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Chronic fatigue syndrome and experience with the Lightning Process

Live Landmark, Rolf Marvin Bøe Lindgren, Børge Sivertsen, Per Magnus, Sven Conradi, Signe Nome Thorvaldsen, Johan Kvalvik Stanghelle

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Live Landmark

Live Landmark (born 1969), master’s degree student (Master of Management) at the Norwegian Business School BI, Oslo.

The author has completed the ICMJE form and reports the following conflicts of interest: She is an instructor in the Lightning Process.

Email: live@livelandmark.no

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Rolf Marvin Bøe Lindgren

Rolf Marvin Bøe Lindgren (born 1967), psychologist at Grendel evidence-based psychology, Lillestrøm.

The author has completed the ICMJE form and reports no conflicts of interest.

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Børge Sivertsen

Børge Sivertsen (born 1975), psychologist. He is a professor and senior researcher at Uni Health and the Norwegian Institute of Public Health.

The author has completed the ICMJE form and reports no conflicts of interest.

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Per Magnus

Per Magnus (born 1951), specialist in medical genetics. He is professor II at the University of Oslo and science director at the Norwegian Institute of Public Health.

The author has completed the ICMJE form and reports no conflicts of interest.

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Sven Conradi

Sven Conradi (born 1953), specialist in physical medicine and rehabilitation. He is a senior consultant at Sunnaas Rehabilitation Hospital.

The author has completed the ICMJE form and reports no conflicts of interest.

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Signe Nome Thorvaldsen

Signe Thorvaldsen (born 1953), specialist in general medicine. She is a member of the Norwegian College of General Practice’s reference group for medically unexplained symptoms and diseases, and a GP at Kaigata medical centre, Tromsø.

The author has completed the ICMJE form and reports no conflicts of interest.

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Johan Kvalvik Stanghelle

Johan Stanghelle (born 1949), specialist in physical medicine and rehabilitation. He is professor II at the University of Oslo and research director at Sunnaas Rehabilitation Hospital.

The author has completed the ICMJE form and reports no conflicts of interest.

Article

The cause of chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is not well understood and is disputed, and therapeutic options are limited. Many patients who attended the Lightning Process course reported positive effects. This should lead to a randomised controlled intervention trial.

Since 2008 several thousand patients with CFS/ME have attended the Lightning Process (LP) course in Norway (1). The course is a three-day intensive brain rehearsal programme with the option for follow-up. Although what triggers CFS/ME in the individual case may vary, it is assumed that symptoms maintenance and chronification can be attributed to a stress response with elevated state of alertness and persisting activation of the sympathetic nervous system, driven by classic and operant conditioning mechanisms. The Lightning Process is based on these theories of stress.

What is the Lightning Process?

What is the Lightning Process?

The Lightning Process course is a form of psychoeducation comprising both a theoretical component and exercises which participants practice at home. The course has elements in common with cognitive behavioural therapy, a therapeutic method that has demonstrated results in CFS/ME (2). Both methods take the association between thoughts, feelings and actions as their starting point, and aim at breaking self-reinforcing and inconvenient spirals. However, the Lightning Process differs from cognitive behavioural therapy in certain aspects: The course is designed as a three-day mental brain rehearsal, led by a coach with specific Lightning Process training. Whereas cognitive behavioural therapy addresses the contents of patients’ thoughts, LP places more emphasis on discussing how one relates to the thought patterns (3). Patients are furthermore encouraged to seek out experiences that engender positive emotions, without a fixed plan, instead of analysing negative thoughts and emotions. In addition, considerable attention is paid to the importance of semantics – how words and concepts contribute to negative thought patterns.

Research

Research

To our knowledge, two scientific studies of the Lightning Process have been conducted, both of them qualitative. In one study, seven of nine adolescents reported significant improvement, while two did not experience any effect (4). The second study investigated patients’ experiences and found that higher scores on understanding of one’s own condition, feelings of confidence towards the course leader and positive bodily response distinguished patients who reported a positive effect from patients who reported a negative or no effect (5). Both studies indicate that the course may be beneficial for some patients with CFS/ME. In England a pilot study has also been conducted with children/adolescents which will lead to a randomised controlled trial (6).

A telephone questionnaire survey was conducted in collaboration with Godthaab Health and Rehabilitation of all participants who had attended Lighting Process courses in 2008 (7). The majority reported an improvement in quality of life and activity level. The improvement persisted one year after course participation, and no serious adverse effects were reported. The user survey of course only allows the generation of hypotheses, but indicates that the course can have a positive effect on these conditions.

Need for further knowledge

Need for further knowledge

CFS/ME can be debilitating for the individual and represents a significant societal problem. There is a great need for more research on the effects of various forms of treatment. The Lightning Process has shown promising results, but these need to be reproduced in randomised controlled trials. Before the results of such studies are available, the evidence base is insufficient for recommending that the Lightning Process be systematically used in the health services.

Literature

1.
Parker P. An introduction to the Lightning Process: The complete strategy for success. 2. utgave. London: Nipton Publishing, 2007.
2.
Price JR, Mitchell E, Tidy E et al. Cognitive behaviour therapy for chronic fatigue syndrome in adults. Cochrane Database Syst Rev 2008; 3: CD001027. [PubMed]
3.
Brosschot JF, Gerin W, Thayer JF. The perseverative cognition hypothesis: a review of worry, prolonged stress-related physiological activation, and health. J Psychosom Res 2006; 60: 113 – 24. [PubMed] [CrossRef]
4.
Reme SE, Archer N, Chalder T. Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis–a qualitative study. Br J Health Psychol 2013; 18: 508 – 25. [PubMed] [CrossRef]
5.
Sandaunet A-G, Salamonsen A. CFE-/ME-pasienters ulike erfaringer med Lightning Process. Sykepleien Forskning 2012; 7: 262 – 8. https://sykepleien.no/forskning/2012/10/cfe-me-pasienters-ulike-erfaringer-med-lightning-process (11.2. 2016).
6.
Crawley E, Mills N, Hollingworth W et al. Comparing specialist medical care with specialist medical care plus the Lightning Process for chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME): study protocol for a randomised controlled trial (SMILE Trial). Trials 2013; 14: 444. [PubMed] [CrossRef]
7.
Aktiv Prosess. Evaluering av deltakelse på Lightning Process kurs. http://livelandmark.no/wp-content/uploads/2011/11/Deltakerevaluering-uten-diagnoser.pdf (7.1. 2016).

Comments ( 10 )

This article was published more than 12 months ago and we have therefore closed it for new comments.

RE: Kronisk utmattelsessyndrom og erfaring med

14.03.2016

Athanasia Mowinckel

Siste refererte brukerundersøkelse burde ikke vært tillatt i denne artikkelen. Her refereres det altså til en brukerundersøkelse gjort på alle deltagere av et kurs, uten noen spesifikasjoner angående diagnoser. Dette ville kanskje vært greit foruten om at…

RE: Kronisk utmattelsessyndrom og erfaring med

14.03.2016

Hanne-Live Andersen

Jeg er helt overbevist om at behandlingen av ME syke og bruk av udokumenterte, spekulative metoder som LP i fremtiden vil fremstå som en av den medisinske historiens største skandaler.

RE: Kronisk utmattelsessyndrom og erfaring med

14.03.2016

Olav Jensen

Skulle Forskningsrådet snu, eller andre velge å støtte en slik studie til tross for at det strider i mot en rekke biomedisinske funn de senere årene (1), og manglende objektiv effekt av kognitiv terapi (2) bør en ta en rekke forhåndsregler som ikke har vært…

RE: Kronisk utmattelsessyndrom og erfaring med

15.03.2016

Mats Reimer

För ett par år sedan deltog jag som observatör vid en LP-kurs. Mitt intryck är att LP innehåller basala fakta om stressrespons (psychoeducation) och element från kognitiv beteendeterapi. I tillägg hade kursledaren själv haft ME-diagnos, vilket rimligen ökar…

RE: Kronisk utmattelsessyndrom og erfaring med

15.03.2016

Mette Hustad

Det britiske forbrukerombudet, ASA, dømte i 2012 Phil Parker for villedende reklame for Lightning Process (LP). Han hadde reklamert for at LP virker mot bestemte sykdommer og lidelser, bl.a. CFS /ME, disse påstandene ble han pålagt å fjerne. ASA uttalte også…

RE: Kronisk utmattelsessyndrom og erfaring med

15.03.2016

Morten Andreas Horn

Landmark og medarbeidere forteller her om erfaringer de og andre har gjort seg med bruk av metoden Lightning Process (LP) ved bl.a. tilstanden CFS/ME. Det gjenstår fortsatt mye før LP kan anses som en behandlingsmetode i medisinsk forstand, bl.a. bør metoden i…

RE: Kronisk utmattelsessyndrom og erfaring med

16.03.2016

Jørgen Jelstad

Artikkelforfatterne ønsker mer forskning på Lightning Process blant annet ut fra lovende resultater fra en spørreundersøkelse. De omtaler ikke en spørreundersøkelse som viser at metoden også kan føre til forverring (1). Når førsteforfatteren selv selger…

RE: Kronisk utmattelsessyndrom og erfaring med

17.03.2016

Petter A. Kjørstad

At innsatsen legges i det myteomspunnede LP er spesielt og har flere etiske betenkeligheter. Med fleksibilitet går det samtidig an å se behovet for å avklare nærmere hvilke pasienter som faktisk kan ha nytte av dette. I den sammenheng er det ugreit at…

RE: Kronisk utmattelsessyndrom og erfaring med

19.03.2016

Hanne Egeland

For snart 9 år siden lå jeg dødssyk med ME. Til sommeren er jeg ferdig sykepleier og kan da komme til å møte ME-pasienter i mitt arbeid. Da jeg fikk diagnosen ME/CFS for 11 år siden var dette en mystisk sykdom som det ikke fantes noen behandling for. Nå 11 år…

RE: Kronisk utmattelsessyndrom og erfaring med

16.06.2016

Erik Hjelmås

NAFKAM fullførte analysen av innrapporterte LP-behandlinger i forbindelse med med ME 28. okt 2015 (1) som bør nevnes i denne sammenheng. Litteratur 1. B. Baumgarten-Austrheim, A. Salamonsen, V. Fønnebø. Gjennomgang av diagnosekriterier for pasienter med…

Published: 15 March 2016

Tidsskr Nor Legeforen 15 March 2016

doi:

10.4045/tidsskr.15.1214

Received 12 November 2015, accepted 11 February 2016. Editor: Martine Rostadmo.

136

:

396

Published: 15 March 2016

Tidsskr Nor Legeforen 2016

136

:

396

doi: 10.4045/tidsskr.15.1214

Received 12 November 2015, accepted 11 February 2016. Editor: Martine Rostadmo.

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