthews, 1988). These views ultimately affected some physicians who believed that CFS was similar to neurasthenia, and that CFS would eventually have a similar fate once people recognized that most patients with this disease were really suffering from a psychiatric illness. Complicating this situation was the fact that psychiatrists and physicians have also regarded fatigue as one of the least important of presenting symptoms (Lewis & Wessely, 1992). ... These biases ...." Guido den Broeder 10:31, 21 October 2007 (UTC)

Both sources you advance are already part of the CFS article. The role of the subject in the CFS/ME controversy is already well established by the present source. JFW | T@lk 11:47, 21 October 2007 (UTC)

Well, I disagree. The historical angle is missing, and for the sake of neutrality, it should be made clear that Wessely's views are not mainstream. Guido den Broeder 13:54, 21 October 2007 (UTC)

Not mainstream? That is quite an accusation, given the fact that the guideline National Institute for Health and Clinical Excellence. Clinical guideline 53: CFS/ME. London, 2007. seems to strongly subscribe to the view that you argue is "not mainstream". If an NHS-wide consensus guideline is not mainstream, then what on earth is? JFW | T@lk 17:35, 21 October 2007 (UTC)

I'd hate to burst your bubble, since you'd fall so deep, but no, this is not a consensus document, and England does not rule the waves. Guido den Broeder 18:17, 21 October 2007 (UTC)

Uh, please WP:NPA and WP:CIVIL, thank you. I note your objections to the NICE guideline (and the fact that some patients' organisations are unhappy about it), but you are simply wrong about the "mainstream" bit. Being on one side of a controversy doesn't make a view "non-mainstream". JFW | T@lk 19:13, 21 October 2007 (UTC)

Why is he wrong about the mainstream bit? I haven't counted it down yet, but it seems to me that a patient organisation not unhappy with the NICE Guidelines ist the exception, rather than the rule. If you see things differently, let's discuss it.

As for what's mainstream and what's not: The opening paragraph of the entire NICE document states something to the effect of "two sides with strongly held views". I don't know how you manage to get to the conclusion that Wessely's view is the mainstream view nevertheless.

Maybe because the guidelines emphasises CBT & GET? Have you ever flipped through the documented stakeholder responses? There is miles & miles of complaints about the guideline and the overemphasis on CBT and GET. Even the Association of british neurologists complained about that very point. Other psychologists are complaining about it. Also, the one major charity who didn't immediately call for a withdrawal (AFME) complained about it.JayEffage 09:24, 22 October 2007 (UTC)

You've missed my point. Even if numerically in the minority, Wessely's perspective is still one of the several mainstream opinions (as opposed to some loony with a blog claiming that CFS is caused by alien abduction etc). JFW | T@lk 21:26, 27 October 2007 (UTC)

Support by you does not make it mainstream. Respect WP:NPOV, if you please. Guido den Broeder 19:33, 21 October 2007 (UTC)

Neither does opposition by you take it out of the mainstream. NPOV is for articles, not for talkpages.

I don't think you should separate your "summary" above from this discussion with extra headers. The discussion follows directly from your summary, and the summary only covers some of the sources discussed. It is obvious that you are trying to restart the discussion, and I don't think your statements should go unchallenged.

Now, is there anything on the menu that comes from the famous cuisine of consensus? JFW | T@lk 21:16, 21 October 2007 (UTC)

I'm waiting for the challenge. Guido den Broeder 21:29, 21 October 2007 (UTC)

Sorry if this is the wrong place to ask this qn, but I'm wondering why the Martin J. Walker article "The WWW. Weird World of Wikipedia" was removed from this page. Surely this would be the appropriate place for it, if not the entire thing, then an intro and a link to it? Virginia (sorry, I'll get myself a proper account some time) —Preceding unsigned comment added by 210.79.21.2 (talk) 17:44, 6 February 2008 (UTC)

• Because it fails our sourcing policies for biographies. Guy (Help!) 22:33, 6 February 2008 (UTC)

But this is a discussion page. And Walker discusses the merits of Wikipedia's sourcing policies vis-a-vis this biography. So surely this is right on-topic. Virginia —Preceding unsigned comment added by 210.79.21.2 (talk) 05:51, 7 February 2008 (UTC)

• Nope. Guy (Help!) 10:45, 7 February 2008 (UTC)

OK - I'm new to Wikipedia, and fine about discussing. Perhaps you could clarify why you simply responded with a "nope", considering (i) I didn't suggest allowing the article to be posted on the actual biography page, but on the discussion page (and it *is* a discussion page, right?) (ii) Walker's article discusses what should go under Simon Wessely's bio, so it is on-topic, even if you disagree with its contents and don't personally support any of its points about changing the bio page (iii) Other comments on this discussion page are likewise discussing what should go on the bio page, but they have not been deleted. Again, I get it if it's an issue about length - so why not just include an intro and then a link to the full article? cheers Virginia —Preceding unsigned comment added by 210.79.21.2 (talk) 10:54, 7 February 2008 (UTC)

• It's just a rant by someone whose friends have, largely due to their own absolute unreasonableness, been prevented from skewing an article towards supporting their external agenda against someone. Such input generally falls somewhere between unwelcome and very unwelcome, especially in cases of sensitive biographies. It has absolutely no merit as a source for content, and as a debating point it will achieve nothing other than further inflaming a dispute which is quite heated enough already. Guy (Help!) 12:00, 7 February 2008 (UTC)

Regarding Wessely's views on ME being mainstream or not, and what exactly these views are, it's worth recognising that his comment in the Gaurdian "Battle fatigue" article was a regret over language used, not a regret over the sentiment expressed. He's more "careful", usually, now about what he says, but the spots haven't really changed. If they had, he'd be turning away CFS research funding and instead nominating Spence, Gow, Kerr et al for much needed pathoetiological research, while he concentrated on the limits of his expertise in mass psychogenic illness/hysteria/PTSD/somatised depression/anxiety etc. His so-called "biological" studies on HPA axis and so on are not specific to ME and quite specific to anxiety disorders and other functional/behavioural/psychiatric/"biopsychiatry" states which are usually reversable through psychological debriefing and exposure therapy, unlike ME. The CDC doesn't seem to agree with him regarding the status of ME anymore. MEspringal (talk) 09:53, 21 February 2008 (UTC)

Daily Mail article of December 14, 2007

Yesterday the Daily Mail had a news story on the Camelford water poisoning scandal of 1988 [4]. The One-Click Group [5] links this to an article by Simon Wessely and Anthony David in the Journal of Psychosomatic Research, Vol 39, No 1. pp.1 9. 1995, "The Legend Of Camelford : Medical Consequences Of A Water Pollution Accident" [6]. The authors claimed that "there was little cause for concern". I don't know whether One-Click's conclusion to an intentional cover-up has any merit, but this seems serious enough as it is, if the Daily Mail sketches the right picture. Any thoughts? Guido den Broeder (talk) 19:37, 15 December 2007 (UTC)

The Daily Mail article does not mention Wessely. Wessely's article from 1995 does not, to my reading, suggest there was little cause for concern - the conclusion reads, in part, "To this day it is impossible to quantify the morbidity, be it primarily psychological or physical, arising from the water contamination incident." I would suggest that One-Click's website is not a suitable source to make unsubstantiated, inflammatory allegations (per WP:BLP). MastCell ^Talk 19:58, 15 December 2007 (UTC)

Ah. I think I see what happened. The article reads: "The committee concluded that acute short-lived intoxication was so unlike the circumstances of long-term renal dialysis that there was little cause for concern." The One-Click group translated this into "Wessely concluded" and concern in general. The members of the committee are not listed, but from the text it seems unlikely that Wessely was a member himself. Guido den Broeder (talk) 20:13, 15 December 2007 (UTC)

The whole tone of Wessely's article is however derisive of any organic basis for symptoms. This is evident in his source selection and of course reading the article in the context of his other work. —Preceding unsigned comment added by 88.108.105.204 (talk) 23:00, 21 December 2007 (UTC)

Certainly; the article should be more explicit about Wessely's views on the topic of ME/CFS and the consequences thereof. Guido den Broeder (talk) 12:37, 22 December 2007 (UTC)

Guido: if you can find a source that can support your interpretation, fine. But so far all we have heard from many contributors is allegations. In what way has Wessely been "derisive" in a way that is not open to various interpretations. JFW | T@lk 17:33, 27 December 2007 (UTC)

The article is called "the Legend of Camelford" which does suggest a degree of unreality and Wessely's views on chemical sensitivity are well known. Also Wessely works for UNUM provident. Surely this should be in the wikipedia article??? —Preceding unsigned comment added by 88.108.43.49 (talk) 15:01, 6 January 2008 (UTC)

Perhaps the question should be, why is there any need for psychological explanations when there is perfectly good toxicological evidence that the disaster occurred? Surely the causality between aluminium sulphate poisoning -- especially when tardily recognised and untreated (if there is a treatment) at the time -- and long term health effects is a no brainer: which part of that exactly is confusing? Why bring in the official state figleaf at all -- unless there's something to cover up? That seems to be Wessely's speciality, after all: is there any condition he hasn't at least initially poured a lakeload of cold water on, reassuring the plebians that we're just getting worked up over everyday "symptoms" (something of a contradiction in terms, not that that's ever bothered the psychological lebensraum).

"Furthermore, the image of evoked potentials as entirely ‘objective’ may be confusing. Like most physiological measures they are influenced by such things as anxiety and hyperventilation [20] as well as being open to deliberate deception." Ah, the old hyperventilation fandango again, scourge of ME sufferers before it was trashed as nonsense there. I don't have access to the full article so I wonder what other delights lurk in his deliberate deception, sorry, "reassurances". The suggestion of "deliberate deception" is surely both beneath contempt and above arrogance.

This character here[7] is citing Wessely's Camelford piece as evidence of "Mass Psychogenic Illness". Are we expected to believe poor ol' Simon has been "misunderstood" again? D'oh! MEspringal (talk) 09:06, 21 February 2008 (UTC)

This talkpage is not for ranting. Please tell us what changes need to be made, not what your opinion is about this or that. JFW | T@lk 13:46, 21 February 2008 (UTC)

Please move the admin category to the talk page

Category:Place of birth missing (living people) should be on the talk page, not the article page. Alex Middleton (talk) 17:45, 21 December 2007 (UTC)

Done. JFW | T@lk 17:33, 27 December 2007 (UTC)

the importance of popularity

Surely to be a good doctor one needs to be liked?? —Preceding unsigned comment added by 88.108.113.151 (talk • contribs) disruptive comments unsuitable for WP:TALK removed by JFW | T@lk 12:42, 28 March 2008 (UTC)

Yes, a small group of noisy people opposes Wessely, despite his high-profile clinical research into several enigmatic conditions and significant benefit derived by patients from his research. You made an edit to name them (Spence, Goldstein and Hooper), and you also alleged that the subject "works for" an insurance company, a claim that has been repeatedly debunked on this talkpage.

This is an article about a living person, and therefore specific guidelines are in place to prevent gross distortions without suitable sources from making their way into a widely read public resource. From your use of rhetorical questions I surmise that you are no great fan of the subject of this article, and perhaps you should also read WP:COI, because in many cases "no great fans" originate very unbalanced content.

I am one of the Wikipedia administrators who watches this article closely in view of previous disruption. Please work with me, and take into account my above comments before making any further attempt at editing this page. JFW | T@lk 12:41, 28 March 2008 (UTC)

So UNUM's annual report was a fake??? associated if you prefer, it is still a conflict of interest. Also I am unable to find any physician apart from one or two north of the border who take his work seriously. "noisy people" is this your attitude when 95% of YOUR patients think the treatments you offer are unhelpful??? It is simply not correct to produce stalinist biographies of people who are so controversial. Threatening and unhelpful comments removed JFW | T@lk 16:03, 28 March 2008 (UTC)

Anyway I'm not about to discuss this with you as I think like various religions you are a wikipedian and thus a cult member ie irrational (like Judaism or Christianity) —Preceding unsigned comment added by 88.108.113.151 (talk • contribs)

Well, suit yourself. You have managed to get the page as well as this talkpage semiprotected. I asked you to work with me, and your agenda and obvious rudeness got in the way. JFW | T@lk 16:03, 28 March 2008 (UTC)

Early days

• In the early days of recognition of chronic fatigue syndrome (also known as myalgic encephalomyelitis), it was often played down in the media, for example being described as "yuppie flu".

This seems not entirely accurate, since the disease had been recognized with the diagnosis of ME decades before. Guido den Broeder (talk) 18:27, 21 May 2008 (UTC)

No, CFS was coined in the 1980s. ME has existed since the 1950s, and probably much longer if we are to believe Byron Hyde. What would you like to change? JFW | T@lk 10:09, 7 July 2008 (UTC)

I would write something like:

• In the early days of the introduction of the diagnosis chronic fatigue syndrome (as an alternative to the existing diagnosis of myalgic encephalomyelitis), it was often played down in the media, for example being described as "yuppie flu". Guido den Broeder (talk) 21:55, 2 August 2008 (UTC)

But there is no consensus about that at all, so I cannot imagine that we could phrase it this way without POV violations. JFW | T@lk 22:07, 2 August 2008 (UTC)

No consensus about what, exactly? Maybe you can rephrase it. Guido den Broeder (talk) 08:13, 3 August 2008 (UTC)

Argh. You seem to be suggesting that ME had no stigma at all, and that when the concept of CFS was introduced it came to be denigrated as "yuppie flu". JFW | T@lk 08:45, 3 August 2008 (UTC)

You have sources that it is otherwise? Guido den Broeder (talk) 12:16, 3 August 2008 (UTC)

The subject speaks

doi:10.1192/pb.29.7.280 is a rapid-fire interview in the Psychiatric Bulletin that could be used to attribute quotes if needed. It is silent on CFS/ME controversy. JFW | T@lk 10:09, 7 July 2008 (UTC)

doi:10.1192/bjp.181.1.81 more from the subject. Contains autobiographical content and again very little on CFS/ME. JFW | T@lk 11:51, 10 August 2008 (UTC)

More Alpinist

Some Alpinist activity on 2/8/2008. The article is protected again. JFW | T@lk 21:27, 2 August 2008 (UTC)

untrue

prompted by members of the ME community I am posting here to say the above is untrue "alpinist" no longer edits wikipedia. As we know people on both sides of this debate myself and my partner wish to distance ourselves from the activities of JFdwolff and whoever has been editing "simon Wessely"

Fiona —Preceding unsigned comment added by Catherinefionarichardson (talk • contribs) 10:58, 3 August 2008 (UTC)

Could you also distance yourself from the miserable nonsense being spouted by 88.108? JFW | T@lk 12:25, 3 August 2008 (UTC)

Why is this article so sanitised?

When I click on a controversial figure at Wikipedia, I expect to see what they said and why it's considered controversial. I can find out exactly what controversial comments James Watson made about race and intelligence, but on Wessely and CFS all I see is some vague sentence about psychological factors. The background which the reader should know about is essentially omitted, and the current article seems to understate the situation and related criticisms. I ask myself why these "noisy patients" are indeed noisy at all, and why the least respected field of medicine is given such weight over other fields despite a poor track record.

I would like to know what Wessely has actually said himself, but without personal journal access or practical library access to the full text of articles in which Wessely comments on CFS and ME, where else can people turn to in order to find out what he has said and why it is deemed controversial? The answer is, "those activists' websites", which highlight the statements apparently made by Wessely (and associates) that can easily be seen as insulting to patients, and alas, the anger from patients suddenly makes a lot more sense, especially when these comments are inaccurate and unrepresentative of patient experience.

If Wessely's work and comments are correct, they should stand on their own merit; but here you will barely even find any direct quotes, yet alone the resultant criticism. On a finishing note, all the historical baggage attached to this article is a turn-off for anything besides a passing comment on this talk page, not to mention any actual edits to the article. Indeed, even this talk page is over-regulated and some interesting points have been deleted.

Tekaphor (talk) 09:15, 6 August 2008 (UTC)

Because those sources attribute views that Wessely claims not to hold in other fora. The Burne source is fine. This article has been blanked by Jimbo in the past for hair-raising NPOV/BLP violations and a number of editors has been banned for soapboxing here. You are free to propose improvements here but they need tight consensus forming before they can be integrated into the article. JFW | T@lk 11:51, 6 August 2008 (UTC)

I agree it is difficult to find the actual text for some of Wessely's supposed views/quotes. However I did just spent some time investigating the comment from the Countess of Mar where she claims that Wessely said "M E exists only because well-meaning doctors have not learned to deal effectively with what he called 'suggestible patients'"[8]. I found the actual text of Wessely's article here [9]. As you can see, he said no such thing. What Wessely does say in his articles is that CFS is a real illness, but primarily psychiatric in nature. For whatever reason, many patients would prefer their illness to be organic rather than psychiatric, and because of this they have vilified Wessely and made false claims about what his views are and what he has said. --Sciencewatcher (talk) 20:39, 31 August 2008 (UTC)

Now if you could find a reliable source for that. It is clear that Mar's comments were immediately seized upon as potentially libellous if not uttered in the Lords. The blog page you cite does not give me the answer at all. If you want to insert a quote to the effect that "Wessely views CFS as a psychiatric illness", then we also need a quote to reflect the fact that the "ME community dislikes this perspective and goes ad hominem about it".

In the absence of a reliable source, this article will remain as sanitised as Tekaphor found it. Rather that than BLP violations. JFW | T@lk 05:23, 1 September 2008 (UTC)

Sciencewatcher, that many patients would prefer an organic illness is a myth. Patients don't care about that. They do care about a correct diagnosis though, and not to be labelled as psychiatric if they have an organic illness, or vice versa. Guido den Broeder (talk, visit) 13:18, 1 September 2008 (UTC)

The Countess of Mar's comments

The Countess of Mar said, "Simon Wessely has been relentless in his proposition that ME does not exist. For example, in the journal of psychological medicine in 1990 he claimed that M E exists only because well-meaning doctors have not learned to deal effectively with what he called 'suggestible patients'." When I searched for "deal" on the reference that Sciencewatcher posted, I found the paper ("Old wine in new bottles: neurasthenia and ME.") where Wessely makes the following statement: "Suggestible patients with a tendency to somatize will continue to be found among sufferers from diseases with ill-defined symptomatology until doctors learn to deal with them more effectively." Elsewhere in this paper, Wessely is clearly equating the symptoms attributed to organic "ME" with psychiatric neurasthenia and therefore implies that ME doesn't exist literally because neurasthenia will suffice.

Her statement about that specific paper wasn't ideally precise, but makes more sense when considering Wessely's statements in other papers he authored (which are featured on the blog too). For example, in another paper ("Functional somatic syndromes: one or many?") he argues that the appearance of such "specific somatic syndromes is largely an artefact of medical specialisation", and in another paper ("Psychiatry in the allergy clinic: the nature and management of patients with non- allergic symptoms.") there is the statement '' ... in distinguishing between the epidemiology of myalgic encephalomyelitis (ME), a belief, and chronic fatigue syndrome, an operationally-defined syndrome". When considering these statements, among others, it's fairly obvious they suggest Wessely holds the following opinions: (a) "ME" as a distinct organic neurological illness (WHO) doesn't exist and outbreaks were likely a form of mass hysteria or psychogenic illness, (b) the symptoms commonly attributed to "ME" today are essentially neurasthenia/CF, (c) such attribution is merely a "belief" of the patient rather than a reality, (d) the supposed distinct existence of ME/CFS is an artifact of medical specialisation, (e) 'suggestible' people prone to somatisation aren't dealt with effectively by doctors and this leads to problems a/b/c/d.

Consider this scenario: a patient goes to the doctor, suffering symptoms which appear to be neurasthenic, a supposed mental illness assumed to be caused by stress and/or negative cognitions and best treated with psychotherapy; however, the patient also happens to match the description of ME, who then resists psychologisation of their physical symptoms and begins to identify with ME. Wessely argues that these physical sensations are symptoms of psychiatric illness, that ME doesn't actually exist and the patient only believes they have ME. He also argues that this belief only perpetuates or worsens these symptoms and hinders the goal of psychotherapy. Additionally, he appears to argue that if doctors only dealt with such patients better (who are suggestible people prone to somatisation), not only would their condition be successfully treated, but they would no longer be wallowing in false illness beliefs (such as being organically diseased and being negatively affected by activity etc). From memory, his colleges whom he supports also argue that the severity of physical symptoms is largely due to (psychiatric) somatosensory amplification of otherwise normal or mild sensations rather than a disease process, thus fueling and fueled by, the false illness beliefs that lead to "fear avoidance" and therefore consequential "deconditioning", the two supposed main factors behind ME/CFS.

So the Countess' words, that Wessely claims ME only exists because doctors don't effectively deal with such patients, is not so far off the mark afterall. I guess there are two interpretations of the Countess' comment: (1) the diagnostic entity of ME only exists because, (2) the illness symptoms of ME/CFS only exist because,. I'm guessing Sciencewatcher's criticism was based on #2. Either one appears valid because, seemingly according to Wessely, neither the belief in ME or the symptoms associated with ME would exist if doctors dealt with these patients more effectively.

_Tekaphor (talk) 17:18, 1 September 2008 (UTC)

So, Tekaphor, please suggest on this talkpage how you would amend the article. I would like to see a reliable source that is actually his own work and not a (re)interpretation of Wessely's writings, and I'd like to see NPOV phrasing that we can all agree with. JFW | T@lk 20:09, 1 September 2008 (UTC)

This is what is generally understood by the 'Wessely school'. The problem for Wikipdia is that Wessely & co have not published their point of view in full. One has to string the pieces together, and that is dismissed as original research, valid or not. The root of it all can be found in Wessely's and David's letter to the Lancet at the time that CFS got classified.

• David A, Wessely S, "Chronic fatigue, ME, and ICD 10", Lancet 342:1247-1248 Guido den Broeder (talk, visit) 22:56, 1 September 2008 (UTC)

It is not Wikipedia that has a problem. It is those who are bent on attributing to a researcher particular views that he either doesn't hold or hasn't expressed in so many words. I think we should move on, unless Tekaphor can show us something. JFW | T@lk 22:58, 1 September 2008 (UTC)

While Wikipedia has every right to make certain demands when it comes to their articles, don't let yourself be blinded to the point that you consider them the scale of absolute truth, conclude proof of lack from lack of meeting these demands and claim that people are making false attributions. Wessely has expressed these views, only not in the neat package that Wikipedia would be willing to consider. Guido den Broeder (talk, visit) 23:24, 1 September 2008 (UTC)

Guido said "Sciencewatcher, that many patients would prefer an organic illness is a myth". Sorry, it is not a myth - I have experienced first hand, many times (including from you Guido) that many patients do very much prefer an organic etiology for the illness. Anyway, back to the point of discussing this article. I agree with JFW that it is better to just leave the article as it is rather than going into a "she says/he says" discussion. As can be seen above, Mar's comments misrepresent what Wessely actually said. All we can say is that Wessely has caused controversy with patient groups due to his views on the illness, and the article says that adequately. It shouldn't be dragged out, especially as this is a biography. The article already gives a summary of Wessely's views on CFS. --Sciencewatcher (talk) 00:12, 2 September 2008 (UTC)

Personally, I would prefer to have no illness. I had a good life before I fell ill. Now, apart from the devastating illness itself that has left me unable to profess my trade or do many things that the healthy take for granted, without income and dependent on others for my bare survival, I am faced with people who fall over each other in their zeal to hammer me down further with the doctrine described by Tekaphor above, simply because they can. Do not claim for one instant that you know what I think or feel. You know nothing. Guido den Broeder (talk, visit) 00:57, 2 September 2008 (UTC)

JFW, NPOV phrasing? I used quotes from Wessely's work, although I didn't bother to hunt down and confirm all the papers in PubMed if that's what you mean. Sciencewatcher said "All we can say is that Wessely has caused controversy with patient groups due to his views on the illness, and the article says that adequately." But what are those views exactly? Imagine saying "James Watson caused controversy over racist comments" and then not elaborating. The article claims "Wessely's summarised his view on CFS in a 2003 review article, co-authored with Baruch Fischhoff and published in the British Medical Journal."; I had a look at this reference ("Managing patients with inexplicable health problems.") and it doesn't seem to be speaking specifically about CFS, although uses it as a prime example; the tone seems more poetic than descriptive.

I demonstrated above yesterday that he clearly implies ME doesn't exist, that patient's beliefs are core to their psychogenic symptoms, and that a diagnosis of neurasthenia can capture these symptoms. The article goes on to say "Some critics hold him responsible for promulgating the view that chronic fatigue syndrome is primarily a psychiatric condition, an approach termed the 'psychiatric paradigm' by opponents. Wessely counters that few deny a potential physical mechanism, but that the effects are mainly functional; research conducted under his direction has detected markers of physical abnormalities in CFS."; I ask, what does Wessely "counter" exactly, as if this is some wildly inaccurate accusation? This is odd considering that Wessely appears to have academic influence and has clearly argued that it is indeed primarily a psychiatric condition, and if I remember correctly, he even tried to reclassify it as such.

On the topic of "interpretations", the article also claims: "Wessely's work suggests CFS is generally consequent from some organic trigger, such as a virus, but that the role of psychological, physiological and social factors should also be considered when considering failure of some patients to recover - and that treatments centred around these factors can be effective in many cases." It does? Who's interpretation is that? More importantly, where is the actual reference that states what "Wessely's work suggests", and how blatantly hypocritical is it to demand high quality references for any changes when the entire "Work on CFS/ME" section is practically unreferenced.

What the euphemistic sentence really means is "patients generally develop symptoms of neurasthenia after a bout of stress and/or ordinary infection, so illness beliefs and social factors should be considered when such patients fail to recover, and related psychotherapy can be effective". It's incredible to insist on one hand that CFS is primarily a mental disorder with secondary physical symptoms, and then on the other hand deny that's what Wessely's papers represent, especially when the "bio" aspect of the BPS model for CFS is focused on biological psychiatry, and when Simon Wessely himself is a psychiatrist publishing psychiatric papers about a supposed psychiatric illness! What's so difficult to fathom about that, and why is it apparently so difficult to summarise Wessely's work?

As for my suggestions regarding how to improve the article; I think I hinted this at the beginning with the comparison to the entry on James Watson (eg actual quotes). However, when considering the long history of intensive arguing on this talkpage I suspect ironically that even Wessely's own papers generally aren't considered "NPOV" and "RS" enough for this article, and editors here can't agree on how to use them anyway, so there appears to be a dead end as far as editing is concerned. JFW previously said, "Because those sources attribute views that Wessely claims not to hold in other fora. The Burne source is fine." OK, so why aren't Wessely's other papers fine and how do they deviate radically from the ME/CFS advocates' claim that Wessely promotes the idea that ME/CFS is a psychiatric illness?

_Tekaphor (talk) 12:50, 2 September 2008 (UTC)

What I believe I asked was an attempt to write an NPOV and well-cited summary that we could integrate into the article once consensus has been reached. Instead we have more personal comments from various editors. You are correct that I would not want Wessely's work to stand on its own; I'd much rather have a secondary source that outlines which areas of his work have drawn so much fire. For these purposes, the Burke source is excellent because it is exactly that: a secondary source that tries to hear out both Wessely and his perceived arch-enemy Hooper. If you have further sources of the kind that document the struggle that you are alluding to: be my guest. JFW | T@lk 22:53, 2 September 2008 (UTC)

However, while secondary, the Burke source is not very informative. Guido den Broeder (talk, visit) 23:41, 2 September 2008 (UTC)

You have not found a similar source that covers the debate fairly. Go back three spaces and miss a turn. Do not pass GO. JFW | T@lk 21:53, 3 September 2008 (UTC)

The letter to the Lancet should be referenced to in the article, but you prevented that earlier. Guido den Broeder (talk, visit) 21:59, 3 September 2008 (UTC)

I think there are two issues here. [1] Whether Wessely ever said that ME doesn't exist and [2] whether he thinks it is primarily psychiatric or organic. I think it's pretty clear he never said ME doesn't exist - he just doesn't agree with the classification of it. But as for his views on whether the illness is primarily psychiatric I would agree with Tekaphor that it's hard to pin down. My own impression is that Wessely views CFS as a primarily psychiatric illness with some physical signs and symptoms (this is what his research implies), but he tends to play this down when he talks in public, most likely because of the reaction he knows he would get. There's a TV interview with him you can find on the internet where he says something along the lines of "emotional factors are also important in the illness, of course, as they are with any other illness" (that's not a direct quote - just a recollection from my probably faulty memory). Of course there's no way you can put this into the article unless you can find a NPOV comment by some respected authority, as JFW has said. --Sciencewatcher (talk) 22:37, 3 September 2008 (UTC)

Wessely's point of view is that ME/CFS is a manifestation of neurasthenia, and does not exist as a separate disease entity. This is in the letter that I mentioned. He is working with a case defintion that reflects this (the Oxford criteria). As a consequence, it is likely that the patients he sees are indeed mostly neurasthenia-type patients rather than genuine ME/CFS patients. Guido den Broeder (talk, visit) 22:54, 3 September 2008 (UTC)

Yes, Wessely views CFS as neurasthenia. But saying it doesn't exist as a separate disease entity is not the same as saying "it doesn't exist". And the difference between CFS and neurasthenia is purely down to the presumed etiology, not a different type of patient. Have a look at the defined symptoms of neurasthenia and you'll see it is the same illness as CFS. --Sciencewatcher (talk) 23:08, 3 September 2008 (UTC)

Neurasthenia explicitly excludes post-viral disorders, see the ICD 10. Yes, some symptoms are the same, hence the recurring confusion in certain circles. But many other symptoms are not, and neurasthenia by definition shows no results if the patient is medically investigated, while ME/CFS shows many. Guido den Broeder (talk, visit) 23:19, 3 September 2008 (UTC)

Then perhaps the definition is wrong, which is what Wessely is saying. --Sciencewatcher (talk) 00:29, 4 September 2008 (UTC)

The Burne source (published 6 years ago) contains an overview of the situation, but isn't very informative about the papers which patient advocates are critical of. Readers are directed towards his casual comments made to a journalist and his summary about dealing with related patients, but not the actual work that critics deem faulty or offensive, which is somewhat misleading. Some researchers have criticised his work, but this is getting too deep into CFS research for a biography rather than simply documenting the existence of criticism. Why were we discussing the Countess of Mar's comment anyway? Was it previously used in this WP article, or is this some attempt at summarising and debunking the critics? Wessely implies that beliefs determine the severity of symptoms, and psychotherapy is based around challenging these beliefs. Suggestions are also made about patients' behaviours, motivations, personalities, introspection, legitimacy and honesty; some of these are perceived as insulting or patronising. However, sometimes the impression is that CFS isn't solely psychiatric but psychosocial factors are substantially important and need to be considered; this more "reasonable sounding" wording is probably what Sciencewatcher and others think about when claiming that patient advocates are making wild accusations about Wessely's work. But it seems that all this has already been thrashed out before without much of a resolution and everyone is firmly holding their ground. - Tekaphor (TALK) 11:02, 21 September 2008 (UTC)

If you're so keen to include criticism of Wessely, could you identify a suitable source? Failing that, will you accept that there are verifiability and BLP problems restricting us from picking alternative sources? Nowhere in Wessely's work have I seen anything that makes suggestions about patients' "behaviours, motivations, personalities, introspection, legitimacy and honesty". I think there's a lot of strawmanning against him in the fringes of the CFS/ME community. JFW | T@lk 19:23, 21 September 2008 (UTC)

I find it odd that you've never read in Wessely's work any suggestions about patients' behaviour etc; I understand that there is room for interpretation of statements made in a research context, but I don't believe that advocates are writing fraudulent extracts. I can't verify or even endorse all the claims made by advocates, but I'm still skeptical about the way these are all dismissed above as "noise" from "trolls" that are only trying to make Wessely "look bad" because they demand an organic classification for their illness in order to "avoid responsibility" (did someone mention strawmanning?). I accept that there are Wikipedia rules which make it more difficult to find "appropriate sources". I'll be tied up with the CFS articles for some time; maybe I'll have another proper look later on. - Tekaphor (TALK) 09:08, 11 October 2008 (UTC)

(Undent.) I have not closely read much of Wessely's work because my task on this article has mainly been to stop the POV pushing by detractors. At no point did I suggest that "advocates" were writing fraudulently. All I did suggest was that they were strawmanning Wessely; there are plenty of doctors who have no time at all for CFS/ME and regard people with diseases from this spectrum as de facto malingerers. Wessely happens not to be one of them, but he is being strawmanned by advocates because he dares to suggest that psychological approaches to CFS/ME might be helpful, irrespective of an underlying somatic cause.

If you can provide purely NPOV content which is appropriately sourced, you are most definitely welcome and I would be the last to opppose you. When you're finished with the CFS articles please come back and discuss constructive ways to improve this article. JFW | T@lk 20:22, 11 October 2008 (UTC)

If you don't know much about his work, then how can it be up to you to decide what is pov? Guido den Broeder (talk, visit) 21:16, 11 October 2008 (UTC)

Thankfully, the purveyors of POV make that job very easy. JFW | T@lk 21:26, 11 October 2008 (UTC)

Straw man? Controversies related to chronic fatigue syndrome documents the Kings College ME=CFS=neurasthenia equation, and references some of Wessely's part in the establishment and maintenance of that position. Sam Weller (talk) 16:23, 14 October 2008 (UTC)

So how do you propose we should change the article? JFW | T@lk 13:58, 16 October 2008 (UTC)

By mentioning the academic and medical controversies around his work? The Opposition & Criticism would be better as Controversy & Crit. :Re CFS, I've placed a few reminders that this section has been unreferenced for 12 months. And it did not mention that the rehabilitation strategy involved CBT & GET. Sam Weller (talk) 07:24, 21 October 2008 (UTC)

Well done for adding CBT/GET as specific modalities. The problem, as stated earlier, is that beyond Burne there are not many accounts that describe the actual controversy dispassionately. As far as can be judged, there is not a lot of academic controversy surrounding his work; on his publications on the subject, I have not seen any methodological criticisms. JFW | T@lk 21:14, 22 October 2008 (UTC)

Naming Wessely is sometimes avoided, when his theories are discussed, as is e.g. apparent from the responses to

• Richard Sykes (2002), "Physical or mental? A perspective on chronic fatigue syndrome", Advances in Psychiatric Treatment, 8: 351-358

See furthermore

• Song S, Jason LA (2005), "A population based study of CFS experienced in differing patient groups. An effort to replicate Vercoulen et al.'s model of CFS", Journal of Mental Health, 14, 3, 277-289

on a model based on Wessely's theories.

Finally, there are now various sources reporting poor results from CBT/GET. Guido den Broeder (talk, visit) 21:52, 22 October 2008 (UTC)

Yes and there is also a Cochrane review supporting CBT and a seperate Cochrane review supporting exercise therapy. It is very very interesting Guido wants CBT and exercise therapy not to help people. But sheesh what does one study you can dig up mean against a Cochrane review, and what in the world it has to do with Wessely?? RetroS1mone talk 02:16, 23 October 2008 (UTC)

Retro, thanks to your work adding refs it will soon be possible to remove the tag above the section. Can you now also add the Cochrane review refs? Asserting CBT's superiority on the basis of an article by Wessely doesn't look good.

JFW, re academic controversy you could start with the debate here [10], where Wessely himself says: "When Mike Sharpe, Tok Nimnuan and I proposed in the Lancet (Wessely et al, 1999) that the classification of the world of unexplained syndromes was a mess, we had little idea of how controversial it would prove to be." White opposes nosological 'lumping' a la Wessely. Sam Weller (talk) 07:53, 23 October 2008 (UTC)

Retro, please stop the personal attacks. Guido den Broeder (talk, visit) 09:24, 23 October 2008 (UTC)

It is an observation relavent to you stating above you do not have a prejudice against psychology, not a personal attack. A personal attack is when you say some one is completely and utterly ignorant. Now what it has to do with Wessely do you say any criticism of CBT is criticism of Wessely. RetroS1mone talk 11:50, 23 October 2008 (UTC)

More on controversy: Controversies_related_to_chronic_fatigue_syndrome#The_cause.28s.29.2C_diagnosis.2C_and_treatment cites evidence that Wessely's theory of the psychiatric nature of CFS was and is still controversial. Why is this not reflected here? Sam Weller (talk) 08:21, 24 October 2008 (UTC)

Like other people said, "Wessely's theory of the psychiatric nature" is a straw man. It does not include up to date thinking on connection of mind and body or recognize progress in CFS research or progress in Wessely's work. Look on this review and it is not easy to say Wessely says CFS is just psychiatric. Cho HJ, Skowera A, Cleare A, Wessely S. Chronic fatigue syndrome: an update focusing on phenomenology and pathophysiology. Curr Opin Psychiatry. 2006 Jan;19(1):67-73. RetroS1mone talk 11:52, 24 October 2008 (UTC)

Who knows why the neurasthenia controversy isn't reflect here; it's not like Wessely has ever recanted on the claim that neurasthenia will suffice for CFS, has he? And did he ever complain that neurasthenia shouldn't be classified as a mental disorder? I doubt it. Additionally, even if Wessely doesn't view CFS as purely a psychiatric disorder in the traditional sense, it seems that he has been emphasizing the primary importance of mental dimensions in CFS for the past 20 years. Obviously people disagree with the degree to which this applies to CFS, but the "up to date thinking on connection of mind and body" hasn't resolved the mind-body problem in CFS either. There appears to be no universally recognised middle category, and the concept of "functional somatic syndrome" still mostly falls within the domain of psychosomatic medicine and therefore with an obvious priority to psychiatry. - Tekaphor (TALK) 17:57, 25 October 2008 (UTC)

Secondary sources that document the existence of the criticism by name are rather hard to come by. A few others above have instead attempted to present research that conflicts with Wessely's work. What about Leonard Jason's papers regarding case definitions, measurements of psychiatric comorbidity, the proposed revival of neurasthenia, and the lumping/splitting of "functional somatic syndromes"; these seem to contrast Wessely's and do mention his work too (from the top of my head, start with [11] which is PMID 9301342, and [12], there is more but you get the idea). A more specific example would be Wessely's argument in the paper PMID 7901572 (in the full text, according to meactionuk.org.uk) that "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." versus findings that the opposite occurs with the Canadian criteria[13], that using a ME criteria instead of CFS does indeed suggest a more "neurological sub-group"(PMID 12629919), and that there are significantly lower scores of emotional functioning and mental health in the CFS group vs ME London criteria group.[14] Several other examples of research conflict could be demonstrated, but this isn't really my goal here, since I'm just trying to understand the controversy itself. - Tekaphor (TALK) 17:57, 25 October 2008 (UTC)

I had a look at the Jason paper, and it appears to have a severe methodological problem: they do a psychiatric evaluation, and if a patient is diagnosed with an Axis I psychiatric disorder they conclude that the illness has a psychiatric cause. However many breast cancer patients are diagnosed with Axis I psychiatric disorders, but we don't think that it is the cause of their illness. But none of this is really anything to do with Wessely anyway. The real reason for the controversy is simply that many people don't like a psychiatric explanation for CFS, and Wessely is a handy scapegoat/strawman that people like to bash. --sciencewatcher (talk) 02:11, 26 October 2008 (UTC)

Take another look, your analysis seemed hasty and largely ineffective. The full-text of either Jason et al research study states that psychiatric conditions were diagnosed using the Structured Clinical Interview for DSM–IV (SCID). This considers previously diagnosed medical disorders, right? So perhaps they didn't do a medical examination on the "CF-psychiatric" participants (to rule out undiagnosed diseases) like they did for the ME&CFS participants (how often do CFS researchers use medical examinations to help determine their psychiatric controls?). Besides, I referenced these papers for the data comparing "ME" vs "CFS" groups, not the CF-psychiatric group; the studies follow the CFS criteria rules on comorbidity and exclusion, plus both papers measured comorbid psychiatric disorders in all 3 patient groups, so it's also unlikely that the authors inappropriately excluded potential ME/CFS subjects simply because they had an Axis I diagnosis. So, this alleged "severe methodological problem" has little weight anyway. As for this not directly relating to Wessely, you chose not to continue the main neurasthenia discussion. Some people are indeed repelled at a psychiatric explanation for CFS, while your above attempt at discrediting those papers could easily be taken as a reverse example of your own accusation: some supporters of psychiatric explanations for CFS simply don't like it when the related research and mind-body ideology are questioned, and avoid responsibility for discrepancies by conveniently dismissing them as bias. - Tekaphor (TALK) 15:47, 27 October 2008 (UTC)

Agreed, Tekaphor. Another avoidance strategy wishes the article to reflect only Wessely's most recent theories. But an encyclopedia is not a newspaper, and should document what has been said historically without airbrushing.Sam Weller (talk) 18:02, 27 October 2008 (UTC)

Can we try to keep the discussion focused? We were looking for direct evidence that Prof Wessely indeed supports a "psychiatric paradigm", and so far all we have is circumstantial. JFW | T@lk 17:54, 27 October 2008 (UTC)

JFW, I drew your attention above to Controversies_related_to_chronic_fatigue_syndrome#The_cause.28s.29.2C_diagnosis.2C_and_treatment, where the first para reads: "Contrasting viewpoints among CFS experts have become apparent. In a letter to the Lancet in 1993, psychiatrists David and Wessely contested the WHO classification of CFS under diseases of the nervous system, arguing that it was a form of neurasthenia to be classified as a psychiatric condition." Sam Weller (talk) 18:07, 27 October 2008 (UTC)

Good point about encyclopedia vs newspaper, and the historical aspect being airbrushed. However, it doesn't seem that Wessely views neurasthenia or ME as a distinct entity; he may have argued that neurasthenia will suffice for ME, but he also argues that a range of syndromes (including ME&CFS) are variants of the same single "functional somatic syndrome". Without access to the full-text, I can't confirm whether he simply notes that "Neurasthenia remains in the Mental and Behavioural Disorders chapter under Other Neurotic Disorders." and "Neurasthenia would readily suffice for ME.", or directly suggests ME should be classified as a neurotic/mental disorder. Perhaps the wiki-article should at least say that Wessely has proposed neurasthenia would suffice for ME, but that ME/CFS etc are variants of a general functional somatic syndrome (and list all these syndromes).

As for classification, the 1990 paper "Old wine in new bottles: neurasthenia and 'ME'." (PMID 2181519), in the abstract it states: "It is further argued that neither neurasthenia nor 'ME' can be fully understood within a single medical or psychiatric model." When commenting on the response to his 1999 paper "Functional somatic syndromes: one or many?", he stated in 2004 he never claimed that functional somatic syndromes are a code for "psychiatric", but instead "unexplained".[15] These suggest that it's technically incorrect to state Wessely claims openly/outright that CFS is a psychiatric illness. However, if anyone has a (wiki)"acceptable" source for Wessely's alleged role in attempting the reclassification of ME/CFS as a mental disorder in the UK, this would be very noteworthy in regards to words vs actions.

Perhaps the conceptual difference between "functional somatic syndrome, where psychological factors are most important" vs "psychogenic/psychosomatic illness" is merely semantic in practice. Considering how such symptoms have been historically treated, it's unsurprising that patients are suspicious or critical towards the emphasis on cognition and behaviour, especially with conflicting researh. Dismissing the claim that Wessely is responsible for "promulgating" the view that CFS is primarily a psychiatric condition" on a technicality doesn't address the thrust of their arguments: research flaws/inaccuracy, review bias, over-emphasis on psychological maladaptation and psychiatric factors in CFS, accompanying commentary which can be interpretated as accusations of "guilt by association", and the subsequent implications on patient treatment and research priorities.

_Tekaphor (TALK) 15:07, 30 October 2008 (UTC)

So, Tekaphor, could I encourage you to write an NPOV sentence or two that covers your concerns, and offer them to us for review? At the moment, you seem to agree that no sources are available to us that state unequivocally what kind of model Prof Wessely actually has of the whole CFS/ME/Neurasthenia rigamorole. All we have is accusations by ME activists that are themselves seeming based more on word-of-mouth than on published evidence. JFW | T@lk 19:29, 30 October 2008 (UTC)

Sure, later on though. - Tekaphor (TALK) 04:02, 3 November 2008 (UTC)

Crazy tag section

There is a section with a rediculous number of tags, citation needed. Most of the stuff is not controversial, it is just put in by some one who does not like Wessely and does not want any thing positive about him in article. Can we pls take this mean spirited stuff out? Thx, RetroS1mone talk 02:19, 23 October 2008 (UTC)

When I first read this article a few days ago I misread the Citations needed tag as Oct 2008. When I looked again I could not believe it had been in place for 12 months. Hence my wake up call. Thanks for your rapid response. Apologies also for inadvertently removing some internal links, which you kindly replaced. Sam Weller (talk) 07:58, 23 October 2008 (UTC)

No problem, I put in the Cochrane reviews. I will try to find more stuff. RetroS1mone talk

External Link Suggestion

There is an hour-long talk, 'Shell Shock or Cowardice?: The Case of Harry Farr' available on-line by Simon Wessely: http://www.gresham.ac.uk/event.asp?PageId=45&EventId=759 I think that this would be good addition to this page. (An extract from this lecture is also avaliable on YouTube: http://uk.youtube.com/watch?v=NJUn7Koe01g). (I only don't put it up myself as there is a possible conflict-of-interest as I am connected with Gresham College, where the lecture was given). Jamesfranklingresham (talk) 12:52, 31 October 2008 (UTC)

Thanks, I've added the link. --sciencewatcher (talk) 22:17, 31 October 2008 (UTC)

Source for hypothesis

There have been previous discussions about how it's hard to pin down the exact model of CFS that Wessely has, and/or secondary sources for it. While looking at something else, I came across this statement from a review on CFS (PMID 12194905) in the full text under "Behavioral Factors":

"The U.K. group in London that studies CFS has focused on disease maintenance, and their 1998 book Chronic Fatigue and Its Syndromes is good reading for those seeking detailed information on CFS (43). Wessely et al. believe that person factors interact with illness triggers and subsequent deconditioning to prolong illness duration. Thus, people with a tendency for mood problems or amplification of somatic sensations might become worried about activity-related symptoms after some viral illness and thus reduce activity further. They support this line of thinking with their successful trials (44,45) of cognitive behavioral therapy (CBT). Although this model may explain continued illness in some CFS patients, it certainly does not pertain to all CFS patients and is thus not too satisfactory."

I didn't include the rest of the section, because it discusses caveats about CBT rather than Wessely et al, but it's freely available for anyone to take a look.

_Tekaphor (TALK) 02:52, 27 December 2008 (UTC)

Leaving aside the authors' opinion on the tenability of the theory, this might actually be a good secondary source for the content in question. JFW | T@lk 23:39, 27 December 2008 (UTC)

Interview with Wessely in New Scientist

I saw this interview today in New Scientist. It should probably be included in the article, either as a link or a reference. There may be things there that we can add to the article, such as the fact that he has received hate mail, his views on CFS, etc. --sciencewatcher (talk) 21:38, 16 March 2009 (UTC)

Work on chronic fatigue syndrome

The text doesn't quite match the source here, "Other work on CFS included the development of new measurement tools,"[16] In the cited source Wessely talks about other's works. "In this issue two papers (p 191 and p 195) are presented describing new work on the measurement of this elusive symptom." (C Wood and M E Magnello), (C Wood, M E Magnello, and M C Sharpe) not his own work.[17] I was reading for my own benefit and will let others who are familiar with this article decide if it needs changing Ward20 (talk) 21:40, 20 March 2009 (UTC)

Article at Independent.co.uk

Adding further to the NewScientist article which Sciencewatcher posted above, there's an article in The Independent, titled "What's wrong with you? It depends where you live".[18] Wessely's views seem to be used throughout the article, but mostly summed up in the following paragraphs:

• Simon Wessely, professor of psychiatry at Kings College, London, who has studied cultural trends in illness, says: "People will always seek explanations when they feel under the weather or not quite right. Much of it depends on what is currently hot in medicine. Each age and each culture has its own answers. Doctors use many different labels to describe patients with unexplained symptoms – somatisation, burn-out, chronic fatigue syndrome, multiple chemical sensitivity, subclinical depression, post traumatic stress disorder, low blood pressure, spasmophilia – despite no evidence that any of these are distinct or separate entities. Our belief is that most of these labels refer to similar clinical problems."

• Professor Wessely, a specialist in the problem, said: "In Britain, people with chronic fatigue think that if they do too much the virus that caused it is still there and will come back and make them worse. That is catastrophising the illness. They don't think like that in France and they don't have the same outcomes. It is how you respond to symptoms that determines the outcome."

_Tekaphor (TALK) 12:36, 29 April 2009 (UTC)

Synthesis you say?

I'm curious as to why RetroS1mone reverted my changes with an accusation of synthesis. Please explain how "likely linked to the condition in some cases" is synthesis when the conclusion section in the cited material says:

This temporal, dose-response relationship suggests that psychiatric disorders, or shared risk factors for psychiatric disorders, are likely to have an aetiological role in some cases of CFS/ME. ^{(Emphasis added.)}

Can I please have consensus from non-involved editors that this is indeed an appropriate interpretation of the source?

Similarly, the conclusion section in one of the cited sources for the "reducing symptoms of" change stated:

CBT is effective in reducing the symptoms of fatigue at post-treatment compared with usual care... ^{(Emphasis added.)}

Also, if you felt the need to revert, why did you also remove the formatting (or at least not re-insert it afterwards)? --Rob (talk) 00:18, 10 June 2009 (UTC), edited --00:29, 10 June 2009 (UTC)

When people that threaten me at my talk page and are SPA, all ways attacking psychiatrists and start at Simon Wessely, I think, OK, I revert. OK, so quote it. RetroS1mone talk 01:06, 10 June 2009 (UTC)

I have never threatened you anywhere, and a quick check of my edits prior to about 2 weeks ago will reveal that I'm not an SPA. As revealed above, there is no synthesis whatsoever. --Rob (talk) 02:02, 10 June 2009 (UTC), --edited 02:30, 10 June 2009 (UTC)

As the abstract clearly states, the conclusion is "likely to have an aetiological role in some cases of CFS/ME". Rob used this same wording from the source and was (ironically) told to "use the conclusions in the source over synthesis". Same goes for the "reducing fatigue" text. This is just another example of a "knee-jerk revert" done on pure speculation about motives rather than the validity of the actual edit (RetroS1mone even just admitted to it above). I've had the same problem before with this same editor, which is now also accusing "us" (Rob, me, others) of "tag team harassment". - Tekaphor (TALK) 04:23, 10 June 2009 (UTC)

"Psychiatric paradigm" source

I'm confused, to say the least, by the recent reversion of my edit by RetroS1mone when I was adding a primary source in place of a {{fact}} tag. If "opponents" refer to it as a "psychiatric paradigm", then it seems entirely appropriate to quote those opponents. I found one document, so I cited it in favour of leaving it unsourced. There may be others, which would substantiate "opponents", but since I didn't find multiple sources that seemed of relevance, I changed it to "one opponent" for now. If more can be found, I absolutely support a change back to "opponents". I'm not sure why duly citing a source is being referred to as "OR", however. --RobinHood70 (talk) 06:25, 10 August 2009 (UTC)

The source in question is a heavily opinionated blog without any claim to authority (i.e. a standalone commentator rather than an organisation). It fails WP:RS on all fronts. We may need to remove reference to the "psychiatric paradigm" altogether if no reliable sources to its effect can be found. JFW | T@lk 22:50, 10 August 2009 (UTC)

I see your point, however, given that we're saying "an approach termed the 'psychiatric paradigm' by opponents", I figured citing an "opponent" would be appropriate. Essentially using the Extremist and fringe sources guideline, in that it can be considered a source of information from the opponents themselves. I don't deny that the piece is an opinion piece (and not a well-written one at that, at least from what little I read of it), but I'm reasonably sure that it's that letter to which the text is referring, as I found it in numerous places on ME/CFS websites. In some versions, I also saw Malcolm Hooper's name on it, though I don't remember in what context. At least in the search I did, I didn't find any other "significant" source of the term. Which leads to my next point: Removing the "psychiatric paradigm" phrasing altogether would actually make a lot of sense to me, as I'm not sure it's particularly notable. --RobinHood70 (talk) 23:15, 10 August 2009 (UTC)

If that is the case, we shouldn't be citing this blog but a proper source. Perhaps we should instead look at submissions made to the UK High Court in the case against the NICE clinical guideline. This submission is likely to contain a denunciation of the "psychiatric paradigm" of some sort, I can assure you. JFW | T@lk 20:43, 11 August 2009 (UTC)

That sounds like a reasonable approach, but where would we find that? Almost all the documents related to the NICE case that I was able to find were on the ME Agenda site, and the few others I found were on similar blog-style ME/CFS sites. Despite having CFS, myself, I don't really keep up-to-date on the latest news about it (especially not court cases in the UK when I live in Canada), so I know very little about the decision or where to find reliably-sourced information about it. Any thoughts? --RobinHood70 (talk) 22:18, 11 August 2009 (UTC)

I was able to find the One Click Group's accusation in their response on the NICE website here on pages 272-274. IMO a related but more notable and less controversial topic would be Wessely's views on the biosocial model of illness. It would be a more valuable addition to the article. Ward20 (talk) 23:12, 11 August 2009 (UTC)

"Trial of cognitive behavioral therapy in CFS sparks criticism" [19] RetroS1mone talk 04:03, 12 August 2009 (UTC)

There is also the BMJ rapid responses, calling Wessely and other people "psychologizers" a funny thing bc psychologizer means another thing also!! RetroS1mone talk 04:10, 12 August 2009 (UTC)

The BMJ article doesn't say psychiatric paradigm and the medscape article doesn't mention Wessely. The NICE page states, "There are broadly two contesting paradigms of ME/CFS: The neurological (biomedical) paradigm, and the psychiatric paradigm. (Appendix 1). The psychiatric paradigm in Britain is supported by various psychiatric researchers such as Simon Wessely, Peter White, Michael Sharpe, Anthony Cleare and Elena Garralda, amongst others." Ward20 (talk) 04:18, 12 August 2009 (UTC)

The Medscape does not need mention Wessely, Wiki article says approach is called "psychiatric paradigm" by opponents. The Medscape article says opponents call approach "psychiatric paradigm." RetroS1mone talk 04:33, 12 August 2009 (UTC)

The Medscape article needs to relate Wessely to "opponents" and "psychiatric paradigm" to be used as a source for the whole sentence. This Wiki article is about Wessely. Ward20 (talk) 04:56, 12 August 2009 (UTC)

(outdent) Good article you found, Retro, though as Ward20 points out, it doesn't mention Wessely by name at all. But setting that aside for a moment, I'm wondering if the "psychiatric paradigm" wording is really all that notable (and not just in the Wikipedia sense of the word). I mean, "paradigm" is really just a fancy word for "model" or "framework" (definition 3 here is a good definition in this context). Given that Wessely is a psychiatrist, it's hardly unusual that he would take a psychiatric approach to his work and lean towards psychiatric views of illnesses without a known cause.

Don't get me wrong here, I think Angela Kennedy's writing is directed at the "Wessely School", Wessely himself, and the psychiatric view at large—and I would clearly categorize her as an opponent of Wessely's—I'm just not sure that the "psychiatric paradigm" wording itself is particularly noteworthy. --RobinHood70 (talk) 05:02, 12 August 2009 (UTC)

I apologize I edited your post RetroS1mone. I didn't mean to do that. Ward20 (talk) 05:36, 12 August 2009 (UTC)

"Evidence submitted by Professor Malcolm Hooper (NICE 07)" to the UK Parliamentary Select Committee on Health mentions "psychiatric paradigm", Wessely and "Wessely school". Sam Weller (talk) 22:54, 12 August 2009 (UTC)

That is a good source Sam thx. I do think, Ward20 is may be wrong?? it is like you write an article about a general and you say General blah was shot at River Dah, which Croatians call River Bah. It is enough, you have a source for Croatians calling River Bah, you do not need source, which says, Bah, Dah and General Blah. RetroS1mone talk 02:41, 13 August 2009 (UTC)

True, but if you have an official publication that not only mentions Bah, Dah, Blah, but also Mah and Pah, then you would need to provide a very good reason for not using it. Sam Weller (talk) 08:37, 13 August 2009 (UTC)

I think the parliamentary evidence is a good shot. Apart from being more reliable than a blog, it also again shows that Hooper is a long-term detractor of Wessely's work in the public sphere (as the Burne source also shows). JFW | T@lk 19:58, 13 August 2009 (UTC)

I would agree with JFW here - it's certainly a far cry better than the source I provided. --RobinHood70 (talk) 22:13, 13 August 2009 (UTC)

Unprotection?

Can this article and talk page be unprotected now so that unregistered users can edit and make comments? We can quickly restore protection if necessary. --TS 19:37, 4 September 2009 (UTC)

In the interests of keeping this discussion all in one place, I would suggest any responses be added to the discussion on Jfdwolff's page, since he was the initial blocking admin (MastCell re-instated it after a page restore). —RobinHood70 ^{(talk • contribs)} 23:12, 4 September 2009 (UTC)

Sentence removed

Some critics accuse Wessely of promulgating the view that chronic fatigue syndrome is primarily a psychiatric condition, an approach termed the "psychiatric paradigm" by opponents.<ref>[http://www.medscape.com/viewarticle/538090 Medscape] "Trial of cognitive behavioral therapy in CFS sparks criticism" Medscape Medical News. January 20, 2005.</ref>

This article does not mention Wessely. The only mention of "psychiatric paradigm" is attributed by name to Angela Kennedy, who has no known medical qualifications.

The claim itself is not about Wessely but about an approach to CFS with which Wessely happens to be associated, and comes from someone who has a documented agenda against Wessely and anything which portrays CFS as having any component at all outside of the physical. The OneClick group has made itself unpopular with other parts fo the ME/CFS patient community due to the exceptionally combative nature of their campaigning. It looks to me like WP:UNDUE. Guy (Help!) 06:48, 2 October 2009 (UTC)

If you haven't already read it, you may want to go over the "Psychiatric paradigm" source section, above, where we discussed it a few months ago. At this point, I'm really neither for nor against its removal. I still tend to think that accusing a psychiatrist essentially of having a psychiatric viewpoint is less-than-notable, but at the same time, it's probably noteworthy that his views are generally not agreed with by the patient community and many other doctors. I'm just not sure that Angela Kennedy is really representative of either of those groups.

Actually, on that note, I'm noticing a rather lonely "Opposition and Criticism" section. Since it relates entirely to CFS, I'll move it up into the CFS section as a sub-section. —RobinHood70 ^{(talk • contribs)} 08:20, 2 October 2009 (UTC)

Well, the term seems to be mainly associated with One Click and they are emphatically not representative of the patient community as a whole, or even a provably significant proportion thereof. I came across some discussion the other day on one of the mainstream patient group sites, they don't think much of One Click at all precisely because their stance is absolutist and confrontational. As Ben Goldacre says, "I think you'll find it's a bit more complicated than that". Guy (Help!) 11:05, 2 October 2009 (UTC)

It was agreed above that the 'psychiatric paradigm' criticism from Malcolm Hooper was preferable, so why not use that? In any case, criticism of Wessely is not just CFS-related, and has come from individuals who are not patient or advocates. Ziauddin Sardar in the New Statesman, for instance, made important points about possible political agendas behind the shift towards psychiatrization of illnesses perceived as organic by sufferers.[20] He named Wessely as a key player, and questioned how he came to be one. If an individual is controversial, why can't their article reflect that? No need for personal abuse, or suppression of criticism, surely. Sam Weller (talk) 16:51, 2 October 2009 (UTC)

Guy: I agree that the One Click group is not representative of the community as a whole. I looked into them and a little bit about how people felt about them maybe a month or so ago, and they really do strike me as a bunch of wingnuts on a crusade (or several, actually), so I certainly see your point about not using that to support a point here. But to Sam's point, I think we should be careful about entirely excising the controversy about some of his views. We're not quite at that point, but there's really not that much left, either. —RobinHood70 ^{(talk • contribs)} 20:46, 2 October 2009 (UTC)

I reaffirm here my view that Hooper should be a better source that the Clickers. Hooper is Wessely's main critic in several arenas (Gulf War syndrome, CFS). JFW | T@lk 21:20, 4 October 2009 (UTC)

That's the source I added in the other day, though I didn't restore the entire sentence. —RobinHood70 ^{(talk • contribs)} 03:58, 5 October 2009 (UTC)

Just because it is in the New Statesman doesn't mean it isn't abuse: follow through to the article and you find-

So Wessely, who occupies a key position in our socio- medical order, denies the existence of Gulf war syndrome, just as he denies the existence of ME. Clearly, he is a follower of Groucho Marx: "Whatever it is, I deny it." Not surprisingly, lots of people hate him. One Gulf veteran has accused him of biasing his supposedly random sample, excluding those who are really ill. A colleague from the States has come to Wessely's defence with suggestions that are more ludicrous than insulting, such as the possibility that the mere experience of fear of chemical attack has brought on these permanent and debilitating symptoms.

Which is clearly unacceptable. —Preceding unsigned comment added by 88.108.41.202 (talk) 16:57, 9 October 2009 (UTC)

I meant this BLP should point out that Wessely has often been controversial, without attacking or defending or promoting his point of view. Sardar makes a series of points (following your quote):

As Wessely's critics in the ME camp acknowledge, he is not a biased or shoddy researcher; there are serious difficulties with research methods themselves. ... So syndrome-based illnesses confront us with problems where science cannot hide our commitments on issues of democracy and of values. Do the sufferers from a disease have anything to contribute to its understanding, aside from providing raw data for the experts' research? They are the ones who know how it feels, who can refine, describe and document the symptoms. If Simon Wessely is our syndromologist-in-chief, who has chosen and vetted him for that post, and by what criteria and procedures? Where is the debate over the shaping of such research? When will we recognise that health and disease are complex entities, where no single expertise is definitive? And when will we have the first officially sponsored study of such a problem which the sufferers do not have the occasion to call a whitewash?

Hard to dismiss that as 'abuse'. And as said above, Wessely has been criticised from many quarters, not just by the ME community. Sam Weller (talk) 19:41, 9 October 2009 (UTC)

Wessely is a serious scientist standing up for what he believes in. Put yourself in his shoes, faced with all these ME work shy neurotics it must be a hard job. So Wessely has worked hard to point out in the nicest possible way that getting out of bed and getting your arse off to work is the best kind of therapy. What does he get in response? Constant heckling and abuse. Look at his Gresham lecture. He took his son along so that people wouldn't throw eggs etc. What kind of world is it where a clinician has to resort to human shields. — Preceding unsigned comment added by 88.108.89.14 (talk) 10:08, 10 October 2009 (UTC)

Categorizing ME patients as "work shy neurotics" is really what's at the heart of the problem here. There is more than sufficient evidence at this point, and Wessely has even agreed with much of it, that there is a physical basis to the disease that goes well beyond simply "getting out of bed and getting your arse off to work". But whatever the reasoning behind his views, and regardless of any evidence about the disease itself, the simple fact remains that Wessely's views have been controversial, and that's entirely appropriate to include in the article as long as it's properly sourced. The article does need to present the information in an unbiased manner, but completely excising the fact that his views have been controversial is, in itself, biasing the article. —RobinHood70 ^{(talk • contribs)} 18:35, 10 October 2009 (UTC)

If Wessely is as "controversial" as you claim then why did the ministry of defence support his research into "Gulf War Syndrome"? As you well know there is no evidence that exposure to depleted uranium, vaccines for a host of biological weapons, oil etc caused any of the symptoms suffered by the vets. Wessely's research was very clear on that point. Similarly to quote Wessely's colleague Mike Sharpe the idea that there is a "disease" called ME is simply a "myth". I am sure that a rexamination of Camelford will also support Wessely's position that exposure to aluminum sulphate did not cause the epidemic of neurological disease suffered by that community, alzheimers etc. As I have said before he is a serious scientist and vested interests (mainly patient charities) are out to get him. —Preceding unsigned comment added by 88.108.89.14 (talk) 16:15, 11 October 2009 (UTC)

(outdent) Actually, I "well know" very little about Wessely, being Canadian. Your statement itself, however, is demonstration that Wessely is controversial. If, as you say, people are "out to get him", then obviously, his work is controversial to them. Please remember that at Wikipedia, we document verifiable information, not necessarily truth. It is verifiable that people have taken him to task for several of his claims over the years, thus he is controversial. That information therefore has a place in the article. This applies regardless of whether those peoples' claims have merit or not. —RobinHood70 ^{(talk • contribs)} 22:15, 11 October 2009 (UTC)

(Some intervening posts removed; my reply altered slightly to remove portions that were no longer applicable) —RobinHood70 ^{(talk • contribs)} 23:48, 14 October 2009 (UTC)

As I've explained before, we don't document "the truth" at Wikipedia, we document verifiable fact, and it's entirely verifiable that there has been controversy over several of Wessely's statements and publications over the years. Unless you can prove that there hasn't been such controversy, then at least a mention of the controversy belongs in the article.

If it helps explain it better, think of it like Holocaust deniers: you're not advocating either the Holocaust nor the deniers by mentioning the deniers in an article about the Holocaust — you're simply mentioning that the deniers exist. In the same vein, this article should neither advocate for Wessely nor those who speak against his work — but it is entirely appropriate for it to mention that those people exist. —RobinHood70 ^{(talk • contribs)} 22:19, 12 October 2009 (UTC)

Oh, I absolutely agree, Robin. I thought I would attempt to further your point while/by having a jab at this clearly ignorant and heavily biased fool. Please carry on. :) 67.242.172.231 (talk) 01:59, 13 October 2009 (UTC)

There is one thing nobody will deny: Wessely has done a lot of research on CFS/ME, the results of which are disputed by patient groups that dislike his psychiatric approach to the condition. Given that there are verifiable source for this debate, we need to mention it. I don't think that as an encyclopedia we need to delve an awful lot into the final details of the debate. This belongs in the CFS/ME articles elsewhere. I'm with RobinHood70 on this. JFW | T@lk 22:07, 13 October 2009 (UTC)

Here here!! he has indeed done a lot of Research. I think it is high time to get the biologists and other clinicians out of this field of medicine so Wessely can get more funding. —Preceding unsigned comment added by 88.108.99.188 (talk) 17:57, 14 October 2009 (UTC)

Can we please put Criticism back on its own, not just as a CFS subsection? The Sardar NS article showed that his approach to GWS is as controversial as CFS. In general, the article doesn't cover his ideas and assumptions clearly enough to show why he's controversial. E.g., he has consistently maintained that CFS is a new name for neurasthenia. He thinks many other syndromes (e.g. GWS, IBS, EMS) are somatoform, and moreover that all are subsets of a single somatoform disorder. It's easy to reference all that, which would give some of the background to why he's controversial. Sam Weller (talk) 07:44, 14 October 2009 (UTC)

I have no objections to that, as long as the information on it is expanded. At the time I moved it, the only mention of criticism left in the article was one or two CFS-related sentences, so it made little sense to leave it on its own. —RobinHood70 ^{(talk • contribs)} 23:18, 14 October 2009 (UTC)

I'm having difficulty understanding why Wessely's stance should be more "controversial" than that of any of his opponents, e.g. Hooper. There is a large body of research supporting both sides, and it would be a form delegitimisation to suggest that his perspective is somehow less valid. He's got an unpopular message, but that does not mean you're controversial. There is no evidence of research misconduct, for instance. One also needs to be very careful not to put words in his mouth. Are we certain that Wessely excludes an organic cause for the fatigue of CFS/ME? And the hypothesis that GWS/IBS/EMS/MCS/FMS are all subsets of a general somatoform disorder is exactly that, a hypothesis that could be tested and rejected or affirmed. What exactly is controversial about that? This is science at work. JFW | T@lk 19:38, 15 October 2009 (UTC)

"When Mike Sharpe, Tok Nimnuan and I proposed in the Lancet (Wessely et al, 1999) that the classification of the world of unexplained syndromes was a mess, we had little idea of how controversial it would prove to be..."[21] Sam Weller (talk) 20:45, 15 October 2009 (UTC)

Very nice, but "controversial" in scientific terms is not "controversial" in sociocultural terms. I think the use of "controversial" in this article is an implicit attack on Wessely's integrity. A theory or hypothesis or treatment is controversial (e.g. the use of aciclovir in Bell's palsy) - that's a scientific controversy. When a person is controversial, you need pretty strong second-hand sources to support such as assertion. JFW | T@lk 21:30, 15 October 2009 (UTC)

If you didn't read the debate you will have missed the point that Wessely is referring to the sociocultural controversy - strong reactions came because "many sufferers did not accept the thesis, and continue to have strong emotional attachments to their label." White replied that the theory is not scientifically fruitful, but as you say that is science at work. Sardar is a strong second-hand source writing sociopolitically, not a CFS/ME/GWS/IBS/EMS/MCS/FMS patient or advocate. Acknowledging obvious and well-established controversies surrounding Wessely is in no way an "attack" on his personal or scientific integrity. Sardar again: "As Wessely's critics in the ME camp acknowledge, he is not a biased or shoddy researcher". Sam Weller (talk) 22:50, 15 October 2009 (UTC)

Would it perhaps be more acceptable if we worded it something to the effect that his assumptions and/or conclusions have been controversial? Or maybe "disputed" is a better word? And I agree completely that Hooper's conclusions have been debated as well, and this is mentioned in his article (although there, the word "conflict" is used, which is perhaps even more loaded of a term). —RobinHood70 ^{(talk • contribs)} 23:16, 15 October 2009 (UTC)

Wessely's stance is also opposed by Jason, Newton, Spence, Kerr, Belch, Costa etc. etc. It strikes me that as such he is very "controversial". His views on exercise have been called "simplistic" given the relation of muscle fatigue in CFS to abnormal proton efflux and muscle ph. There is no patient body promoting his views.

Wessely acknowledges in The Lancet that he is a controversial figure - socioculturally:

Wessely had already made waves with his research on chronic fatigue (CF). The work played a big part in changing the way that the illness is treated, and his doubts about the popular viral theory of CF made him some enemies. “There’s a small number of people who are almost psychotically obsessed with me. But I’m used to that.” Then came the Gulf War and its aftermath. “I started seeing reports of soldiers who were exactly like my CF patients. At the same time it was clear that the MoD [Ministry of Defence] was making a dog’s breakfast of dealing with it. Every time a Gulf veteran died, the headline was ‘Veteran dies of Gulf War Syndrome’. The MoD hadn’t got even the most elementary mortality statistics.” Wessely saw a research opportunity, and seized it. More controversy. Is this something he regrets or enjoys? “A bit of both.” With hindsight he admits “I could have been more diplomatic. I wasn’t thinking about the language I used or its impact. I was just keen to get into print.” He understands why patients would prefer to be told they’ve acquired a virus. Nowadays, he reckons, he can make a better fist of handling controversy. PMID 17531873

Sam Weller (talk) 09:53, 18 October 2009 (UTC)

"Wessely, a controversial and influential figure who today remains the bugbear of many patients, construes ME primarily as learned helplessness." Medical Sociology online current issue Sam Weller (talk) 17:36, 18 October 2009 (UTC)

• But that is not a true reflection of his views on the disorder. I also don't believe that Hooper has any relevant academic credentials in this field, unless someone can show me otherwise? Guy (Help!) 11:17, 19 October 2009 (UTC)

Hooper is an amateur when it comes to CFS/ME, but clearly enough of a voice to be author of a review in J Clin Pathol and quoted as an opponent of Wessely in the Guardian interview. I'm happy to let Hooper represent the opposing camp as there is evidence for his prominence. JFW | T@lk 23:19, 20 October 2009 (UTC)

Eh? The discussion has moved on from 'psychiatric paradigm'. It currently concerns whether Wessely is deemed 'controversial', socioculturally. He agreed he is, in a Lancet interview. Sam Weller (talk) 14:06, 19 October 2009 (UTC)

Whatever. JFW | T@lk 23:19, 20 October 2009 (UTC)

Yeah Sam, Whatever, as if we care. Wessely rocks. Look at all those Camelford nutters with their aluminium free pans- Wessely pissed all over them and their insurance claims- ha ha. —Preceding unsigned comment added by 88.108.54.44 (talk) 21:37, 27 October 2009 (UTC)

It's amusing that there is a long standing controversy at Wikipedia over whether Wessely, who apparently himself admits to controversy, is controversial or not. It's good to see that the many unsourced statements that existed last year have now been sourced, although I question the wording that Wessely "discovered" an endocrine "signature" for CFS that differed from depression (perhaps it was Demitrack?). I added a tag. - Tekaphor (TALK) 06:35, 31 October 2009 (UTC)

Yeah I'd question that too. ANd I'm not sure how much of a "signature" something can be if it isn't unique -- if it is why isn't being used to diagnose?

"Wessely, a controversial and influential figure who today remains the bugbear of many patients, construes ME primarily as learned helplessness." Medical Sociology online current issue Sam Weller (talk) 17:36, 18 October 2009 (UTC)

* But that is not a true reflection of his views on the disorder.

Says who. Doesn't matter, it's a popular interpretation of his views. If SW is widely misunderstood in professional circles then that should be reflected in the article. It is odd how often other professionals, one of whom may well be 88.108.89.14 above, who agree with the "gist" on CFS can't seem to quite grasp exactly whatever it is he is saying, and instead actually do what SW et al keep blaming on patients and "stigmatising" mental illness as our friend 88.108.89.14 "workshy" demonstrates.

I also don't believe that Hooper has any relevant academic credentials in this field, unless someone can show me otherwise? Guy (Help!) 11:17, 19 October 2009 (UTC)

What is the magic number for publications on a subject one academic must have to demonstrate disagreeing with another? Prof Hooper has been published on CFS/ME and even has his own WP article so I don't quite follow your reasoning here. This is a biography article rather than an academic one as well, so it shouldn't necessarily be a prerequisite for recognising opposition. —Preceding unsigned comment added by 82.41.231.193 (talk) 17:32, 3 November 2009 (UTC)

Excellent point IP-82 regarding the ironic misplace of blame for alleged misinterpretations. Who knew that treating CFS patients as mentally ill because of psychiatrists' primary emphasis on psychological factors in CFS would somehow give these patients the impression that CFS is regarded as a mental illness and that psychiatrists are responsible for it? - Tekaphor (TALK) 05:34, 5 November 2009 (UTC)

Hooper is not a professor of anything relevant, as far as I can tell; he is as much a layman as anyone else on this subject. I do not see any evidence of his having specialist qualifications in this subject. Guy (Help!) 02:44, 15 November 2009 (UTC)

Protection

In response to Sciencewatcher's suggestion of protection: At this point, given the rarity of the posts, I don't think semi-protection would be granted. I tried on a different page a month or two ago for anon edits that were happening every few days or so and was turned down because the editing wasn't frequent. If it gets worse than this, though, it's probably not a bad idea. —RobinHood70 ^{(talk • contribs)} 01:27, 13 October 2009 (UTC)

C Class

I've removed the auto-rating parameter and bumped the article up to C class, as I believe it qualifies based on the guidelines listed in the Biography quality scale. Note that I did not do the same for the Military History template, as they do not support C class, and I don't think this article rates B class.

This is my first time rating an article, so if anybody disagrees and thinks it should be bumped back down to Start class, feel free to do so. I won't debate the point, though I'd certainly appreciate an explanation of the reasoning for any future assessments I might do. —RobinHood70 ^{(talk • contribs)} 00:11, 16 October 2009 (UTC)

"Wessely and his co-workers established..."

In the first years after the introduction of the diagnosis chronic fatigue syndrome the condition was often mocked in the media, for example being described as "yuppie flu".[5] Wessely and his co-workers established that this stereotype was a misnomer, demonstrating an association between low blood pressure and chronic fatigue[6]

The reference (6) given for this was only published 2004. So apparently for a whole sixteen years not one other piece of research by any other group disproved this media prejudice. At least that's how this reads. If you do have a better Wessely reference that beats say e.g Jason et al by date then please use it, otherwise I suggest this misleading grandstanding be removed. As for the unremarkable sounding "low blood pressure" the paper in question actually said:

Autonomic testing in patients with chronic fatigue syndrome yielded a significantly greater increase in heart rate together with a more pronounced systolic blood pressure fall on standing compared to healthy individuals. (from the abstract)

This sounds more like the definition of POTS than common-or-garden "low blood pressure". Anyway I believe Rowe, Bell, Streeten demonstrated NMH and even low blood volume many years previously [22], and there have been a number of studies on NMH/POTS prior to 2004, though you wouldn't think it from this. —Preceding unsigned comment added by 82.41.231.193 (talk) 17:09, 3 November 2009 (UTC)

Autonomic dysfunction

POTS has also been linked with abnormal muscle PH and proton efflux (MYALGIC). For Wessely et al muscle weakness in ME/CFS is functional and thus psychogenic. This is an opportunity to link the page to Newton et al's contrasting research. It should be noted that the magnetic resonance spectroscopy is shortly to be a routine (albeit specialist) investigative procedure at the mitochondrial clinic in Newcastle and will thus be used via referral from the CFS clinic there (who don't adhere to Wessely's model of CFS but see it as a range of poorly understood conditions). The neurologist also involved in this is my own neurologist. With regard to Wessely this questions whether he has made such a big contribution to ME/CFS as this article claims.

Abnormalities in pH Handling by Peripheral Muscle and Potential Regulation by the Autonomic Nervous System in Chronic Fatigue Syndrome Short title: Muscle bioenergetics in CFS David EJ Jones MD PhD1 Kieren G Hollingsworth MD PhD2, Roy Taylor MD2, Andrew M Blamire PhD2, Julia L Newton MD PhD1,3 Institute of Cellular Medicine1, Newcastle Magnetic Resonance Centre2 Institute for Ageing and Health3, Newcastle University, UK —Preceding unsigned comment added by 88.108.90.213 (talk) 20:51, 6 November 2009 (UTC)

Hostile reverts by user ScienceWatcher

Please justify your reverts and stop trying to start edit wars just because you disagree with someone's edits. Explain. This is just another example of your bullying tactics to dominate in control over this and the CFS pages. Or has it now come to it that pointing out that for ex. "some" is a weasel word, is something that must be endlessly debated on the talk page before it can, if ever, be enacted? —Preceding unsigned comment added by 82.41.231.193 (talk) 17:38, 3 November 2009 (UTC)

I don't believe the reverts were "hostile" in any way; they were done according to WP policy—especially the {{weasel word}} and {{clarify}} tags. For the "played down" vs. "mocked", I would suggest looking at the source, if we can find it. "Newsweek cover story, November 1990" isn't the most accurate way to link to a source. I do agree on the "ambulatory" change, though, as that was pointed out as a flaw of several of his studies, as I recall (though I don't remember what the source of that information was off-hand). —RobinHood70 ^{(talk • contribs)} 00:06, 4 November 2009 (UTC)

I don't recall the newsweek article mocked the illness. Just used a term that was a misnomer and talked about burnout. I am sure other early articles can be found that mocked the illness. Ward20 (talk) 01:13, 4 November 2009 (UTC)

WikiProject Psychology Classification

I went ahead and classified this article under the new WikiProject Psychology banner added by the bot. For the time being, I've given it a C class, since the material is more than a stub, but hardly qualifies as highly detailed. In terms of importance, it was harder to judge: Simon Wessely is certainly well-known in the fields of CFS and a few similar topics, and probably qualifies as important within the UK. His notability outside of those topics and outside the UK, however, is much less. Therefore, I gave it Mid importance. Feel free to change either of these if you disagree, but given that his views are considered controversial in some settings, it's probably best to provide an explanation of any changes here. —RobinHood70 ^{(talk • contribs)} 02:18, 11 December 2009 (UTC)

Sounds reasonable. JFW | T@lk 19:40, 12 December 2009 (UTC)

Opposition and Criticism

re: "but its effects are mainly functional" really needs a cite. I don't see this in the Guardian article which is the cite at the end of the sentence. I need to read the source to verify and to understand exactly what he means. I assume he means somatisation as Functional somatic syndrome is the general medical classification equivalent to somatisation in psychiatry. Thanks. JustinReilly (talk) 21:00, 19 February 2010 (UTC)

I agree that this ref doesn't seem to support the word functional (although that seems to be a fair summary of Wessely's viewpoint). The word functional was put in here. --sciencewatcher (talk) 22:35, 19 February 2010 (UTC)

Oh, and "functional" is defined as "a physical disorder with no known structural explanation for the symptoms" (i.e. something like a headache, migraine, IBS, etc). "Functional somatic syndrome", as I understand it, means basically the same thing but is used to refer to a long-term illness rather than a transient symptom. It's basically the new word for "psychosomatic". You'll probably find more info and a better definition in the DSM. --sciencewatcher (talk) 22:46, 19 February 2010 (UTC)

Just looked at this- science watcher you are inaccurate to say that functional is the new word for psychosomatic. Wessely and indeed Sharpe are using it to refer to Charcot and other 19th century ideas. I originally put the word functional in the article but with subsequent editing it has become displaced. Also Wessely reads his page quite a bit- liaison psychiatrists curiously have little better to do. So best to keep it accurate - Simon :-) —Preceding unsigned comment added by 79.79.217.59 (talk) 19:29, 24 August 2010 (UTC)

No, I didn't say 'functional' was the new word for psychosomatic, I said 'functional somatic syndrome' was. But I'm not an expert - you might want to look at the DSM for a definitive answer. Also, the word 'functional' still appears to be in the article but it may be WP:SYNTH. --sciencewatcher (talk) 19:46, 24 August 2010 (UTC)

JustinReilly is correct, the Guardian article does not support the text in question. In fact, the entire sentence is questionable: "Wessely counters that few deny a potential physical mechanism for CFS, but that the effects are mainly functional; research conducted under his direction has detected markers of physical abnormalities in CFS."

Wessely probably does see the effects as "functional", but this term and concept is not discussed in the source, and even his quoted usage of the phrase "biological basis" is ambiguous: ("Oh, it's years since anyone has denied there is a biological basis to CFS," he declared. [...] But it turned out that what Wessely meant by a biological basis wasn't quite the same as what researchers such as Hooper and Meirlier understood by the phrase. "We aren't confident about the physiological basis of ME," Wessely said a little later. "It's an ambiguous illness that you can't make black and white. It's possible that, in the future, we will have a biological basis for the disease but, until something does stand up to proper testing, we are right to be sceptical.") So apparantly, Wessely allows the possibility of a "biological basis" but is clearly skeptical of one and doesn't currently believe in it. It's not even clear (from this source) that Wessely believes there are any biological correlates to CFS at all, "functional" or otherwise, I guess it depends on what he meant by "basis".

As for "research conducted under his direction has detected markers of physical abnormalities in CFS", this is not really supported by the source either. Accordingly, it states that Wessely has done studies involving physical markers and is interested in running specialised tests in research, but only "neuroendocrine difference between CFS and depressed patients" is actually mentioned in terms of a result from these studies (and even this does not explicitly imply a physical marker, it is only used to explain why he changed his mind about CFS being very similar to depression). Also, depending on how one defines "physical marker", it is obvious Wessely has not discovered or accepted any physical markers as diagnostic: "Over the past 10 years, I have lost count of the number of objective tests that have been proposed as diagnostic markers, which have gone down the plughole."

I think the Wikipedia sentence should be replaced with something like, "Although Wessely has studied physical markers and allows the possibility of a biological basis to CFS, he is not confident of such a basis and remains skeptical." - Tekaphor (TALK) 03:23, 8 December 2010 (UTC)

(←) Why are you resuscitating this thread >3 months later? JFW | T@lk 06:25, 8 December 2010 (UTC)

Why not? The above issue was never resolved, is therefore open to further discussion, and it took me this long to post a comment. It was also the most recent thread on the current talkpage, it is not like I pulled some ancient resolved issue out from the archives. - Tekaphor (TALK) 03:13, 9 December 2010 (UTC)

Pending changes

This article is one of a number selected for the early stage of the trial of the Wikipedia:Pending Changes system on the English language Wikipedia. All the articles listed at Wikipedia:Pending changes/Queue are being considered for level 1 pending changes protection.

The following request appears on that page:

Comments on the suitability of theis page for "Pending changes" would be appreciated.

Please update the Queue page as appropriate.

Note that I am not involved in this project any much more than any other editor, just posting these notes since it is quite a big change, potentially

Regards, Rich Farmbrough, 00:01, 17 June 2010 (UTC).

Wessely would not treat viruses even if found?

In a BMJ podcast during March 2010, Wessely briefly describes his approach to CFS, and explains how the cause or trigger of CFS is irrelevant to the management of symptoms and recovery, eg we don't need to know the license plate of the car that ran you over before you can recover from the injuries. Then at about 11m15s, Wessely states, "We’re not going to go doing more and more tests to find out what was the virus because, frankly, even if we found it there's nothing we're going to do about it. We're in the business of rehabilitation." This is relevant for the discussion about his response to supposed viral etiology of CFS, not only is it alleged by Wessely (elsewhere in the Wikipedia article) that viral attribution of CFS is "somatisation par excellence", but according to this podcast Wessely would not treat viruses even when they are actually detected?

Also, seconds later in the podcast, "It may well be that in 100 years time people will look back and laugh at our pathetic and puny approach to this illness". He also stated earlier (9m42s) "The model we use at the moment, unsatisfactory though as it may be ...". This reminds me of a Wessely quote I've heard before, that CBT is "not remotely curative". I did a quick Google search for this and found some NICE stakeholder comments from ME Research UK: As proponents of the biopsychosocial model of ME/CFS (CMO report 2002, page 24) themselves make clear: it is "not a cure" (Deale 2001); it is "modestly effective" and not "remotely curative" and "not the answer to CFS” (Wessely 2001); and “...it should be kept in mind that evidence from randomized trials bears no guarantee for treatment success in routine practice. In fact, many CFS patients, in specialized treatment centres and the wider world, do not benefit from these interventions. When it comes to the management and treatment of CFS patients, there is still a lot to be learned.” (Huibers and Wessely 2006). [23] I'm not going to track down these sources right now, but apparently he has acknowledged on multiple occasions that his approach is far from optimal, which may be relevant for this Wikipedia article and perhaps something someone else may wish to expand on later with the appropriate references.

_Tekaphor (TALK) 03:27, 8 December 2010 (UTC)