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More PsychNotes: Physical Health

March 11, 2016       

If You Are Sick, Does That Mean You Are Irrational?
by Monica A. Frank, PhD

Reading the controversy regarding research showing Mindfulness-based Cognitive Behavioral Therapy (MCBT) can help improve symptoms for those with Chronic Fatigue Syndrome, I came across this quote: “These theories presume and insist that patients are not medically sick but simply suffering from dysfunctional cognitions that need to be changed (Wall Street Journal, March 8, 2016, quoting David Tuller, lecturer in public health and journalism).”

Such statements represent a common misunderstanding of MCBT. This person quoted above as well as many others, even those in the health field, use cause and effect reasoning where it doesn't exist. For example, I've heard people state that children who are abused are likely to become abusers. However, this statement is a cause and effect misinterpretation of the research that shows adults who abuse were likely to be abused as children. These are two very different concepts! Many people who were abused as children don't become abusers although most people who abuse children were abused themselves.

This same reasoning creates misinterpretations of research regarding MCBT. Many people bristle when psychotherapy is recommended for their medical symptoms because they think that must mean the medical professionals believe their symptoms are "all in their head." However, just because changing irrational thinking and developing a more mindful attitude can help improve physical symptoms does not mean that illness is caused by irrational thinking. Instead, a secondary factor is involved. In particular, when people have illness and experience stress (even that caused by their illness) their physical symptoms of that illness may worsen.

Thus, teaching people how to better care for themselves when under stress can reduce physical symptoms of illness—including heart disease, diabetes, colds and flu. And, likely, Chronic Fatigue Syndrome. However, that does not mean irrational thinking and lacking a mindful attitude caused the symptoms in the first place.

An article of mine explains this in much more detail: A Brief Primer on the Biology of Stress and How CBT Can Help. Another talks about how you can use these methods to better manage physical illness: Mobilizing Your Body's Resources: Healing from Illness or Injury.

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