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.