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1) 🇫🇷 France' public health insurance Ameli has updated its info on ME/CFS including sections critical of graded exercise and CBT. In this article, however, proponents of psychosomatic medicine explain how they pushed back to get some of the language changed.

2) The authors, who include Dr. Cédric Lemogne and Dr. Brigitte Ranque criticise, for example, that the webpage presented CBT mainly as "a means of supporting patients in coping with the condition, rather than as a treatment that might itself reduce symptoms or disability."

3) They also questioned "language that might inadvertently imply an invariably poor prognosis or obscure evidence that some patients substantially improve or recover."

4) "Some of us separately raised these concerns with the French national health insurance"., the article writes. Afterwards, the text was indeed (slightly) changed in their favour. It now includes references to the controversial PACE and Cochrane review on GET.

5) In the article, the authors explain that this provides a lesson for psychosomatic medicine. They caution not to conflate onset, pathology and treatment of an illness and that blame should be avoided when discussing cognitive and behavioural aspects.

6) I personally find this influence problematic. Although multiple perspectives and insights are welcome, this seems driven by ideological views on psychosomatic medicine rather than concerns about scientific accuracy.

7) I don't think any of the authors have actually done research on ME/CFS, only on related conditions such as Long Covid, fatigue or functional disorders. So it's a bit weird to try change medical guidelines on a condition that you haven't actually studied or have expertise in.

8 ) Some proponents of psychosomatic medicine have become involved in ME/CFS just because this field has largely rejected CBT and other psychosomatic approaches. So they think that this can't be right and feel a need to correct this before it spreads to other fields.

9) I don't like this development: don't want ME/CFS to become the battleground for the relevance of psychosomatic medicine in the 21th century. This type of lobbying will only encourage further controversy, conflict and division.