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Book published this week in UK referring to ME as psychosomatic

Kyla

ᴀɴɴɪᴇ ɢꜱᴀᴍᴩᴇʟ
Messages
721
Location
Canada
Is the correct response

a) to rant & rave giving the misleading impression that some ME/CFS patients are mentally ill.

Or

B) Take a more positive approach by promoting the work of Drs Fluge, Mella, Hornig, Montoya & Newton?

Maybe you can clarify your position for us @Seanko

Judging by your earlier comments, and review of the book, you seem to think conversion disorders are a valid diagnostic category. Do you think ME is psychosomatic? do you believe you have a "conversion disorder"? or do you just think we have been extricated from that category and we should distance ourselves from other unexplained diseases and leave them to rot in this category until someone discovers their organic pathology...And that that research will come about without any patients or advocates fighting for it?

earlier in this thread you said it didn't matter whether an illness was physical or mental, and that "Modern Medicine no longer differentiates between body & mind"
But then you say that Me patients should be meek and well behaved so they don't give the "impression they are mentally ill"
So it doesn't matter if it is mental or physical, but if someone has a mental illness their opinion can be ignored as irrelevant? How does one "sound" mentally ill? Are patients who have both ME and a mental illness not allowed to have a voice or an opinion? Is treatment decided for them without their consent?

This is exactly the sort of logic that makes some think it is essential to advocate against the sort of nonsense that is in this book. ie - that it is ignoring the reams of biological evidence, spreading the erroneous and outdated opinion that people with ME have a "conversion disorder" and cannot be trusted to report their own symptoms, and must be coerced into "treatments" which have been shown to cause harm to the majority of patients:
http://www.meassociation.org.uk/wp-...No-decisions-about-me-without-me-30.05.15.pdf

Finally you don't think we should loudly advocate for ourselves...but are criticizing our experts for not being loud enough?
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
When someone says "I believe your symptoms are real, so it doesn't matter if the cause is physical or mental", then I may or may not rant and rave at them, as the mood takes me. If they want to indulge in petty name calling ("mentally ill") as a result of that, it's their problem, I shall continue to rant and rave for whatever time period I deem appropriate.

Of course it matters if the cause is mental or physical. If it's mental and my symptoms continue, it's my fault for not accepting therapy / getting myself sorted out by seeing someone who will help me unlearn my helplessness, stand on a large circle on a piece of paper chanting, or explore my childhood issues, or my grief at my children's increasing independence, or my unhappy marriage, or whatever else some gullible psychoquacker who's read a book and swallowed it whole has decided is my problem.

If it's physical, then I've just been unfortunate enough to catch a horrible illness.
 

Cheshire

Senior Member
Messages
1,129
Seanko

Calling "this" opinions differing from yours is not the best way to engage in a constructive discussion.


The two options (refuting the psychosomatic views and highlighting the work of Fluge, Mella and all the others) are not at odds. The two are necessary IMO. And refuting the psychosomatic view is not necessarily, as you seem to view it, irrational ranting and whining.
 
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Messages
5,238
Location
Sofa, UK
earlier in this thread you [seanko] said it didn't matter whether an illness was physical or mental, and that "Modern Medicine no longer differentiates between body & mind"
This myth ought to be one of the easiest psychobabble arguments to expose, and it's one of the most important, IMO. When Wessely says (as he often has) that dissenting ME patients are working from a false and outdated mind/body paradigm, and claims that modern medicine is more sophisticated and holistic in its thinking, there is a simple response. The health insurance industry very much does make this distinction, with the backing of the law, denying long-term payment (>2 years) of insurance claims for illnesses classified as mental illness, as ME/CFS is (for insurance purposes). Wessely, White, et al, must all surely know this, from their paid work for insurance companies in relation to ME/CFS.

The above paragraph is my understanding of industry practice, but quite likely there is some disinformation and inaccuracy behind it...the situation around Wessely and White's insurance company work seems a bit hard to definitively pin down. I would love for somebody to research evidence and references for the above points, to get a water-tight exposition of this situation. This would be a killer argument, IMO, against any psychobabbler claiming that we're making a 'false dichotomy' between body and mind, or that we're applying 'stigma' to mental illnesses by arguing that ME/CFS should be treated as a biomedical disease rather than a psychological one.

To any member of the public reading a Wessely tweet like "Patients are making a false distinction between mind and body" and a patient response like "Insurance companies don't pay out for mental illnesses as they do for physical ones (REF), as you well know from your paid work as a consultant on ME/CFS for insurance companies (REF)"...well, I think such an exchange alone would be game over for any reasonable 'floating voter'...it shows quite clearly what kind of games are being played here...
 

A.B.

Senior Member
Messages
3,780
It would be useful to make a list of all the contradictions and baseless claims surrounding the Wessely school.

For example the idea that patients cannot be trusted to accurately report their symptoms except when they report improvement from some psychiatric intervention.

Or the concept of conversion disorder having zero basis in objective reality - one might as well speak of demonic possession.
 

shahida

Senior Member
Messages
120
Now now everyone, as Wessely has recently said he has maintained all along that mE is a brain disorder like dementia. We've all misconstrued him all along......;
 
Messages
85
There has to be a way to harness all the brilliant thinkers and writers on this site. I can't tell you how grateful I am for all the effort you people put in to debate and analyse all this stuff. My poor old brain won't let me join in much but I think I would go mad without 'hearing' your discussions.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
We have had some long debates on the mind-body philosophy on this forum. Let me reiterate my view for those who have not read it dozens of times, though perhaps a little differently - mind is a fiction. There is no mind-body dichotomy, because there is no such thing as mind.

Mind is a label applied to aspects of brain function. That is the simplest hypothesis. We have no basis for thinking that mind is something other than an aspect of how the brain works, except myth and theory and dogma.

I am a physicalist monist on mind-body issues. I look at the "modern mind and brain are one dogma" from some aspects of psychiatry, and I see relabeled dualist concerns. Indeed, BPS is inherently dualist if not used right (biopsychosocial theory). We have better explanations of what we call mind from consideration of brain than from any outdated mind theory.

The irony is that saying patients have obsolete ideas on mind-body they reveal their own obsolete ideas.

BPS holds that all illness has mental, biological and social aspects. Great. Obviously right. They ignore environment though ... chemicals, dietary nutrient profiles, pathogens, etc. Ok, so far so good.

They then promote this idea that mind and body are not different. Great. I think the same, with the clarification that mind is an aspect of brain, and just a label.

So if mind and body are one, then we only have to treat mind to treat disease. Say what? Or we only have to manipulate society to treat disease? There is no question that some alteration of attitude, thought or behaviour can help in some cases, and how society reacts can help (or hinder), but there is a massive leap here from influence to causation, mostly based on unproven theory and dogma.

The mythical weight challenged lady with a great voice has indeed sung, but most proponents of dogmatic mind-body thinking and the PSYCHObiosocial model are tone deaf ... or they just don't want to hear.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
There has to be a way to harness all the brilliant thinkers and writers on this site. I can't tell you how grateful I am for all the effort you people put in to debate and analyse all this stuff. My poor old brain won't let me join in much but I think I would go mad without 'hearing' your discussions.
I think its possible to start a project looking at fallacies and poor reasoning in psychobabble. I wanted to do that in a book but its on hold for now. We could do it as a forum, taking one paper at a time, starting a debate on that one specific aspect of the paper. Psychiatry is vulnerable to this to some extent, but psychogenic psychiatry is completely dependent on fallacious thinking.
 

Cheshire

Senior Member
Messages
1,129
I think its possible to start a project looking at fallacies and poor reasoning in psychobabble. I wanted to do that in a book but its on hold for now. We could do it as a forum, taking one paper at a time, starting a debate on that one specific aspect of the paper. Psychiatry is vulnerable to this to some extent, but psychogenic psychiatry is completely dependent on fallacious thinking.
Totally agree.
We need to have a more systematic approach to counter BPS arguments, clearly listing contradictory papers that invalidate their own theories.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Totally agree.
We need to have a more systematic approach to counter BPS arguments, clearly listing contradictory papers that invalidate their own theories.
This is another avenue, but with a different focus. It would be good to have such references. However the papers and discussions are often irrational. The claims are unsupported. They rely on fallacy after fallacy in order to argue. Those can be pointed out , and its not easy to dispute them except by indulging in even more fallacious thinking.
 

user9876

Senior Member
Messages
4,556
This myth ought to be one of the easiest psychobabble arguments to expose, and it's one of the most important, IMO. When Wessely says (as he often has) that dissenting ME patients are working from a false and outdated mind/body paradigm, and claims that modern medicine is more sophisticated and holistic in its thinking, there is a simple response. The health insurance industry very much does make this distinction, with the backing of the law, denying long-term payment (>2 years) of insurance claims for illnesses classified as mental illness, as ME/CFS is (for insurance purposes). Wessely, White, et al, must all surely know this, from their paid work for insurance companies in relation to ME/CFS.

The above paragraph is my understanding of industry practice, but quite likely there is some disinformation and inaccuracy behind it...the situation around Wessely and White's insurance company work seems a bit hard to definitively pin down. I would love for somebody to research evidence and references for the above points, to get a water-tight exposition of this situation. This would be a killer argument, IMO, against any psychobabbler claiming that we're making a 'false dichotomy' between body and mind, or that we're applying 'stigma' to mental illnesses by arguing that ME/CFS should be treated as a biomedical disease rather than a psychological one.

To any member of the public reading a Wessely tweet like "Patients are making a false distinction between mind and body" and a patient response like "Insurance companies don't pay out for mental illnesses as they do for physical ones (REF), as you well know from your paid work as a consultant on ME/CFS for insurance companies (REF)"...well, I think such an exchange alone would be game over for any reasonable 'floating voter'...it shows quite clearly what kind of games are being played here...

I accept the insurance argument but I think the whole mind body false dichotomy argument is just lazy. What matters in understanding mechanism and disease processes and this is what helps lead to treatments. Mechanisms may start in the mind (if we know what that is!) or in biological processes which may affect neurons and hence the 'mind' or if there is some other biological processes. But what science and medicine needs to explore is mechanism.

What Wessely does is present a lazy thought process where he dismisses patients for trying to separate out mind and body. He then goes on to talk of mental illness such as schizophrenia which is likely to have a biological cause (i.e. neurons or other things in the brain malfunctioning) but he then pushes CBT and get which have a very different theory of mechanism. So he comes across to me in a very confused manner because he is clearly pushing one theory whilst trying to get away with not justifying it by bashing patients with a much wider classification.

To me what he is presenting is a false argument that confuses things that have traditionally been presented as mental illness with his beliefs in psychosomatic mechanisms which could form one set of theories. I think he is doing that so that his beliefs in psychosomatic medicine don't get questioned in any detail because they simple don't stand up to rigorous scientific examination (either as mechanisms since they don't look at mental processes and representations, or in terms of evidence). The question I have with Wessely is does he understand the flaws in the way he puts his argument.
 

user9876

Senior Member
Messages
4,556
Now now everyone, as Wessely has recently said he has maintained all along that mE is a brain disorder like dementia. We've all misconstrued him all along......;

He keeps saying it is a brain disorder but pushes psychosomatic treatments whose trial results are at best tenuous. This suggests that he believes it is psychosomatic - I think when people have put that as a straight question to him he has not answered.
 

nasim marie jafry

Senior Member
Messages
129
This is possibly one of most offensive comments a 5 star reviewer of O'Sullivan's book has uttered:

Ms O'Sullivan's carefully argued account of ME and various other disorders is treated by some reviewers as if she were denying the holocaust. I'm afraid Dr O'Sullivan comes out of it far better than they do

Full review here: 'Vivid and compassionate': http://www.amazon.co.uk/review/RFC4Y9G2JU0SS/ref=cm_cr_rdp_perm?ie=UTF8&ASIN=0701189266

I wouldn't know where to begin, trying to educate this person.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
We are not going to educate that person, but there has already been one very good comment (calm, balanced, objective) that might educate people in the middle ground. I don't trust myself to make a comment as I could easily end up ranting and venting, and don't want to let down the people who so admirably manage to put our case in a calm and reasonable manner.

I have just given the review a thumbs down, and clicked on the "report abuse" button for the first time in my life, never noticed it before. As my reason I wrote that I found the holocaust denial analogy offensive. See what happens.
 

nasim marie jafry

Senior Member
Messages
129
Oh dear, this nurse entirely missing the point (gives 4 stars):

http://www.amazon.co.uk/review/RAWYT14HLL2WC/ref=cm_cr_rdp_perm?ie=UTF8&ASIN=0701189266

I certainly didn't feel this was a book dismissing ME in some way and in fact ME only had a small part in the book and I am sorry to see the negative responses. We are holistic beings and it is positive to see a doctor expressing this and placing equal value on the body and the mind.

So a whole chapter misrepresenting neuroimmune illness is somehow not harmful. Give me strength!
 

nasim marie jafry

Senior Member
Messages
129
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TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
We are holistic beings and it is positive to see a doctor expressing this and placing equal value on the body and the mind.

What? I admit I haven't read the book, but does she really place equal value on the body and the mind? Does the ME chapter include an up-to-date analysis of recent neurological and immunological research to complement and balance her psychological observations? In that case I apologise and retract all my comments, I didn't realise that she had taken a balanced and holistic view. Maybe I was misled by the title of the book.
 
Messages
1,446
I wish someone would write a book examining the compulsion and desire to believe that other peoples diseases are psychosomatic. When given evidence that ME is not psychosomatic, the believers switch off, ignore it, behave as though the evidence doesn't exist and roll onwards proclaiming they occupy the 'compassionate' high ground.

Mindbody ideology, far from being balanced or compassionate, has become a tyranny, a new version of the moral high ground.