• Welcome to Phoenix Rising!

    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

    To become a member, simply click the Register button at the top right.

Psychogenic explanation of physical illness: time to examine the evidence

SOC

Senior Member
Messages
7,849
:rofl::rofl::lol::lol::lol::rofl::rofl::rofl:

This made my laugh till it started to hurt, @SOC!
:D

Sometimes my mind gets in this weird mode where is makes funny mental images like these. Today seems to be one of those days. The other one that keeps popping into my mind reading the BPS threads resembles a scene from ... is it Finding Nemo...? I see these BPS folks as seagulls dive-bombing some poor unexplained symptom patient, screaming, "Mine! Mine!"
 
Messages
3,263
nemo meme.jpg
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
The BPS people are like petty criminals, aren't they? If it's not nailed down, they steal it.
This is much older than BPS. Psychogenic medicine was failing when BPS gave it a new fancy name and theory, without actually providing any substance. Its more like a slick version of a con game. No matter what happens, no matter how you get caught, you always deny wrongdoing and pretend innocence, or point the finger of blame somewhere else.

It reminds me of an old fictional character, slippery Jim, who makes outlandish arguments for his behaviour - this is paraphrased a heck of a lot, as I read this stuff decades ago. You see he steals from businesses. But they are insured so don't lose anything. The insurance companies might make a little less, and pass on less to their shareholders. But insurance companies are downright evil corporations ... so, really, stealing from businesses is doing a public service.
 

amaru7

Senior Member
Messages
252
Lots of revealed truth, little evidence of anything.
That's kind of how the field of psychology works, it's mostly subjective. You can't separate the mind from the body, so yes, psychogenic illness is proven to lead to many physical alignments like cancer, diabetes, high blood pressure (scientifically also called hypertension) allergies, asthma and others. Watch Gabor Mate, what he speaks sounds reasonable.
 
Last edited:
Messages
3,263
You can't separate the mind from the body,
Okay, agreed, they're not separate entities, there's really only a body. The "mind" is not a "thing" but just a collection of capabilities and activities of one bit of the body, mainly the brain. A bit like your knee being able to bend. Bending your knee can affect other bits of your body (like the blood rushing to that area from other parts). And so can using your brain (e.g., if you're frightened, it can initiate the production of chemicals that then circulate through your body).

So let's see how that goes, now thinking in a totally non-dualistic way. Not separating the mind from the body at all. What's causing, say, cancer now? Could it be some cells are reproducing in your body that your immune system should have killed but missed (cos it doesn't work perfectly 100% of the time, or because it was busy at the time fighting off some infection or whatever)? Would that seem plausible?

Now let's try the psychogenic view, again not separating mind and body. Maybe you were thinking really negative thoughts or having really negative feelings, and they were so negative that your brain somehow ended up producing too much of some chemical (maybe a glucocorticoid, for argument's sake), and this reaction was intense enough and sustained enough that it messed up your immune system, and caused it to miss the cancer.

What you notice is the first explanation is really elegant and simple. The second one is much more complex. You'd need a really good reason to prefer the second over the first. You'd need strong evidence. The other thing you notice is that for the second explanation, you have to assume the brain has quite extraordinary and sustained ability to modify other body systems. I'd wanna see evidence of this too.

So, I guess I'm just playing thought games. But I just wanted to point out that the claim that "you can't separate the mind from the body" can't just be usedwilly-nilly to justify psychological explanations for illness. It comes at a price. It requires that we talk about these things in a truly non-dualistic way.

(PS. This is in no way intended as a criticism of you @amaru7. What you said just got me thinking about the whole thing. Thanks for posting.)

rant over.....
 

Art Vandelay

Senior Member
Messages
470
Location
Australia
What you notice is the first explanation is really elegant and simple. The second one is much more complex. You'd need a really good reason to prefer the second over the first. You'd need strong evidence. The other thing you notice is that for the second explanation, you have to assume the brain has quite extraordinary and sustained ability to modify other body systems. I'd wanna see evidence of this too.

Spot on. I've always said that those that favour the psychogenic explanation for CFS (and other illnesses) have never heard of Occam's Razor.
 

user9876

Senior Member
Messages
4,556
Okay, agreed, they're not separate entities, there's really only a body. The "mind" is not a "thing" but just a collection of capabilities and activities of one bit of the body, mainly the brain. A bit like your knee being able to bend. Bending your knee can affect other bits of your body (like the blood rushing to that area from other parts). And so can using your brain (e.g., if you're frightened, it can initiate the production of chemicals that then circulate through your body).

So let's see how that goes, now thinking in a totally non-dualistic way. Not separating the mind from the body at all. What's causing, say, cancer now? Could it be some cells are reproducing in your body that your immune system should have killed but missed (cos it doesn't work perfectly 100% of the time, or because it was busy at the time fighting off some infection or whatever)? Would that seem plausible?

Now let's try the psychogenic view, again not separating mind and body. Maybe you were thinking really negative thoughts or having really negative feelings, and they were so negative that your brain somehow ended up producing too much of some chemical (maybe a glucocorticoid, for argument's sake), and this reaction was intense enough and sustained enough that it messed up your immune system, and caused it to miss the cancer.

What you notice is the first explanation is really elegant and simple. The second one is much more complex. You'd need a really good reason to prefer the second over the first. You'd need strong evidence. The other thing you notice is that for the second explanation, you have to assume the brain has quite extraordinary and sustained ability to modify other body systems. I'd wanna see evidence of this too.

So, I guess I'm just playing thought games. But I just wanted to point out that the claim that "you can't separate the mind from the body" can't just be usedwilly-nilly to justify psychological explanations for illness. It comes at a price. It requires that we talk about these things in a truly non-dualistic way.

(PS. This is in no way intended as a criticism of you @amaru7. What you said just got me thinking about the whole thing. Thanks for posting.)

rant over.....

Shouldn't the questions always be in terms of setting up how interactions happen between parts of the different systems in our body as you suggest. Whether the brain or the knee. There always seems something magical about the argument you have thoughts and lead to this or that problem with the body. What are the mechanism, why those thoughts and not other thoughts? I don't think the proponents of psychogenic illness should be allowed to get away with vague statements that they claim are hypothesises but should be pushed to define mechanisms.

In the cancer example though there are other potential mechanisms. For example, you feel bad about something so you eat more junk food/take drugs which may be carcinogenic so there is another path of thought->environmental factors->affects on the body. But the real mechanism is the carcinogenic stuff not the thoughts (or really the wide range of many different reasons that mean people come into contact with carcinogenic stuff.
 
Messages
3,263
What are the mechanism, why those thoughts and not other thoughts?
I was just thinking the same thing, @user9876. How did the negative thoughts get there? Those thoughts could themselves be outcomes of some other bodily process. Lots of diseases seem to give rise to depression that is disproportionate to what you'd expect from the loss of quality of life alone (e.g., Parkinson's, left hemisphere stroke). And they're only the ones we know about for sure.

Or maybe there's some trigger external stimulus or set of events, that you react to with negative thoughts, but then these thoughts/feelings are somehow sustained longer than they should be (by some magical process we don't yet understand).

And yes, "negative thoughts" is itself vague. If thoughts/feelings can cause cancer, we need to be really specific about which type are cancer-triggering and which types aren't. "Negative" is really not good enough.

And you're right about the mediated effect of thoughts/feeling on health related practices (get depressed, drink and smoke too much, hello cirrhosis of the liver and emphysema). That's never what the psyc medicine folks mean, though, is it?

And don't get me started on why most people with major depression or an anxiety disorder don't all have cancer.

Edit: funny, I put "sclerosis" of the liver earlier :rolleyes:, now edited that to cirrhosis.
 
Last edited:

Sean

Senior Member
Messages
7,378
I don't think the proponents of psychogenic illness should be allowed to get away with vague statements that they claim are hypothesises but should be pushed to define mechanisms.
Selective causal inferences based on cherry picked correlations, arbitrary statistical thresholds, and vague subjective definitions, and all in the face of objective evidence to the contrary.

What could possibly go wrong?

Apart from everything. :meh:
 
Messages
5,238
Location
Sofa, UK
Okay, agreed, they're not separate entities, there's really only a body. The "mind" is not a "thing" but just a collection of capabilities and activities of one bit of the body, mainly the brain. A bit like your knee being able to bend. Bending your knee can affect other bits of your body (like the blood rushing to that area from other parts). And so can using your brain (e.g., if you're frightened, it can initiate the production of chemicals that then circulate through your body).

So let's see how that goes, now thinking in a totally non-dualistic way. Not separating the mind from the body at all. What's causing, say, cancer now? Could it be some cells are reproducing in your body that your immune system should have killed but missed (cos it doesn't work perfectly 100% of the time, or because it was busy at the time fighting off some infection or whatever)? Would that seem plausible?

Now let's try the psychogenic view, again not separating mind and body. Maybe you were thinking really negative thoughts or having really negative feelings, and they were so negative that your brain somehow ended up producing too much of some chemical (maybe a glucocorticoid, for argument's sake), and this reaction was intense enough and sustained enough that it messed up your immune system, and caused it to miss the cancer.

What you notice is the first explanation is really elegant and simple. The second one is much more complex. You'd need a really good reason to prefer the second over the first. You'd need strong evidence. The other thing you notice is that for the second explanation, you have to assume the brain has quite extraordinary and sustained ability to modify other body systems. I'd wanna see evidence of this too.

So, I guess I'm just playing thought games. But I just wanted to point out that the claim that "you can't separate the mind from the body" can't just be usedwilly-nilly to justify psychological explanations for illness. It comes at a price. It requires that we talk about these things in a truly non-dualistic way.
I really like this analysis. I think it very effectively debunks a certain kind of naive psychosomatic view.

However, I'm not sure that what's above on this thread is an effective argument against the most prevalent model that we're up against, i.e. the current model of the 'Wessely school'. Their BPS model seems to be saying that beliefs influence behaviours, and those behaviours are what perpetuate the 'disease'. In the 'fear avoidance' model, if I believe that exertion may harm me, and I therefore decide not to exert myself, that perpetuates my disease (via deconditioning, presumably, despite the evidence that deconditioning does not normally cause ME/CFS symptoms). Or alternatively I might 'boom and bust' (ironically, failing to 'pace' myself), and the cycle of overactivity is what perpetuates the disease.

Perhaps Woolie's line of thinking needs to be extended to address this model: the challenge to proponents of the model would seem to be that the behaviours that they claim are perpetuating the disease ought to be measurable, and the physiological way in which they perpetuate the disease also ought to be a physically measurable thing. As far as I'm aware, they have no evidence at all for that physical part of their model, either from measurement of patients' alleged 'boom and bust' or 'fear avoidance' behaviours, or from the physical harm that those behaviours supposedly cause and how that physical harm causes the symptoms that patients experience. Perhaps there is a line of attack there to debunk this pseudoscientific model of ME/CFS?
 
Messages
3,263
Yes, you're right @Mark. Its a different kind of model. The post that inspired my rant was talking about how the mind can contribute to the development of cancer, that's where I was coming from.

Its interesting what you say about ME/CFS. Its hard to test the fear avoidance hypothesis, because of course we actually do fear exercise and avoid it - for good reason. Thinking about it, all I can come up with is that we would definitely need a sedentary control group (that is, no illness, but they don't exercise... maybe not a fear of, but a disinclination to exercise). Prediction would be if both groups underwent a supervised exercise programme - strictly monitored by a physio in a clinic (e.g., a certain time and intensity of bike riding on a daily basis, perhaps increasing duration at each session), they should show similar improvements on the chosen outcome measure.

What would the outcome measure be? Something activity related? (e.g., activity monitors, walking test)? Certainly not self-report.

You could maybe add a control intervention too, like a nice relaxation therapy, perhaps.

Another problem: who'd want to be a participant in this study? Not me!
 

anciendaze

Senior Member
Messages
1,841
I'm going to chime in with a story from the distant past, but not so far back that it didn't happen in my adult lifetime. A young girl was sent to a psychiatrist who was just starting to practice because she obviously had "a psychogenic movement disorder". He worked with her diligently, but could accomplish nothing. She died of MS at the age of 17. It still bothered that doctor years later that she did not get the palliative care she deserved.

This was at a time when MRI was still new and expensive. The probability that the diagnosis was wrong was thought so low they didn't bother to check. Anyway, even if they found MS, they had no effective treatment for it. The disease was confirmed at autopsy, which was the traditional way to confirm MS.

Sound familiar?
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Perhaps Woolie's line of thinking needs to be extended to address this model: the challenge to proponents of the model would seem to be that the behaviours that they claim are perpetuating the disease ought to be measurable, and the physiological way in which they perpetuate the disease also ought to be a physically measurable thing.

I have argued something similar before. What psychosomatic research does is gloss over or ignore physical issues, things that are measurable. Then they claim the mind causes it, either directly or by influencing behaviour (this last bit I have not argued before). Yet there is no causal chain, no mediators, in their arguments. If this is going on there ARE measurable biomarkers. End of argument. Yet they fail to measure, monitor or discuss them.
 
Last edited: