Lightning Process: Difference between revisions

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The '''Lightning Process''' is a psychological intervention created by [[Phil Parker]] that has been promoted to [[myalgic encephalomyelitis]] and [[chronic fatigue syndrome]] patients as a cure. It gets its name because it is supposed to cure in three days.<ref>[http://www.cbc.ca/sitemap/ Controversial training program comes to Canada - CBC April 2008]</ref>
The '''Lightning Process''' is a psychological intervention created by [[Phil Parker]] that has been promoted to [[myalgic encephalomyelitis]] and [[chronic fatigue syndrome]] patients as a cure. It gets its name because it is supposed to cure in three days.<ref name="CDC-lp">{{Cite news | url=https://www.cbc.ca/news2/background/health/lightning-process.html | title = Lightning Process: Controversial training programme comes to Canada | last = Cormier | first = Zoe | date = Apr 18, 2008|work=CBC news|access-date=Apr 20, 2019|archive-url=|archive-date=|url-status=|publisher=|quote=}}</ref>


==Overview==
==Overview==


The Lightning Process claims to be a combination of [[neurolinguistic programming]] (NLP) and [[osteopathy]]. The content of the process is copyrighted but according to patient reports involves affirmations and counteracting negative thoughts:<ref>[http://hubpages.com/health/The-Lightning-Process-Didnt-Work-For-me The Lightning Process Didn't Work For me]</ref>
The Lightning Process claims to be a combination of [[neurolinguistic programming]] (NLP), [[positive psychology]] and [[osteopathy]].<ref name="Anderson2021" /><ref name="Chellamuthu2022" /> The content of the process is copyrighted but according to patient reports involves affirmations and counteracting negative thoughts:<ref name="hubpages">{{Cite web|url=https://hubpages.com/health/The-Lightning-Process-Didnt-Work-For-me | title = The Lightning Process Didn't Work for Me | website = HubPages|language=en|access-date=2019-04-20}}</ref><ref name="Anderson2021" />


<blockquote>"You ask yourself if you want to choose happiness. Which you obviously do and then you say how fantastic you are to have stopped the negativity thought. You ask yourself what you really want, then you answer yourself, and again ask yourself how you are going to get there. The answer of course is to keep doing the process, getting rid of those negative thoughts. Then you tell yourself how great you are again and maybe have a bit of a hug with yourself, then…….. no nothing, that’s it."</blockquote>
<blockquote>"You ask yourself if you want to choose happiness. Which you obviously do and then you say how fantastic you are to have stopped the negativity thought. You ask yourself what you really want, then you answer yourself, and again ask yourself how you are going to get there. The answer of course is to keep doing the process, getting rid of those negative thoughts. Then you tell yourself how great you are again and maybe have a bit of a hug with yourself, then... no nothing, that's it."<ref name="hubpages" /></blockquote>


The cost is between £695 and £1,997 for a three day course with additional sessions up to £250 an hour. (September 2016 rates) <ref>[http://lightningprocess.co.uk/lightning-process/what-next/ Cost of Lightning Process courses & sessions-Lightning Process website]</ref>
The cost is between £695 and £1,997 for a three day course with additional sessions up to £250 an hour. (September 2016 rates)<ref>{{Cite web|url=https://lightningprocess.co.uk/prices-and-taking-the-seminar/ | title = Prices and taking the seminar | last = Parker | first = Phil|website=The Lightning Process (LP)|language=en-GB|access-date=2021-11-20}}</ref>
 
The Lightning Process is based on the view that [[chronic fatigue syndrome]] is a "stress response" which leaves the person's body constantly on alert. It includes some [[cognitive behavioral therapy]], a form of psychotherapy.<ref name="Landmark2001" />


==Evidence==
==Evidence==


The Lightning Process has not been tested with any randomized, controlled trials.
The Lightning Process is not based on any theory derived by studying patients with ME/CFS, fibromyalgia or any particular illness or disease. LP practioners do not normally have either medical or mental health qualifications or training, they act as life coaches/trainers.
 
The Lightning Process has not been tested with any randomized, controlled trials.ref name="Toussaint2012"/> Evidence of benefits largely comes from personal testimonials, which often mention medical diagnoses that have not been confirmed from medical records, and it is not possible to know if patients later relapsed.
 
Before being accepted on a training course patients are expected to do preparatory work ''and'' to be psychologically "ready to engage" which appears to involve an assessment during a pre-course telephone call which includes already having the belief that change is possibly using the LP, and the belief in their own capability to recover/resolve their own issues.<ref name="Anderson2021" /> These conditions are likely to bias any outcomes when compared with controls or people undertaking a treatment which is open to everyone.
 
==Harms, risks and side effects==
Harms, risks and side effects are not documented in scientific literature, with the exception of Anderson et al. (2021),  who reported "no serious adverse effects" in the controversial [[SMILE trial]] in children.<ref name="Anderson2021" /> The LP states it is a training course, not a treatment.  


==Anecdotal evidence==
===Anecdotal evidence of patient harm===
According to a national survey by the Norwegian ME association [[ME Foreningen]] in (2012), Lightning Process was found to be  one of the treatments that has done the most harm to patients. The Lightning Process resulted in 50% of the [[myalgic encephalomyelitis|ME]] patients reporting that LP had made their condition worse, 25% seriously worse. 30% reported that LP had no effect on symptoms.<ref>{{Cite web|url = http://www.me-foreningen.info/wp-content/uploads/2016/09/ME-Nat-Norwegian-Survey-Abr-Eng-Ver.pdf | title =Norwegian ME Association National Survey Abridged|version=English | date = May 12, 2014 | last = ME Foreningen  | authorlink = ME Foreningen |language=en}}</ref>


According to a national survey by the Norwegian ME Association (2012), Lightning Process is one of the treatments that has done the most harm to patients. 50% of the participants reported that LP had made their condition worse, 25% seriously worse. 30% reported that LP had no effect on symptoms.<ref>[http://www.me-foreningen.info/wp-content/uploads/2016/09/ME-Nat-Norwegian-Survey-Abr-Eng-Ver.pdf]</ref>
===Attempted suicides===
 
In 2011, a 13 year-old Norwegian boy with ME attempted suicide after he failed to improve with the Lightning Process.<ref name="suicide">{{Cite web|url=https://www.nrk.no/livsstil/forsokte-selvmord-etter-me-kurs-1.7891470 | title = Forsøkte selvmord etter ME-kurs | last = Sand | first = Camilla | date = 2011-11-26 | website = NRK|language=nb-NO|access-date=2019-04-20}}</ref>
 
In 2020, a Twitter user came forward with her story of 10 years of intense [[depression]] and [[suicide]] attempts as a result of being [[Medical gaslighting|gaslit]] by the Lightning Process as a child.<ref name="scam">{{Cite web|url=https://www.podbean.com/media/share/pb-wk5yw-fcbbf1 | title = Alice Urbino: scam 'lightning process' causes internalized gaslighting - beware of charlatans | last = | first = | website = Podbean Development|language=en|access-date=2021-05-19}}</ref>


==Studies with ME/CFS==
==Studies with ME/CFS==
====King's College London Study ====
A small non-randomised qualitative study took place at King's College London, reporting in 2012. The study was conducted by [[Trudie Chalder]] and Nicola Archer with Silje Endresen Reme of Harvard University. Nine Participants aged 14 to 26 were recruited through advertisements. They were interviewed after undergoing the process along with three of their parents.<ref name="Reme2012" />
Seven participants reported being satisfied with two as dissatisfied. The intensity and poor follow-up were criticised by participants along with the secrecy surrounding it and feelings of guilt and blame if the treatment did not work.
==== [[SMILE trial]] ====
The Smile study protocol<ref name="SMILE">[http://trialsjournal.biomedcentral.com/articles/10.1186/1745-6215-14-444 SMILE Study protocol]</ref>
==Criticisms==
{{Video
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|service  = youtube
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John Greensmith criticised the Lightning Process programme as a costly pyramid scheme noting that people who train in the process frequently go on to become practitioners themselves.<ref name="CDC-lp" />
Psychologist [[James Coyne]] has described the Lightning Process as "quackery backed by pseudoscientific theory".<ref>[https://twitter.com/CoyneoftheRealm/status/703327405944008704 Twitter: James Coyne on the Lightning Process]</ref>


===King's College London Study ===
Some patients critique the Lightning Process for its high cost, lack of evidence, and the pressure placed on participants if they do not improve.<ref name="hubpages" />
A small non-randomised qualitative study took place at King's College London, reporting in 2012. The study was conducted by [[Trudie Chalder]] and Nicola Archer with Silje Endresen Reme of Harvard University. Nine Participants aged 14 to 26 were recruited through advertisements. They were interviewed after undergoing the process along with three of their parents.<ref>[http://onlinelibrary.wiley.com/doi/10.1111/j.2044-8287.2012.02093.x/abstract Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study by Reme, Archer & Chalder]</ref>.


Seven participants reported being satisfied with two as dissatisfied. The intensity and poor follow up were criticised by participants along with the secrecy surrounding it and feelings of guilt and blame if the treatment did not work.
===SMILE trial===


=== SMILE Study ===
In a joint statement in August 2010, the [[ME Association]] and [[the Young ME Sufferers Trust]] called the [[SMILE trial]] "unethical" saying, "The ME Association and The Young ME Sufferers Trust do not believe that it is ethically right to use children in trialling an unproven and controversial process such as the Lightning Process."<ref name="unethical">{{Cite web|url = http://www.meassociation.org.uk/study-involving-children-and-the-lightning-process-is-unethical-says-joint-charity-statement/| title = Statement of ME Association and Young Sufferers Trust on SMILE | date = Aug 2010 | website = ME Association}}</ref>
The Smile study protocol<ref>[http://trialsjournal.biomedcentral.com/articles/10.1186/1745-6215-14-444 SMILE Study protocol]</ref>


==Criticisms==
[[Invest in ME Research]], in a letter to the UK's National Research Ethics Committee (NRES), described the process as "rather like [[CBT]] but with bullying and risks of harm."<ref name="IiMER">{{Cite web|url = http://www.investinme.org/Article-501%20Childrens%20Study.htm| title = Letter to National Research Ethics Committee | last = Invest in ME Research  | authorlink = Invest in ME Research | date =Oct 2010|access-date=|website=|first = |archive-url=|archive-date=|url-status=}}</ref>
 
Professor Robin Gill, a member of the [[British Medical Association]] medical ethics committee, wrote to the Church Times about the LP and the SMILE trial. He expressed concern about the issue of coercion of children in the trial.<ref name="Gill">{{Cite web|url = https://meagenda.wordpress.com/2010/10/14/children-should-not-be-used-as-guinea-pigs-prof-robin-gill-church-times-lp-pilot-study/ | title = Children should not be used as Guinea Pigs | last = Church Times | date = Oct 8, 2010}}</ref>


John Greensmith criticised the programme as a costly pyramid scheme noting that people who train in the process frequently go on to become practitioners themselves.<existing CBC citation>
'''[[The BMJ]] Archives of Disease in Childhood,'''


Psychologist [[James Coyne]] has described the Lightning Process as "quackery backed by pseudoscientific theory".<ref>[https://twitter.com/CoyneoftheRealm/status/703327405944008704 Twitter: James Coyne on the Lightning Process]</ref>
Dr. Nick Brown, Editor-in-Chief Archives of Disease in Childhood, published by the BMJ, added an Editor's Note to the trial article 'Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial'.


Some patients critique the Lightning Process for its high cost, lack of evidence, and the pressure placed on participants if they do not improve.<ref>[http://hubpages.com/health/The-Lightning-Process-Didnt-Work-For-me The Lightning Process Didn't Work For me]</ref>
:Editor's note


'''SMILE Trial'''
:This study was published online in Archives of Disease in Childhood after peer review in September 2017. The trial tested the effectiveness of a neurolinguistic programming intervention (used widely but never formally tested) in children and young people with chronic fatigue recruited between 2010 and 2013. Though the number of participants was small, analysis suggested a benefit in terms of physical function (measured by the standard SF 36 scale) at both 6 and 12 months after intervention.


In a joint statement in August 2010, the [[ME Association]] and [[the Young ME Sufferers Trust]] called the SMILE study "unethical" saying, "The ME Association and The Young ME Sufferers Trust do not believe that it is ethically right to use children in trialling an unproven and controversial process such as the Lightning Process."<ref>[http://www.meassociation.org.uk/study-involving-children-and-the-lightning-process-is-unethical-says-joint-charity-statement/ Statement of ME Association and Young Sufferers Trust on SMILE (August 2010)]</ref>
:Since publication, the study has been criticised for failing to meet ICMJE and BMJ policy on trial registration and for not fully adhering to CONSORT guidance on trial reporting. The journal has been criticised for not detecting these issues during editorial and peer review. We have acknowledged these comments and reviewed our processes in relation to this paper and relating to EQUATOR guidance in general. In addition, we have received clarifications from the authors which are under editorial consideration.<ref name="ADC" />


[[Invest in ME]] in a letter to the National Research Ethics Committee (NRES) described the process as "rather like [[CBT]] but with bullying and risks of harm."<ref>[http://www.investinme.org/Article-501%20Childrens%20Study.htm Letter to National Research Ethics Committee - Invest in ME]</ref>
'''[[Trial By Error]] by [[David Tuller]], DrPH via [[Virology blog]]'''


Professor Robin Gill, a member of the BMA medical ethics committee, wrote to the Church Times about the LP and the SMILE trial. He expressed concern about the issue of coercion of children in the trial.<ref>[https://meagenda.wordpress.com/2010/10/14/children-should-not-be-used-as-guinea-pigs-prof-robin-gill-church-times-lp-pilot-study/ Children should not be used as Guinea Pigs - Church Times 8 October 2010]</ref>
*Dec 13, 2017, [http://www.virology.ws/2017/12/13/trial-by-error-the-smile-trials-undisclosed-outcomes/ The SMILE Trial's Undisclosed Outcome-Swapping]
*Jan 17, 2018, [http://www.virology.ws/2018/01/17/trial-by-error-professor-crawleys-bogus-buzzfeed-claims/ Professor Crawley’s Bogus BuzzFeed Claims]
*Jan 30, 2018, [http://www.virology.ws/2018/01/30/trial-by-error-a-letter-to-archives-of-disease-in-childhood/ A Letter to Archives of Disease in Childhood]
*Feb 19, 2018, [http://www.virology.ws/2018/02/19/trial-by-error-a-letter-to-bmj-open/ A Letter to BMJ Open]
*March 7, 2018, [http://www.virology.ws/2018/03/07/trial-by-error-my-exchange-with-archives-of-disease-in-childhood/ My Exchange With Archives of Disease in Childhood]
*May 28, 2018, [http://www.virology.ws/2018/05/28/trial-by-error-nices-consideration-of-the-lightning-process/ NICE’s Consideration of the Lightning Process]
*Jun 4, 2018,[http://www.virology.ws/2018/06/04/trial-by-error-bmj-still-looking-into-lightning-process-paper/ BMJ Still “Looking Into” Lightning Process Paper]
*Jun 11, 1018, [http://www.virology.ws/2018/06/11/trial-by-error-more-letters-about-bmjs-flawed-pediatric-studies/ More Letters About BMJ's Flawed Pediatric Studies]
*Jul 11, 2018, [http://www.virology.ws/2018/07/11/trial-by-error-waiting-for-godlee/ Waiting for Godlee]
*Jul 11, 2018, [http://www.virology.ws/2018/07/11/trial-by-error-my-letter-to-the-science-and-technology-committee/ Trial By Error: My Letter to Parliament’s Science and Technology Committee]
*Aug 21, 2019, Trial By Error: [https://www.virology.ws/2019/08/21/trial-by-error-joan-mcparlands-lightning-process-experience/ Joan Parland's Lightning Process Experience]


==Controversy==
==Controversy==


===Advertising Standards Authority (ASA) ruling===
===British Advertising Standards Authority (ASA) ruling===
In 2012 the British Advertising Standards Authority ruled against an claims on the Lightning Process (LP) website.<ref>[https://www.asa.org.uk/Rulings/Adjudications/2012/8/Phil-Parker-Group-Ltd/SHP_ADJ_158035.aspx#.Vro3WduLRD9 ASA Ruling on Phil Parker Group Ltd]</ref>
In 2012 the British [[Advertising Standards Authority]] ruled against claims on the Lightning Process (LP) website.<ref name="ad-ASA2018">{{Cite web | last = Advertising Standards Authority {{!}} Committee of Advertising Practice | authorlink = Advertising Standards Authority|first = |website=Advertising Standards Authority | date = August 2012|access-date=2022-06-05|url=https://www.asa.org.uk/Rulings/Adjudications/2012/8/Phil-Parker-Group-Ltd/SHP_ADJ_158035.aspx#.Vro3WduLRD9 | title = ASA Ruling on Phil Parker Group Ltd}}</ref>


The ASA upheld a complaint from Hampshire County Council trading standards made about false claims about the use and effectiveness of LP on ME/CFS.  The claims were that "Our survey found that 81.3%* of clients report that they no longer have the issues they came with by day three of the LP course", which the complainant stated "misleadingly implied that the Lightning Process could treat or cure CFS/ME."
The ASA upheld a complaint from Hampshire County Council trading standards made about false claims about the use and effectiveness of LP on ME/CFS.  The claims were that "Our survey found that 81.3%* of clients report that they no longer have the issues they came with by day three of the LP course", which the complainant stated "misleadingly implied that the Lightning Process could treat or cure CFS/ME."
Line 54: Line 96:
The ASA ruled that Phil Parker Ltd should not make medical claims for the LP unless they were supported with robust evidence and the company was not to refer to conditions for which advice should be sought from suitably qualified health professionals.
The ASA ruled that Phil Parker Ltd should not make medical claims for the LP unless they were supported with robust evidence and the company was not to refer to conditions for which advice should be sought from suitably qualified health professionals.


===Attempted suicide===
===The Nordic Consumer Ombudsman===
The 2017 Agenda for the Nordic Consumer Ombudsman ruled that it is illegal to claim that any alternative medicine treatment is effective against specific illnesses and conditions. This ruling forbids the Lightening Process (LP) owners to market Lightening Process (LP) as a treatment for ME/CFS.<ref name="NCO">https://forbrukerombudet.no/english/agenda-2017</ref>


In 2011, a 13 year-old Norwegian boy with ME attempted suicide after he failed to improve with the Lightning Process.<ref>[http://www.nrk.no/livsstil/forsokte-selvmord-etter-me-kurs-1.7891470 13-year-old attempted suicide after ME courses] </ref>
==Videos ==
*[https://www.youtube.com/watch?v=xUwU-e79hPk The Lightning Process Trial: A Saga of Very Bad Research--and Even Worse Editorial Decisions] - [[David Tuller]]


==Learn more==
== Articles and blogs ==
*[http://skepdic.com/lightningprocess.html Skepdic overview of Lightning Process]
*2021, [https://thesciencebit.net/2021/10/31/self-styled-medical-leaders-defend-neurolinguistic-processing-as-legit-treatment-for-me-cfs/ Self-styled medical leaders defend “neurolinguistic processing” as legit treatment for ME/CFS] - Brian Hughes
*[https://en.wikipedia.org/wiki/The_Lightning_Process Wikipedia - Lightning Process]
*2020, [https://www.virology.ws/2020/01/22/trial-by-error-my-talk-last-october-at-oxford-video/ Trial By Error: My Talk Last October in Oxford (Video)]
*2019, [https://www.virology.ws/2019/08/21/trial-by-error-joan-mcparlands-lightning-process-experience/ Joan Parland's Lightning Process experience]
*2018, [https://www.buzzfeed.com/tomchivers/inside-the-controversial-therapy-for-chronic-fatigue A Controversial Therapy For ME Has Led To Claims Of Death Threats, Harassment, And Pseudoscience - Buzzfeed]
*2015, [http://forums.phoenixrising.me/index.php?threads/a-balanced-view-of-the-lightning-process.35835/ Patient's account of Lightning Process - Phoenix Rising]
*2015, [http://forums.phoenixrising.me/index.php?threads/a-balanced-view-of-the-lightning-process.35835/ Patient's account of Lightning Process - Phoenix Rising]
*2014, [http://www.healthrising.org/blog/2014/01/16/big-lightning-process-trial-underway-think/ Cort Johnson on the Lightning Process SMILE Study - Health Rising]
*2014, [http://www.healthrising.org/blog/2014/01/16/big-lightning-process-trial-underway-think/ Cort Johnson on the Lightning Process SMILE Study - Health Rising]
==Notable studies and peer-reviewed articles==
===by independent scientists ===
*2021, Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study<ref name="CRF2021">{{Cite journal | title = Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study | date = Jan 2021|url=https://www.mdpi.com/2072-6694/13/16/4076/htm|journal=Cancers|volume=13|issue=16 | pages = 4076 | last = Fauske | first = Lena | authorlink = | last2 = Bruland | first2 = Øyvind S. | authorlink2 = | last3 = Dahl | first3 = Alv A. | authorlink3 = | last4 = Myklebostad | first4 = Aase | authorlink4 = | last5 = Reme | first5 = Silje E. | authorlink5 = | last6 = | first6 =  | authorlink6 = | last9 = | first9 = |language=en|doi=10.3390/cancers13164076|pmc=|pmid=|access-date=|issn=2072-6694|quote=|via=}}</ref> - [https://www.mdpi.com/2072-6694/13/16/4076/htm (Full text)]
*2020, Patients' experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome–a scoping mixed methods review<ref name="Mengshoel2020">{{Cite journal | title = Patients’ experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome – a scoping mixed methods review | date = 2020-01-01|url=https://www.tandfonline.com/doi/full/10.1080/17482631.2020.1764830|journal=International Journal of Qualitative Studies on Health and Well-being|volume=15|issue=1|pages=1764830 | last = Mengshoel|first = Anne Marit | authorlink = | last2 = Helland | first2 = Ingrid Bergliot | authorlink2 = | last3 = Meeus | first3 = Mira | authorlink3 = Mira Meeus | last4 = Castro-Marrero | first4 = Jesús  | authorlink4 = Jesús Castro-Marrero | last5 = Pheby | first5 = Derek  | authorlink5 = Derek Pheby | last6 = Bolle Strand | first6 = Elin | authorlink6 = Elin Strand | last9 = | first9 = |language=en|doi=10.1080/17482631.2020.1764830|pmc=PMC7782327|pmid=32432991|access-date=|issn=1748-2631|quote=|via=}}</ref> - [https://www.tandfonline.com/doi/pdf/10.1080/17482631.2020.1764830 (Full text)]
*2018, Editor's Note by Dr. Nick Brown: Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial - Archives of Disease in Childhood BMJ<ref name="ADC">{{Cite journal | title = Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial | date = 2018-02-01|url=https://adc.bmj.com/content/103/2/155|journal=Archives of Disease in Childhood|volume=103|issue=2|pages=155–164 | last = Crawley|first = Esther M. | author-link = Esther Crawley | last2 = Gaunt | first2 = Daisy M. | authorlink2 = Daisy Gaunt | last3 = Garfield | first3 = Kirsty  | authorlink3 = | last4 = Hollingworth | first4 = William | authorlink4 = | last5 = Sterne | first5 = Jonathan A.C. | authorlink5 = | last6 = Beasant | first6 = Lucy  | authorlink6 = Lucy Beasant | last7 = Collin | first7 = Simon M. | authorlink7 = Simon Collin | last8 = Mills | first8 = Nicola | authorlink8 = Nicola Mills | last9 = Montgomery | first9 = Alan A.|language=en|doi=10.1136/archdischild-2017-313375|pmc=|pmid=28931531|access-date=|issn=0003-9888|quote=|via=}}</ref> - [https://adc.bmj.com/content/103/2/155.responses (Editor's note)]
===by LP practioners ===
*2022, Reflections on NICE, CFS/ME, and the Lightning Process<ref name="Chellamuthu2022">{{Cite journal | date = Mar 3, 2022 | title = NICE, CFS/ME, and the Lightning Process|url=https://bjgplife.com/reflections-on-nice-cfs-me-and-the-lightning-process/ |journal=BGP Life | first = Anna | last = Chellamuthu | authorlink = |url-status=dead|archive-url=http://web.archive.org/web/20220303084424/https://bjgplife.com/reflections-on-nice-cfs-me-and-the-lightning-process/|archive-date=Mar 3, 2022 }}</ref> (Opinion piece)
::Unpublished by journal in 2022 after complaints
*2021, CBT repackaged or a novel treatment? The Lightning Process compared with UK specialist medical care for paediatric Chronic Fatigue Syndrome<ref name="Anderson2021">{{Cite journal | title = CBT repackaged or a novel treatment? The Lightning Process compared with UK specialist medical care for paediatric Chronic Fatigue Syndrome | date = 2021-04-03|url=https://doi.org/10.1080/21641846.2021.1935373|journal = Fatigue: Biomedicine, Health & Behavior |volume=9|issue=2 | pages = 79–98 | last = Anderson | first = Emma C. | author-link = | last2 = Loades | first2 = Maria | authorlink2 = Maria Loades | last3 = Starbuck | first3 = Jennifer  | authorlink3 = | last4 = Parker | first4 = Phil | authorlink4 = Phil Parker | last5 = Finch | first5 = Fiona | authorlink5 = Fiona Finch | last6 = Barnes | first6 = Rebecca | authorlink6 = | last7 = Beasant | first7 = Lucy  | authorlink7 = Lucy Beasant | last8 = Crawley | first8 = Esther  | authorlink8 = Esther Crawley | last9 = | first9 = |doi=10.1080/21641846.2021.1935373|pmc=|pmid=|access-date=|issn=2164-1846|quote=|via=}}</ref> - [https://doi.org/10.1080/21641846.2021.1935373 (Full text)]
*2013, Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study<ref name="Reme2012">{{Cite journal | last = Reme | first = Silje Endresen | authorlink = | last2 = Archer | first2 = Nicola | authorlink2 = | last3 = Chalder | first3 = Trudie | authorlink3 = Trudie Chalder| date = 2013  | title = Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study|url=https://www.academia.edu/download/31364771/Reme_et_al_2012_BJHP.pdf | doi=10.1111/j.2044-8287.2012.02093.x|journal=British Journal of Health Psychology|language=en|volume=18|issue=3 | pages = 508–525|issn=2044-8287|pmc=|pmid=22989369|access-date=|quote=|via=}}</ref> - [https://www.academia.edu/download/31364771/Reme_et_al_2012_BJHP.pdf | doi=10.1111/j.2044-8287.2012.02093.x (Full text)]
*2001, Kronisk utmattelsessyndrom og erfaring med Lightning Process<ref name="Landmark2001">{{Cite journal | last = Landmark|first = Live | authorlink = Live Landmark | last2 = Lindgren | first2 = Rolf Marvin Bøe | authorlink2 = Rolf Lindgren | last3 = Sivertsen | first3 = Børge | authorlink3 = Børge Sivertsen | last4 = Magnus | first4 = Per  | authorlink4 = Per Magnus | last5 = Conradi | first5 = Sven | authorlink5 = Sven Conradi | last6 = Thorvaldsen | first6 = Signe Nome | last7 = Stanghelle | first7 = Johan Kvalvik | date = 2016 | title=Kronisk utmattelsessyndrom og erfaring med Lightning Process|url=https://tidsskriftet.no/2016/03/kommentar-og-debatt/kronisk-utmattelsessyndrom-og-erfaring-med-lightning-process|journal=Tidsskrift for Den norske legeforening|language=en|volume=136|issue=5 | pages = 396–396|doi=10.4045/tidsskr.15.1214|issn=0029-2001|quote=|via=}}</ref> - [https://tidsskriftet.no/2016/03/kommentar-og-debatt/kronisk-utmattelsessyndrom-og-erfaring-med-lightning-process (in Norwegian)]
*2012, A Mind-Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue<ref name="Toussaint2012">{{Cite journal | title = A Mind-Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue | date = 2012-03-01|url=https://www.sciencedirect.com/science/article/pii/S1550830711003405|journal=EXPLORE|volume=8|issue=2 | pages = 92–98 | last = Toussaint | first = Loren L. | author-link = Loren Toussaint | last2 = Whipple | first2 = Mary O. | authorlink2 = | last3 = Abboud | first3 = Lana L. | authorlink3 = | last4 = Vincent | first4 = Ann | authorlink4 = | last5 = Wahner-Roedler | first5 = Dietlind L. | authorlink5 = | last6 = | first6 =  | authorlink6 = | last9 = | first9 = |language=en|doi=10.1016/j.explore.2011.12.003|pmc=|pmid=|access-date=|issn=1550-8307|quote=|via=}}</ref> - [https://www.researchgate.net/profile/Loren-Toussaint/publication/229324365_A_Mind-Body_Technique_for_Symptoms_Related_to_Fibromyalgia_and_Chronic_Fatigue/links/59e3bb3f458515393d5b935f/A-Mind-Body-Technique-for-Symptoms-Related-to-Fibromyalgia-and-Chronic-Fatigue.pdf (Full text)]
::Nobody with ME/CFS completed the programs, harms and reasons for dropping out were not reported on. The Lightening Process was compared with CBT and GET for fibromyalgia, which were ineffective, and there was no control group.
==Books==
*[[An Introduction to the Lightning Process|An Introduction to the Lightning Process: The First Steps to Getting Well]].<ref name="IntroBook2012">{{Cite book | title = An Introduction to the Lightning Process: The First Steps to Getting Well | date = 2012-09-24|publisher=Hay House, Inc|isbn=978-1-78180-097-3|language=en | url = https://books.google.co.uk/books?hl=en&lr=&id=Q9Vqesa6xVQC&oi=fnd&pg=PR9&dq=+lightning+Process | last = Parker | first = Phil | authorlink = Phil Parker}}</ref> Hay House, Inc., Phil Parker, P (2012)
*Get the life you love, now: how to use the Lightning Process® toolkit for happiness and fulfilment. Hay House, Inc., Parker, P. (2013)


==Online presence==
==Online presence==
Line 70: Line 134:


==See also==
==See also==
*[[An Introduction to the Lightning Process]], book by [[Phil Parker]]
*[[Pseudoscience]]
*[[Ethical issues]]
*[[Neurolinguistic programming]]
*[[Esther Crawley]]
*[[Esther Crawley]]
*[[Live Landmark]]
*[[Martine McCutcheon]]
*[[Martine McCutcheon]]
*[[Mickel therapy]]
*[[Mickel therapy]]
*[[Cognitive behavioral therapy]]
==Learn more==
*[http://www.sayer.abel.co.uk/MESNORFOLK/LP.html The Lightning Process did not work for ME] - Collection of patient experiences
*[https://lp-fortellinger.no/en/lp-stories/ LP-fortellinger (In English: LP-Stories)] - A collection of stories from ME/CFS patients who have experienced the Lighting Process
*[https://tidsskriftet.no/en/2016/03/chronic-fatigue-syndrome-and-experience-lightning-process Chronic Fatigue Syndrome and the Experience of the Lightning Process] - A commentary article in the Journal of the Norwegian Medical Association. The lead author is a Lighting Process practitioner
*[https://en.wikipedia.org/wiki/The_Lightning_Process Wikipedia - Lightning Process]


==References==
==References==
<references/>
{{Reflist}}


[[Category:Psychological paradigm]]
[[Category:Psychological paradigm]]
[[Category:Potential treatments]]
[[Category:Potential treatments]]
[[Category:Psychological and behavioral therapies]]
[[Category:Mind body treatments]]

Latest revision as of 13:48, July 25, 2023

The Lightning Process is a psychological intervention created by Phil Parker that has been promoted to myalgic encephalomyelitis and chronic fatigue syndrome patients as a cure. It gets its name because it is supposed to cure in three days.[1]

Overview[edit | edit source]

The Lightning Process claims to be a combination of neurolinguistic programming (NLP), positive psychology and osteopathy.[2][3] The content of the process is copyrighted but according to patient reports involves affirmations and counteracting negative thoughts:[4][2]

"You ask yourself if you want to choose happiness. Which you obviously do and then you say how fantastic you are to have stopped the negativity thought. You ask yourself what you really want, then you answer yourself, and again ask yourself how you are going to get there. The answer of course is to keep doing the process, getting rid of those negative thoughts. Then you tell yourself how great you are again and maybe have a bit of a hug with yourself, then... no nothing, that's it."[4]

The cost is between £695 and £1,997 for a three day course with additional sessions up to £250 an hour. (September 2016 rates)[5]

The Lightning Process is based on the view that chronic fatigue syndrome is a "stress response" which leaves the person's body constantly on alert. It includes some cognitive behavioral therapy, a form of psychotherapy.[6]

Evidence[edit | edit source]

The Lightning Process is not based on any theory derived by studying patients with ME/CFS, fibromyalgia or any particular illness or disease. LP practioners do not normally have either medical or mental health qualifications or training, they act as life coaches/trainers.

The Lightning Process has not been tested with any randomized, controlled trials.ref name="Toussaint2012"/> Evidence of benefits largely comes from personal testimonials, which often mention medical diagnoses that have not been confirmed from medical records, and it is not possible to know if patients later relapsed.

Before being accepted on a training course patients are expected to do preparatory work and to be psychologically "ready to engage" which appears to involve an assessment during a pre-course telephone call which includes already having the belief that change is possibly using the LP, and the belief in their own capability to recover/resolve their own issues.[2] These conditions are likely to bias any outcomes when compared with controls or people undertaking a treatment which is open to everyone.

Harms, risks and side effects[edit | edit source]

Harms, risks and side effects are not documented in scientific literature, with the exception of Anderson et al. (2021), who reported "no serious adverse effects" in the controversial SMILE trial in children.[2] The LP states it is a training course, not a treatment.

Anecdotal evidence of patient harm[edit | edit source]

According to a national survey by the Norwegian ME association ME Foreningen in (2012), Lightning Process was found to be one of the treatments that has done the most harm to patients. The Lightning Process resulted in 50% of the ME patients reporting that LP had made their condition worse, 25% seriously worse. 30% reported that LP had no effect on symptoms.[7]

Attempted suicides[edit | edit source]

In 2011, a 13 year-old Norwegian boy with ME attempted suicide after he failed to improve with the Lightning Process.[8]

In 2020, a Twitter user came forward with her story of 10 years of intense depression and suicide attempts as a result of being gaslit by the Lightning Process as a child.[9]

Studies with ME/CFS[edit | edit source]

King's College London Study[edit | edit source]

A small non-randomised qualitative study took place at King's College London, reporting in 2012. The study was conducted by Trudie Chalder and Nicola Archer with Silje Endresen Reme of Harvard University. Nine Participants aged 14 to 26 were recruited through advertisements. They were interviewed after undergoing the process along with three of their parents.[10]

Seven participants reported being satisfied with two as dissatisfied. The intensity and poor follow-up were criticised by participants along with the secrecy surrounding it and feelings of guilt and blame if the treatment did not work.

SMILE trial[edit | edit source]

The Smile study protocol[11]

Criticisms[edit | edit source]

Load video
YouTube

John Greensmith criticised the Lightning Process programme as a costly pyramid scheme noting that people who train in the process frequently go on to become practitioners themselves.[1]

Psychologist James Coyne has described the Lightning Process as "quackery backed by pseudoscientific theory".[12]

Some patients critique the Lightning Process for its high cost, lack of evidence, and the pressure placed on participants if they do not improve.[4]

SMILE trial[edit | edit source]

In a joint statement in August 2010, the ME Association and the Young ME Sufferers Trust called the SMILE trial "unethical" saying, "The ME Association and The Young ME Sufferers Trust do not believe that it is ethically right to use children in trialling an unproven and controversial process such as the Lightning Process."[13]

Invest in ME Research, in a letter to the UK's National Research Ethics Committee (NRES), described the process as "rather like CBT but with bullying and risks of harm."[14]

Professor Robin Gill, a member of the British Medical Association medical ethics committee, wrote to the Church Times about the LP and the SMILE trial. He expressed concern about the issue of coercion of children in the trial.[15]

The BMJ Archives of Disease in Childhood,

Dr. Nick Brown, Editor-in-Chief Archives of Disease in Childhood, published by the BMJ, added an Editor's Note to the trial article 'Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial'.

Editor's note
This study was published online in Archives of Disease in Childhood after peer review in September 2017. The trial tested the effectiveness of a neurolinguistic programming intervention (used widely but never formally tested) in children and young people with chronic fatigue recruited between 2010 and 2013. Though the number of participants was small, analysis suggested a benefit in terms of physical function (measured by the standard SF 36 scale) at both 6 and 12 months after intervention.
Since publication, the study has been criticised for failing to meet ICMJE and BMJ policy on trial registration and for not fully adhering to CONSORT guidance on trial reporting. The journal has been criticised for not detecting these issues during editorial and peer review. We have acknowledged these comments and reviewed our processes in relation to this paper and relating to EQUATOR guidance in general. In addition, we have received clarifications from the authors which are under editorial consideration.[16]

Trial By Error by David Tuller, DrPH via Virology blog

Controversy[edit | edit source]

British Advertising Standards Authority (ASA) ruling[edit | edit source]

In 2012 the British Advertising Standards Authority ruled against claims on the Lightning Process (LP) website.[17]

The ASA upheld a complaint from Hampshire County Council trading standards made about false claims about the use and effectiveness of LP on ME/CFS. The claims were that "Our survey found that 81.3%* of clients report that they no longer have the issues they came with by day three of the LP course", which the complainant stated "misleadingly implied that the Lightning Process could treat or cure CFS/ME."

The ASA noted, "the website breached CAP Code (Edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation) and 12.1 (Medicines, medical devices, health-related products and beauty products)."

The ASA ruled that Phil Parker Ltd should not make medical claims for the LP unless they were supported with robust evidence and the company was not to refer to conditions for which advice should be sought from suitably qualified health professionals.

The Nordic Consumer Ombudsman[edit | edit source]

The 2017 Agenda for the Nordic Consumer Ombudsman ruled that it is illegal to claim that any alternative medicine treatment is effective against specific illnesses and conditions. This ruling forbids the Lightening Process (LP) owners to market Lightening Process (LP) as a treatment for ME/CFS.[18]

Videos[edit | edit source]

Articles and blogs[edit | edit source]

Notable studies and peer-reviewed articles[edit | edit source]

by independent scientists[edit | edit source]

  • 2021, Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study[19] - (Full text)
  • 2020, Patients' experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome–a scoping mixed methods review[20] - (Full text)
  • 2018, Editor's Note by Dr. Nick Brown: Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial - Archives of Disease in Childhood BMJ[16] - (Editor's note)

by LP practioners[edit | edit source]

  • 2022, Reflections on NICE, CFS/ME, and the Lightning Process[3] (Opinion piece)
Unpublished by journal in 2022 after complaints
  • 2021, CBT repackaged or a novel treatment? The Lightning Process compared with UK specialist medical care for paediatric Chronic Fatigue Syndrome[2] - (Full text)
  • 2013, Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study[10] - | doi=10.1111/j.2044-8287.2012.02093.x (Full text)
  • 2001, Kronisk utmattelsessyndrom og erfaring med Lightning Process[6] - (in Norwegian)
  • 2012, A Mind-Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue[21] - (Full text)
Nobody with ME/CFS completed the programs, harms and reasons for dropping out were not reported on. The Lightening Process was compared with CBT and GET for fibromyalgia, which were ineffective, and there was no control group.

Books[edit | edit source]

Online presence[edit | edit source]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Cormier, Zoe (April 18, 2008). "Lightning Process: Controversial training programme comes to Canada". CBC news. Retrieved April 20, 2019.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Anderson, Emma C.; Loades, Maria; Starbuck, Jennifer; Parker, Phil; Finch, Fiona; Barnes, Rebecca; Beasant, Lucy; Crawley, Esther (April 3, 2021). "CBT repackaged or a novel treatment? The Lightning Process compared with UK specialist medical care for paediatric Chronic Fatigue Syndrome". Fatigue: Biomedicine, Health & Behavior. 9 (2): 79–98. doi:10.1080/21641846.2021.1935373. ISSN 2164-1846.
  3. ↑ 3.0 3.1 Chellamuthu, Anna (March 3, 2022). "NICE, CFS/ME, and the Lightning Process". BGP Life. Archived from the original on March 3, 2022.
  4. ↑ 4.0 4.1 4.2 "The Lightning Process Didn't Work for Me". HubPages. Retrieved April 20, 2019.
  5. ↑ Parker, Phil. "Prices and taking the seminar". The Lightning Process (LP). Retrieved November 20, 2021.
  6. ↑ 6.0 6.1 Landmark, Live; Lindgren, Rolf Marvin Bøe; Sivertsen, Børge; Magnus, Per; Conradi, Sven; Thorvaldsen, Signe Nome; Stanghelle, Johan Kvalvik (2016). "Kronisk utmattelsessyndrom og erfaring med Lightning Process". Tidsskrift for Den norske legeforening. 136 (5): 396–396. doi:10.4045/tidsskr.15.1214. ISSN 0029-2001.
  7. ↑ ME Foreningen (May 12, 2014). "Norwegian ME Association National Survey Abridged" (PDF). English.
  8. ↑ Sand, Camilla (November 26, 2011). "Forsøkte selvmord etter ME-kurs". NRK (in norsk bokmål). Retrieved April 20, 2019.
  9. ↑ "Alice Urbino: scam 'lightning process' causes internalized gaslighting - beware of charlatans". Podbean Development. Retrieved May 19, 2021.
  10. ↑ 10.0 10.1 Reme, Silje Endresen; Archer, Nicola; Chalder, Trudie (2013). "Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis – a qualitative study" (PDF). British Journal of Health Psychology. 18 (3): 508–525. doi:10.1111/j.2044-8287.2012.02093.x. ISSN 2044-8287. PMID 22989369.
  11. ↑ SMILE Study protocol
  12. ↑ Twitter: James Coyne on the Lightning Process
  13. ↑ "Statement of ME Association and Young Sufferers Trust on SMILE". ME Association. August 2010.
  14. ↑ Invest in ME Research (October 2010). "Letter to National Research Ethics Committee".
  15. ↑ Church Times (October 8, 2010). "Children should not be used as Guinea Pigs".
  16. ↑ 16.0 16.1 Crawley, Esther M.; Gaunt, Daisy M.; Garfield, Kirsty; Hollingworth, William; Sterne, Jonathan A.C.; Beasant, Lucy; Collin, Simon M.; Mills, Nicola; Montgomery, Alan A. (February 1, 2018). "Clinical and cost-effectiveness of the Lightning Process in addition to specialist medical care for paediatric chronic fatigue syndrome: randomised controlled trial". Archives of Disease in Childhood. 103 (2): 155–164. doi:10.1136/archdischild-2017-313375. ISSN 0003-9888. PMID 28931531.
  17. ↑ Advertising Standards Authority | Committee of Advertising Practice (August 2012). "ASA Ruling on Phil Parker Group Ltd". Advertising Standards Authority. Retrieved June 5, 2022.
  18. ↑ https://forbrukerombudet.no/english/agenda-2017
  19. ↑ Fauske, Lena; Bruland, Øyvind S.; Dahl, Alv A.; Myklebostad, Aase; Reme, Silje E. (January 2021). "Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study". Cancers. 13 (16): 4076. doi:10.3390/cancers13164076. ISSN 2072-6694.
  20. ↑ Mengshoel, Anne Marit; Helland, Ingrid Bergliot; Meeus, Mira; Castro-Marrero, Jesús; Pheby, Derek; Bolle Strand, Elin (January 1, 2020). "Patients' experiences and effects of non-pharmacological treatment for myalgic encephalomyelitis/chronic fatigue syndrome – a scoping mixed methods review". International Journal of Qualitative Studies on Health and Well-being. 15 (1): 1764830. doi:10.1080/17482631.2020.1764830. ISSN 1748-2631. PMC 7782327. PMID 32432991.
  21. ↑ Toussaint, Loren L.; Whipple, Mary O.; Abboud, Lana L.; Vincent, Ann; Wahner-Roedler, Dietlind L. (March 1, 2012). "A Mind-Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue". EXPLORE. 8 (2): 92–98. doi:10.1016/j.explore.2011.12.003. ISSN 1550-8307.
  22. ↑ Parker, Phil (September 24, 2012). An Introduction to the Lightning Process: The First Steps to Getting Well. Hay House, Inc. ISBN 978-1-78180-097-3.

bias Bias in research is "a systematic deviation of an observation from the true clinical state". (Learn more: me-pedia.org)

adverse reaction Any unintended or unwanted response to a treatment, whether in a clinical trial or licensed treatment. May be minor or serious.

BMJ The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

randomized controlled trial (RCT) - A trial in which participants are randomly assigned to two groups, with one group receiving the treatment being studied and a control or comparison group receiving a sham treatment, placebo, or comparison treatment.

Short Form 36-Item Health Survey (SF-36) - A 36-item patient-reported questionnaire, used to determine patient health status and quality of life.

BMJ The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

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