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Gupta program
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== Theory == The hypothesis behind the Gupta Program was published in 2002 and describes a theory involving amygdala overactivation, the hypothesis and treatment were later updated to describe [[insula]] involvement, neither version has been [[peer review]]ed.<ref name="MAIR2020" /> The new hypothesis is described on the Gupta Program website but is not published or peer-reviewed research.<ref name="website">{{Cite web | last = Gupta | first = Ashok | authorlink = Ashok Gupta | date = | title = Gupta Program {{!}} The Secret of Amygdala Retraining | url = https://www.guptaprogram.com/|website=The Gupta Program|access-date=2022-06-04|quote=}}</ref><ref name="Medical3Pager">{{Cite web | last = Gupta | first = Ashok | authorlink = Ashok Gupta | date = Feb 2021 | title = Medical Pager Final Version | url =https://guptaprog.b-cdn.net/wp-content/uploads/2021/02/Gupta-Program-Medical-Pager-Final-Version.pdf | website=The Gupta Program|access-date=2022-06-04|quote=}}</ref> Well-known patients [[Jennifer Brea]] and Ana Harris have criticized the Gupta Program's assumption that symptoms were caused by an overactivation/reactivity in the brain that was claimed to be unrelated to the underlying illness, an assumption which is presented as an uncontested fact by the Gupta Program.<ref name="JenTweets" /><ref name="Harris2018" /> This belief of "symptoms without disease" and the assumption that flawed [[illness beliefs]] exist that should be challenged are core parts of the [[The 3Ps model|cognitive behavioral model]] of ME/CFS and an hypothesis underlying the use of [[graded exercise therapy]] and the psychosomatic approach to [[Medically unexplained physical symptoms|medically unexplained symptoms]], treatments associated with significant rates of harm.<ref name="Nodecisions">{{Cite web | url=http://www.meassociation.org.uk/wp-content/uploads/2015-ME-Association-Illness-Management-Report-No-decisions-about-me-without-me-30.05.15.pdf | title=ME/CFS Illness Management Survey Results - "No decisions about me without me" Part 1 | last = ME Association | first = | authorlink = ME Association | date = May 30, 2015 | website = [[ME Association]]|archive-url=|archive-date=|url-status=|access-date=}}</ref><ref name="OxfordBrookesSurvey">{{Cite web | url = https://www.meassociation.org.uk/wp-content/uploads/NICE-Patient-Survey-Outcomes-CBT-and-GET-Final-Consolidated-Report-03.04.19.pdf | title =Evaluation of a survey exploring the experiences of adults and children with ME/CFS who have participated in CBT and GET interventional programmes. FINAL REPORT | last = Oxford Clinical Allied Technology and Trials Services Unit (OxCATTS)|location=Oxford Brookes University | date = Feb 27, 2019}}</ref><ref name="TimeToDeliver">{{Cite web | url=https://www.actionforme.org.uk/uploads/pdfs/me-time-to-deliver-survey-report.pdf | date = 2014| title = Time to deliver: initial findings of Action for ME's 2014 survey | last = Action for ME | authorlink = Action for ME |access-date=Jul 1, 2016}}</ref><ref>{{Cite web | quote =CBT/GET have been proven to be based on non-science for ME and should be removed from any recommendations in the guideline.| url = http://www.investinme.org/IIMER-Newslet-17-07-04.shtml | title = Response to NICE 10 year surveillance (2017) – Chronic fatigue syndrome/myalgic encephalomyelitis | last = Invest in ME Research | first = | authorlink = Invest in ME Research | date = Jul 2, 2017 | website = [[Invest in ME Research]]|archive-url=|archive-date=|url-status=|access-date=2019-07-02}}</ref> This "not a disease" theory provides justification for the Gupta Program teaching patients to ignore or minimize their symptoms―despite significant the evidence that ME/CFS has an underlying disease process, and the [[ICD-11|World Health Organization's ICD-11]] manual classes it as a neurological disease rather than a set of symptoms that may not indicate disease.<ref name="icd10">{{Cite web | url=https://icd.who.int/browse10/2016/en#/G93 | title = ICD-10 Version:2016 | last = World Health Organization | first = | authorlink = World Health Organization | date = |website=World Health Organization|archive-url=|archive-date=|url-status=|access-date=2020-09-25}}</ref> Ignoring or minimizing symptoms is inconsistent with [[pacing]], which involves monitoring symptoms and using them to help decide when best to stop an activity in order to avoid a "crash".<ref name="Goudsmit-pacingbasics">{{Cite journal|quote=Although a gradual increase in activity levels is permitted, the rule is that they should stop when the initial mild fatigue turns into a more unpleasant sensation, or where arms or legs begin to feel weak. Most patients will experience these symptoms fairly quickly after commencing an activity, but it is not unusual for some reactions to be delayed. Depending on where they are and what kind of activity triggered the symptoms, the patient may choose to respond either by resting, or if the fatigue is localised, by switching to an activity which uses a different muscle group. | last = Goudsmit | first = EM | authorlink = Ellen Goudsmit | last2 =Howes | first2 = S | authorlink2 = Sandra Howes| url = http://www.axfordsabode.org.uk/me/pacing.htm | title = Pacing: a strategy to improve energy management in chronic fatigue syndrome|journal=Health Psychol Update | date = 2008|volume=17 | pages = 46–52}}</ref>
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