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Interesting Article On Somatizing Patients

Discussion in 'Action Alerts and Advocacy' started by PhoenixDown, May 13, 2013.

  1. PhoenixDown

    PhoenixDown Senior Member

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    http://www.aventinomedicalgroup.com/Dimsdale.book(jd12.pdf

    This unrelated link (again about somatizing) http://www.dsm5.org/research/pages/somaticpresentationsofmentaldisorders(september6-8,2006).aspx

    Not sure how official the domain name is, but very interesting references there. The talk about different cultural labels for alleged somatizing or functional somatic syndromes, fails to resolve the issues of doctor's prejudice, bias, incomplete testing, and the negative effects that these labels have on patients (especially those who's symptoms don't respond to the staple treatment options).

    PS: Please refrain from mentioning the name of certain researchers who's names inevitably pop up in research that affects us.
    Sean likes this.
  2. Sean

    Sean Senior Member

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    "may seem to us"

    Says it all.

    Call me a crazy radical, but they could try just saying that they do not have a good explanation or treatment yet. Couldn't possibly be a worse outcome than the one they are currently inflicting upon us. The 'any explanation and treatment is better than nothing' approach is not exactly scientifically or ethically defensible.
    Little Bluestem and ukxmrv like this.
  3. Living Dead

    Living Dead

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    I shit you not.
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  4. PennyIA

    PennyIA Senior Member

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    What ticks me off the most? Is that it's worded the way it is. "one of my somatizing patients" ... instead of "A patient that I misunderstood to being overly concerned about their health ended up being justified by the diagnosis of multiple sclerosis."

    So, they still don't 'get it' even after fighting for and getting a diagnosis, the patient is still considered to be 'somatizing' ... and 'at least one of' means that just perhaps, there were more than one with undiagnosed MS? sad. very sad.
  5. IreneF

    IreneF Senior Member

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    There's a difference between being overly worried about one's health and suddenly being unable to do what you used to do.
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  6. alex3619

    alex3619 Senior Member

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    Angela Kennedy's book "Agents of their own misfortune?" addresses the cultural and social bias in somatization and psychogenic hypotheses generally.

    If you couldn't do what you always could, and nobody could help, wouldn't you be worried?

    If most of what you did made you sicker, wouldn't you be anxious?

    If you lost your former life, as in career, relationships and even hobbies ... wouldn't you be unhappy?

    They confuse cause and effect, they have untestable and therefore nonscientific hypotheses, and their treatments don't improve functional capacity.
  7. Sean

    Sean Senior Member

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    If the theory disagrees with experimental results, the theory is wrong.

    No way around that.
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  8. alex3619

    alex3619 Senior Member

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    Actually, Popper ran into this problem. They keep making ad hoc changes ... theory was wrong, well, no, it was just not quite right, now we have fixed it! They then keep making such changes, ad infinitum. They also raise numerous spurious arguments against counter-claims. Each has to be defended against, and something interesting happens: most who read this stuff read the counter-arguments, but dont get to read all the rebuttals. So most people tend to think things are explained away. They need to get nailed down, there needs to be fair and open journal publication of rebuttals, and they need to agree at some point that indefinite ad hoc modifications of their hypotheses look increasingly untennable. They also need to stop releasing increasingly irrational press statements that rely on pursuasive rhetoric rather than evidence and reason.

    The other problem is that entire brances of psychiatry do not embrace critical rationalism. They are empiricists ... just look at their study designs.
  9. Enid

    Enid Senior Member

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    Doc's prejudice stands out for me - which I equate with ignorance, not keeping themselves informed or stuck with attitudes of the time learnt years ago at medical school or inability to admit "I just don't know" (as my Consultant Neurologist could).
  10. Sean

    Sean Senior Member

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    Deeper and deeper into ever more ludicrous cognitive contortions. Eventually such indulgent revisionism collapses under its own hair splitting and persistent discordancy from the real world.

    See Ptolemy and his planetary epicycles.
    biophile and Enid like this.
  11. alex3619

    alex3619 Senior Member

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    Yes, but our goal is to make that happen, allied with anyone else who wants to see psychiatry based on science and not superstition.

    The problem is we are not dealing with one lone theoretician. We are dealing with a global self reinforcing system, where support comes from medical dogma/tradition, an entire branch of psychiatry that is not scientific, and the rest of the medical community that does not like to see mediicine "attacked" even if its justified. Added to this they receive corporate and government support. Zombie science can and should be trashed, but its not as easy as things used to be.
  12. Enid

    Enid Senior Member

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    Quite alex - not one lone theoretician but an impotent medical establishment unable to understand.
  13. roxie60

    roxie60 Senior Member

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    The Dr in my recent IME has decided the majority of my 'complaints' are due to somatoform syndrome so he has concluded based on a 30 minute eval that I all my issues are in my head and that I dont need a Dr I need a psychiatrist. The more I think about his recap the angrier I get. Has anyone written a rebuttal to an IME evaluation they received?

    I think I should put this ? in my LTD thread too
  14. IreneF

    IreneF Senior Member

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    I have a cat who suffers from somatoform disorders. She gets stressed very easily, mostly from interactions with other cats. She just doesn't like them, even when they are friendly. When one of the other cats got old, incontinent, and demented she started peeing blood. She's had other very expensive problems that could never be pinned down. We were told that Prozac might help, but she's a difficult cat to pill.

    She's a cat, and unless she runs away from home she has to live with others. People, on the other hand, can alter their circumstances, and even when they can't, they can use insight and reason to help themselves. I suspect that somatoform disorders are more common among animals than people.
  15. alex3619

    alex3619 Senior Member

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    The problem with somatoform disorders is that NONE of them are validated disorders, and there is no objective evidence of their existence. The argument basically comes down to "we don't know what is wrong, so it must be in the mind". Undiagnosed disorders, and disorders which might become diagnosable in the future, are simply dismissed. In some cases, including with ME, diagnosable disorders which can from known pathophysiology derive most of the symptoms are simply ignored.

    Furthermore, the existence of somatoform disorders cannot be scientifically tested: the are not scientific. Every other aspect of Freudian psychotherapy has mostly been discredited and abandoned, but this area has not. Its overdue to be scrapped. Large numbers of people have died after having been told "its all in the mind", some from even very aggressive cancers. "Somatoform disorder" is a diagnosis of medical failure - it avoids having to admit medical failure and avoids further investigative tests.
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  16. PhoenixDown

    PhoenixDown Senior Member

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    I found another good link, perhaps we should Make a sticky/pinned thread for this kind of thing.

    He also goes on to talk about Engel's cautions and ATOS work assessments.

    https://dl.dropboxusercontent.com/u/32109159/Illness as Deviance.pdf
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  17. Esther12

    Esther12 Senior Member

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  18. alex3619

    alex3619 Senior Member

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    This is not the first interesting article from Gill Thorburn. I recall reading some very interesting ones a few years back.

    I think he is missing something though. While I agree that BPS is more bPs and even just _P_, it was designed that way from the beginning. It was a rebadging of psychosomatic medicine, which was becoming increasingly irrelevant, and made more acceptable by describing it as an integrated approach. This model is really a fabrication, almost empty in its implementation, and can typically be considered to be just another name for psychosomatic medicine. However they sell it as the next great hope, particularly to bureaucrats. I hope to expand upon this in my book.
  19. alex3619

    alex3619 Senior Member

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    She refers to this page, which is worth reading: http://www.soilandhealth.org/03sov/0303critic/030313illich/Frame.Illich.Ch2.html

    Please note this: "Social Iatrogenesis
    Medicine undermines health not only through direct aggression against individuals but also through the impact of its social organization on the total milieu. When medical damage to individual health is produced by a sociopolitical mode of transmission, I will speak of "social iatrogenesis," a term designating all impairments to health that are due precisely to those socio-economic transformations which have been made attractive, possible, or necessary by the institutional shape health care has taken."
  20. PhoenixDown

    PhoenixDown Senior Member

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