I missed writing something for 12th May, international ME awareness day this week but I read a lot of really good posts on people’s blogs that commemorate those lost and missing because of this disease.
I wondered what I wanted to write for ME Awareness Day. The thought: “write about what you know,” kept running around my mind.
So here’s my post.
Milgram experiment, PACE trial, the NHS and compliance and obedience in large organisations
Some time ago I wrote a post about the PACE trial and what it says about the NHS when people such as Tom Kindlon do the critical analysis better than they did.
There’s a bigger question though. That is why a group of people would comply with a treatment regimen that even their own patients report is a blunt, harmful instrument in the treatment of CFSME.
Is it because the NHS is paying their wages they go along with it or comply?
Is it because that’s all we’ve got…..?
It must be for some reason, because it’s bleedin’ obvious that the combination of GET and CBT in the NICE Guidelines for CFSME works for a few people sometimes but fails many, many, many more….
Well, Psychiatrists like Simon Wessely know of a very famous experiment carried out into human compliance and obedience.
It is known as The Milgram Experiment
Milgram was interested in World War 2 and specifically why it was that people complied with the torture and death of the Jews.
“Is it a human, hard wired biologically determined thing that people comply with authority, putting their own feelings to one side?” he asked himself.
He decided he’d set up an experiment to test his theory.
The experiment took place in a room divided down the middle with a screen.
In a nutshell he asked people to sit on either side of the screen. One would administer electric shocks to the person on the other side of the screen if they got the answer to a question wrong – torture in other words.
As time and the numbers of inaccurate questions increased, so did the voltage.
Except there was no voltage – it was all a sham. The people in the experiment administering the shocks didn’t know that though.
If they heard shouts and screams from the other side and asked the person in charge if they should carry on and were told they had to, they did.
The room was resounding with shouts and cries from the actors on the other side of the screen but no matter how bad it got, because the majority of experimenters were told to – they carried on increasing the voltage of shocks even into life threatening levels.
They didn’t know it was a false situation. They thought it was real.
The Milgram Experiment rocked the world
The experiment shocked those reading the results. It was repeated in many different ways over many different years until Psychologists threw down their hats and said:
“OK, we’ve got it, human beings are compliant to other human beings in authority. Tell them whose in charge and they’ll pretty much to any terrible thing when being obedient.”
The Milgram Experiment unlocked a particularly fascinating area of human psychology and social psychology.
Now that’s Social Psychology. Social psychology also informs Organisational Psychology – i.e. what people in organisations do, how they behave, how workplaces create positive or negative environments for performance, etc.
Organisational psychology is a big branch of psychology too.
NHS is a BIG organisation
The NHS is a HUGE organisation. It is VAST and built into it are tiers and a hierarchy, bosses and staff members, those in charge and those receiving ‘orders.’
This works in very unique and specific ways in clinical settings where people are qualified to carry out particular types of work and their chain-of-command states who is ultimately clinically responsible for those decisions too.
There are also large research organisations and charities like Cancer Research UK , ME Association and ActionForME. They are not NHS organisations but they are informed by it and in the case of conducting research, may influence it.
Where does NHS research happen?
Well that’s a good question and very relevant to the PACE Trial. It seems the PACE trial was funded to the tune of 8 million by the government ( I think that means the NHS research budget.)
Part of that funding contract went to Queen Mary University Of London – it’s in the East End – to do the number crunching required to produce the results.
It was carried out at Kings College Hospital and Oxford University.
Blimey, that’s a lot of organisational power there in that paragraph. Stacks of public money, a major London hospital of world renown, two major Universities and the government too.
I’m quaking in my boots at the thought of standing up to that monolithic collection of organisations, aren’t you?
Milgram has a place in considering PACE
In thinking about why it is that the official, organisational narrative about the PACE trial from within the NHS and NHS partners is against criticism and pro support, I think you need to consider what Milgram’s experiment has taught us.
It has taught us that no matter what, if we are in a situation where power and influence is exerted upon us, the chances are we will comply with what we are told to do even if it leads to harm.
Clinicians shouldn’t comply
No, clinicians shouldn’t comply if it is going to cause harm.
However if those very same clinicians are brainwashed by a hugely influential piece of organisationally initiated and ratifed research – In Milgram’s experiment that would be the person in charge – into thinking that perceived harm – again that would be the shouts and screams- is infact result of maladaptive thinking in a patient, then there’s nothing stopping them, is there….
Copyright Lindy 2016.