Mind and Body in the Guardian again

[poetinsf]

But why is it 'software', since it is going to be neuronal microstructure presumably that mediates response patterns

Because of the possibility that neuronal circuitry/connections can be trained/retrained? Again, there are instances of these. I only can speak from my experience on this for now, but I could look up.

Did you mean controversial? Controvertible presumably means something you can argue about and we are.

I meant that there are instances of such dysfunction and the fact that there are is not controvertible. Are you arguing that we don't know for a fact that there are such cases? If you are, then, OK, I'll retract "incontrovertible" and agree to disagree.

 

[Jonathan Edwards]

Because of the possibility that neuronal circuitry/connections can be trained/retrained?

So when does hardware become firmware or software? Looking back at the old BBC-B computers with software chips

it is all rather unclear.

Neural circuits can be trained but I am not sure there is evidence they can be de-trained. You just overwrite some further training.

I meant that there are instances of such dysfunction

There are instances of people with illnesses we do not understand, yes, but I would not claim we know of a 'dysfunction'. If we have no idea why people have these problems I think best to just say so.

I guess you just meant incontrovertible - something that cannot be denied. It all depends on what we are denying. I think any description that evokes mechanism can be denied or at least queried.

 

[Jonathan Edwards]

Another Guardian piece, this time on shortage of physiotherapists for children.
Maybe some are badly needed but maybe someone needs to check whether the treatment does anything useful.

https://www.theguardian.com/society...irreversible-harm-due-to-physiotherapy-delays

 

[Lou B Lou]

Guardian being supportive of mind-body/psychosomatics article in it's selection of letters yesterday (30/1/2025). Two in favour of the arguments in the article, one against.

https://www.theguardian.com/society/2025/jan/30/medicine-that-crosses-the-mindbody-divide


One published letter writer writes about how she 'hacked" her "wiring" as part of her recovery from LC:

"This article was a well-written summary of an understanding that I have used to hack my wiring as part of recovery from long Covid. Many others are doing this for conditions such as fibromyalgia (which the article mentions) and ME (or CFS – chronic fatigue syndrome).

The role of the mind in illness is difficult to explain in a way that resonates with most people and is not interpreted as dismissive or as saying: “It’s all in the head.” The article does a really good job of this, and so it is a shame that illnesses including ME and long Covid are not even mentioned. Far more people suffer from long Covid today, for example, than most of the conditions mentioned in the article.

While this knowledge is helping many, it could help so many more people if it were more widely understood by both medical practitioners and society in general. Those searching online using “ME” or “long Covid” will miss this piece of otherwise excellent journalism and, potentially, the understanding that can help them recover. That is the real shame."



The very long (critical) letter from Alan Bleakley (Emeritus professor of medical humanities, Plymouth Peninsula School of Medicine) finishes with:

" .... During the winter of 1885-86, Sigmund Freud attended Charcot’s theatrical demonstrations of psychosomatic treatment of women patients, where his idea of a deep relationship between body and mind – as a symptom linked to repression – was formed. Drawing on Suzannah Jones’s work arguing that, in comparison with men, women are airbrushed from history, we might note that historically the “psychosomatic” in medicine is largely gendered as “women’s issues”. Or the rest is “hystery”."

.

 

[poetinsf]

So when does hardware become firmware or software?

Firmware is basically unmodifiable software written in read-only memory. Hardware never becomes software. Memory is a hardware, but it is not software. Can a memory failure cause software bug? Sometimes. Most software bugs, however, are caused by bad programming.

I think we have to accept possibility of "software" fix if we accept FND as a possible neural circuitry problem. The question is, is it really a neural circuitry problem? Maybe nobody can answer that yet. But it seems to me a definite possibility. Things like ants or bees have a large number of pre-programmed "firmware" aka instincts that automatically respond to sensory inputs. I'm sure many things humans do also fall into that category except that many are learned or trained rather than pre-programmed. And the computer analogy is more apt than ever, now that we have AI that emulates human brain with neural network.

Neural circuits can be trained but I am not sure there is evidence they can be de-trained. You just overwrite some further training.

There are some researches going on with drugs like Psilocybin or MDMA. I think the idea is to erase the programming and start over to treat disorders like PTSD.

If we have no idea why people have these problems I think best to just say so.

That would be like throwing in towel and say there is nothing we can do for them. What's wrong with having a working hypothesis, act as if the hypothesis is true as long as it's not doing any harm, and then update the hypothesis when new evidence comes along? Application of Baye's law, perhaps.

[edit: grammatic fix]

 

[Hutan]

If we have no idea why people have these problems I think best to just say so.

That would be like throwing in towel and say there is nothing we can do for them. What's wrong with having a working hypothesis, act as if the hypothesis is true as long as it's not doing any harm, and then update the hypothesis when new evidence comes along? Application of Baye's law, perhaps.

I suspect you are just playing with us, seeing who will bite.

I think if you think that 'acting as if a hypothesis is true' isn't by definition harmful, when it comes to confidently telling someone why they are ill, you haven't been paying attention. Not to mention the damage it does to the reputation of anyone who has said one thing (e.g. 'your [peptic ulcer] is caused by your inability to manage stress well') and then has to

update the hypothesis when new evidence comes along

 

[Jonathan Edwards]

That would be like throwing in towel and say there is nothing we can do for them. What's wrong with having a working hypothesis, act as if the hypothesis is true as long as it's not doing any harm

Well, as Hutan points out there is huge scope for harm - and since the amount of harm is unknown it is completely unethical to behave that way in routine practice without getting some reliable trial data.

The longer I life the more sure I am that psychological approaches cause massive widespread harm. And paradoxically the psychologists are perfectly aware of the harm of treating people on the basis of hypothesis without reliable evidence. Of course they call it 'medicalising' because in their book 'medical' approaches are by definition wrong. But psychologising can harm just as much.

I actually agree that inappropriate application of medical theories can do a lot of harm. I have seen the harm of medicalising. But ironically the people who overmedicalise are often the same people who overpsychologise - people like Peter Denton White, Bjorn Bragee, Hans Koop ... the list is familiar.

And I guess you mean Bayes's Theorem (with two s's).

 

[poetinsf]

Well, as Hutan points out there is huge scope for harm - and since the amount of harm is unknown it is completely unethical to behave that way in routine practice without getting some reliable trial data.

I agree: foisting psychology without reliable data can do huge harm. I'm strictly limiting the possibility of "software" problem to well-defined FND though. I'm only saying that practitioners' penchant to write off anything with unknown etiology as functional should not be a reason to write off the possibility of FND being real.

And I guess you mean Bayes's Theorem (with two s's).

Thank you, I stand corrected.

 

[Utsikt]

@poetinsf Afaik, the brain is an analogue computer, so it’s all hardware. The software/hardware divide makes no sense.

 

[Sean]

But psychologising can harm just as much.

Even more. Because it is so much more unfalsifiable, and hence much harder to refute. Psychologisers have an endless supply of arbitrary re-framings to play whack-a-mole and use to hang onto their power.

@poetinsf Afaik, the brain is an analogue computer, so it’s all hardware. The software/hardware divide makes no sense.

The software/hardware analogy simply does not apply to wetware (biology). They are fundamentally different.

 

[bobbler]

Even more. Because it is so much more unfalsifiable, and hence much harder to refute. Psychologisers have an endless supply of arbitrary re-framings to play whack-a-mole and use to hang onto their power.


The software/hardware analogy simply does not apply to wetware (biology). They are fundamentally different.

It’s why it’s the main weapon in coercion control, and at a more general level bullying of any kind to call your victim deluded or imagining it or sensitive and so on.

it’s not new and was known about before the bps cruelty strategy was invented so I’m now having watched their behaviour of each complicit person when harm has been shown to them plainly conclude it was deliberate- the psychology science at the time was that the most important thing for ‘mental health’ was support network and the most likely cause of things like depression was ‘three significantly stressful events’ with the former being the buffer for eg divorce or losing your job etc .

The invented hostile environment for me/cfs targeted each of the known elements so cruelly and precisely there is no conclusion possible of it being accidental. As for then trying to downplay that as ‘stigma’ to transfer sympathy to the perpetrators and infer the nonsense labels were real ‘if only the public were nicer about it’ i have been silenced in being able to use words that are near to appropriate in level for what someone would have to be to do that.

At best those who’ve attracted themselves to this like getting a kick in for the person once they are already knocked down ie the kindest excuse I can give them is that they are so deluded or lacking in seeing humans or the impact of what they do that they somehow lied to themselves that what they do is just actions and closed their eyes to the objects of what they did. Whilst invoking it being ‘in the name of’ - which is disgusting in itself.

I don’t think all of them were in this group and sadly some of us have been at different positions of vulnerability- a fluctuating and ‘can be made invisible’ condition gives you that unique window because the very same people show you who they pretend to be when they think they can’t get away with it and then I’ve felt their real who they are when no one’s watching and they think their labels mean no one will belief us if we tell on them what they just did or said.

it’s never been mental health it’s just weaponising of labels and powrs I think their behaviour mean need to be withdrawn entirely (find another safer way to do the original reason) and fgs should never have been extrapolated to all these people further down the tree left right and centre - without powers to call ou those making errant suggestions being even stronger. The default now is for some whatever non-profession , nothing to do with knowledge on anything to do a rumour-mill level suggestion and there are no consequences for anyone other than the victim of that, and it never being verified properly or errors in it treated with the seriousness that power should implicitly require.

 

[poetinsf]

@poetinsf Afaik, the brain is an analogue computer, so it’s all hardware. The software/hardware divide makes no sense.

The software/hardware analogy refers to function/physiology in case of the brain. A computer needs to be programmed to function, and replacing on/off switches with wires doesn't make "software" vanish. How it is wired, not the wires themselves, is the software in analog computers.

 

[dave30th]

We've seen examples on this forum of studies that purported to improve or cure irritable bowel syndrome and so called functional epilepsy with CBT. I recall that in both cases the physical symptoms did not improve, it was just the patients had been taught to fill in the questionnaires differently to say they had improved. It's all smoke and mirrors.

And of course Trudie Chalder was a key player in the major trials for both of these--CODES was CBT for dissociative seizures, and ACTIB for IBS. I posted a lot about both of them.

 

[Amw66]

This is a problematic somatic modification - too much strudel etc.

? Can you ever get too much strudel?

 

[Robert 1973]

And I guess you mean Bayes's Theorem (with two s's)

Bayes’ Theorem is the more conventional form but I always add the extra s to the possessive form of singular nouns which end with an s. To me, it adds clarity, which is what grammar is for.

 

[Jonathan Edwards]

Bayes’ Theorem is the more conventional form but I always add the extra s to the possessive form of singular nouns which end with an s.

Yes, we were taught at school to do without the second s but as you say it is much better to have it (the theorem might belong to several sorts of Baye otherwise). I think there has been a move to another s in the last forty years that probably isn't in the maths textbooks yet.

 

[Robert 1973]

Got the same impression when looking into psychosomatic theory for other diseases.

It was usually presented as a progressive view and contrasted with genetic determinism. People like Kubler-Ross and Bettelheim believed that patients with schizophrenia/autism had no biological abnormalities (they treat this like an insult) but that they were normal people reacting to an abnormal situation (parents were blamed a lot). In a caring and trusting environment of the psychologist they would be able to be fully cured.

It was often a romantic and hopeful view coupled with the idea that studying these diseases would tell us more about the nature of human kind and society. It wasn't so much about medicine but about psychology and sociology as well. In the early days of CFS, some argued it was a reflection of a neoliberal and individualistic society, like a burnout.

All these view seem to come from the political (center) left and progressive side. It wouldn't surprise me if people like Wessely, Sharpe, Moss-Morris, Chalder, Rosmalen, Wyller mostly have background like this rather than a rightwing view that patients are degenerates or lesser people.

I wonder if SW and Dame Clare are libertarians. As far as I’m aware they are friends with Fiona and Claire Fox, and I seem to remember CG was anti-mask on Twitter before doing a reverse ferret. (I’ve not followed the Cochrane mask controversy but I wonder if it was the same libertarian forces that are responsible for the exercise review scandal.) I think SW and possibly both have written articles for Spiked, which is a libertarian publication that was set up by people who worked for LM (previously Living Marxism/RCP) before it lost its libel case again ITN and was shut down. But it could be that they identify as left of centre progressive.

Whatever their political values, I’d be surprised if they allowed them to interfere with their personal and professional ambitions.

 

[Snow Leopard]

What's wrong with having a working hypothesis, act as if the hypothesis is true as long as it's not doing any harm, and then update the hypothesis when new evidence comes along?

Firstly, the hardware/software analogy has no place in medicine or psychology as it is simply mind-body duality being rehashed with different words and the analogy with computers is just plain wrong. Neurons do not operate anything like transistors and the signal patterns that pass between them are nothing like that of software. AI models despite using 'neural networks' also operate nothing like animal brains.

Secondly, FND is not a working hypothesis, its the absence of a hypothesis.

FND needs to be discarded as it is a catch all and we shouldn't pretend different "functional" symptoms have a similar basis. Many of the hypothesis for these symptoms are flat out impossible for many symptoms, such as the "predictive coding" hypotheses because there is no predictive coding system except where real-time prediction is required. So it is plausible for functional motor tremor but it is not plausible for fatigue or pain. The other FND that plausibly has a psychogenic basis is non-epileptic seizures, but this group should not be assumed all to be the same illness. Those symptoms can be induced from panic attacks (which causes altered breathing so it cannot be induced purely in the mind) but in principle there could be over sensitised pathways leading to vasovagal responses within the brain itself.

 

[Utsikt]

You also have to account for the things that are proven wrong when you update a hypothesis.

Sticking to the core assumptions in FND is like trying to get a rocket to fly to the moon using diesel, and refusing to swap out the fuel. You’re never going to succeed. Tweaking the aerodynamics isn’t going to cut it.

 

[Woolie]

In fact, nearly all physical illnesses cause changes in psychology and behaviour, so the division between “mental” and “physical” illnesses seems needlessly arbitrary and based on old conventions.

The psychobehaviouralists are right that the mind and the body are very linked. What they don’t get right is they assume the mind has a sort of magical power to change the body. The reality is that the mind is nearly certainly created by the body, so changes in the body will lead to changes in the mind. Not the other way around.

Yes, this!! Well said, @Yann04!