I think this is such an important issue that Flex is raising, and one so easily missed amidst our rising tide of optimism, that although I don't really have the time to post at the moment I want to encourage people to think very carefully about the issues being opened up here.
Flex's analysis is slightly different to what my own has been, because I've been thinking mainly about the 'game theory' position of how the psych lobby would play the game if they wanted to guard against the future discovery of a physical mechanism for some CFS. I've been assuming - similarly to some of Gerwyn's analysis elsewhere - that their finding of no XMRV in Wessely's patients could in the future be used to claim that, even though a lot of people with CFS have XMRV, there are large and well-defined patients groups (Wessely's patients) who do not, and so there's still a whole lot of people for them to treat as CFS. Then all they have to do is use a strict XMRV test that draws the line a long way up towards 'severe' and they get to keep a big proportion of us under their wings...
Flex is suggesting different and even more worrying possibilities, but they are real ones IMO. They will certainly claim that even if XMRV is real and physical, until there is a treatment available, CBT and GET are still the best treatments available; that argument will remain unchanged until a treatment has gone through the process, and that will probably take many years. They will also continue to claim it's a valuable and useful treatment even after that point. And as Flex points out, the existence of an organic illness in no way rules out their somatising theories because they have been mumbling incoherently about 'grey areas between physical and psychological' ever since it became politically impossible for them to deny the existence of a physical component, so they are quite free now to continue to emphasise the psychological component.
We ignore all this at our peril. Reeves and Wessely are not going to retire or be retired by default however XMRV plays out. So long as there is a large enough subset of people left over with (however broadly) CFS-like symptoms who are XMRV-negative, they know that they will then be able to claim "Ah, that's why it was all complex and controversial, there was this XMRV thing mixed in. The people left over who don't have XMRV, they're the true CFS patients, the true somatisers". They may perhaps then loosen their definitions and look for other people to make the numbers back up - or they may not need to, because they will soon be getting huge extra numbers of people with depression to treat anyway, so they may be able to make the numbers up that way.
So this fall-back position gives them great security - unless it turns out that the whole of what they call ME/CFS has a single physical explanation.
But that doomsday scenario (for them) is exactly what XMRV purports to be - when you say 98% of CFS patients tested have XMRV, then even if you are only looking at a subset of CFS, you are raising the possibility that the entire patient group might disappear overnight! I feel sure that the fact that this possibility is now being widely and seriously discussed must have put the wind up them, and they must surely have started thinking about the implications for them if it turns out to be true, just as much as we have. They must surely have plans and strategies for how they will deal with various scenarios, and they must surely be discussing - you could say plotting - their way forward.
As has been pointed out, they do so in private discussions, whereas we do so in public where they can read exactly what we are thinking. If you think of things in terms of a war (as we have been pretty much obliged to) that's a pretty major disadvantage. However I think you can actually go quite a long way towards predicting the behaviour of institutions, just by understanding the public arguments they make and trying to understand their mindset, and analysing them as psychopathic units that act in their own self-protective interests. They will follow the best strategy for them - work out what that is, and that's roughly what they will do.
So we can't know what's going on in their minds, what they're planning, what lies round the corner - but I do think it's very intelligent of Flex to raise this issue and to suggest that we need to think a little less naively about what's going on. We can laugh at the IC PCR test, and watch in disbelief as they apparently make a desperate bid to cling on - but surely we have to pause as well and think "Surely, they must have something up their sleeves here?". I think it's important that we do keep a very careful and suspicious mindset when thinking about what the Wesselys and Whites are planning next.
The DSM categorisation review does seem enormously important to us as well, whenever I've seen that raised it's struck me as an important thing to watch that could easily get missed while attention is focused elsewhere. There's no real reason why the as-yet-'unproven' XMRV research should affect the categorisation deliberations, and the assumption that XMRV makes it less likely that CFS can be categorised as psychological, is a dangerous one. Actually, a confirmation of XMRV in 50% of CFS patients could even make it MORE likely that CFS will in future be recategorised as a psychological condition rather than less.
The argument would be roughly "well, we were sort of 50/50 as to whether it was psychological or physical - turns out that about half of them were really sick and the other half were making it up". And sadly, there are people with ME/CFS even now who would agree with this division of ME/CFS and who suspect that their own real condition is being devalued by the somatic, psychological and psychiatric illnessess of other people with the CFS label - who they therefore blame for their situation, seemingly without noticing that they are accepting the psychologists' theories by doing so. Some of those former ME/CFS sufferers will turn on X-negative fellow sufferers and abuse them in exactly the same way the psychologists do now - but with more feeling - as soon as they get their X+ result. Some are content to do this already based on guesswork, so imagine what they'll be like when they get approval! Divide and rule has never been easier than it will be in this particular case...
I can see why raising all these sorts of fears might appear negative and despairing, but in this case I do think Flex's warnings are well-timed and appropriate and I'd like to see further analysis of the psych lobby's tactical position and likely strategies. Reeves and Wessely appear to be in very different situations at the moment, but both deserve close scrutiny...
Finally, I'm left with one conclusion as to our appropriate strategic response to their manouevres, whatever that may be, and that is to say that their plans can only succeed if they are able to keep us both ghettoised and internally divided. If we are able to reach out and make connections with other medically unexplained conditions, other 'somatic' conditions, and join together in saying that this unscientific somatic diagnosis is unacceptable for all of us; if we are able to remain unified in our support for each other even after some of us have been legitimated and others not, then the psych lobby won't have a leg to stand on - for a brief window, they cannot stand against our argument that if they were dead wrong about all these XMRV people, they cannot be trusted with the rest of the medically unexplained. Whereas if we play into their hands and fight amongst ourselves, they will be able to do pretty much whatever they want.
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