Dysfunction of the hypothalamus is likely central to the disease, but I doubt it has anything to do with trauma or stress.I now believe that the key is hypothalamic dysregulation.
The hypothalamus becomes damaged by long-term chronic stress and trauma (explaining the tendency for PWMEs to be over-achievers, athletes, and people with histories of trauma and chronic stress).
One of the Royal Free victims who later died of unrelated causes was autopsied and was found to have lesions and intense perivascular cuffing in the hypothalamus; a result not inconsistent with viral encephalitis, but sadly in situ hybridization and PCR technology wasn’t available in the 1950s to prove it. Thankfully it was available in the 1990s, when another ME case came to autopsy, and she was found to have enterovirus infecting her hypothalamus. This finding is consistent with John Richardson’s research showing patients with evidence of chronic enterovirus infection have provokable, measurable abnormalities in hypothalamic function.
Again, any hypothesis about ME must be compatible with recorded outbreaks. Chronic stress and trauma would fall under the hysteria umbrella in my opinion and this is incompatible with the outbreak evidence base which shows objective evidence of immune activation from a pathogen.