Well, okay, ME/CFS research has long recognized that any number of stressors, be it an infection, injury, or psychological trauma, trigger ME/CFS. So why is this study all that significant unless it's to underscore that patients with CFS are a bunch of crazy people?
In addition, the study has a number of methodological problems which Pamela Weintraub lays out rather neatly using quotes from an interview with author Hillary Johnson.
Some of the Weintraub/Johnson highlights include:
- The CDC recently watered down the definition of "Chronic Fatigue Syndrome" so that people with psychiatric conditions that cause fatigue are included among those who qualify for a diagnosis of CFS. As Johnson puts it, "they have essentially medicalized ‘fatigue,' defining ‘fatigue' as a specific disease."
- The study fails to cite a 2001 study that found the exact opposite of what this study supports. That paper, by noted ME/CFS researcher Lenny Jason, "revealed that significantly fewer individuals with CFS reported abuse as compared with those who did not." The CDC group should have at least said what it thought the Jason et. al. group did wrong and why it discovered such a markedly different result.
- It was nice to see someone argue this same point I have, namely, that researchers should not be comparing CFS patients to healthy controls, but rather to MS patients or cancer patients or patients with congestive heart failure or Parkinson's disease. Are child abuse victims more likely to get other diseases such as MS or congestive heart failure? The fact that ME/CFS is singled out as connected to child abuse demonstrates a bias that believes people with CFS specifically are suffering from a form of psychopathology (or neuro-endocrine-immune-psychopathology) while those with other similar conditions are sick simply because they got the wrong genes.
- Lastly, the empirical data that the CDC used for this study were questionnaires that individuals filled out themselves and morning salivary cortisol levels. There were no tests of other known ME/CFS physical abnormalities such as low natural killer cell levels or Rnase L enzyme activation. Basically we have "fatigued" and "unwell" people who report being abused as children and have low morning cortisol levels. Big shock there!
And why child abuse? Why not study childhood infection, especially as ME/CFS patients are far more likely to develop the disease following an infection? Not to belabor the point -- or maybe indeed to belabor the point -- but it does exhibit a distinct psychiatric bias here.
And, of course, the elephant in the room is always always always that the condition is defined so broadly that we don't even know if the abused CFS patients even have the same disease as the non-abused CFS patients.
I will acknowledge that I was abused as a child, and I don't doubt that has had a distinct physiological impact on me. For the longest time after leaving home I struggled with my body going into that dizzying "fight or flight" response every time I had to deal with the least bit of conflict.
After undergoing a form of therapy known as Dilectical Behavioral Therapy in which I learned various mindfulness techniques, as well as developed habits such as daily meditation, I have been able to calm that "fight or flight" response. But I remain bedridden most of the day. At best, it has helped me with pain -- of both body and soul -- as well as cope with and manage this devastating illness.
It may well be that the combination of child abuse and physical injuries and infection was just far too much for my poor body to handle. And perhaps having therapy earlier in life may have saved me from developing ME/CFS later.
(It goes without saying that um, child abuse is bad, mmkay. And does lots of bad things to a developing child, mmkay. So, you know, don't abuse your kids because they will be fucked up in ways you may not even realize, mmkay. [South Park reference for those of you not familiar with Mr Mackey and his infamous "mmkay."])
But I also know that therapy did not make me better now that I am sick. What I need the CDC to do is figure out what is happening in my body now and figure out how to to treat that now. We know that stress can cause heart disease and cancer, but we don't merely give heart disease and cancer patients a therapist. No, we treat the underlying cardiovascular and immune system pathology in addition to any underlying psychopathology. Why should it be any different in ME/CFS?