Atos Medicals - Questions, Answers and Support
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existentialist
Tired and unemotional
It may be that I am seeing a particularly narrow spectrum of ME sufferers - my experience is solely with teenagers, and every one I have seen has had some prior history of emotional trauma. It may even be that I am seeing people diagnosed with ME who simply have symptoms that are concomitant with that diagnosis, or that ME is a spectrum disorder with multiple causes. I'm more than happy to bow to the views of those with broader experience of the area.
spirals
Something uber witty here.
I have ME and had to see a psychiatrist to rule out depression or somatisation as part of getting a diagnosis. In fact in the area where I live you won't get a diagnosis of ME if you have depression or show any signs of a mental illness. The problem with that is it's quite natural to get depressed about feeling very unwell 100% of the time, it's natural to grieve when you see how your life is changing and the losses that having a chronic illness can cause and the later you are diagnosed the more likely you are to be struggling with such issues so more weight is given to the whole it's in part due to mental illness.
ViolentPanda
Hardly getting over it.
Masters in forensic psychology and criminology after much amateur enthusiasm. I'm fairly decently-read on sociology, criminology and psychology as a result of that, although not a practicing psychologist (clinical psychology doesn't "tweak my knobs").
existentialist
Tired and unemotional
Point(s) taken, though the underlying point I was making, which is that this biopsychosocial theory enables some (probably mostly non-medical types) to treat illness, somatic or otherwise, as a kind of lifestyle choice that can be tackled by beating people with a stick, is, I think, still valid.
Whether ME or similar illnesses are somatic or not, there is a school of thought - and the DWP seem to have leaped upon it - which regards them as a kind of avoiding strategy and aims to tackle that by forcing change via circumstances, rather than engaging the sufferer in a constructive process.
Which is, I think, totally wrong.
We know, for example, that post-heart attack outcomes are much improved if survivors can engage in a process of lifestyle change - exercise, dietary improvement, stopping smoking, etc. Even where that is clinically validated to a 100% certainty, we are entering a dangerous area when we start regarding it as our right (eg by virtue of the fact that the "hard-working taxpayer" is supporting such people) to force lifestyle change upon them. One of the prices we have to pay as a civilised society prepared to operate a welfare system is that we should allow people to be able to make those decisions for themselves, if for no other reason than that compliance is very much less likely to occur if people feel they are being browbeaten into such changes, rather than being enabled to make them for their own, positive, reasons.
Whether ME or similar illnesses are somatic or not, there is a school of thought - and the DWP seem to have leaped upon it - which regards them as a kind of avoiding strategy and aims to tackle that by forcing change via circumstances, rather than engaging the sufferer in a constructive process.
Which is, I think, totally wrong.
We know, for example, that post-heart attack outcomes are much improved if survivors can engage in a process of lifestyle change - exercise, dietary improvement, stopping smoking, etc. Even where that is clinically validated to a 100% certainty, we are entering a dangerous area when we start regarding it as our right (eg by virtue of the fact that the "hard-working taxpayer" is supporting such people) to force lifestyle change upon them. One of the prices we have to pay as a civilised society prepared to operate a welfare system is that we should allow people to be able to make those decisions for themselves, if for no other reason than that compliance is very much less likely to occur if people feel they are being browbeaten into such changes, rather than being enabled to make them for their own, positive, reasons.
ViolentPanda
Hardly getting over it.
I reckon that's a definitional issue, in that if we're talking about "Ramsay M.E." or any of the succeeding clinical diagnostic definitions, it isn't (the diagnoses all exclude all manifestations of psychiatric illness/psychological distress), but if you're rolling on Wessely et al's re-definitions, or the iterations that turn up in their research, then sure: a somatoform disorder might be an element in the disease process of some sufferers, although there's the "chicken and egg" quandary to adress there - how many had a somatoform disorder to start with, and how many of them developed a somatofrm disorder as a result of how they were treated by the medical world for having a disorder that the medical world didn't entirely acknowledge?
ViolentPanda
Hardly getting over it.
This is something that those who don't buy the psychiatric route have been investigating for decades, mostly with little or no funding, 'cos it ain't sexy, and doesn't bring in research funding from anti-depressant manufacturers.
I'm also (unlike many other sufferers I know) willing to acknowledge that somatisation may be an element but, as I say above, it's hard to determine whether the chicken or the egg came first for many sufferers. Your "sub-group" (so to speak) of teenagers appear to have clear causation, but so many people don't. What many of them do have is a common history of repeated bacterial, viral or chemical physiological insult of one form or another (or even multiple forms).
ViolentPanda
Hardly getting over it.
Let's be plain. They haven't so much "leapt on it", as helped in manufacturing it, via their involvement with UNUM and other vested interests. I'm not conspriracising here, just drawing a conclusion from widely-available data about, for example, Sir Mansell Aylward, his Civil Service role, and his post-Civil Service roles; the membership roles of "interest groups" in the medical world that are pro-medical insurance insofar as it can bring them lucrative opportunities; the DWP's long-established interest in using external data from (as a completely offhand example) insurance companies to inform their payment strategies...well, the list is long!
I'd be happy to see CBT rolled out to every ME sufferer, although most of the people I know have already found coping strategies that don't involve playing the sick role. CBT can still help you to order your thinking about your illness process. As for graded exercise therapy, I'm not a supporter of it. Not because it is prescriptive and/or oppressive, but because despite over a decade and a half of deployment, it hasn't shown any real benefit to anything except the ego of psychiatry.
existentialist
Tired and unemotional
I really must stop responding to these complex discussions on my phone!
Yes, confusion of cause and effect is a big deal, and it's one I see a lot in my work - professionals often tend to cleave to one view or another (much as I probably appear to have been doing here), and struggle to accept the other.
It is conceivable that a lot of my clients with ME are depressed because of the effects of the ME - I am sure that happens. I came to this as a result of discussions with fellow professionals who were absolutely opposed to the idea of any kind of emotional cause to the ME symptoms, and found myself wondering whether they were right: when I then explored histories with clients with ME (including - not as a client - my own stepdaughter), it struck me that, in many of the cases, the ME had provided a way of being that rather neatly fitted their pre-existing emotional pathologies. However, it was notable that, in quite a few cases, including that of my stepdaughter, the ME had come on following a viral infection, which seemed to imply some kind of organic cause as well.
So, the nuanced version of my position is: I can fully accept that there is at least one possibility for an underlying cause for ME, but I set my face very much against the idea of excluding the potential for an emotional causative aspect, too; and, while there is no doubt that ME has physiological effects (pain, weakness, etc), it clearly also has the potential to have profound emotional effects (not entirely surprisingly) as well.
In the case of my stepdaughter, a sensitive approach to her difficulties, coupled with robust emotional support and some sometimes fairly assertive encouragement to "take risks" (like going outside for a walk) has resulted in improvements, and I'm delighted to say that she got through a 3 year university degree without any significant setbacks, and has functioned effectively for the last two years post-graduation as well. Her mum is sure that she still has ME episodes where she's a bit more low, emotionally and physically, though I tend to prefer not to pathologise those too much and just regard them - absent any significant increase in symptoms - as the kind of ups and downs we all have a bit of.
existentialist
Tired and unemotional
Nothing I could possibly disagree with here!
I'd be wary of throwing CBT at it, to be honest. In situations where there was clearly no underlying emotional aspect, CBT might be a useful way of helping sufferers manage their response to the symptoms; but, in Maslow's words, "When all you have is a hammer, everything looks like a nail", and I feel that the conflation of "CBT" and "therapy" runs the risk of treating everything as a cognitive process that CBT can address and thereby missing more complex patterns of thought that may underly that.
I use CBT, more than anything, as a "sticking plaster" approach, to help people get functional enough that they can operate a little better and find themselves able to engage in more in-depth therapeutic work. Sometimes, CBT is all they need, but if we premise the idea of providing therapy solely around CBT, we run the risk of missing the other stuff that might be going on, and leaving our client feeling blamed, misunderstood, or unheard. None of them good things.
That, incidentally, is one of the reasons I think IAPT was completely the wrong way to go, and it is beginning to look as if the evidence is bearing that out. Oh, how lovely it is to be right!
existentialist
Tired and unemotional
Oh, and...
One of the things that troubles me about a lot of my teenage ME clients is that most of them have had no kind of psychiatric assessment, or if they have, it has been rudimentary to the point of non-existence. So a "psychiatric" element is ruled out, but essentially only because it hasn't been looked for. That's a bit of a side-issue in the context of this discussion, though.
WouldBe
Dislicksick
Despite doctors keep telling me I'm delusional I've never been refered to a psychiatrist. I was refered to a psychotherepist, who after several weeks of trying different techniques on me ruled out somatisation as a cause of my problems.
As far as I can see if it's not somatisation then it must be a physical cause yet the doctors can't be arsed to look (unless they lnow what it is, MS, and aren't allowed to diagnose it for financial reasons.)
I didn't quite need a 6" nail to hold all the paperwork together but there was 32 pages of extra information sent in (33 if you include the index) and some of my medical notes I haven't got copies of yet so might have been able to send more in.
I could do with a months holiday after all that but I've got to chase up the progress on my DLA appeal. 
Nothing I could possibly disagree with here!
I'd be wary of throwing CBT at it, to be honest. In situations where there was clearly no underlying emotional aspect, CBT might be a useful way of helping sufferers manage their response to the symptoms; but, in Maslow's words, "When all you have is a hammer, everything looks like a nail", and I feel that the conflation of "CBT" and "therapy" runs the risk of treating everything as a cognitive process that CBT can address and thereby missing more complex patterns of thought that may underly that.
I use CBT, more than anything, as a "sticking plaster" approach, to help people get functional enough that they can operate a little better and find themselves able to engage in more in-depth therapeutic work. Sometimes, CBT is all they need, but if we premise the idea of providing therapy solely around CBT, we run the risk of missing the other stuff that might be going on, and leaving our client feeling blamed, misunderstood, or unheard. None of them good things.
That, incidentally, is one of the reasons I think IAPT was completely the wrong way to go, and it is beginning to look as if the evidence is bearing that out. Oh, how lovely it is to be right!
I fail to see how cock & ball torture's going to help anyone. Especially when mentioned in the same breath as hammers & nails.
Bakunin
I am Noodle's bitch.
Further proof of dodgy goings-n at everyone's favourite welfare benefit assessors:
http://www.guardian.co.uk/society/2013/may/16/atos-doctor-claimants-biased-medical-assessments
http://www.guardian.co.uk/society/2013/may/16/atos-doctor-claimants-biased-medical-assessments
No, ATOS.
You do not refute it.
You do not even make much of an attempt to rebut it.
You merely rebuff it.
Unqualified for this work. Off to Poundland with you...
And you, DWP, lied last time and the time before...
WouldBe
Dislicksick
I don't know. Threatening to crush your balls or nail your cock to a plank of wood could be quite persuasive in people who want to stay in the sick role.
I don't know. Threatening to crush your balls or nail your cock to a plank of wood could be quite persuasive in people who want to stay in the sick role.
Nah.
geminisnake
a complex mass of conflicting ideas
So I've just got two letters from DWP. One says your benefit is changing to ESA, the other says about your Income Support. Plus a letter from the council asking about changes 
I opened the council one first so was like wtf??
Apparently I have been placed in a WRAG but will get a separate letter, so 8 pages of nothing has changed except the name and the WRAG thing.Can someone what the WRAG thing is?
So does this mean I don't have to go to an ATOS thing?
I opened the council one first so was like wtf??Apparently I have been placed in a WRAG but will get a separate letter, so 8 pages of nothing has changed except the name and the WRAG thing.Can someone what the WRAG thing is?
So does this mean I don't have to go to an ATOS thing?
equationgirl
Respect my existence or expect my resistance
If you've been placed in the WRAG they'll be looking to get you into work over the next 12 months. You can appeal this decision and ask to be placed in the support group if you want.
Here is a useful explanation of the WRAG activities:
http://thefullfacts.com/esa/forum/viewtopic.php?f=34&t=651&sid=c99e058fe9aead3e50c9d0292971f373
It also points out that unless your progress for improvement is within 3-6 months, you can't be compelled to carry out any work-related activities.
I don't think you have to go to an ATOS assessment, geminisnake, because you've been put into the WRAG straight away. This is A GOOD THING
Here is a useful explanation of the WRAG activities:
http://thefullfacts.com/esa/forum/viewtopic.php?f=34&t=651&sid=c99e058fe9aead3e50c9d0292971f373
It also points out that unless your progress for improvement is within 3-6 months, you can't be compelled to carry out any work-related activities.
I don't think you have to go to an ATOS assessment, geminisnake, because you've been put into the WRAG straight away. This is A GOOD THING
So I've just got two letters from DWP. One says your benefit is changing to ESA, the other says about your Income Support. Plus a letter from the council asking about changes
Apparently I have been placed in a WRAG but will get a separate letter, so 8 pages of nothing has changed except the name and the WRAG thing.Can someone what the WRAG thing is?
So does this mean I don't have to go to an ATOS thing?
I reckon equtiongirl is right - Unless the letter specifically says you have to go to a medical, you won't have to. You can appeal to be put in the support group and it's worth doing - You've got the right to appeal so use it. Realisticly though, everyone gets put in the work group - Unless you're a head in a jar you probably won't get into the support group.
E2a - The WRAG thing just means you've got to go and see some clown once a month for an hour - It's a piece of piss, a mere formality. You shouldn't have to but these are the hoops.
geminisnake
a complex mass of conflicting ideas
Well I don't think the ABI and its affects are suddenly going to disappear after 10 years are they??
So once I have calmed down I will read the link, thanks If it's only once a month and 1 to 1 I could try it, it's not going to make a stuff of difference, the fact is there are no jobs in this area and the last lady I spoke to at the JC knew that and was fine with it!
equationgirl
Respect my existence or expect my resistance
Sounds like in your case appealing for support group might be more hassle than it's worth.
Libertad
Sparking up a rollie in the Reichstag
When I was put into the WRAG I should have appealed it but I didn't know that at the time. I was very lucky in that the DWP staffer who conducted my first interview knew immediately that I should have been placed in the Support Group and gave me a DLA claim pack.
My subsequent interviews have taken place by telephone at four month intervals.
It's all so random and as such not everyone gets the decision that they should, but we know this.
My subsequent interviews have taken place by telephone at four month intervals.
It's all so random and as such not everyone gets the decision that they should, but we know this.
Why? Is there a consequence beyond time-wasting interviews? Or is it just that you can't get to interviews?
Libertad
Sparking up a rollie in the Reichstag
I'm having chemo. and shouldn't really have to be dealing with this shit but as it turned out the person who initially interviewed me appeared to be of the same opinion. Quite brave of them to circumvent the decision made by the DWP "Decision Maker".
Right. So, for people who can get to the interviews, WRAG status is merely annoying and time-wasting?
Congratulations on finding a human who brought their heart to work
Jackobi
swallows anything
One of the major differences between the Work Related Activity Group and the Support Group is the WRAG's 365 day limit to contribution-based ESA, there is no such limit imposed on the support group. For single claimants it has little impact, but for couples it can reduce or cease entitlement to ESA completely, particularly where one partner works or also claims ESA.
geminisnake
a complex mass of conflicting ideas
It does but I'm not sure the wrag thing will work either. I won't remember to do stuff and the idea of getting sanctioned freaks me out, which leads to more stress, leading to even less memory. Vicious circle!!
I don't understand the contributions bit either. I haven't paid tax/contributions for over 10 yrs
equationgirl
Respect my existence or expect my resistance
You can appeal if it want to - I have to admit I couldn't see how putting you in the WRAG would help given your circumstances. You could ask for the appeal documents and see if you feel up to filling them in. You'll still get ESA whilst you appeal.It does but I'm not sure the wrag thing will work either. I won't remember to do stuff and the idea of getting sanctioned freaks me out, which leads to more stress, leading to even less memory. Vicious circle!!
I don't understand the contributions bit either. I haven't paid tax/contributions for over 10 yrs
geminisnake
a complex mass of conflicting ideas
I'm going to try and ignore it til Monday. Can't do anything atm anyway eh?
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