Social Science & Medicine (SSM) is a prominent interdisciplinary journal that publishes social science research related to health. A recently published SSM paper is called “Chronicity rhetoric in health and welfare systems inhibits patient recovery: a qualitative, ethnographic study of fibromyalgia care.” Part of a larger, multi-partner, Oxford-based project called Patient-centred Care for Fibromyalgia: New pathway Design, or PACFiND, the new paper is based on 59 interviews with health care providers as well as field notes from observation of service provision. The providers interviewed are from a range of specialties, but they share one characteristic: They offer services and interventions categorized as “biopsychosocial.”
In this context, “biopsychosocial” includes not just standard psycho-behavioral treatments like cognitive behavior therapy (CBT) and graded exercise therapy (GET)—the treatments recommended in the fraudulent PACE trial for ME/CFS–but also so-called “mind-body” programs. These approaches tend to toss together, in various combinations, elements of meditation, relaxation exercises, positive affirmations, neurolinguistics programming, cognitive behavior therapy, health coaching, and other modalities. Well-known examples include programs like the Lightning Process, the Gupta Program, Dynamic Neural Retraining System, and the Chrysalis Effect, the latter mentioned specifically in the paper.
The three main authors are from Oxford University; the corresponding author is a health services researcher and the senior author is a medical sociologist. (Perhaps they are colleagues of Professor Michael Sharpe, lead PACE investigator and Oxford’s self-styled “harassment” victim?) They reveal their view of the insidious nature of “chronicity rhetoric” from the start. “We focus on representations of fibromyalgia as a ‘chronic condition,’ which infiltrate and disrupt healing work,” the paper declares.
Basically, the argument goes something like this: Any approach to fibromyalgia focused on biopsychosocial “healing” is good. The rigid evidentiary demands of biomedical research’s “hegemonic position” disadvantage biopsychosocial healers, who are unfairly barred from making claims about “recovery” based solely on anecdotal accounts. Advocacy organizations are grifters who hype the “chronicity rhetoric” for fundraising purposes. The welfare benefits system further reinforces the need for fibromyalgia to be constructed as “chronic.” And so on.
This is the premise grounding the paper:
