Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A philosophical investigation, 2021, Byrne (thesis)

There are a few threads on her papers but I’m not sure her thesis has been posted

Source: University of York
Date: December 2021, Online May 21, 2022
URL: https://etheses.whiterose.ac.uk/30502/

https://etheses.whiterose.ac.uk/30502/1/Byrne_201017289_Thesis.pdf
Ref: https://liu-se.academia.edu/EleanorAByrne


Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A philosophical
investigation
-----------------------------------------------
Eleanor Alexandra Byrne
- Department of Philosophy, University of York, U.K.
Email: eleanor.byrne@york.ac.uk


Abstract

Situated somewhere in no man's land, Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) presents scientific and social issues to those who research, treat and experience it. Living with CFS/ME is profoundly disruptive; it is exceptionally physically, emotionally and socially difficult. This thesis offers the first philosophical analysis of the condition, how it is experienced, and how it is handled.

A phenomenological perspective is present throughout this analysis. How does the world of the person with CFS/ME change? How do we understand the sense of loss in CFS/ME, and does it amount to grief, or is grief reserved for bereavement? How does CFS/ME obstruct emotion regulation? How, if at all, are these experiences distinct from depression? How much epistemic privilege, and over which domains, belongs to medical professionals, and how much of it belongs to patients? Which social and political issues can be attributed to distinctive types of injustice, and which have their roots in something else? What does this mean for how we understand the newly-emergent phenomenon of 'Long Covid'?

The answers to each of these questions are taken to support the view that a significantly improved understanding of CFS/ME is dependent upon the revision of a collection of commonplace distinctions and categories which currently restrict our efforts. A nuanced investigation of CFS/ME reveals the restrictiveness of the distinctions between psychiatric and somatic illness, between functional and organic illness, and between primary and secondary psychopathology. An approach to CFS/ME which is not bound by the confines of these distinctions shows itself to be uniquely illuminating.

 

It actually shows that no one can tell the difference either way, and that the old distinction is about as scientific as the concept of race, created in a time of ignorance and with roots from the same tree of bigotry. It's also not even grounded in reality, instead in the flawed perception of a few.

You gotta love how these "not dualist" people keep placing "psychiatric" as some sort of esoteric distinction. Totally not dualists, though. Must be the limits of language, as if using "and" means a separation between two concepts. As if...

 

"Fix" ME by passing new social policies? Have a big fancy conference, talk about the philosophical issues, and then all PWME can go back to their normal lives (and give the conference leaders prestigious awards for their great work)?

 

My guess is that they envision ME as an attempt to avoid the stigma of mental illness by people who in reality have a mental illness, and that fixing the stigma will lead to the diagnosis ME disappearing as it's no longer needed.

I often have the impression that psychiatrists love evoking the stigma of mental illness to avoid having to confront reality.

ME patients don't like being placed into mental health care pathways? Must be the stigma, as surely these pathways could not be inappropriate or causing harm.

 

I skimmed as much of the thesis as I could bear. What confuses me is how this can be described as philosophy, and was accepted as such by the department at York.

There is a youthfully arrogant Hegelianism implicit in the blithe assumption that the somatic and psychosomatic can be synthesised, if only one has been clever enough to consider factors like grief and shame. But overall there is a massive lack of philosophical tooling or process. Instead, the paper sits in that weird, postmodern category of “theory”, where everything is narrative, and all can be jumbled together in the toy box.

It’s bad enough that people who haven’t done any philosophy think that this is what philosophy is like. Far worse that this seems to be what academic philosophy has become.

 

I used to study philosophy (unfortunately!!) If I'd handed in something like this, it would not have passed. Not because it's "not philosophy", which does happen to some people. (I know someone who failed his PhD because he basically did a social science essay instead of a philosophy essay. It was the university's fault for letting it get that far. He had little philosophical training so struggled to produce something in the right format; someone must have okayed it for three years before failing him and it's their fault not his.)

I have not read the whole thing as I cannot due to illness, but as you can see from the setup of the "problem" this work appears to just be some loosely connected talking points grappling around in search of a thesis structure which is then found in the form of a BPS-oriented template "let's reject a bunch of mind-body sounding distinctions". It's cookie-cutter stuff with little argumentation. The lack of rigour on display here is depressing and reflects badly on the department.

Also, "How much epistemic privilege, and over which domains, belongs to medical professionals, and how much of it belongs to patients?"
LOL at patients' "epistemic privilege". This reads like someone upset that anyone now says we must "listen to patients" about their experiences, and is trying to gloss this as a privilege or injustice of some kind, completely distorting the patient/clinician power dynamics for propagandistic purposes. Not surprised CP and SW are thanked.

 

Philosophy is generous. Blathering is more like it. To be fair, a lot of philosophy is just blathering, but this is as blather as blather gets.

Philosophy is the study of knowledge. Ain't no knowledge here.

 

Her supervisor seems to work in the same space, and should take his share of the blame.

https://www.york.ac.uk/philosophy/staff/ratcliffe-matthew/#research-content

 

Yes; it is absolutely down to the advisors of these projects, usually. It's mostly their responsibility imo.

 

Why do the hard work of understanding pathophysiology, inventing drugs, and getting formerly bedbound people back to normal lives when you can sit in your armchair and philosophize?

 

The issue was never mind–body dualism or the distinction between psychiatric and somatic illness. That statement is a red herring repeated ad-nauseam. The issue is whether ME/CFS is psychogenic in nature and whether the illness may be reversed or significantly improved with thoughts accessible to consciousness. Multiple CBT-trials according to the cognitive-behavioural model for ME/CFS without any improvement in objective outcomes show that there is no scientific support for that claim.

 

Indeed, what data we have suggests services based on a model attempting to change behaviour (GET) and thinking (CBT) result in people ultimately undertaking less work and claiming more benefits, at least here in the UK. I suspect these ‘negative outcomes’ are a good thing given our lack of any meaningful treatment, indicating that people are coming to terms with their disability and adapting to it.

One is reminded of the scholars gathered to establish the number of teeth in an ass’s mouth. They consulted the Bible, Old and New Testament, the Greek authors, the Roman authors, the Church Fathers. A young impetuous scholar then said there was an ass tied up outside and why did they not go out and count its teeth. They rose as a single mass, smote him about the back and the thighs and expelled him from their midst. The scholars then consulted the apocrypha and the Arab scholars before eventually concluding God never intended we should know the number of teeth in an ass’s mouth.