Thanks Orla, that was a fascinating read.
The whole thing could do with a new edition though...
With many, many patients, including more than half of people with gastroenterology and neurological problems, we haven't a clue what's going on. In fact we're of so little help to them that patients are turning away from us in droves, and getting angry with their doctors. Some of them even try treatments that haven't been proven by our wonderful modern scientific methods! We like to sneer at those treatments and suggest the patients are behaving strangely, even though by our own admission we have nothing to offer them ourselves apart from suggesting they might be imagining it and sending them to a shrink.
Psychosomatic used to mean malingering and imaginary symptoms, and carried considerable social stigma. The Newspeak version is to say - if pressed - that psychosomatic now means that we don't know what's going on and there might be something physical going on as well, but since these people are a bit crazy anyway, we still send them to see a shrink. After all, every illness has an interaction with the patient's mental state, so we can do this any time we like. This does tend to put the whole thing into a confusing grey area, especially since we haven't got round to telling the general population that the word no longer means what it has meant for the last century or two, so the stigma remains. But this is a good thing, because this sort of behaviour can literally drive patients mad, and isolates them from their friends, family and society, so our theory works well as a self-fulfilling prophecy, keeping us in gravy for as long as we can get away with it.
They could add a footnote as well:
In 2009 this was all proven to be a load of hogwash when the physical explanation was found. At this point all the talk of unknown physical explanations and grey areas evaporated, and we tried hard to deny it, but the truth eventually came out, and when a huge army of previously-weakened nutters all got well again, people were so angry that many of us were scientifically discredited, publicly humiliated, and dragged through the courts. We tried to explain that we sincerely believed in what we were doing, that it had all just been an unfortunate mistake, and there were still people left with unexplained illnesses who were crying out for psychiatric treatments. But unfortunately, now that the boot was on the other foot, now they decided it was their turn not to listen to us.
"Hmm," they said to us. "And how does that make you feel?"
The whole thing could do with a new edition though...
Translation:Medically unexplained symptoms and syndromes are very common in both primary care and the general hospital (over half the outpatients in gastroenterology and neurology clinics have these syndromes). Because orthodox medicine has not been particularly effective in treating or understanding these disorders, many patients perceive their doctors as unsympathetic and seek out complementary treatments of uncertain efficacy.
With many, many patients, including more than half of people with gastroenterology and neurological problems, we haven't a clue what's going on. In fact we're of so little help to them that patients are turning away from us in droves, and getting angry with their doctors. Some of them even try treatments that haven't been proven by our wonderful modern scientific methods! We like to sneer at those treatments and suggest the patients are behaving strangely, even though by our own admission we have nothing to offer them ourselves apart from suggesting they might be imagining it and sending them to a shrink.
Translation:The word psycho-somatic has had several meanings, including
psychogenic, `all in the mind'; imaginary and malingering. The modern
meaning is that psychosomatic disorders are syndromes of unknown
aetiology in which both physical and psychological factors are likely
to be causative, The psychiatric classification of these disorders
would be somatoform disorders, but they do not fit easily within
either medical or psychiatric classification systems, since they
occupy the hinterland between them.
Psychosomatic used to mean malingering and imaginary symptoms, and carried considerable social stigma. The Newspeak version is to say - if pressed - that psychosomatic now means that we don't know what's going on and there might be something physical going on as well, but since these people are a bit crazy anyway, we still send them to see a shrink. After all, every illness has an interaction with the patient's mental state, so we can do this any time we like. This does tend to put the whole thing into a confusing grey area, especially since we haven't got round to telling the general population that the word no longer means what it has meant for the last century or two, so the stigma remains. But this is a good thing, because this sort of behaviour can literally drive patients mad, and isolates them from their friends, family and society, so our theory works well as a self-fulfilling prophecy, keeping us in gravy for as long as we can get away with it.
They could add a footnote as well:
In 2009 this was all proven to be a load of hogwash when the physical explanation was found. At this point all the talk of unknown physical explanations and grey areas evaporated, and we tried hard to deny it, but the truth eventually came out, and when a huge army of previously-weakened nutters all got well again, people were so angry that many of us were scientifically discredited, publicly humiliated, and dragged through the courts. We tried to explain that we sincerely believed in what we were doing, that it had all just been an unfortunate mistake, and there were still people left with unexplained illnesses who were crying out for psychiatric treatments. But unfortunately, now that the boot was on the other foot, now they decided it was their turn not to listen to us.
"Hmm," they said to us. "And how does that make you feel?"