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Psychosomatic medicine and ME/CFS.

digital dog

Senior Member
Messages
646
Moderator's note -- the next 52 posts relate to an off-topic discussion on this thread. The thread was supposed to be about the BMJ and became about psychosomatic medicine. Therefore, the thread was split and any comments relating to psychosomatic medicine can be posted here.

Is there any actual illness that has been proven to be psychosomatic; An illness where there are real symptoms and hundreds of thousands of sufferers?

Can anyone name an illness that a substantial percentage of the population has which is thought to be psychosomatic?
 
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DanME

Senior Member
Messages
289
Is there any actual illness that has been proven to be psychosomatic; An illness where there are real symptoms and hundreds of thousands of sufferers?

Can anyone name an illness that a substantial percentage of the population has which is thought to be psychosomatic?

Little anectode: I used to work at a psychosomatic hospital, where the doctors mostly treated depression and anorexia. As a curious and naive medical student, I explicitly asked, what is psychosomatic about those diseases, but they didn't came up with a sufficent answer. They just stated, depressed and anorexic patients have ALSO some psychosomatic symptoms like back pain or fatigue.
 
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3,263
EllenGB said:
"Psychosomatic medicine needs to be thrown out of medicine entirely. It's nothing but an unsubstantiated belief, backed up by piles of junk science."
That's unfair.

@EllenGB
Some of us here are interested in psychosomatic medicine more generally, and would like to hear your views on the better side of it. Are there illnesses where you feel that approach has particular merit? Or studies/evidence that you feel is especially strong?

I know you won't have time to answer in detail, just whatever comes to mind readily.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
Here's my opinion on an aspect of personality that might, at least, perpetuate CFS. We already know based on the backgrounds of many sufferers that they were accomplished and successful in their pre-illness lives.

We don't "know" this at all. It is a myth. I for one was a lazy adolescent when I became ill.

Any anecdotal obsevations of this is likely to be due to the fact that those people who are more 'driven' are more likely to be visible advocates, participate in support groups etc.
 

daisybell

Senior Member
Messages
1,613
Location
New Zealand
I fail to see any link between personality type and propensity to develop ME. The only link I can tentatively guess at is that people who are more driven or who like order/knowledge, are more likely to pursue medical diagnosis in the (vain) hope of treatment. And when there isn't any, those same people seek answers elsewhere - like on here for example. So perhaps depending on where any sample is taken from in research explains the results found. If a wide enough sample is taken, any personality factors disappear.
There's no logic in personality having any impact.
 

EllenGB

Senior Member
Messages
119
@EllenGB
Some of us here are interested in psychosomatic medicine more generally, and would like to hear your views on the better side of it. Are there illnesses where you feel that approach has particular merit? Or studies/evidence that you feel is especially strong?

I know you won't have time to answer in detail, just whatever comes to mind readily.

I believe after long thought that there are psychosomatic disorders. Tension headaches come to mind. (I control mine with relaxation as well as neck exercises). I also get abdominal pain if stressed. Mind does affect body. I only have to start talking abut nits and people start itching and scratching their heads. I feel sick when I see people vomit. I don't feel sick because I am ill but something goes on in my brain. I think it's a common response. And so on.
 

EllenGB

Senior Member
Messages
119
I believe after long thought that there are psychosomatic disorders. Tension headaches come to mind. (I control mine with relaxation as well as neck exercises). I also get abdominal pain if stressed. Mind does affect body. I only have to start talking abut nits and people start itching and scratching their heads. I feel sick when I see people vomit. I don't feel sick because I am ill but something goes on in my brain. I think it's a common response. And so on.
Evidence: link between sex abuse and various symptoms. there's a lot. Too much for busy me a the mo.
 

EllenGB

Senior Member
Messages
119
I fail to see any link between personality type and propensity to develop ME. The only link I can tentatively guess at is that people who are more driven or who like order/knowledge, are more likely to pursue medical diagnosis in the (vain) hope of treatment. And when there isn't any, those same people seek answers elsewhere - like on here for example. So perhaps depending on where any sample is taken from in research explains the results found. If a wide enough sample is taken, any personality factors disappear.
There's no logic in personality having any impact.
Couch potatoes tend not to get ME. It's often people who will plod on when ill. The conscientious types. There is some evidence for that. Can't recall name but he's now a MEP. Tannock?
 
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15,786
I believe after long thought that there are psychosomatic disorders. Tension headaches come to mind. (I control mine with relaxation as well as neck exercises). I also get abdominal pain if stressed. Mind does affect body. I only have to start talking abut nits and people start itching and scratching their heads. I feel sick when I see people vomit. I don't feel sick because I am ill but something goes on in my brain. I think it's a common response. And so on.
But these are reactions, not illnesses ... and I think that's where psychogenic theory goes horribly wrong. Just because some observations or feelings trigger a sensation or physiological response does not necessarily mean that such a response can be maintained continuously and become disabling.

When you relax, the headache or abdominal pain go away. People forget about the nits and stop itching. They get away from the vomit, get some fresh air, and don't feel sick any more. I don't think there's good (any?) support for the extrapolations from psychological reactions to psychogenic illnesses.
 
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EllenGB

Senior Member
Messages
119
Evidence: link between sex abuse and various symptoms. there's a lot. Too much for busy me a the mo.

Arguments for the role of personality in epidemics of ME/CFS can easily be found: the people with the most vulnerable traits succumb first and generate hysteria. The hysteria increases in its potency and its tendency to cross-infect those with comparatively less vulnerable personalities as the number of those that have succumbed to it already in the particular microcosm in which the outbreak occurs itself increases.

Also just thought that the people with 'ME' and 'CFS' who have been bedbound for years, do the Lightning Process and find themselves able to walk and live near normal lives. I don't know why but I would investigate the possibility of something psychosomatic there. The Gupta programme is aimed at psychosomatic fatigue etc so if those patients really improve, that is suggestive. Viruses would not respond to such programmes and certainly not within days. I'm open to alternative explanations though. And could whoever can cure progressive ME in a few days come round to me and cure me please? (Though denying I'm ill as per Lightning Process will be hard. I can't tell myself that.).
But these are reactions, not illnesses ... and I think that's were psychogenic theory goes horribly wrong. Just because some observations or feelings trigger a sensation or physiological response does not necessarily mean that such a response can be maintained continuously and become disabling.

When you relax, the headache or abdominal pain go away. People forget about the nits and stop itching. They get away from the vomit, get some fresh air, and don't feel sick any more. I don't think there's good (any?) support for the extrapolations from psychological reactions to psychogenic illnesses.


IBS is not an illness? If it was so easy (relax and the pain disappears), thousands of patients would be very happy. True, tension headaches are a reaction but IBS is an illness. Maybe an umbrella term for various ones, but it's still an illness and it can last years.
 
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2,087
Couch potatoes tend not to get ME. It's often people who will plod on when ill. The conscientious types. There is some evidence for that. Can't recall name but he's now a MEP. Tannock?
Yes this is the only link to personality type I could think of. The type A will more than likely keep going during an illness not wanting to rest or take time off. If this is linked to disease onset then it could be a factor. However, i am speculating.
In my case my initial illness wasn't too bad so I didn't slow down at all, I was very active, thinking it would just go away.
 

EllenGB

Senior Member
Messages
119
Arguments for the role of personality in epidemics of ME/CFS can easily be found: the people with the most vulnerable traits succumb first and generate hysteria. The hysteria increases in its potency and its tendency to cross-infect those with comparatively less vulnerable personalities as the number of those that have succumbed to it already in the particular microcosm in which the outbreak occurs itself increases.

You need to rule out infection first and re the ME epidemics, you can't. Enteroviruses, including echo 7 are a more logical explanation. One of the 1984 outbreaks was linked to contaminated milk if I recall. One to giardia. Two were ME though and that includes Lake Tahoe.

Index cases at the Royal Free were glandular fever. Which doctors would get anxious about that? there were nurses who became anxious but they were not diagnosed with ME. (Files went to doctors McEvedy and Beard.) I've compared ME and hysteria in a paper, published in Meeting Place years ago, and ME has none of the characteristics associated with mass hysteria.
 

adreno

PR activist
Messages
4,841
There are probably some relations between personality and disease, but it's irrelevant. For example, a more adventurous person is likely to come in contact with more pathogens. But what does the personality matter, once you're sick? The psychogenic crowd believes it's the personality that drives and perpetuates the illness, this is false.
 
Messages
15,786
Also just thought that the people with 'ME' and 'CFS' who have been bedbound for years, do the Lightning Process and find themselves able to walk and live near normal lives. I don't know why but I would investigate the possibility of something psychosomatic there. The Gupta programme is aimed at psychosomatic fatigue etc so if those patients really improve, that is suggestive.
But these are anecdotal reports produced by for-profit organizations. They have an incentive to produce these reports, regardless of veracity. There was one such organization which was discussed on the forum here where several anecdotal reports were actually from the same person, and seemed to claim repeated cures for different problems. Though they were presented separately and sounded like discreet cases unless looking quite closely.

To the best of my knowledge, there has been no research showing that these programs are successful for anyone, with any problem. Until they at least attempt such a thing, I view them as more unsubstantiated and exploitative quackery.

IBS is not an illness? If it was so easy (relax and the pain disappears), thousands of patients would be very happy.
Is IBS psychosomatic? Is there proof of that somewhere? I thought there was simply lack of proof of causation, and some preliminary evidence suggestive of physiopathology.
 
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TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
Couch potatoes tend not to get ME. It's often people who will plod on when ill. The conscientious types.
This view presuposes that trait theory and personality types are valid, which I'm not sure about. Before getting ME I worked hard, achieved, did lots of sport etc, but at the same time was very good at slobbing about and being lazy doing nothing in particular. I've been both types in different phases of my life, and often switched between types in the same week. Although I miss a lot of the things I used to do, I think that having extreme couching in my skill set has helped me adjust to my life post ME better than someone who is permanently driven. But to be honest I don't find the whole personality type thing helpful, not least because I feel if it's given too much credence it's only a small step for me to be diagnosed with Multiple Personality Type / Ambiguous Trait Syndrome, and there's quite enough of that kind of thing going on already.
 

adreno

PR activist
Messages
4,841
Yeah, this 'type A personality drives disease' is utter BS. There are so many achievers out there who doesn't get sick. What type of personality do you think Wessely et al. is?

But perhaps we should start teaching kids in schools that they should just slack and not try to achieve, as it is bound to be bad for their health?
 

Gijs

Senior Member
Messages
690
where is the psyche? Can you see the psyche on an MRI scan? Can you measure it objectively? No, conclusion: the psyche does not exist. So what are we talking about in psychology. It is not a science but an ideology or philosophy. psychotherapy and CBT is not falsifiable. Sexual abuse in childhood is a popular link that will be attached to almost all unexplained somatic complaints. Psychology is a waste bin for doctors to dump all unexplained somatic complaints. Psychology is taken too seriously. It is a very dangerous ideology!