Regarding “Whiter than white?” : Response from Prof Peter Denton White

Ed: Extract taken from conference speakers Abstracts and Biographies document published by the Royal Society of Medicine for their conference on “CFS”, which took place on 28 April 2008:

“Peter White is Professor of Psychological Medicine at Bart’s and the London School of Medicine. His clinical work is as a liaison psychiatrist to Bart’s hospital, and he also jointly leads a clinic for patients with CFS/ME, which he helped to establish in 1984. His research interests include the nosology, causes and treatments of CFS/ME, particularly establishing the aetiological role of viral infections, such as Epstein-Barr virus, and the utility of graded exercise therapy as a treatment. He is currently the lead co-principal investigator of the MRC funded PACE trial, which is a multi-centre trial that compares four different rehabilitation approaches for 600 patients with CFS/ME.”

 

See Whiter than White? by Margaret Williams

See also: A selection of points the Barts CF Service submitted as part of the NICE CFS/ME Guidelines consultation process

See also: Round up of links for Prof Peter Denton White’s views on ME and “CFS”

 

Regarding “Whiter than white?” written by Margaret Williams, 6th November 2007: A response from Professor Peter Denton White, circulated via the Co-Cure mailing list

Statement issued by Prof P D White

7 November 2007

Being a psychiatrist in the field of CFS/ME, I am used to being misquoted, misunderstood, or quoted out of context. However, I think it would have been both wise and courteous for Margaret Williams to have checked with me first before reporting what she thinks I said off-air after a radio programme last Monday. I was asked a question by Dr Weir about abnormal illness beliefs and whether I still thought they existed. To which I replied that they do, believing he was talking in general. Abnormal illness beliefs (beliefs that may hinder improvement) are sometimes held by patients (as well as some doctors) and this can occur whatever the diagnosis or illness. I was not referring to CFS/ME specifically when I answered the question. This is completely different from saying “ME is an abnormal illness belief.” To the best of my knowledge, I have never said or written that, and I certainly do not believe that either.

As I did say in the interview, which can be listened to again

http://www.bbc.co.uk/radio4/youandyours/me_series.shtml

Ed: BBC transcripts of this broadcast and the other broadcasts in this ME strand can be accessed at the above URL and are also available at: http://www.bbc.co.uk/radio4/youandyours/transcripts_autumn07.shtml 

I think CFS/ME is caused and/or maintained by both physical and psychological factors. On the physical front, one of my first studies showed that infectious mononucleosis, caused by Epstein-Barr virus, increases the risk of CFS by a factor of five. Regarding psychological factors, stressful life events have been shown to exacerbate the illness and many of my patients tell me this. More importantly, I said that our current understanding of CFS/ME is still based on an out-moded Cartesian dualistic model in which we have a separate body and mind. As the American philosopher Searle said “conscious states are caused by neurophysiological processes”. In other words we cannot think or feel anything without a physical process occurring in our brains. This means we cannot and should not separate the physical from the psychological. Our minds are the psychological manifestation of a physical brain. If I ever were to have the misfortune to fall ill with CFS/ME, I would want an integrated (biopsychosocial) understanding and approach to help me to recover my health. We would be doing a disservice to patients if we ignored how they feel and what think about their illness. We would be doing an equal disservice if we ignored the physical aspects, such as their pain and weakness.

May I respectfully suggest that it would be better for us to concentrate our energies on attacking our common enemy, which is CFS/ME, rather than each other?

Peter White

Peter D White
Professor of Psychological Medicine
Barts and the London
Queen Mary School of Medicine and Dentistry
St Bartholomew’s Hospital
London EC1A 7BE, UK
p.d.white@qmul.ac.uk
http://www.bartscfsme.org/index.htm
http://www.pacetrial.org/

 

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