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Boudewijn Van Houdenhove
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=== Controversy === ==== Membership of a patient organization as an illness-perpetuating factor ==== Boudewijn Van Houdenhove has responded to criticism by patient advocates. In his book ‘[https://books.google.be/books?id=eS7ZED-n8AUC&printsec=frontcover&dq=moe+in+tijden+van+stress&hl=nl&sa=X&ved=0ahUKEwjh4N3Lq4DcAhVDLlAKHd_TDXYQ6AEIKDAA#v=onepage&q=moe%20in%20tijden%20van%20stress&f=false Moe in tijden van stress’ (2001)] he wrote that he felt "surprise, pity and vicarious shame" as he read criticism of patients on the internet. In another of his books, [https://books.google.be/books?id=yDauPwAACAAJ&dq=%E2%80%98Herwin+je+veerkracht%E2%80%99+(2009)&hl=nl&sa=X&ved=0ahUKEwjGw-rbq4DcAhUFYlAKHTDuBYEQ6AEIKDAA ‘Herwin je veerkracht’ (2009)] he referred to the website of patient advocate (and published researcher) [[Frank Twisk]] with the remark (translated from Dutch) “It is suffice to say that most of them do not bother to read what I write […] They just echo each other's prejudices.” And concerning the protest of some ME/CFS patients against a psychiatric approach to their illness, Van Houdenhove noted (translated from Dutch): <blockquote>"The stubbornness with which this happens in some patients sometimes prompts us to think that, if the energy wasted in this fight were used to work on rehabilitation, the process of recovery would probably have come a long way."<ref>Neerinckx E and Van Houdenhove B. [http://www.tijdschriftvoorpsychiatrie.nl/assets/articles/articles_599pdf.pdf Kort signalement Gegijzeld door chronische vermoeidheid...] Tijdschrift voor Psychiatrie 39 (1997) 4: 339-341.</ref> </blockquote>In a 2008 scientific paper on the treatment of ME/CFS, Van Houdenhove wrote that membership of a patient support group could be regarded as a perpetuating factor of the disease.<ref>Van Houdenhove B and Luyten P. Customizing treatment of chronic fatigue syndrome and fibromyalgia: the role of perpetuating factors. Psychosomatics. 2008 Nov-Dec;49(6):470-7. [[doi:]][https://doi.org/10.1176/appi.psy.49.6.470 10.1176/appi.psy.49.6.470] [[PubMed Identifier|PMID]] [[pubmed:19122123|19122123]]</ref> ==== Recovery is an undesirable goal ==== Another controversial statement Van Houdenhove has made, is that for ME/CFS patients, full recovery is not only an unrealistic but also an undesirable goal.<ref name=":13" /> This has to do with Van Houdenhoves view that the premorbid behavior of ME/CFS patients is an important precipitating factor of the disease (translated from Dutch): <blockquote>"Elsewhere we have argued that in many CFS/FM patients - before the outbreak of their disease - the balance between their will and ability had become lost. They perpetrated continuous violence against themselves, whether intentionally or unintentionally. This imbalance was a source of chronic, undermining stress. Sooner or later this had to go wrong..."<ref name=":7">Van Houdenhove, B. (2005). [https://books.google.be/books?id=xuQONxCnpIgC&pg=PA13&dq=in+wankel+evenwicht+boudewijn+van+houdenhove&hl=nl&sa=X&ved=0ahUKEwjgtMv-qYDcAhUJPFAKHb5qBl0Q6AEIKDAA#v=onepage&q=in%20wankel%20evenwicht%20boudewijn%20van%20houdenhove&f=false In wankel evenwicht. Over stress, levensstijl, en welvaartsziekten.] Tielt: Lannoo. p 139-140.</ref> </blockquote> According to Van Houdenhove some ME/CFS patients were "trapped in a narcissistic urge to perform" while others were "a slave of their perfectionism".<ref name=":7" /> This is the reason why there will never be a simple pharmacological cure for ME/CFS. (Translated fom Dutch): <blockquote>"[…], it seems unlikely that CFS/fibromyalgia can be 'cured' completely by pharmacological therapy. Indeed, as discussed above, the course of the condition often depends heavily on secondary physical and psychosocial factors. For many patients with CFS/fibromyalgia, a return to 'former times' is an entirely undesirable goal, given the factors that contributed to the disease."<ref>Van Houdenhove B, Luyten P, ke S. [https://www.tvg.be/index.php/article/het-stressadaptatiemodelvan-het-chronischevermoeidheidssyndroomfibromyalgieeen-update Het “stressadaptatiemodel” van het chronischevermoeidheidssyndroom/Fibromyalgie: een update.] Tijdschrift Voor Geneeskunde. 2013;69: 905.</ref></blockquote> ==== Patients should help themselves ==== At Van Houdenhoves clinic, the ME/CFS patient was encouraged to be more self-sufficient. (Translated fom Dutch) "We tell him that he must stop expecting medicine to solve everything, that he must stop doctor-shopping."<ref>VandelooD. (1997 June 3) Psychosomatische afdelingen luiden nieuw tijdperk van hulpverlening in – “Patiënt moet stoppen met dokter-shopping”. Het Belang van Limburg. Retrieved fom: http://www.gopress.be/Public/bibnet-article.php?issueDate=1997-06-03&publicationId=18&articleOriginalId=hetbelangvanlimburgrug902893061997-00000&language=dut</ref>According to Van Houdenhove, ME/CFS patients “can best be helped by helping themselves.”<ref name=":4" /> ==== ME should not be a condemnation of [[disability]] ==== Another controversial intervention by Van Houdenhove occurred at the turning of the millennium when Belgian ME/CFS patients, through lobbying and protests, just about managed to have their disease recognized by the government. At the time, Van Houdenhove published an article, cautioning about these developments.<ref name=":3" /> Though he stressed that the ‘illness’ of these patients (by which he means the subjective feeling of being sick) should always be respected by physicians and society, recognition of an official disease and disability is a more complicated matter. He published an opinion piece in the Belgian newspaper, De Standaard, stating: <blockquote> "Recognition of the authentic feeling of illness and inability of the CFS patient certainly does not have to result in long-term or permanent disability. After all, in many cases the GP can intervene in a timely and adequate manner in order to prevent the patient from falling into a downward spiral."<ref>Van Houdenhove B. (1998 October 25). Chronischvermoeidheidssyndroom erkennen? De Standaard. Retrieved from: http://www.gopress.be/Public/bibnet-article.php?issueDate=1999-10-25&publicationId=2&articleOriginalId=destandaardvumcuscusds25101999-00000&language=dut</ref> </blockquote> According to Van Houdenhove "labels such as CFS and ME should be used in a constructive way, not as a condemnation of disability, but as a point of departure for realistic and pragmatic help."<ref name=":2" />
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