• 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.

"Suzanne O'Sullivan's It's All in Your Head wins Wellcome Book Prize 2016"

Roy S

former DC ME/CFS lobbyist
Messages
1,376
Location
Illinois, USA
Jack Nicholson's character has a line in the movie One Flew Over the Cuckoo's Nest to explain his situation as a patient in a psychiatric ward:
"It's like a rigged game, you know?"
(meaning you can't win)
The author Ken Kesey used his experiences working in a psychiatric hospital in writing it. It was published in 1959. The movie came out in 1975.
 
Messages
2,087
Poor Coyne finds out the whole thing is even worse than he could have imagined.
Coynes next blog should be very interesting - will he drop the subject altogether, defend or excuse Shorter or denounce him.
I'm pretty sure he would have denounced him prior to this, but in the aftermath of his invitation to opine, Coyne finds himself in a sticky situation. It's funny cause he can't blame anyone.
 

Forbin

Senior Member
Messages
966
The patient’s subconscious may not have chosen the symptoms. It’s really the culture that choses them, and patients get from the culture an idea of what is medically “credible.” Patients strive to produce symptoms that are medically believable, that cannot be disproven, in other words. This is why the hysterical gait paralyses of the nineteenth century have largely disappeared: The Babinski test “disproved” them. But you cannot prove that someone is not fatigued or in pain, which is why we see so much of that today.
https://jcoynester.wordpress.com/20...ommentary-on-imaginary-illness-in-the-lancet/

As my subconscious was surveying the culture of the early 1980's, you know, looking around for symptoms that were medically credible but which could not be disproved, it apparently decided that its best bet was to lead with constant, unrelenting dizziness.

Had my subconscious only known that, even back then, balance impairment could be objectively quantified at a well-equipped otological research center, it would never have allowed me to attend one, thus running the risk that its well-crafted deception would be discovered.

So, when a world renowned otologist told me that objective tests showed that I had indeed lost nearly half of my balance function - and that this kind of dizziness was usually seen in micro-vascular insufficiency to the vestibular system (take note, endothelial dysfunction fans) - my subconscious dreams of having a medically credible but unprovable illness were dashed.

It was proven - darn the luck.
________________
If the Wellcome Trust would like to give me a prize for the above account, they can just donate it to the Center for Infection and Immunity at Columbia University, New York, NY.
 
Last edited:

Gingergrrl

Senior Member
Messages
16,171
Patients strive to produce symptoms that are medically believable, that cannot be disproven, in other words.

Yes, exactly, and they have finally discovered that my life-long dream when getting my masters degree, writing my thesis, having a 16 year successful career, getting married, raising my daughter, having an active social life, exercising at the gym, walking my dog that I raised for ten years, etc... was to secretly have it all taken away from me due to severe, alarmingly worsening dyspnea and lung weakness b/c I secretly wanted to become 100% wheelchair bound and stay home alone while my family participated in life. I secretly wanted to pay for caregivers to help me shower and secretly wanted to be gasping for air with chest pain. And somehow they discovered my secret plan to develop a mast cell disease and be hospitalized for anaphylaxis. How did they figure it out?!!! This definitely deserves a top book prize. When the doctor cannot figure out the exact mechanism behind the symptoms this equals psychosomatic. Brilliant work. Well done. Is it still psychosomatic after the autopsy is done?
 

Cheshire

Senior Member
Messages
1,129
As my subconscious was surveying the culture of the early 1980's, you know, looking around for symptoms that were medically credible but which could not be disproved, it apparently decided that its best bet was to lead with constant, unrelenting dizziness.

Yes, we've got the stupidest subconscious minds of the world, instead of mimicking things that are diagnosed clinically, like Parkinson for eg. they go for the unrecognised symptoms of ME...

This evening my subconscious is making my right foot swell up and 5 lymph nodes enlarge and ache in my neck and arm pit - damn you pesky subconscious!!! *shakes fist*

I remember Shorter saying (sorry can't recall where) that swollen lymph nodes were "easy to produce"...
 

Gingergrrl

Senior Member
Messages
16,171
Yes, we've got the stupidest subconscious minds of the world, instead of mimicking things that are diagnosed clinically, like Parkinson for eg. they go for the unrecognised symptoms of ME...

I've recently learned that if a doctor is going to give you the psychosomatic label, there is absolutely nothing that you can say or do that will change his/her mind. I have too many abnormal tests to list at this point but a few include an abnormal V/Q (lung) scan, five abnormal breathing tests, two newly found auto-antibodies that should not be there at all, an abnormal tilt table test confirming "significant POTS", blood tests confirming MCAS, etc, and I was still just labeled "psychosomatic" by a doctor who I had truly believed was going to help me. ME/CFS was not even discussed with this doctor nor on the radar, and yet I still got this label and all offers of treatment were retracted. It was really quite stunning and really set me back as far as my faith in the entire human race (minus those on this board :D.) And yes, this person was a neurologist.
 
Messages
724
Location
Yorkshire, England
Research Proposal:

Provisional Title - Assuming 20 - 50 % of mainly women who I meet are manipulative liars, unable to recognize and verbalize their true feelings and are out to get something from me. A RCT.

  • Experimental resources - Thermal camera to examine the variation in temperature of patients pants when presenting with MUPS.
  • Icky Women
  • Protective codpiece

I await your input and further suggestions :p







 
Messages
2,087
I have to admit, the psychology of those who psychologize is a continual source of fascination to me.

I understand that's a bit recursive of me... I fascinate myself? ;)

-J

There is a very recursive nature to their logic...
It cant be explained medically therefore its psychosomatic, psychosomatic can't be explained medically therefore it's...

Can't figure out if this is recursive or an infinite loop or just leading down the road to quackery.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Research Proposal:

Provisional Title - Assuming 20 - 50 % of mainly women who I meet are manipulative liars, unable to recognize and verbalize their true feelings and are out to get something from me. A RCT.

  • Experimental resources - Thermal camera to examine the variation in temperature of patients pants when presenting with MUPS.
  • Icky Women
  • Protective codpiece

I await your input and further suggestions :p

Laughing AND crying, @Luther Blissett ...
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
There is a very recursive nature to their logic...
It cant be explained medically therefore its psychosomatic, psychosomatic can't be explained medically therefore it's...

Can't figure out if this is recursive or an infinite loop or just leading down the road to quackery.

It may be a form of Begging the Question, in which the conclusion and the premise are, in fact, different ways of stating the same thing.

BTQ is one of those fallacies that's often misunderstood; it's used popularly to say, "which begs us to ask the question..." which is not the same thing!

A good example of this fallacy is, "murder is wrong because killing people is wrong."

Murder may be wrong, but this sentence doesn't prove it. Since 'killing' is a synonym for 'murder', the speaker is quite literally saying killing is wrong because killing is wrong. Both the premise and the conclusion match too closely to constitute an argument.

-J
 
Messages
724
Location
Yorkshire, England
It may be a form of Begging the Question, in which the conclusion and the premise are, in fact, different ways of stating the same thing.

BTQ is one of those fallacies that's often misunderstood; it's used popularly to say, "which begs us to ask the question..." which is not the same thing!

A good example of this fallacy is, "murder is wrong because killing people is wrong."

Murder may be wrong, but this sentence doesn't prove it. Since 'killing' is a synonym for 'murder', the speaker is quite literally saying killing is wrong because killing is wrong. Both the premise and the conclusion match too closely to constitute an argument.

-J

Does this mean that instead of a medical diagnosis, it is more of a label than an explanation?

I'm confusing myself :p because I'm sure I agree, but can't describe what I mean very well.

Is this the kind of thing that pathopysiology studies?

For instance, in a banal example like the common cold, the diagnosis includes the symptoms and how they effect different systems functioning, whereas in a 'diagnosis' of somataform disorder, medically unexplained symptoms = somatoform disorder, and somatofrom disorder = medically unexplained symptoms?
 

Hip

Senior Member
Messages
17,824
'diagnosis' of somataform disorder, medically unexplained symptoms = somatoform disorder, and somatofrom disorder = medically unexplained symptoms?

Diagnosis of a functional disorder, which is similar to medically unexplained physical symptoms (MUPS), is predicated on the observation that the symptoms experienced have no observable physical cause in the body. Or when there is an observable physical cause, the symptoms experienced are far excess of what the physical cause would be expect to produce (eg, you would not expect a small cut to feel as if your leg is being sawn off).

For example, in interstitial cystitis (IC), there can be excruciating pain from the bladder, and severe IC can be a life-destroying disease; but when you look at the bladder, there are not many obvious abnormalities to explain how such severe pain could arise.


So all functional disorder diseases follow this pattern: there can severe symptoms, but very little pathology is observed in the body.

Diseases that are classified as functional disorders include: ME/CFS, fibromyalgia, interstitial cystitis, irritable bowel syndrome, lower back pain of unknown cause, non-cardiac chest pain.

This lack of finding anything major physically wrong (by today's medical knowledge of course), combined with the fact that functional disorders often come with significant mental symptoms (such as brain fog, anxiety, panic attacks, depression, emotional lability), has unfortunately led many medical professionals to conjecture that the physical and mental symptoms of functional disorders are psychologically-caused.

When you view a functional disorder as a psychologically-caused disease, then you usually call it a somatoform disorder. And once you class it as somatoform, this means you usually give up looking for physical causes, and hand the patient over to the psychiatrists, who will then do very little for the patient.


However, fortunately, not all medical professionals view functional disorders as being psychologically-caused. Others view functional disorders as having some physical cause that has not yet been identified.

Obviously the physical causes are going to be occult and obscure factors (had they been plain to see and obvious, medical science would have likely already detected them). But there are plenty of things in the body that are fairly occult, such as for example autoantibodies that affect the functioning of the nervous system. In fact, a paper just published in Medical Hypotheses suggests that functional disorders are caused by autoantibodies to neuronal proteins.
 
Last edited: