Psychology & Psychological Therapy

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Psychology and Chronic Fatigue Syndrome

Over the last twenty years of treating CFS/ME I enjoyed the support of a Consultant Clinical Psychologist. However, he retired about five years ago and, as the waiting list for patients to see a Clinical Consultant Psychologist in this area has been inordinately long, I have had to provide the necessary cognitive behavioural therapy and give stress management advice etc. As I am not a qualified Psychologist I am sure that a lot of it has not been terribly good.  If it is not available on the NHS and patients cannot afford to ‘go private’, then they don’t get help in this area at all.

As you will see elsewhere, I know that the most important predisposing factor to CFS/ME is an unremitting set of negative stressor factors, and it is very important that patients remove these before they can start to improve.  I tend to be very confrontational with these problems, in as much as I would say to a patient, in essence, “If you have a problem then you must sort it.” That, however, may not always be possible and my approach may not always be entirely helpful in this area, but if you have a one man band you might end up having just one tune played in the same way each time. In my defence, however, I do try to make sure that my approach is sensitive and varied, although I am afraid I may not always be successful at that!  When it boils down to managing internalised negative anxieties born of the patient’s personality,   an entirely different set of management applications  are required, and these are best supplied by a Psychologist.

A Psychologist in this respect will help a patient understand their own anxieties and how to best cope with and manage them, applying a whole series of techniques to do so.  Psychologists do not use medications. Indeed when I have been able to refer some patients to a Consultant Psychologist on the NHS, when these services were available to me, and where the waiting list wasn’t as long as they usually are, the Psychologist concerned usually wants the patient to stop their medications before they feel they can help him or her.  Their approach would be perfectly right by saying that if you cover up your anxieties and stresses  by taking pills to get rid of them then you can’t learn to handle such anxieties and stresses in another and better way.

In an ideal world we shouldn’t use drugs to remove anxieties but learn how to keep them in perspective.  In the sixties, of course, Doctors used ‘mother’s little helper’, Valium, rather than sort out the patient’s problems.   If somebody had a bereavement, it was felt that they should be given an antidepressant or Valium to make them feel better, and not go through the appropriate grieving process.  This seems to be a very English thing; that you should not be seen crying your eyes out or screaming and jumping up and down, but doing the ‘stiff upper lip’ thing by burying your anxieties and stress in some cupboard in the back of your brain.  This doesn’t help because, I promise you, that cupboard keeps banging open and these red hot skeletons have a horrible habit of coming back from time to time to haunt us all. 

Psychologists can help patients to go back over their anxieties and their previous stresses, to work through them in an appropriate fashion so, eventually, the skeletons become white, dead, cold bones. Then you can bury them and they don’t rattle any more.

What is Psychological Therapy?

(We are grateful to The Atrium Clinic for the following notes (Ó Atrium 2004) on this subject and you can visit their website by clicking on their logo below.) 

Psychological therapy is also known as counselling and is a talking and listening therapy to enable and facilitate a change or a move for the client.  Therapy does not change people - people change themselves.  However, if a person wants to change, counsellors/therapists have the skills, knowledge and the imagination to help people work towards their goals or outcomes. 

One of the best known therapies is cognitive behavioural therapy (CBT), particularly used for stress, anxiety and depression.  It looks towards challenging and changing negative thoughts, which in turn change feelings and behaviours.

 Other therapies include:

§        Person Centred - This therapy, as the name suggests is designed around the client. The theory underpinning this therapy is that it is important for the client to learn to understand himself/herself and make independent choices that are significant in understanding the problem.

§        Rational Emotive Therapy (REBT) teaches individuals to be responsible for their own emotions and gives them the power to change and overcome their unhealthy behaviours that interfere with their ability to function and enjoy life.

§        Transactional Analysis (TA) The theory of TA is based on the fact that the human personality is made up of three "ego states" parent, adult and child and within counselling TA works towards creating changes desired by the client and involves using the adult state to sort out behaviours, emotions and thoughts that are preventing the development of a client’s full potential.

§        Neuro Linguistic Programming (NLP) was developed from studying the thinking and behavioural skills used by particularly effective and successful people. Neuro refers to how the mind and body interact. Linguistic refers to the insights into a person’s thinking that can be obtained by careful attention to their use of language. Programming refers to the study of the thinking and behavioural patterns or ‘programmes’ which people use in their daily lives.

§        Solution Focused Brief Therapy (SFBT) is a short-term goal-focused therapeutic approach, which helps clients change by constructing solutions rather than dwelling on problems. Elements of the desired solution often are already present in the client's life, and become the basis for ongoing change.