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Boudewijn Van Houdenhove
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=== Victimization === Van Houdenhove wondered why ME/CFS patients were in a continuous state of overdrive before falling ill, as his research indicated. He argued that this behavior acted as a "stabilizing factor in the psychic economy". He wrote: <blockquote>"In our clinical practice, we often hear from CFS/FM patients that—before they got ill—they never could sit still, they were always busy to avoid becoming nervous, or they needed physical workout to chase away negative thoughts or feelings."<ref name=":1">Van Houdenhove B. [http://www.uppitysciencechick.com/van_houdenhove_pain-fatigue-overactivity.pdf Letter to the Editor. Premorbid "overactive" lifestyle and stress-related pain/fatigue syndromes.] Journal of Psychosomatic Research 2005;58:389-390.</ref> </blockquote> In another study by Van Houdenhove and colleagues, ME/CFS patients reported more emotional and physical [[trauma#abuse|abuse]] than controls with [[multiple sclerosis]] (MS) or [[rheumatoid arthritis]] (RA).<ref name=":17" /> A considerable subgroup experienced lifelong victimization.<ref name=":17">Van Houdenhove B, Neerinckx E, Lysens R, Vertommen H, Van Houdenhove L, Onghena P, Westhovens R, D'Hooghe MB. Victimization in chronic fatigue syndrome and fibromyalgia in tertiary care: a controlled study on prevalence and characteristics. Psychosomatics. 2001 Jan-Feb;42(1):21-8. [[doi:]][https://doi.org/10.1176/appi.psy.42.1.21 10.1176/appi.psy.42.1.21] [[PubMed Identifier|PMID]] [[pubmed:11161117|11161117]]</ref> Van Houdenhove uses this to support his claim that ME/CFS patients are often perfectionistic and in need of external validation. <blockquote>"This case report illustrates the multifactorial etiology of CFS. Mr. A’s severe abuse history and his premorbid overactive lifestyle may be considered important vulnerability factors. Based on a deep-rooted lack of self-esteem, this man was driven to work hard and take part in sports to a fanatic degree (bodybuilding and karate) as a means of compensation for feelings of emptiness, worthlessness, and insufficiency."<ref>Cuykx V, Van Houdenhove B, Neerinckx E. [[pubmed:9854653|Childhood abuse, personality disorder and chronic fatigue syndrome.]] Gen Hosp Psychiatry. 1998 Nov;20(6):382-4.</ref></blockquote> When their outlet of overactivity becomes hampered, persons like Mr. A are susceptible to developing ME/CFS: <blockquote>"What happens, then, when a protracted illness or physical injury makes further (over)activity impossible? Such events may seriously threaten the patient’s psychobiological equilibrium and precipitate a dysregulation of the stress system."<ref name=":1" /> </blockquote>
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