CFT and FND

[hschubiner]

Hi all.
I really enjoyed the class yesterday. I hope you did too!
I just looked up some of the research on CFT, cognitive-functional therapy, as applied by my friend, Peter O’Sullivan in Perth, Australia. The few articles I saw compared CFT to manual medicine and exercise. They did not show decreases in pain compared to the control group, which is too bad.

I recently saw a really great article by someone who had a whole set of severe symptoms (obviously MBS). He ended up seeing the folks at the NIH Rare Disease Center and they told him that he had FND. I will send the article to Grace so she can send it to you. He did a great job researching the topic. However, he is still suffering and I don’t think he really understands the whole breadth of the issue (as Becca pointed out in class yesterday).

Best, Howard

[dschwarz]

Unfortunately, I missed yesterday. I look forward to watching the video. Cognitive functional therapy does have some interesting elements that still need teasing out. I see the same thing with acceptance and commitment therapy base models of care in physical therapy and rehabilitation services. One substantial element that is missing it seems is that of positive psychology. I do not think physical therapists are very good at this. I am currently writing up a national survey on physical therapist knowledge, attitudes, beliefs, and behavior related to functional neurological disorders. It has been interesting to see some of the perspectives and the variety of practice. The document that it is based on is unfortunately flawed in my opinion, but it is what the profession has. I believe that the understanding of functional neurological disorders and the treatment of people who have them has a long way to go. There are some good ideas coming out of the UK on functional neurological disorders however the research in general especially the United States is very limited. Fortunately for me this creates a lot of opportunity for my dissertation.

[dschwarz]

Here is an interesting study that came out. I would say it is not groundbreaking but it is affirming. It is on the observed prevalence of FND in chronic pain clinics: https://pubmed.ncbi.nlm.nih.gov/37227931/

Another study occurred a while back that looked at the high prevalence of autism and autistic traits in FND. When we bring it around full circle, we can see how there is a high rate of abuse/childhood trauma in children with autism especially with a lack of appropriate follow up by adults. The interconnectedness of common context can be such an interesting thing.

[khughes]

thank you for that reference!

[hschubiner]

It’s been so interesting to watch as autism and “spectrum” disorders have risen dramatically in our society. It certainly seems that the rises in anxiety, depression, and chronic pain are all related; and are all related to stress and cultural ways that stress is manifest in our current society.

Links between FND and autism makes one wonder how much of autism or spectrum disorders might also be mind-body or neuroplastic conditions?? The same question might be applied to ADHD and how that has also risen significantly.

Best, Howard

[mwoods]

I believe that even conventional western medicine is realizing that the notion of a spectrum can apply to many conditions, not just a few, such as Autism Spectrum Disorder. Chronic lung disease, liver disease, dyslipidemias, and most most notably the spectrum of T2D, are all great examples of this. Maybe the future will be one where we can all be placed on a spectrum for many conditions, and use that information/proneness to recognize our own vulnerabilities to a host of mind and body conditions, and hence manage our lives better. RR Grinker wrote a very insightful book about that (Nobody’s Normal: How Culture Created the Stigma of Mental Illness), specific to psychiatry, his field, but with far reaching implications and suggestions for applications outside the realm of mental illness.

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