This article is part of a series on |
Alternative medicine |
---|
The Lightning Process (LP) is a three-day personal training programme developed and trademarked by British osteopath Phil Parker. [1] It makes unsubstantiated claims to be beneficial for various conditions, including ME/CFS, depression and chronic pain.
Developed in the late 1990s, it aims to teach techniques for managing the acute stress response that the body experiences under threat. The course aims to help recognise the stress response, calm it and manage it in the long term. It also applies some ideas drawn from neurolinguistic programming (a pseudoscience), as well as elements of life coaching.
The approach has raised some controversy due to using psychological techniques in an attempt to cure a physical illness. [2] The website was amended after the Advertising Standards Authority ruled that it was misleading. [3] In 2021, after a review of the available evidence, the National Institute for Health and Care Excellence advised against the use of Lighting Process among patients with chronic fatigue syndrome. [4]
The Lightning Process comprises three group sessions conducted on three consecutive days, lasting about 12 hours altogether, conducted by trained practitioners. [5] [6] [7]
According to its developer, Phil Parker, the programme aims to teach participants about the acute stress response the body experiences under threat. It aims to help trainees spot when this response is happening and learn how to calm it. Techniques based on movement, postural awareness and personal coaching are intended to modify the production of stress hormones. Participants practice a learnt series of steps to habituate the calming method. [6] [8]
The Lightning Process is based on the theory that the body can get stuck in a persistent stress response. The initial stressor may be a viral or bacterial infection, psychological stress, or trauma, which causes physical symptoms due to the body's stress response. These symptoms then act as a further stressor, resulting in overload of the central nervous system and chronic activation of the body's stress response. Neuroplasticity then causes this abnormal stress response to persist and be maintained. The Lightning Process suggests that while this disruption initially happens at an unconscious level, it is possible for the patient to exert conscious control and influence over the process, eventually breaking the cycle. [9]
The rationale for the programme draws on ideas of osteopaths Andrew Taylor Still and J M Littlejohn regarding nervous system dysregulation and addressing clients' needs in a holistic manner rather than focusing solely on symptoms. [10] It also incorporates ideas drawn from neuro-linguistic programming and life coaching. [11] A basic premise is that individuals can influence their own physiological responses in controlled and repeatable ways. [12] Such learnt emotional self-regulation, it is suggested, could help overcome illness and improve well-being, if the method is practised consistently. [12]
Parker advocates attending the training course in order to gain a full understanding of the tools in a safe and supportive context. [13] He also lays emphasis on the trainee playing an active role in recovery (the course is framed as a fully participatory 'training', not a passive 'treatment' or set of answers given to a 'patient'). [14] [15] He claims that the programme has helped to resolve various conditions including depression, panic attacks, insomnia, drug addictions, chronic pain and multiple sclerosis. [16] The program has also been used with Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). [17] [8]
The Lightning Process is trademarked. [5]
There has been criticism of the cost of the three-day course. [18] [19] There has also been criticism of the claimed benefits (see also below). [2] [19] John Greensmith, of the British advocacy group ME Free For All, stated "We think their claims are extravagant... if patients get better, they claim the success of the treatment – but if they don't, they say the patient is responsible." [2] In 2022 the World ME Alliance issued the statement "The World ME Alliance and its members do not endorse the Lightning Process for people with Myalgic Encephalomyelitis (ME), sometimes called Chronic Fatigue Syndrome (CFS)." [20]
In a BBC "File on Four" episode, Rachel Schraer commented on a Lightning Process course she attended. She commented: "Not only did my coach say my thoughts were maintaining my symptoms, she also told me quite explicitly that there was nothing physical wrong with my body, that’s despite having no apparent medical qualification or requesting access to any test results." The practitioners statement is at odds with usual lightning process practice. [21] Neuroscientist Camilla Nord a specialist in neuroscience and mental health comments on the instructions given to participants to use positive reinforcing language, saying “I’m afraid now we’ve strayed very, very far from neuroscience. What I would call neuro-bollocks. It’s a kind of abusive of neuro-scientific terms in order to give quite simple psychological techniques a kind of sheen of science about them.” [22]
Some ME/CFS patient support groups have strongly objected to the perceived implication that the disease has psychological causes. [2] However, the Lightning Process website states that it is a neuro-physiological approach and that it considers ME/CFS to be a physical illness. [23]
Nigel Hawkes writing for The BMJ describes the Lightning Process as being "secretive about its methods, lacks overall medical supervision, and has a cultish quality because many of the therapists are former sufferers who deliver the programme with great conviction" and that "Some children who do not benefit have said that they feel blamed for the failure". [24]
In 2011 Hampshire Trading Standards requested that the UK Advertising Standards Authority (ASA) give a ruling on the website www.lightningprocess.com, arguing that the information on the site was misleading in four areas. [25] ASA upheld two of the four challenges. [3] They concluded that although there seemed to be some evidence of participant improvement during trials conducted, the trials were not controlled, the evidence was not sufficient to draw robust conclusions, and more investigation was necessary; consequently, the website's claims at the time were deemed misleading and was amended. [3]
The National Institute for Health and Care Excellence (NICE) states that "[d]o not offer the Lightning Process, or therapies based on it, to people with ME/CFS" in their guideline for the management of ME/CFS published in 2021. [4]
The ME Association is a UK health charitable organization that provides information, advocacy, and services to persons and families affected by ME/CFS, and raises funds for research into ME/CFS. It has been reported to be one of the two largest UK charities for ME/CFS.
Malcolm Hooper is a British pharmacist and emeritus professor of medicinal chemistry at the University of Sunderland. He is best known for his advocacy related to Gulf War syndrome.
Rintatolimod, sold under the tradename Ampligen, is a medication intended for treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). There is some evidence it may improve some ME/CFS symptoms.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has a long history with an evolution in medical understanding, diagnoses and social perceptions.
Management of ME/CFS focuses on symptoms management, as no treatments that address the root cause of the illness are available. Pacing, or regulating one's activities to avoid triggering worse symptoms, is the most common management strategy for post-exertional malaise. Clinical management varies widely, with many patients receiving combinations of therapies.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is an illness with a history of controversy. Although it is classified as an organic disease by a majority of researchers, it was historically assumed to be psychosocial, an opinion still held among many physicians. The pathophysiology of ME/CFS remains unclear, there exist many competing diagnostic criteria, and some proposed treatments are controversial. There is a lack of education and accurate information about the condition among a significant number of medical practitioners, which has led to substantiated accusations of patient neglect and harm.
Clinical descriptions of ME/CFS vary. Different groups have produced sets of diagnostic criteria that share many similarities. The biggest differences between criteria are whether post-exertional malaise (PEM) is required, and the number of symptoms needed.
Graded exercise therapy (GET) is a programme of physical activity that starts very slowly and gradually increases over time, intended as a treatment for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Most public health bodies, including the CDC and NICE, consider it ineffective, and its safety is disputed. However, GET still enjoys support among a minority of clinicians and organizations.
Daniel Peterson is an American physician in private practice in the state of Nevada, and has been described as a "pioneer" in the treatment of Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). He graduated from the University of Rochester School of Medicine, Rochester, New York, in 1976 and was an intern and resident at the University of Utah Medical Center from 1976 to 1979. In 1979, he became a diplomate of the American Board of Internal Medicine. He is president of Sierra Internal Medicine of Incline Village, established in 1981.
The Chronic Fatigue Syndrome Advisory Committee (CFSAC) was formed in response to the use of funds by the United States Centers for Disease Control and Prevention in the study of chronic fatigue syndrome (CFS). The CFSAC was charted under the Public Health Service Act of the US and funded by the United States Department of Health and Human Services (HHS). The CFSAC advises the Secretary of Health and Human Services on issues related to its mandate, including issues related to access and care for individuals with CFS, research, public health, clinical care and education regarding CFS. In November, 2008, support for CFSAC activities was changed to the Office on Women's Health, a division of the Office of Public Health and Science. It held it first meeting in 2003.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling chronic illness. People with ME/CFS experience profound fatigue that does not go away with rest, sleep issues, and problems with memory or concentration. Further common symptoms include dizziness, nausea and pain. The hallmark symptom is a worsening of the illness which starts hours to days after minor physical or mental activity. This "crash" can last from hours or days to several months.
Functional somatic syndrome (FSS) is any of a group of chronic diagnoses with no identifiable organic cause. This term was coined by Hemanth Samkumar. It encompasses disorders such as fibromyalgia, chronic widespread pain, temporomandibular disorder, irritable bowel syndrome, lower back pain, tension headache, atypical face pain, non-cardiac chest pain, insomnia, palpitation, dyspepsia and dizziness. General overlap exists between this term, somatization and somatoform. The status of ME/CFS as a functional somatic syndrome is contested. Although the aetiology remains unclear, there are consistent findings of biological abnormalities, and major health bodies such as the NAM, WHO, and NIH, classify it as an organic disease.
Rosamund Vallings is a medical doctor, known as one of the leading authorities on Chronic Fatigue Syndrome (ME/CFS) in New Zealand.
Post-exertional malaise (PEM), sometimes referred to as post-exertional symptom exacerbation (PESE) or post-exertional neuroimmune exhaustion (PENE), is a worsening of symptoms that occurs after minimal exertion. It is the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and common in long COVID and fibromyalgia. PEM is often severe enough to be disabling, and is triggered by ordinary activities that healthy people tolerate. Typically, it begins 12–48 hours after the activity that triggers it, and lasts for days, but this is highly variable and may persist much longer. Management of PEM is symptom-based, and patients are recommended to pace their activities to avoid triggering PEM.
Idiopathic chronic fatigue (ICF) or chronic idiopathic fatigue or insufficient/idiopathic fatigue is a term used for cases of unexplained fatigue that have lasted at least six consecutive months and which do not meet the criteria for myalgic encephalomyelitis/chronic fatigue syndrome. Such fatigue is widely understood to have a profound effect on the lives of patients who experience it.
DecodeME is an ongoing genome-wide association study searching for genetic risk factors for ME/CFS. With a planned recruitment of 25,000 patients, it is expected to be the largest such study to date. Recruitment closed on 15 November 2023 and results are expected in 2025.
The Open Medicine Foundation (OMF) is a US-based charity that funds research into the illnesses myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia, post-treatment Lyme disease syndrome, and long COVID.
Andrew Melvin Ramsay (1901–1990) was a British physician, who is known for his research and advocacy on myalgic encephalomyelitis (ME), a chronic disease causing muscle weakness and cognitive dysfunction. Ramsay worked as a consultant at the Royal Free Hospital in London during a mysterious 1955 disease outbreak of what later became known as ME. He studied the disease and similar outbreaks elsewhere. Work by Ramsay showed that although ME seldom caused death, the disease could be highly disabling.
Carmen Scheibenbogen is a German immunologist who is the acting director of the Institute for Medical Immunology of the Charité university hospital in Berlin. She specialises in hematology, oncology and immunology. She leads the Outpatient Clinic for Immunodeficiency and the Fatigue Centre at the Charité hospital. She is one of the few doctors specialised in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in Germany, and also researches long COVID.
The PACE trial was a large and controversial trial which compared the effects of cognitive behavioural therapy (CBT), graded exercise therapy (GET), adaptive pacing therapy, and specialist medical care for people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).
The pilot study conducted with the International Centre For Wellness Research reported positive results from a sample of 17 participants. However, we understood that the study was not controlled and had concluded that further investigation was necessary... We noted that the trials conducted by the ME Association, the Brighton and Sussex Medical School and the Sussex & Kent CFS/ME Society reported positive results but were self-assessment studies and had not been controlled. We considered that those studies and surveys did not constitute a suitably robust body of evidence to demonstrate the effectiveness of the LP in the treatment of CFS/ME. Because of that, we concluded that the CFS/ME page of the website was likely to mislead... The claims on the website should not appear again in their current form. We told Phil Parker Group to ensure they did not make medical claims for the LP unless they were supported with robust evidence.