The Psychiatric explanation of ME/CFS I am going to post this in different sections as it is long. I might edit in a few other quotes over time from other authors and sources. Obviously not all psychiatrists hold these views, only the ones who think ME/CFS is a behavioural and psycho-social problem. Not all of the people who hold the psychiatric view of ME/CFS would agree fully with all of these views, but you see variations of these views cropping up again and again. Even people who think ME/CFS is physical can be somewhat influenced by these view (I think sometimes not realising the background to the ideas). I think it is important to understand these views as these people have been aggressively promoting the view that our symptoms are a result of psychological and behavioural factors, and not due to an ongoing organic physical disease. They have blocked progress into biomedical investigation and treatment of ME/CFS, as they know that an organic explanation is inconsistent with their theory of ME/CFS. Basically you cannot agree with them, and think that ME/CFS is an organic condition like MS, Lupus or the like. It is the practical effects that these views have on medical care, research, and access by patients to services in general (medical, social, welfare etc.) that makes it important to argue against the dominance of these views. If you wonder sometimes why you are treated so badly, well this is it. People who hold these views have consistently, and very successfully, blocked progress for patients in the UK, where “specialist” CFS clinics have been set up that offer no tests or biomedical treatments, just behavioural interventions. It is interesting to look at the ideas contained in one document, the Royal Colleges Report (1996. Go to http://www.cfs-news.org/rcp.htm for more info) as it reflects many of the psychiatric views on ME/CFS, and it is interesting to see that in many ways these people got their way in influencing the UK health and welfare-services approaches to this illness. Under a section Essential skills/tasks for a multidisciplinary CFS unit: this is the approach advocated by the Royal Colleges Report: “Perform the minimum number of investigations” and ”Provide appropriate and unambiguous reassurance when there is no evidence of relevant physical pathology” [which there isn’t going to be if you don’t run the tests!] Royal Colleges Report 1996. Advocates of the psychiatric theory of ME/CFS think that CBT and GET can cure ME/CFS, and sometimes argue that the patients who are not helped by these strategies are just poorly motivated, or are getting some gain from adopting the sick role. For example: The CBT/management these people offer is not to help people cope with their illness better, but to try to get the patient around to their way of thinking about their illness, and get the patients to get themselves better through doing more.