Diane O'Leary, philosopher, media articles and interviews

Podcast: "Doctors and dualism" - Diane O'Leary, 2022

A podcast from ABC Australia featuring Diane O'Leary. Apparently ME/CFS is a prominent feature of the discussion:

https://www.abc.net.au/radionational/programs/philosopherszone/doctors-and-dualism/14004928

(I haven't the cognitive function to listen to it yet.)

Edit: discussion specifically relating to ME and Long Covid starts at around the 14 minute mark.

 

We have been discussing this stuff on forums for decades, you probably know much of it already. I might try to listen later.

 

she is a member here
@Diane O'Leary

 

Errr, no, not quite.

well, I guess self-belief is a virtue but I personally think it's taken an effort of more than 8 years by many many people to get us to the point where NICE properly analysed the evidence for behavioural therapies and discovered for themselves how poor it was.

 

Indeed it took a lot of patient protesting to undo the damage that the PACE study did and expose its flaws, to get people such as yourself on a committee and then all that work to publish updated guidance. There is a lot more to do to, the bulk of hospitals are still using GET/CBT by the looks of all the letters Charles Shephard is sending out, some are in open revolt and its going to require something stronger than a letter to change their ways. Charles Shephard's influence is largely nepotism based due to Sajid Javid's personal relationships, its not patient lobbying or the guidance that got that working group there. Your average GP still doesn't have a clue but the fight right now is to get the specialists to accept the evidence, that is insane when you think about it! This fight has only just begun, it will probably take a generational change in the medical staff to solve it unless someone finds a good biomarker and a treatment that works, that will accelerate acceptance a lot faster, without it this is a long uphill battle for acknowledgement.

 

From reading S4ME I would question the idea that English medicine and English doctors have rejected the psychosomatic approach. I thought it was still increasing dramatically, despite the NICE Guidelines rejecting CBT and GET.

 

i have always thought that the mind body approach was just an excuse used by medical practitioners to put the onus on patients rather than doing the hard work necessary to get answers to patient problems . political an insurance motivation to reduce cost has just made the whole fiasco a thousand times worse .

 

I was just musing on the idea that mind-body duality is probably a cultural issue, having been introduced into Christian theology by the neo-Platonist, Plotinus. That made me refer to Russell's History of Western Philosophy. He makes the interesting observation:

Both Aristotle and the Platonic Socrates complain that Anaxagoras, after introducing mind, makes very little use of it. Aristotle points out that he on;y introduces mind as a cause when he knows no other.

Plus ca change... He was born in about 500 BC.

This is not a problem of modern origin.

 

if only!

That just makes me laugh. If anyone can show me where anything has actually changed in terms of treatment of patients, rather than lip service language change, i'll be thrilled to hear it, but the notion that everything has changed is laughable iyam

 

There have been a lot of newspaper articles talking about dualism over the last few years - often from columnists who didn't do philosophy as their educational background getting inspired by BPS-related people mentioning dualism.

I'm no philosophy expert, but through my career had to look at it enough that I know what they spout is nonsense and I'd be mightily peeved if my area was being bas****ised naughtily - and then redone by people infected by hubris (they are unaware of) and enthusiasm amateur part-time philosophers have - and then becoming more discussed than the real stuff. It's shocking really like the meme dodgy version of the social media account of the famous person not just getting more famous but being more believed as 'the word of' that subject area.

Having been brain-wise and experience-wise not suitably positioned to retort the pseudophil, but knowing enough to know that is what it is and that a real philosopher could use their special techniques to cut through fallacy, I'm pleased at least one of them is doing this. They did it to Engel's model, then CBT didn't fight back..

 

There you go, the book I was once going to write summed up in a sentence. "Embracing Uncertainty" was a very deliberate title for me.

 

Moved posts

Diane O'Leary has an article on medical gaslighting.
.
https://twitter.com/user/status/1699829100339151348

 

There might be a better place for this post. I don't think we have a general thread on gaslighting.

From this article :

Title : Opinion: Here’s why #MedicalGaslighting has taken social media by storm
Link : https://edition.cnn.com/2023/09/06/opinions/medical-gaslighting-social-media-women-health-oleary

My bolding in the quote...

The bit I've bolded makes me wonder why it is that doctors appear to learn to communicate in a different language to their patients. How can the authors believe what they've written? They think all they need to do is learn how to dismiss their patients better and they'll be happy?

I've often thought that the doctors I've met in appointments don't understand or recognise "desperation". Since I've been labelled as a drug-seeker for 50 years every contact between me and the medical profession becomes just a way for the doctor to practice how to get me out of their office as quickly as possible. And then they don't bother recording the appointment or they lie about what was said.

Edit : Another paragraph worth quoting :

 

In the final quote from the previous post (#17) the references from Medscape and American Family Physician are :

Medscape : https://emedicine.medscape.com/article/294908-overview

which says the following in the Epidemiology section :

Reference 6 for this paragraph is :

Kurlansik SL, Maffei MS. Somatic Symptom Disorder. Am Fam Physician. 2016 Jan 1. 93 (1):49-54. [QxMD MEDLINE Link].

and the Link in blue in reference 6 takes you to the abstract only :

https://read.qxmd.com/read/26760840/somatic-symptom-disorder

From that link the full reference can be found here :

*** https://www.aafp.org/pubs/afp/issues/2016/0101/p49.html

Under the heading "Epidemiology" that link says :

Yates WR, Dunayevich E. Somatic symptom disorders. http://emedicine.medscape.com/article/294908-overview. Accessed August 5, 2014.

And that link takes us back to the Medscape link that I first quoted. So its circular, and who originally came up with the 10:1 female:male ratio for Somatic Symptom Disorder is unknown.

Following up the American Family Physician reference from that last quote in post #17 takes us to the link above with three stars next to it. So it is circular too.

I expect doctors everywhere think that 10 times as many females have SSD as males. And since SSD is essentially a hysteria diagnosis it means that ten times as many women are being labelled as hysterical and untreated as men. (Even though in modern times the hysteria word is allegedly never or rarely used.)

 

The epidemiology is especially awful. It can begin in childhood, adolescence, or adulthood. Which is basically all there is. When you have to include nonsensical facts like this just to pad up a weak claim, you obviously got nothing.

But if you can get away with circular references, then you can get away with anything. What an embarrassment this all is, and it can't stop precisely because it's to embarrassing to stop. This stuff has as much basis as whatever nobles in old aristocracies used to justify their superiority over the rest of the population. And they all believed it, because they didn't know any better.

 

interview with Diane O'Leary on The Dissenter vodcast by Ricardo Lopes, episode #863 (haven't listened yet)

https://www.youtube.com/watch?v=610dKJEbbL0