"Physical or Mental: Why it Matters" (March 31 blogpost by Clark Ellis)

[Dolphin]

March 31 blogpost by Clark Ellis.

"This article is going to explore the broader topic of why it matters whether the disease is considered physical or psychological."

https://autodidactauthor.wordpress.com/2015/03/31/physical-or-mental-why-it-matters/

 

[alex3619]

I am substantially in agreement with Clark Ellis. I look forward to the third blog.

I do think that what happens a lot in messages on related topics, especially from the biopsychosocial proponents, is that they state indisputably correct things, but do so in a way that implies something other than what their message actually addresses.

The nearest hypothetical example is a cult leader who always brings the argument back to scripture and adds a distinctive twist that implies things beyond what should be implied. I am also reminded of sales techniques. Once people agree with the obvious, again and again, when you say something dodgy many who are not paying attention will be tempted to agree again. I mean, the obvious things were so right, weren't they?

The issue here is that some are playing by rules of logic, reason, evidence, while others are playing by rules of politics, persuasion and authority.

 

[Martial]

The issue here is that some are playing by rules of logic, reason, evidence, while others are playing by rules of politics, persuasion and authority.

That is a damn good quote haha!

 

[alex3619]

http://www.meassociation.org.uk/201...on-and-the-science-media-centre-3-march-2015/

It is of equal concern that some in the community seem desperate to distance the condition from psychological diagnoses or treatments, as though mental health is somehow inferior to, or less real than, physical health. I do not know any credible scientist who would make that distinction.

On the face of it this is accurate. It does however have deceptive implications. Let us break it down, and see how this kind of rhetoric makes false argument.

some in the community seem desperate to distance the condition from psychological diagnoses or treatments

This is technically correct, but has a false implication. Some of us are very concerned about specific unproven claims that are often treated as proven by some proponents. We are more concerned that the research involved does not come to grips with the available evidence base, including both the biomedical evidence and patient surveys.

Many who take this view, including me, think that its a damn shame ME patients cannot get appropriate psychological support. We think its a shame that the position many medical professionals take, including many psychiatrists, creates distrust with patients, and I think this distrust is often justified. Its a real problem that more medical professionals, and especially researchers and opinion leaders, do not directly tackle these issues and admit the shortfalls in some of this research.

I have something else to do, I hope to come back to this later. I will continue in a new post so as not to substantially edit this one.

 

[redviper]

It matters because it is only a mental illness in the mind of a few delusional psychiatrists and select private interests. You can see just how damaging the research from Lipkin/Hornig has been to our opponents if they are now forced to argue the narrative "well, what does it matter if the disease is physical or mental"?. It's just a pathetic attempt to portray ME patients as the "bad guys", because patients are increasing calls for proper treatment options and recognition for the severity of our disease

As for the ME Association writing the Science Media Centre, I'm not even sure why they would give those monsters the satisfaction. The Science Media Centre is a heartless institution that remains one of the biggest oppressors of ME patients, ALL options should be on the table for minimizing their influence moving forward.

 

[Sean]

some in the community seem desperate to distance the condition from psychological diagnoses or treatments

Certainly we are desperate to distance the condition from unjustified psychological diagnoses or treatments, because we have to live with the consequences of the medical profession repeatedly failing to make that basic but critical distinction.

I do not know any credible scientist who would make that distinction.

That they may be inextricably intertwined, doesn't mean that there is no distinction between them, nor that they have equal causal power or are arbitrarily interchangeable.

You don't cure cancer by substituting proven drugs/radiation/surgery with [insert your psycho-metaphysical practice of choice here]. Such practices might help make the whole experience less stressful and maybe even more meaningful for you, but I doubt the metastatic cells will be grooving along to your personal vibe.

ALL options should be on the table for minimizing their influence moving forward.

All legal and ethical options, certainly.

 

[A.B.]

Psychiatry is to some degree stuck in 18th century thinking where physical disease has mental causes.

Patients that don't agree are maligned as prejudiced and emotionally immature.

 

[eafw]

We really need to get away from their argument over the physical/mental issue and just tell them to get lost and leave us alone.

psych: "but psychological problems are a real illness"
us: "yes they are, now GO AWAY and do something about the terrible state of mental health provision in this country and do something about all the people with actual mental health problems that you are neglecting, instead of targetting those of us with physical health needs with irrelevant diagnoses and treatments"

It is like the way politicians talk about "hard-working families" vs benefit scroungers, as if providing a decent welfare system was putting down said hwfs. Complain about atos/bedroom tax/workfare/sanctions ... "waah, why do you hate "hard-working families" ? "

Classic propoganda

 

[sarah darwins]

This seems like one reason why it matters: http://forums.phoenixrising.me/index.php?threads/my-cfs-me-was-ghd.36797/

When I returned to the UK last year, my diagnosis was 'confirmed' through a referral to a CFS Centre. On the day of my consult, the specialist couldn't even access my medical records (computer failure) but still had no hesitation in referring me to an OT. This is one of the reasons I'm scraping together/borrowing the money to go to Belgium to get some actual testing done. We're in a self-fulfulling circle of hell — the prevailing view of 'ME/CFS' as a somatoform condition means less physiological testing gets done, reducing the amount of solid clinical data being generated, which means less likelihood of alternative avenues of research being pursued, which allows the somatoform paradigm to flourish ... ... Lasciate ogne speranza, voi ch'intrate

 

[alex3619]

This seems like one reason why it matters

It seems to me that diagnoses of CFS based on prolonged substantive chronic fatigue are more likely to be misdiagnoses than accurate, even before getting into the ME issue. Further some ME patients don't have chronic fatigue, but chronic fatiguability is present.

 

[alex3619]

I do not know any credible scientist who would make that distinction.

What does this really say? Here is my interpretation before I get to further analysis: the author does not know many credible scientists.

I think MOST scientists would make the distinction. In fact, I think those that make the distinction are more credible.

Scientists are about understanding the nature of things. Finding out how thing work. If you suggested to an astrophysicist that it does not matter if the universe is largely governed by string theory rather than another theory, and they were not credible scientists if they thought a distinction was important, they would not have nice things to say about your comment.

This is most likely a silencing strategy. Its actually a subtle attack on scientists, and on medical professionals who like to think they are using scientific or evidence based practices: if you complain or disagree you lose credibility. Its more political rhetoric in action.

For the record, I know of lots of scientists who would make the distinction.

This argument is being used to blur the distinction with this claim: If a treatment helps or cures patients then it does not matter if its psychological or biomedical in nature. I agree. IF. Is it so hard to understand we need good evidence to back that IF in a disease in which they have failed and failed and failed, and many of us are made worse by GET in particular, patients are sectioned and treated against their will with unproven therapies, and in which the science is plagued by bad design, poor implementation of that design, cherry picking of results, ignoring contrary data, and incomplete release of data?

 

[alex3619]

http://www.meassociation.org.uk/201...on-and-the-science-media-centre-3-march-2015/

The comment on the Sykes reply about the SMC and what it does is irrelevant to the argument. Its a distraction.

 

[alex3619]

We send out all the replies that come back to us, but of course not everyone will reply.

This actually seems credible. However one would think that an investigator would be more sure to get a balanced view, including directly contacting relevant experts.

 

[alex3619]

The idea that those who investigate psychological causes or treatments have nothing to contribute to a discussion of CFS/ME is absurd and I reject your suggestion that their views should not be sought.

This is not unlike saying the idea that software engineers should not be consulted on a hardware publication is absurd. Its another distraction.

Its not an issue that people who want to investigate psychological causation or treatment have nothing to contribute to the field in general. It IS absurd to claim that this gives expertise outside their field. I actually have no issues with there being comments from such people. I do have issues with one sided commentary. Its the journalist's responsibility to ensure the reporting is more accurate.

This argument also conflates discussion of the general nature and research in ME with the discussion of specific biomedical research.

Were I to take this argument seriously, I would be forced to accept this proposal (which I actually think is not inappropriate in a broad debate):

The idea that those who investigate biomedical causes or treatments have nothing to contribute to a discussion of ME or CFS or SEID is absurd and I reject your suggestion that their views should not be sought.

Bravo! Bring on the comments from physicists, biochemists, and research engineers on the psychogenic research papers! Were there opinions sought? Was Marty Pall contacted? Dr Peterson? Anyone from the IACFSME? Its unrealistic to expect that the SMC would be contacting experts all over the world, and unrealistic to expect they would contact biochemists (for example) who do not work on CFS or ME, but its not unreasonable to expect them to see an obvious distortion in the list of experts they want to contact.

Let me add one final point. There have been concerns raised in independent media about bias in SMC reporting. Has the SMC contacted the nonresponders to see why they did not respond?

 

[Sean]

Highlighting the blatant selectivity of the psych crowd is a good tactic, I think. (Selectivity of both the evidence they choose to cite, and the way they choose to interpret it.)

Most people have a basic sense of fairness, and understand how important it is, and the dangers of trashing it.

If you can show one side of an argument is being unfair in their approach (or hypocritical, dishonest, etc), especially if they are the conventional 'authorities' on the subject, that can at least open minds to the possibility of other interpretations.

 

[Snow Leopard]

What does this really say? Here is my interpretation before I get to further analysis: the author does not know many credible scientists.

It was a strawman. Sykes was saying no credible scientists would claim that "mental health is somehow inferior to, or less real than, physical health". Which is true. It is a strawman however, because no advocate or patient with ME is claiming that mental health conditions like depression are 'not real' either.

Sykes is either not listening to us, or deliberately playing a political game. Either way, it is clear there is a breakdown in communication.

 

[alex3619]

Sykes is either not listening to us, or deliberately playing a political game. Either way, it is clear there is a breakdown in communication.

Maybe. Or maybe no breakdown but part of the game.

 

[Sean]

They are getting to the stage where the intellectual & ethical contortions required to justify their failure to themselves are obviously ludicrous and desperate, and an undeniable embarrassment to the rest of the profession.

 

[alex3619]

They are getting to the stage where the intellectual & ethical contortions required to justify their failure to themselves are obviously ludicrous and desperate, and an undeniable embarrassment to the rest of the profession.

Much of psychiatry has been an embarrassment since the nineteenth century and it never stopped them. Scandal after scandal, abuse of tens to hundreds of thousands of patients documented (I have not compiled the numbers), made up diagnostic categories, not much clue as to mechanisms, poor treatment outcomes, no cures.

The argument is that people need help, so they have to do something. However with such a record you would expect conservative methods. Instead we get assurances of accuracy, certainty, recovery, even though we all know all three are hyped statements. We get coercive methods. We get blatant disregard of nonpsychiatric conditions.

Now psych does need to update from nineteenth century thinking to twentieth century thinking. There are a lot of people who need help. However unproven and unscientific practices must be moved to alternative medicine. They have no part in mainstream medicine.

 

[chipmunk1]

ask them if it matters if you use mainstream medicine or alternative medicine and you will surely get a reply!