• 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.

article on hysteria

WillowJ

คภภเє ɠรค๓թєl
Messages
4,940
Location
WA, USA
I didn't read all of it, stopped when I got to the part that said,

There is, however, a crop of bizarre new illnesses that, like hysteria, afflict mostly young women and stubbornly resist biological explanation. No drug exists to cure anorexia, bulimia, self-mutilation, chronic fatigue syndrome, and multiple personality disorder, and no genetic flaw has been found to explain them. Furthermore, as was true for hysteria, these contemporary disorders are thought to be contagious, spread by suggestion, imitation, and therapy. The numbers of women diagnosed with multiple personality disorder, for example, soared after the television airing of Sybil, the story of a twentieth-century medical celebrity.

Please one or two people make some comments on the npr article by Jessica Loudis about the biological findings, genetic findings, and supportive treatments that do exist. (do a quick search; if I link the page, it will make it more important to the search engines) Or is it a better strategy to respond to the article here? Not make traffic there?

Odd that a woman would be so enthusiastic about hysteria as a form of expression for the psyche, rather than realizing the historic and modern oppression and misogyny which drives these theories. There's another Trudi Chalder! :headache:
 

insearchof

Senior Member
Messages
598
Hi Willow

I would like some details on where I can read this article.

I would like to say that we should expect to see a lot of articles along the lines of the para you cited in the next 12 months possibly as part of your countries psychiatric associations members campaign for merging hyperchondriacs in the new dianostic manual into the new category of complex somatic system disorders into which CFS will also easily fall.

The APA is in the process of amending the DSM. If this goes through it will mean that for those of you with an existing diagnosis of CFS you will now be eligible for the bolt on psychiatric diagnosis of CSSD. That in turn would enable a doctor to refuse to undertake further biological based tests and treatments, especially if it is the view of your doctor that the subsequent bolt on diagnoses is more apt than CFS.

Whilst this is likely to have repercussions for the rest of PWCFS across the world, PWCFS in the USA are in real trouble it would seem.

This is what I wrote yesterday in response to Cort article on the front page about CFS and GWS which will both be effected by this change, as will many other syndromes and illnesses that the psyche refer to as medically unexplained



Yes and both will be caught by the proposed new diagnostic criteria Complex Somatic Symptom Disorder CSSD ( which tellingly absorbs the old crieria of hyperchondriacs) under amendments to DSM 5 being developed by the American Psychiatric Association.


There Is a real danger in the future that persons who might have ME CFS will be diagnosed as having CSSD instead. PWCFS and GWS may also get this psychiatric diagnosis as a bolt on diagnosis..especially if they are perceived by their doctor has having high anxiety about one or more of their symptoms and make requests for say, an XMRV test (or any other test ) and bring in information in support of such and this subjectively assessed "excessive thought, feeling and or behavior" occurs over a consecutive period of more than 6 months.

For all those doctors in the USA who believe PWCFS or GWS are too difficult, non compliant with recognized treatment protocols or who simply see such patients as hyperchondriacs, then it will be very easy to assign the proposed new CSSD diagnosis to them and deny their requests for treatment other than anti depressants, GET and CBT.

The APA also are lobbying and calling for the WHO to harmonize these changes in their current review of ICD classifications.

If this all proceeds, it is not too hard to imagine CFS becoming lost in CSSD and recognised as a pure somatic illness and if that eventuates then grants of the nature you report here will dry up.

The deadline for public submissions on this proposal is 15 th June 2011.

Is the Board of PR making a submission Cort?

Irrespective, don't you think this development and a call for all PWME CFS to lobby CFS orgs and other stakeholders to make submisions quickly.... warrants an article on the front page? Perhaps you could interview Suzy Chapman?

After all this will directly effect all patients in the USA, with ripple on effects for other countries.
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,079
Location
australia (brisbane)
My immune abnormalities and poor nk function are due to mass hysteria. Will the mass go away so my nk function improves.
There bloody idiots!
 

insearchof

Senior Member
Messages
598
My immune abnormalities and poor nk function are due to mass hysteria. Will the mass go away so my nk function improves.
There bloody idiots!

Hi heaps

Your biological issues won't go away.......but the ability of psychs to legally promote PWCFS as having CSSD won't either if the DSM 5 amendments go through.....and calling them evey name under the sun is unlikely to change anything, but putting in a submission against the proposal might!
 

heapsreal

iherb 10% discount code OPA989,
Messages
10,079
Location
australia (brisbane)
Hi heaps

Your biological issues won't go away.......but the ability of psychs to legally promote PWCFS as having CSSD won't either if the DSM 5 amendments go through.....and calling them evey name under the sun is unlikely to change anything, but putting in a submission against the proposal might!

calling them names makes me feel better, lol.
 

insearchof

Senior Member
Messages
598
calling them names makes me feel better, lol.

Hi Heaps

I understand that -----its good to let off some steam as to what is going on here - but if you and others dont put in -even a short submission against what is going on, then if this goes through, it will be - ''game, set and match'' to the psychs and you will need a very long list of names indeed to trott out and use -for the rest of your days. :(
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Hi Heaps

I understand that -----its good to let off some steam as to what is going on here - but if you and others dont put in -even a short submission against what is going on, then if this goes through, it will be - ''game, set and match'' to the psychs and you will need a very long list of names indeed to trott out and use -for the rest of your days. :(

That's not strictly true ISO. YES- people should submit objections if they can (I'm going to). BUT- the APA aren't necessarily going to listen to reason. IF they don't, it doesn't mean we are screwed. There are other strategies that can be adopted should the APA push through with these ludicrous changes. We might have to be in it for the long haul in terms of exposing the fallacies contained in these new disorders - but we have to stop blaming people for events that may not be within our control (i.e. the fallacies of psychogenic explanations for somatic (bodily) illness and the willingness of the APA to comply with those in making the next DSM).
 

insearchof

Senior Member
Messages
598
That's not strictly true ISO. YES- people should submit objections if they can (I'm going to). BUT- the APA aren't necessarily going to listen to reason. IF they don't, it doesn't mean we are screwed. There are other strategies that can be adopted should the APA push through with these ludicrous changes. We might have to be in it for the long haul in terms of exposing the fallacies contained in these new disorders - but we have to stop blaming people for events that may not be within our control (i.e. the fallacies of psychogenic explanations for somatic (bodily) illness and the willingness of the APA to comply with those in making the next DSM).

Whilst I agree that the psychs are probably not going to listening to reason, they may respond to political pressure.

The most effective political pressure would come from professional based submissions i.e: from other areas of medicine, allied health care professionals, scientific researchers, lawyers and politicians.

Of course patient submissions, will add to the overall picture of disquiet on what is being proposed and will apply pressure on the administrative process and could push final deadlines back, which would enable the CFS community (especially in the USA) to start to seriously lobby these other professional groups .

Other strategies I have seen employed by XMRV activitists could have been(and may still be) useful here too, if USA based PWCFS can channel some of their effort into this extremely important issue and step away from other projects for a while.

This forum has over 4,000 members - and I dont know how many are active and or are USA based - however, given the activity on threads here - and on other projects - there should be enough people, with enough skills and energy to do something significant here.

As for XMRV saving the day, it might only do so for a sub set of CFS patients. For the remainder with an existing CFS diagnosis who make a repeated request to their doctor for an XMRV test - in a climate where the new CSSD criteria takes root - these patients may fast find themselves with a CSSD bolt on psychiatric diagnosis, and once there - they might find it very difficult indeed to get any sort of aetiological tests or treatments.

Unfortunately Angela, at this stage - due to what seems to me as a paltry almost non existent lobbying campaign on the part of the international CFS community - you may well be right.

We might be lumped with these changes and have to resort to other strategies. But then again, that is a rather defeatist attitude I think.

There will be another final review process, although it will probably only address minor or window dressing issues.

However, before that occurs - a concerted effort by the international CFS community and many currently active XMRV advocates, might add to mounting pressure to have this extrodinarily wide criteria ditched.

It would not be hard to do - it would just mean refocusing and channelling some effort there.

It would be pretty easy to high light and get general public support on... how destructive this criteria is going to be for medicine and society generally. It is so extrodinarily wide, that it will catch many people with unexplained medical symptoms.

A quick online search at this site here: http://www.medindia.net/patients/patientinfo/syndrome/home.aspindicated the following 115 syndromes in various classifications:

Environmental (4)


Cardiac (13)

Congenital (21)

Pulmonary (5)

Renal (7)

Gastrointestinal (7)

Neoplastic (9)

Infectious (9)

Neurological (15)

Reticulo-endothelial Hematologic (8)

Others (17)

For those interested in a brief explanation of some of them - see: http://www.doctorslounge.com/studlounge/downdirty/syndromes.htm


Some of these syndromes will be more well recognised and therefore easier to diagnose than others. However, the point remains - that a doctor or physician who fails to to recognise the collection of symptoms and assign them to an appropriate syndrome classification, may easily discontinue the investigative process and assign the patient to a CSSD classification instead where they exhibit what the doctor might consider ''excessive'' thoughts, feelings or behaviour over their symptom(s) and this has been evident to the doctor in the patient for more than 6 months. Perhaps 2 consecutive attendances to a doctor expressing anxiety over symptoms and requesting further investigative tests, might be enough to have a doctor consider CSSD.

Based on the sheer number of syndromes that exist - there appear to be a lot of scope for thousands of patients to be parked in a CSSD classification and this would not account for how many thousands or hundreds of thousands who have an existing syndrome diagnosis, that might also find themselves with a new bolt on diagnosis when they want further investigations of symptoms that they feel, might be new or in addition those they generally experience.

This will be a boon for psychiatry but will, I fear - result in the death of many more patients, from illness and suicide.

If we have to resort to other tactics if this fails, so be it. I don't generally believe in the idea of chasing a horse that has bolted. Better to do all you can, to avoid this taking place.


Sadly, Angela my personal view is this. If DSM 5 goes through as proposed, then the efforts you have pumped into the ME CFS area re the antics of psychiatry for the last 8 years, will now require a quadruppled effort, especially if these changes succeed and have a flow on effect in the UK.
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
What I'm saying is not defeatist: far from it as you can get. I'm just making long-term plans and being realistic. I'm not saying no-body else was, but that's what I've been doing.

Please don't call my comments here defeatist. I'm fully aware of what the ramifications of all this are, hence my call for longer term strategies should things not work out for us in the short-term. It is thinking ahead.
 

insearchof

Senior Member
Messages
598
Hi Angela

Thanks for the clarification. You have your eye on the long term strategy - which is great. I, on the other hand have my eye on doing all we (the community) can here and now. I appreciate that you are personally doing all you can in the short term.


Rightly or wrongly, I read your words as: accept that there is not much that we may be able to do right now, (because the psychs are unlikely to listen to reason) and lets focus on the long term.

If your view is, that there may not be much we can do now because the psychs are unlikely to listen to reason - then even though I suspect this might be true, that is not in my view, reason not to do all we can to bring pressure to bear from influential sources, to see if we can get this ditched.

Lets do our best to get them to ditch this and then when and if, things do not pan out -yes indeed, bring on your long term strategies.

Are we on the same page here? I think we might be?

I am sorry Angela my comments were not directed at you personally, but the conceptual idea -as viewed from my immediate short term strategy perspective. Sorry for the upset.
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Hi Angela

Thanks for the clarification. You have your eye on the long term strategy - which is great. I, on the other hand have my eye on doing all we (the community) can here and now. I appreciate that you are personally doing all you can in the short term.


Rightly or wrongly, I read your words as: accept that there is not much that we may be able to do right now, (because the psychs are unlikely to listen to reason) and lets focus on the long term.

If your view is, that there may not be much we can do now because the psychs are unlikely to listen to reason - then even though I suspect this might be true, that is not in my view, reason not to do all we can to bring pressure to bear from influential sources, to see if we can get this ditched.

Lets do our best to get them to ditch this and then when and if, things do not pan out -yes indeed, bring on your long term strategies.

Are we on the same page here? I think we might be?

I am sorry Angela my comments were not directed at you personally, but the conceptual idea -as viewed from my immediate short term strategy perspective. Sorry for the upset.

Thanks ISO for this clarification, yes we are definitely on the same page! :thumbsup:
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
This was disgusting when Elaine Showalter did this in the 80s and even worse now.

Hillary Johnson put up a great comment.

I encourage everyone to leave a one-star review, as I did, at:
http://www.amazon.com/Medical-Muses...5608/ref=sr_1_1?ie=UTF8&qid=1306564529&sr=8-1
and
amazon.co.uk

if you have any extra time, you can offer a correction to publisher w.w. norton. They do not list an email address:
http://books.wwnorton.com/books/correction.aspx?id=4666&mid=66

ISBN:
978-0747576334

Page # or url:
Chptr 1; http://www.npr.org/2011/05/26/136581522/medical-musing-on-politics-poetry-and-hysteria

Quote the error:
"There is, however, a crop of bizarre new illnesses that, like hysteria, afflict mostly young women and stubbornly resist biological explanation. No drug exists to cure anorexia, bulimia, self-mutilation, chronic fatigue syndrome, and multiple personality disorder, and no genetic flaw has been found to explain them. Furthermore, as was true for hysteria, these contemporary disorders are thought to be contagious, spread by suggestion, imitation, and therapy...
The cultural and historical homologies between hysteria and these present-day diseases are so detailed and undeniable that it would be accurate to categorize them all as incarnations of hysteria. They are perceived as social and cultural diseases that express in some direct, if undetermined way social and cultural conditions. Moreover, I believe that they may be read as a metaphor both for women's position in society and for the image of the feminine in the history of scientific discourses. Hysteria, that bizarre rupture between symptom and source played out on the female body has resurfaced in our post-Freudian era in new but oddly familiar forms."

Suggest a correction:
The reference to "CFS" should just be left out, it is patently incorrect. As Anthony Komoroff, professor of infectious disease at Harvard Med School, has said "there are over 5,000 articles" in peer-reviewed medical journals showing frank physical pathology (disease) in ME/"CFS." This inaccuracy is anti-science, anti-woman, anti-disabled and just plain 100% patently scientifically false.
 

Tammie

Senior Member
Messages
793
Location
Woodridge, IL
I just posted the following review on Amazon:

"In the very first chapter, the author shows her complete ignorance of the documented objective biological abnormalities in ME/CFS; she ignores the statistics that show severe trauma histories are what lead to what she terms Multiple Personality Disorder (that name alone demonstrates that she is looking into outdated material as her sources, because the disorder has been called Dissociative Personality Disorder for quite some time now; and she also fails to recognize the current medical literature that discusses the complexities of such disorders as anorexia, bulimia, and self-injury. She even admits that she has garnered much of her "knowledge" from newspaper articles and very old (and long since disproven) medical literature.

Put simply she is a journalist with no medical or psychological background or education who is relying on outdated and inaccurate information to write a highly inflammatory, derogatory, and discriminative book about something which she clearly knows nothing. Yet far too many people will take what she says as the truth becasue it is in print. Unfortunately since that is the case, her book has the potential to cause great harm to the many who are struggling to deal with having these very real and very difficult to deal with, and in some cases very disabling illnesses."

I hope that others will also give one star reviews and post comments; however, though obviously most are going to be likely to comment on CFS alone, I urge anyone who can to also mention that the other issues she brings up should not be compared to the old diagnosis of hysteria. Even anorexia, which of those mentioned comes the closest to fitting the old criteria for hysteria, is much more complex than she makes it out to be and if one knows much at all about it, he/she would be aware that any seeming similarities are not truly accurate. It is actually much more closely related to addictions like alcoholism than it is to anything anyone would have diagnosed in years past as hysteria.

Anyway, I mention the other diagnoses she brings up because if we review what she wrote and only bring up CFS, it sort of seems to say that she may be right about the other issues, and even if it doesn't, it also sort of appears to allow her to further stigmatize illnesses that are (like CFS) already very stigmatized and misunderstood, and also very real and extremely hard to live with.
 

Wayne

Senior Member
Messages
4,284
Location
Ashland, Oregon
I tried reading this, and quite honestly, had a very hard time trying to figure out what the author is trying to convey. It sounded terrible the way she brought up CFS, but I get the impression it may not necessarily have been her intent to denigrate people with CFS. It may be generous on my part, but my take is she's just a sloppy writer, researcher and thinker.
 

justinreilly

Senior Member
Messages
2,498
Location
NYC (& RI)
Wayne, I disagree. There were at least a couple of people posting on the article that the Hustvedt was not trying to denigrate pwME. I read as much as I could cobble together of the epilogue- which is the only other place in the book where "CFS" is mentioned- from amazon and google.

Her position is that "CFS" is not caused by biology, but instead is psychogenic; it is hysteria. She says that Charcot was a neurologist and that he felt there was an organic origin to hysteria. But she notes that every autopsy he did of hysterics showed no pathology in the brain or spinal cord. She also claims no biological abnormalities in "CFS" and implies that Charcot's belief that hysteria was somatogenic was wrong- that hysteria, including "CFS", is in fact psychological. Like Wessely, he claims that the reason we claim biological origin is that we don't want to be revealed to be head cases and assigned to the psych ward. Like Showalter, she feels that psychological illness should not be dismissed or seen as less worthy or real than biological illness. But this does not absolve her of not researching her subject.
 

Angela Kennedy

Senior Member
Messages
1,026
Location
Essex, UK
Wayne, I disagree. There were at least a couple of people posting on the article that the Hustvedt was not trying to denigrate pwME. I read as much as I could cobble together of the epilogue- which is the only other place in the book where "CFS" is mentioned- from amazon and google.

Her position is that "CFS" is not caused by biology, but instead is psychogenic; it is hysteria. She says that Charcot was a neurologist and that he felt there was an organic origin to hysteria. But she notes that every autopsy he did of hysterics showed no pathology in the brain or spinal cord. She also claims no biological abnormalities in "CFS" and implies that Charcot's belief that hysteria was somatogenic was wrong- that hysteria, including "CFS", is in fact psychological. Like Wessely, he claims that the reason we claim biological origin is that we don't want to be revealed to be head cases and assigned to the psych ward. Like Showalter, she feels that psychological illness should not be dismissed or seen as less worthy or real than biological illness. But this does not absolve her of not researching her subject.

It's interesting that Charcot claimed not to have seen pathology on autopsy of 'hysterics'. Medical knowledge was very much in its infancy even in Charcot's time (not that it's anywhere near mature' now), for one thing. I'm not even sure epilepsy/narcolepsy or other brain disorders showed much on autopsy then. So I'm hoping her book can shed light on some of Charcot's (flawed) 'reasoning' from the historical sources: as Simon Overton has characterised it "Charcot's bad idea". But I'm willing to bet money she's approached this looking through the prism of uncritical acceptance of psychogenic explanations which are based on medical ignorance.

But I think she's also wrong in believing Charcot was claiming hysteria as 'somatogenic' (or organic). From what I've seen Charcot was working to a belief in 'hysteria' being psychogenic (that was the message Freud took home with him from the Salpetriere, certainly!)

At best, Charcot seems to have exhibited confusion in his psychogenic explanations. That's a common phenomenon as we know!

I'm trying to access a copy. I think it's going to be an interesting read - if only to see how Hustvedt treats the historical sources from her own (flawed) position. If I had the resources, one thing I would do is access those sources myself (I'm very interested in how doctors historically 'hytericised' women's illness (i.e. misdiagnosed). There's often an absurd acceptance of the notion of hysteria in this sort of literature - one which needs to be rectified.

And don't even get me started on Freud as a wholly unreliable narrator in his 'case study' of 'Dora'!