"You think I'm mad"

[worldbackwards]

http://www.theguardian.com/society/...-im-mad-the-truth-about-psychosomatic-illness
Haven't really had time to have a look, but I suspect we're going to have an opinion on this one.

 

[chipmunk1]

Seems like Charcot is back. Nice PR for psychosomatic illness. As usual they have to rely on anecdotes.

What's more interesting is that none of these cases here had a real serious emotional conflict preceding the problems yet it is assumed because it can not be explained and does not resemble organic illness the cause MUST be emotional.

Where is the evidence that it is emotional? Why couldn't it just be a processing problem from the brain?

Does anyone really understand how the brain works? Our brain just operates via emotions and the "subconscious"?

There is no other type of processing involved? That is nonsense.

This seems to be a logical fallacy. They believe that because they can reliably disprove an organic cause they have proven an emotional cause even when there is where little evidence in the presented cases that it was emotional.

Also these are cherry picked anecdotes which are far in between.

Most so-called psychosomatic diagnoses are given out randomly and very often there is a very credible alternate explanation which does not use the mystical Freudian concept of the subconscious.

In science you will also want to choose the least mystical most down to earth explanation if it is sufficient to explain what you can observe and it makes at least as much as sense as the other.

 

[sarah darwins]

Seems like Charcot is back. Nice PR for psychosomatic illness. As usual they have to rely on anecdotes.

Funny how those anecdotes never seem to end with "Turned out I was wrong. She had MS."

Psychologists must be the only health practitioners who are never wrong. Isn't that great?

I was struck by this paragraph:

In 2011, three GP practices in London identified 227 patients with the severest form of psychosomatic symptom disorder. These 227 constituted just 1% of those practice populations – but estimates suggest up to 30% of GP encounters every day are with patients who have a less severe form of the illness. If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?​

So, how did those GP practices identify those patients? Because it sure as hell wasn't with an affirmative test. Presumably it was with the help of a handy checklist drawn up by psychologists.

And where does that 30% estimate come from? Hmm ... can't think.

 

[Valentijn]

And where does that 30% estimate come from? Hmm ... can't think.

I think Per Fink (imprisoned ME patient Karina Hansen in Denmark) came up with that number, or something similar. Basically "we don't know and didn't really bother trying to find out" = undeniably psychosomatic, in their alternate reality.

 

[A.B.]

If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?

If invisible evil gremlins cause so much trouble, why are we so bad at dealing with them? None of our anti-gremlin solutions work well.

 

[chipmunk1]

If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?'If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?

Because there are no long-term follow up studies. that is what happens when you have no clue what is going on.

 

[sarah darwins]

Where is the evidence that it is emotional? Why couldn't it just be a processing problem from the brain?

Does anyone really understand how the brain works? Our brain just operates via emotions and the "subconscious"?

There is no other type of processing involved? That is nonsense.

Years back we had a cat who developed partial paralysis of his back legs. The vet ran screens for infection, and x-rayed to look for signs of spinal compression, which he thought the most likely cause, but found nothing. He was a very experienced vet, however, who said if it was a compression injury there was a reasonable chance it would resolve itself. Which it did, after about a month. After two months the cat was back to normal.

Now, if that cat had been human he would likely have ended up in the care of someone like Suzanne O'Sullivan. She would have delved into his emotional life, discovered that he resented our feeding him from a plastic bowl when we were eating off china (in turn leading to feelings of inadequacy and rejection). She would have told us to change his dinnerware and hey presto!, when he recovered that would be another one chalked up in the win column for psychosomatic illness.

How many of these people with psychosomatic conditions are actually suffering from transient neurological disruptions, the result of viral infections or minor physical injuries?

 

[duncan]

"Yvonne's drawing was evidence not of guilt but of innocence, and, at the moment she handed it to me, it was I who could not see."

 

[chipmunk1]

Years back we had a cat who developed partial paralysis of his back legs. The vet ran screens for infection, and x-rayed to look for signs of spinal compression, which he thought the most likely cause, but found nothing. He was a very experienced vet, however, who said if it was a compression injury there was a reasonable chance it would resolve itself. Which it did, after about a month. After two months the cat was back to normal.

Now, if that cat had been human he would likely have ended up in the care of someone like Suzanne O'Sullivan. She would have delved into his emotional life, discovered that he resented our feeding him from a plastic bowl when we were eating off china (in turn leading to feelings of inadequacy and rejection). She would have told us to change his dinnerware and hey presto!, when he recovered that would be another one chalked up in the win column for psychosomatic illness.

How many of these people with psychosomatic conditions are actually suffering from transient neurological disruptions, the result of viral infections or minor physical injuries?

i think in all of these cases you could easily find another explanation which does not involve emotional causes and makes at least as much as sense.

1. Some could have intentionally faked it for whatever reason.
2. The nerve injury triggered some kind of brain processing problem which has nothing to do with emotions.
3. There was some kind of neurological or organic problem present which remained undetected.

 

[sarah darwins]

"If psychosomatic symptoms are so ubiquitous, why are we so ill equipped to deal with them?"

Just to be clear, I didn't say that. She did!

 

[Esther12]

I skimmed through for something other than stories, and didn't find anything I was interested in.

I don't like speaking broadly about 'psychosomatic' illness, and things like that don't seem impossible to me... but I have come to realise that my reasons for thinking such problems did occur were really all based on anecdotes in medical papers, and that there isn't really any more compelling evidence than that.

I used to faint at the sight of my blood as a child, and that's surely some sort of psychsomatic response. I do wish there was less of an emphasis on doctor's interpretations of individual cases when discussing this sort of stuff though, as I think that does encourage quackery.

 

[chipmunk1]

The understanding of the brain/mind has changed quite a bit over the past 100 years. The theory of psychosomatic illness is more less the same.

why do we still need to use psychosomatic models when other theories make at least as much as sense?

 

[Snow Leopard]

Title should be renamed "Some anecdotal stories and speculation about psychosomatic illness".

I used to faint at the sight of my blood as a child, and that's surely some sort of psychsomatic response. I do wish there was less of an emphasis on doctor's interpretations of individual cases when discussing this sort of stuff though, as I think that does encourage quackery.

Fainting during panic attacks is not psychosomatic in the sense described by the article. It is brought on by specific behaviour, which has physiological consequences: improper breathing is the usual cause. This can be demonstrated.

 

[chipmunk1]

I used to faint at the sight of my blood as a child, and that's surely some sort of psychsomatic response.

Depending on how you define "psychosomatic response". Did your subconscious make you faint to protect you from seeing the blood? That is a pure old-school psychosomatic explanation. Note that these were used in the anecdotes in the article.

Or did an emotional stressor cause a sudden drop in blood pressure which caused the fainting? That is a more credible explanation. Note that many or most neurologists talking about somatisation seem to prefer the former.

I think vasolidation, improper breathing etc. can be affected by psychological stressors and can cause fainting etc.

And where does that 30% estimate come from? Hmm ... can't think.

70% of patients receive a diagnosis. In 30% of cases no diagnosis can be made.

 

[chipmunk1]

what is also interesting is that A LOT if these psychosomatic illnesses appear after a physical injury of the affected organ/body part.

http://jnnp.bmj.com/content/83/9/864

 

[SilverbladeTE]

In much of Science, if you have evidence of repeated unusual things but you cannot pin them down by current theory or investigative tools, you don't say "Oh it's crap, it's all made up"!
you accept it's just something that is currently not understood and WORK on it, developing new tools and theories if need be, until eventually it is understood and you can accept it may take a very long time to do so.

alas "Accepted Wisdom" is a problem across the board as Human psychology in groups SUCKS, but the attitudes of psychology/psychiatrists like this above is evidence of institutional STUPIDITY

 

[worldbackwards]

See also:
"Oh, them biological abnormalities are because of deconditioning"
"How so?
"Oh, we don't know much about deconditioning..."

 

[alex3619]

Because there are no long-term follow up studies. that is what happens when you have no clue what is going on.

My guess is that most patients die or move on, or recover on their own. Yet I am willing to bet many doctors count patients moving on as successes, rather than failures.

 

[alex3619]

you accept it's just something that is currently not understood and WORK on it, developing new tools and theories if need be, until eventually it is understood and you can accept it may take a very long time to do so.

Precisely, and an important difference between science and pseudoscience.

Let me use the psychogenic fallacy. The following argument has the same form. If a psychogenic claim has validity, so does this:

In psychiatric disorders we find no evidence of objective pathology. Therefore these are not mental disorders but simply unexplained disorders.

Let me point out this last statement is also a fallacy. More rationally it can be truncated to the more sound form:

In psychogenic disorders there is no objective evidence of pathology, so these must be considered unexplained rather than caused by the mind.

Arguing they are caused by the mind requires proof. They have none.

 

[chipmunk1]

well even if they could prove that it is caused by the mind doesn't mean that it is psychogenic.

Or is the mind only the psyche? What is the mind? Does it even exist?

Their reasoning is: not body = brain, brain =mind and mind=psyche

they have to use cherry-picked anecdotes to make a case but even these do not really make so much sense or are too credible.

The anecdotes here are better than most that i found in the medical literature. There is even a lack of anecdotes and the few that you can find are not very convincing.

You would think that if 30% of patients are somatizers you would have billions of credible and detailed reports and case studies. In reality there is very little out there.

Per Fink s favourite case studies did not even get any better but were still considered successes.