It is ME Awareness Day, and the publication of our open letter to the Royal College of Psychiatrists sits within a long and well-documented history of contested approaches to ME within psychiatry and adjacent services.

This article explores how cognitive therapies contribute to a dangerous medical paradigm for chronic illness. We shall focus on Paul, ‘he’s not the messiah, he’s a very naughty boy’, Garner’s opinion piece for the BMJ and his appearance at the SIRPA conference. We examine the historical, rhetorical, and systemic forces behind mind-body medicine and how they obscure harm through compassion-washing, concept laundering, and misplaced optimism.