Exploring the relationship between service-users' with CFS/ME and NHS professionals
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (hereafter referred to as CFS/ME) is a multi-system chronic illness, sufferers of which experience a range of symptoms that are often different in each individual case. The sole commonality amongst all sufferers appears to be severe and disabling fatigue (Sharpe et al. 1991). Despite the body of literature that has investigated the possible aetiology of CFS/ME, to date there is no known cause of the long-term condition (Erdman, 2003). Current systematic reviews of randomized control trials (RCTs) investigating the efficacy of treatment of CFS/ME identify cognitive-behavioural therapy (CBT) and graded exercise therapy (GET) as the most effective evidence-based interventions (Erdman, 2003; Bagnall et al. 2002). There are, however, inconsistencies and disagreement in the evidence-base, adding a further layer of uncertainty to an already uncertain long-term condition. A service-user dissatisfaction with NHS services and professionals are frequently reported in the CFS/ME literature, the current literature review explores whether attachment theory could offer a different and useful perspective regarding the treatment of people with CFS/ME. An attachment relationship can be defined as any relationship where proximity to the other affects perceived security (West & Sheldon-Kellor, 1994). Proximity seeking is most apparent when a person is frightened, fatigued or sick, and gains some relief by receiving comfort and care-giving (Bowlby, 1979). In view of reconsidering CFS/ME from an attachment theory perspective the latter of the literature review explores the current research regarding attachment theory and illness, and the available research linking adult attachment needs and engagement with Health Services. The relevance of using attachment theory to inform the treatment of people with CFS/ME is then discussed.