“What this overview must ultimately conclude is unspectacular and perhaps precisely because of this radicality: a primarily psychosocial model of illness for ME/CFS and PAIS is no longer tenable according to the current state of knowledge.
Unfortunately, this misses the point. Psychobehavioral ideology is a strictly psychosocial model pretending to argue for a mix of various, including psychosocial, factors. The lie is baked in the ideology and is foundational to it. It is 100% psychosocial, and pretends to loosely include it, so this is already the ideological argument, has been for decades. It doesn't matter that it's a filthy lie, the fact that it's a lie is baked in the ideology and its practices, and so goes unquestioned.
The truth is that not a single so-called psychosocial factor has ever been demonstrated to be relevant other than as a consequence, and in every single case, without a single exemption, it makes 10-100x more sense the other way around: that illness causes so-called psychosocial problems, in a way such that only treating the illness matters, because the relationship is strictly directional and one-dimensional.
Treat the illness, and the psychosocial problems vanish entirely. Same goes when the illness resolves itself. Meanwhile we have decades of false assertions that biased questionnaires showing slight improvements on oddly-framed questions, which everyone interprets and answers directly, never lead to improvements in the illness and in functioning.
Every single claim, foundational or complementary, made in psychobehavioral models isn't just much more plausible backwards, it only makes sense the way we patients experience and explain them. Those models are weird, they make no intuitive or common sense, they are roughly the ethereal equivalent of homeopathy: a little bit of what harms to cure the harm, except as an idea, a concept. Which is, of course, identical in construct to expensive shaken water, but they all completely miss the point. Points that they are taught not to miss. Somehow.
There is simply no place for anything psychosocial here, simply because it will always be misused. Always, without fail. It should actually be dealt with in a similar way as with a strongly addictive substance and a group of people who are madly addicted to it. Medical professionals simply cannot be trusted with using them, having made it 100% clear that they will always misuse them, even with actual good intentions. And not only would it be a massive net positive, it wouldn't even have any gross negative, not a single one. Absolutely nothing of value would be lost if this wretched ideology were entirely erased, treated with the contempt it deserves.
All this framing does is prop up the common excuses by pretending that lies are not explicitly that: a means to an end. Our end. The end of tens of millions of lives. Not a hypothetical future, but a fact already accomplished, and going stronger than ever, an evil impossible to stop. Mostly because everyone expects there will never be consequences when they are proven wrong. Which is why the consequences will have to be extreme, to make an example that will be remembered for centuries. Any other option will be a failure.
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