By David Tuller, DrPH
Coda Story is an excellent news organization focused on international stories related to the misuse of science and technology, among other topics. Today, it published a piece of mine about the training program called the Lightning Process. Sites devoted to the Lightning Process are full of tales of recovery from prolonged illness. I included one such account in my Coda article along with accounts from others who reported suffering severe relapses after the training. The article also points out that the scientific claims cannot withstand scrutiny.
To be clear, I’m not telling people whether they should or should not do the Lightning Process. If someone checks it out and thinks it could help them, that’s their call. My concern is that it is promoted as scientific, when it is not. And despite the glowing testimonials, it is easy to find people who say, in contrast, that they experienced serious harms. Their stories are not posted on Lightning Process sites but nonetheless deserve to be shared as well.
While working on the story, I sent an e-mail with a few questions to Lightning Process founder Phil Parker, a British osteopath and psychologist. Within a few days, he responded with a gracious note, along with his answers and a list of supporting references. I have included all the references below, so others can make their own assessments of their merit.
In the Coda story, I mention these references once. In relation to Parker’s statement that the “vast majority” of Lightning Process participants “achieve good and lasting change,” I indicate that the references do not “reasonably support this conclusion.” Obviously, the precise definitions of “vast majority” and “lasting” are up for grabs. But we don’t need to overcome these linguistic challenges to demonstrate that the claim is not grounded in the data.
First, many of the references are for “unpublished” research—that is, not published in a peer-reviewed journal. I’m a journalist as well as a public health academic, so of course I believe in the value of non-peer-reviewed investigations. And I know very well from my own work on this project that peer review is not much of a barrier in many cases. Even so, the issue here is the credibility and robustness of Parker’s sweeping claim of the Lightning Process’ prolonged effectiveness, and it is fair to expect a certain level of, you know, actual documentation. The forwarded references do not meet the required level.
For example, the unpublished 2010 Finch survey reported on the responses of Lightning Process participants when they were asked about the experience right after the end of the program. Here is the salient sentence: “Of the 1092 people who said they had CFS/ME 888 (81.3%) reported that they no longer had CFS/ME by day 3 of the LP course.”
Perhaps 81.3% could be construed as “the vast majority.” But responses at the end of the training program obviously do not represent “lasting change” and might have no relationship to the responses that would be obtained a week or ten weeks later. It should be noted that in my Coda story I included the accounts of two people who would also have offered positive reviews right after the training but crashed badly within months.
Another unpublished Finch study, from 2013, included data for participants extending out three months after the Lightning Process training. At baseline, there were 205 participants. Between baseline and six weeks, the averages of responses to questionnaires on a range of functioning measures rose. Between six weeks and three months, the averages leveled off and hovered in the same general range.
The authors interpret this as an indication that the Lightning Process produces improvements, especially in the first six weeks. But that is hard to tell from the data. Unfortunately, the authors do not indicate how many people responded to questionnaires at six weeks and three months; they do indicate that “missing data” were excluded from the analyses.
This methodological shortcoming renders the analysis of questionable value. If an unknown number of participants did worse and dropped out and the averages at six weeks and three months are drawn only from those remaining, the apparent improvements could be a statistical illusion—an artifact of assessing a shrinking but healthier pool. We simply can’t tell from what is presented.
Moreover, this study provides data only about the averages, or the mean values. Averages of patients’ scores have some interest but they tell us nothing about how many people get better and how many get worse, and by how much—which is what doctors and patients really want to know. Averages can be dramatically affected by outliers. If you averaged my income with Bill Gates’ income, we’d both look like we have billion-dollar incomes. We don’t.
In short, this study also does not support any assertion about the “vast majority” of participants; we don’t even know if the “vast majority” of the 205 participants filled out their three-month questionnaires. And three months is too short a time-frame to be considered “lasting,” by my understanding of the word.
Interestingly, Table 1 indicates that “data for 6 and 12 months is [sic] currently in collection.” Presumably these longer-term data were “in collection” with the intention of calculating longer-term outcomes. Parker did not provide a follow-up study including these later results, which would have been helpful in making his case for “lasting change.”
Let’s see, what else? The Hagelsteen & Moen Reiten article was published not in a peer-reviewed journal but in something called Dagens Medicin, a news update for people working in health care. The article is a report about a dozen kids with chronic headaches who received the Lightning Process. A year later, nine reported they were better. I think we can all agree that this is also not sufficient evidence for stating that the “vast majority” of the 25,000 Lightning Process participants have achieved “good and lasting change.”
That’s about it. The other references are equally unconvincing.
The Landmark et al article, for example, noted that we know too little about the Lightning Process and called for more research. And Parker, interestingly, cited the 2013 protocol, Crawley et al, for the one clinical trial that has been conducted to date, However, he did not cite the 2017 report of the actual results. Perhaps that is because he knows the study has been slapped with a 3,000-word correction triggered by my investigation of its methodological and ethical violations, and that the reported findings are therefore suspect.
Presumably, Parker made what was his best case for the Lightning Process last year in a paper that he and two colleagues called a “systematic review of the evidence base.” Brian Hughes, a professor of psychology at NUI Galway, was not impressed with this presentation, as he noted in a post on his blog, The Science Bit. Hughes’ entire post is well worth a read, but here’s an excerpt:
This so-called “systematic review” is surely one of the most atrocious academic papers that I have ever had the misfortune to read. It isn’t even a “systematic review”. Rather, it is a self-serving pseudostatistical jargon-filled waffle-fest, utterly untroubled by even the tiniest smidgen of scholarly objectivity. It is, in fact, deeply depressing.
Bibliography (References sent to me by Phil Parker)
Crawley, E., Mills, N., Hollingworth, W., Deans, Z., Sterne, J., Donovan, J., Beasant, L., & Montgomery, A. (2013). 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, 14, 444. https://doi.org/10.1186/1745-6215-14-444
Finch, F. (2010). Snapshot Survey 2018 for clients with CFS.ME.pdf. http://philparker.org/wp-content/uploads/2010/07/Snapshot%20Survey%202018%20for%20clients%20with%20CFS.ME.pdf
Finch, F. (2013). Outcomes Measures Study. doi.org/10.13140/RG.2.2.29818.24002
Finch, F. (2014). MS Proof of Concept Study. doi.org/10.13140/RG.2.2.26462.79686
Hagelsteen, J. H., & Moen Reiten, I. M. (2015). Evaluation of a treatment strategy. Dagens Medicin. http://www.dagensmedisin.no/artikler/2015/10/12/evaluering-av-en-behandlingsstrategi/
Kristoffersen, A. E., Musial, F., Hamre, H. J., Björkman, L., Stub, T., Salamonsen, A., & Alræk, T. (2016). Use of complementary and alternative medicine in patients with health complaints attributed to former dental amalgam fillings. BMC Complementary and Alternative Medicine, 16, 22. https://doi.org/10.1186/s12906-016-0996-1
Landmark, L., Lindgren, R. M. B., Sivertsen, B., Magnus, P., Sven Conradi, Thorvaldsen, S. N., & Stanghelle, J. K. (2016). Chronic fatigue syndrome and experience with the Lightning Process. Tidsskrift for Den norske legeforening, 136(5), 396–396. https://doi.org/10.4045/tidsskr.15.1214
Parker, P. (2011). Dû: Unlock your full potential with a word. Nipton Publishing.
Parker, P. (2012). An introduction to the Lightning Process®: The first steps to getting well. Hay House.
Parker, P. (2013). Get the life you love, now: How to use the Lightning Process® toolkit for happiness and fulfilment. Hay House.
Parker, P. (2020). LP Protocol 2020. https://doi.org/10.13140/RG.2.2.22761.72801
Parker, P., Aston, J., & de Rijk, L. (2020). A Systematic Review of the Evidence Base for the Lightning Process. EXPLORE, 1–30. https://doi.org/10.1016/j.explore.2020.07.014
Parker, P., Aston, J., & Finch, F. (2018). Understanding the Lightning Process approach to CFS/ME; a review of the disease process and the approach. Journal of Experiential Psychotherapy, 21(2), 8. https://jep.ro/images/pdf/cuprins_reviste/82_art_2.pdf
Parker, P., Banbury, S., & de Rijk, L. (2021). Self-control or Flourishing? A Thematic Analysis of Experiences of Alcohol Users of the Rediscovery Process. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-021-00520-3
Reme, S. E., Archer, N., & Chalder, T. (2012). Experiences of young people who have undergone the Lightning Process to treat chronic fatigue syndrome/myalgic encephalomyelitis—A qualitative study. British Journal of Health Psychology, 18(3), 508–525. https://doi.org/10.1111/j.2044-8287.2012.02093.x
Sandaunet, A.-G., & Salamonsen, A. (2012). CFE-/ME-pasienters ulike erfaringer med Lightning Process. Sykepleien Forskning, 7(3), 262–268. https://doi.org/10.4220/sykepleienf.2012.0132
Sussex & Kent ME/CFS Society. (2010). Sussex and Kent report. https://lightningprocess.com/research/
5 responses to “Do the “Vast Majority” of Lightning Process Participants Achieve “Lasting Change”?”
I can’t see anything new or different about this approach. To me it just sounds like some sort of army-style training – getting people to ignore what their brain is telling them and to push through the pain/fatigue barrier to attain a better level of fitness. We can all attempt to do that and those who are suffering because they are deconditioned may well benefit, greatly even perhaps. But those whose bodies are compromised by real disease will suffer the consequences. Isn’t that the crux of the matter?
Many years ago I made a determined effort to overcome my apparent deconditioning by regular attendance at the gym. I was properly assessed and was given a programme to follow. I pushed through the pain and the fatigue, burned lots of calories and didn’t feel as drawn to food for energy as I had been before. After a while I could get up small inclines without the struggle that I’d previously had. I could feel that I was getting a little bit fitter. But the improvements were small and my gym instructor couldn’t understand why I wasn’t managing to move up the strength/resistance levels – she said that everyone else who followed the same programme was able to do this. She could see from my printout that I was very committed so was stumped by my lack of progress. I mentioned in passing to her that my pain had been increasing but I didn’t tell her how bad it was, I suppose I didn’t want to be regarded as a wuss. But it had been getting progressively worse such that I couldn’t sit down for even quite short periods of time. In the end I stopped going. Perhaps this is a known problem for some people that could have been overcome by going about my exercise in a different way. I’m not saying that a disease was definitely causing this problem but nobody’s been able to offer me an explanation and doctors don’t care. Their assumption was that I wasn’t committed, didn’t try hard enough, was being a typical ‘Moaning Minnie’.
What I’m getting to in a roundabout way is that the BPS cabal have arrived at a point where they are conflicted. They appear to be saying now that patients should follow their graded exercise therapy programme but in a careful way, listening to their bodies and reporting to their therapists on how they are managing so that, by diligent monitoring and timely adjustment, those who might otherwise be harmed by it don’t come to any harm. And yet at the same time they are promoting through the UK media Paul Garner’s method of rehabilitation, the man-up-and-push-through method, denying there’s a problem not only to others but to yourself too, saying ‘stop’ to any negative thoughts and choosing ‘the life I love’ over ‘the pit’. These two approaches are diametrically opposed, so which one do they support?
Can Trudie, Rona and co please make clear which it is?
I am particularly concerned about the use of the Lightening Process (LP) with children. Though there is some argument that informed adults should be allowed to make their own choice and as long as they are aware of the risks have the option to participate, this is much less clear cut with children.
Desperate parents/guardians are likely to feel pressure to try anything, and this pressure is likely to be increased by the LP being seemingly endorsed by national organisations as in the current planned research in Norway and the previous research on children in Bath/Bristol. With the Bath/Bristol research, you have the head of the Bath CFS/ME service, an eminent paediatrician and professor, leading research that seemingly endorses the LP. That this project was methodologically incapable of producing unambiguous results and involved research misconduct is not necessarily obvious to the lay reader and certainly went unreported by the media outlets that lauded it as a cure for ME.
In addition to the methodological problems with LP research discussed above, I feel there are further ethical and child protection issues that should be pointed out:
– given LP participants are enjoined to verbally deny their symptoms, this means children are being in effect instructed to lie to their parents/guardians, their teachers and their doctors, which in turn has serious implications for future medical treatment and could result in delay or failure to treat any changes in their ME or any subsequent additional medical conditions, putting participants at risk of serious medical complications or even preventable deaths. Given studies find rates of misdiagnosis in ME as high as 40% and that people with ME are at higher risk of have other potentially life threatening conditions, this is not a trivial issue.
– given LP participants are instructed to behave as though their symptoms did not exist, this means in conditions such as ME, which by definition is made worse by over exertion, that is made worse by failing to act on your symptoms, it is inevitable that for some participants at least their condition will worsen. The LP is consequently also instructing participants with ME to effectively ignore current best medical practice which in the context of vulnerable children could be seen as abuse.
– LP participants are screened for their suitability for the programme and the cynically minded could interpret that as selected for their suggestibility. Then they are also enjoined to secrecy as to what the course involves. One can not but see parallels to such as grooming behaviour in child abuse. The process also involves victimised blaming and gaslighting, in that when it fails to produce the anticipated benefits participants are told that they are not doing it properly. Unsurprisingly psychological distress and potentially suicide have been reported following LP programmes.
– because the LP is subject to commercial secrecy and can only be undertaken by current trainers with the authorisation of the LP organisation, independent verification of research involving it is impossible. Indeed it is impossible for any one other that the trainers and the participants to have full information on what happens during a course. That means researchers who are not trainers or participants are undertaking research without full knowledge of what is being done to their subjects and any other academics or clinicians are unable to fully asses the process. This means this research can not be fully assessed by those whose job is to validate and/recommend the research and can never be subject to fully independent verification.
How bizarre to include a *protocol* of a trial which has already published!? That in itself tells quite a story. It’s like providing an account of the curriculum you studied for O level Physics rather than supplying the ‘D’ grade you actually got in your final exams! (This might be based on a true story… not the ‘pretending bit’ but the ‘dismal failure’ bit 😉 ).
This is a very useful blog and the Coda piece is excellent. Thank you.
The Finch survey measures the ability of LP promoters to influence questionnaire answering behavior. It appears they are very good at conning desperate ill people.
When I first read about this LP stuff I speculated that it would be laughed out of medicine and leave a black mark on the psychobabblers who promote it. It is such an obvious scam; how could anyone promote it with a straight face? And yet here we are…
If only BBC2’s Newsnight had put both sides of the story (like David’s done in his Coda Story piece) when they reported on Paul Garner’s recovery from long covid. From memory, they failed to interview anyone who had been harmed by the approach that Garner advocates. It was very one-sided.