Knowledge gaps and hubris Hi pictureofhealth. Indeed. It really is a rabbit hole without end. Recently I was looking at "Functional somatic syndromes" (Barsky & Borus 1999) as well as the reader comments and authors' reply. They allow for the possibility of biomedical factors but aren't really interested in them even if they exist, they just care about the alleged psychosocial and cognitive behavioural factors which are given obvious preference. Nor do they seem all that concerned about the looming contradiction of finding biomedical causes and subtle structural damage in "functional" disorders, unless of course what they really mean is a biomedical event "triggered" the psychological maladaptation rather than "cause" it, and at some point there will be an argument over exactly where "functional" ends and structural damage begins. Even then, they state "these same psychosocial factors are operative in illnesses that have a clearly demonstrable medical basis, such as ischemic heart disease". I think "functional somatic syndromes" will be renamed to compensate for future biomedical findings while still clinging to the initial psychosocial conceptualisation. Having biomedical research into ME/CFS reveal undeniable evidence of organic pathology and allow for effective treatments, this is really only one side of the story, one part of a victory over a devastating illness and a despicable response to it from society. I do believe there are genuine psychological factors in disease but it has been difficult teasing out fact from ideology and cutting through all the overstatement and overgeneralisation. Unfortunately, much of the research degrades into mere psychobabble and assfacts by the time it reaches the public and the medical profession. Angela mentions US and UK as "societies where psychobabble has run rampant without logical and effective critique". Mind over body wishful thinking, illusion/myth of control, and just world theory; these are all common human traits, it may be hard to find any society that isn't affected. You mention the knowledge gap. Every generation seems affected by it, and fills in the gaps with speculation. The hubris comes in when this is swallowed as fact and when the previous lessons are ignored because recent progress has set up a false confidence that similar mistakes won't be repeated with the modern methodology. The toolset available to researchers has expanded greatly over the last 50 years, but still vulnerable to self-deception via measuring one's own bias. A good example is how some people have been wooed by the "evidence base" of CBT/GET. When I first read the CBT literature it sounded impressive, until I realised it employed flawed hypotheses, flawed criteria, and flawed psychometrics or fatigue scales taken for granted as reliable but don't match what is happening in reality.