Paradox of diagnosis The positive effects and limitations of diagnosis in ME/CFS and fibromyalgia (Nojima, 2019)

Dolphin

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PARADOX OF DIAGNOSIS: THE POSITIVE EFFECTS AND LIMITATIONS OF DIAGNOSIS IN MYALGIC ENCEPHALOMYELITIS/CHRONIC FATIGUE SYNDROME (ME/CFS) AND FIBROMYALGIA (FM) SUFFERERS

Natsuko Nojima*

Abstract

Diagnosis is a topic of discussion in recent studies on contested illnesses. Without an accurate medical diagnosis, sufferers face the risk that people may think they are malingering or faking. Therefore, receiving a diagnosis can be a critical event for sufferers because it legitimizes their illness. This paper explores how diagnosis impacts the illness experience of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or fibromyalgia (FM) sufferers. The findings can be divided into the positive effects and limitations of diagnosis. Positive effects of diagnosis include achieving relief because of the legitimation of suffering and liberation from guilt; however, diagnosis posits several shortcomings. Often, despite being diagnosed, others fail to recognize the sufferers’ condition as a serious disease or as a disease at all. This paradox of diagnosis highlights the significance of delegitimizing sufferers’ experiences and the vulnerability of legitimate diagnosis.

Key words: contested illnesses, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), paradox of diagnosis, delegitimation of suffering
 
From the footnotes. Published 2017 in Japanese.

This article is the English translation of the original one “Nojima, N (2017). Paradox of Diagnosis: The Positive Effects and Limitations of Diagnosis in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Fibromyalgia (FM) Sufferers. The Japanese Journal of Health and Medical Sociology, 27(2), 77–87 (in Japanese)”.
 
since when did patients go to a doctor thinking a diagnosis is a way to legitimise anything .I thought well my younger naïve self thought you went to the doctors for answers and hopefully medical help . all this bs never came into consideration I do not think any sick person ever thought oh I will go to the quacks to legitimise my symptoms . some academics really do live in a phantasy world .
 
I had gradual onset ME went for a long time not knowing what was wrong with me. I had a bad sick record at work and it was causing problems. Getting a diagnosis and ironically getting referred to the hospital to the CFS clinic both made friends family and work take m6 illness more seriously.

ETA as did getting myself a consultation with an ME specialist who sees people privately and getting ME diagnosis confirmed 2 years after CFS diagnosis
 
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since when did patients go to a doctor thinking a diagnosis is a way to legitimise anything .I thought well my younger naïve self thought you went to the doctors for answers and hopefully medical help . all this bs never came into consideration I do not think any sick person ever thought oh I will go to the quacks to legitimise my symptoms . some academics really do live in a phantasy world .

I am not sure whether those remarks are aimed at my post directly above them. There is unfortunately substantial literature on illness behaviour and the sick role which guided the thinking ot the BPS brigade in establishing their views of CFS. This paper in comparison appears quite benign.
 
since when did patients go to a doctor thinking a diagnosis is a way to legitimise anything .I thought well my younger naïve self thought you went to the doctors for answers and hopefully medical help . all this bs never came into consideration I do not think any sick person ever thought oh I will go to the quacks to legitimise my symptoms . some academics really do live in a phantasy world .

By way of contrast with the writing of this author I thought I would provide an indication of SW's earliest recorded musings on this subject in 1987. This was the reason this article seemed benign :

The treatment of mass motor hysteria is more complex. Steps must be taken to remove the advantages of the sick-role by the withdrawal of
social validation. If the emotional nature of the contagion is pointed out the reaction of onlookers, who may be potential participants,becomes negative. Dr St. Clare cured persistent collapse amongst Lancashire mill girls in 1787 by administering galvanic shocks and declaring the disease to be 'merely nervous, easily cured and not introduced by cotton' (St. Clare, 1787).
Should social validation be granted, the epidemic may persist. This can occur when onlookers have a vested interest in supporting the authenticity of the hysteria

In the paper SW refers to ME and although he indicates that the condition is controversial, he offers nothing to counter the McEvedy and Beard explanation.
 
Or, as we would interpret it, 'Dr' St Clare scared off anybody else from reporting that they were ill by shocking them with electricity and using social influence to deny their illness. I'm sure the mill owners were very grateful, 230 odd years later similar tactics are still in use, just substitute GET for electrical shock.
 
So if you electrocuted people for not working then they start working? How about if you beat or whip them?

Isn't this rather an old discovery? At least several thousand years old.

What are we paying these psychos for, to discover stuff we already know, stuff that would be illegal if not suggested by them.

For some reason they seem to be immune from the law and any ethical or moral responsibility.
 
Steps must be taken to remove the advantages of the sick-role by the withdrawal of
social validation.
Don't you just love the absolute certainty in these kind of declarations.

So if you electrocuted people for not working then they start working? How about if you beat or whip them?
The beatings and whippings will continue until morale improves. :devilish:
 
Steps must be taken to remove the advantages of the sick-role
Definitely success on this front, pretty much the only success they can legitimately claim. Zero advantages exist. Never even existed, in fact, except for heirs of multi-millionaires or aristocrats, and even that is no guarantee.

You certainly can't fault these people for lacking imagination, they will explain complete fiction with utmost confidence and never skip a beat.
 
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