Poll - Have You Ever Believed In Psychosomatic Illness?

I interpret the original question asked broadly, in meaning, do I have any belief in psychosomatic illnesses? I pointed out that in some cases (as you've highlighted with an obvious mechanism) I will consider its existence. I don't think this thread is only about the ideas Wessley and Chalder support, but as a whole if psychosomatic illnesses exist in general.

 

https://books.google.co.uk/books?id=Dm6Xt6pk8aQC&pg=PA244&lpg=PA244#v=onepage&q&f=false P244 Charles Shepard believes in somatization, and seems relatively uncritical of it.

 

My point was also that he doesn't take the opportunity to be critical of it, he should have mentioned the lack of evidence for the concept as well as the double standard of evidence required for medical professionals to accept such a concept.

 

It is quite a controversial topic, but I thought I would revisit this because recently, I recalled someone I have known since my adolescent years who I would describe as possibly having something that comes across as MUS/FND.

Although not surprising, everyone has differing views about psychosomatic illness. I see the benefit of discussing it because, in my opinion, it helps me argue against the psychologisation of my physical symptoms during contact with health professionals.

I will refer to the person in question as person A.

Person A is a relative of very close childhood friends of mine. We met through these friends as teenagers. Before I met person A, I heard about them from another close friend who met them first at a social gathering. I received a call from a friend, upset that person A had appeared to feign illness at her relative's party. My friend described person A had dramatically thrown herself on the floor midway through the party and began shaking as though they were having a fit. She described her as rolling and shaking and making faces. Of course, everyone at the party was very concerned and immediately rushed to the aid of person A. Except for our close friends, the known relatives of Person A. My friend and the other partygoers began providing person A with provisional aid. Person A was offered water and was advised to get some fresh air after they came round from the first episode of fits. As person A was led to get some air, they started having fits again. Of course, everyone now felt it was a medical emergency and agreed to call emergency services. My friend says that despite all this, person A's relatives seemed strangely detached from the situation.

According to my friend, when person A realised that emergency services were being called, they started to come around and pleaded with everyone not to call an ambulance. I would now say this is a reasonable request in some cases, as I know someone diagnosed with Epilepsy who doesn't like being taken to hospital if they recover quickly from a short episode. However, according to my friend, Person A's attacks appeared severe and prolonged in nature. The partygoers were shaken and profoundly concerned but ultimately respected the wishes of person A. At this point, the party was now over as everyone just wanted to ensure person A was okay, and afterwards, they began to leave.

Once the party ended, my friend, person A, and their relatives remained. My friend was in the kitchen helping to tidy up when the relatives of person A entered the kitchen. My friend expressed their concerns about person A and asked if this kind of thing had happened before as it felt very serious. The relatives explained person A had a history of appearing to fabricate illness, amongst other lies, so they were not surprised that person A did not want to go to the hospital. They apologised for their relative's behaviour. Of course, my friend was now upset as it seemed person A had ruined their aunt's party for attention.

I spoke to my close friends - the relatives of person A, who confirmed person A was known to occasionally fabricate lots of things, which to them felt like some form of mental illness with which they sympathised due to person A's hard upbringing.

When I met person A, all seemed fine the first couple of times, until one day, they said they could no longer walk midway through a journey and sat on the ground bawling of leg pain. We were with person A's uncle, who told them to stop pretending. We continued to walk while some of us took turns to support person A. We asked person A if they wanted an ambulance, which they declined but continued to yelp out in pain.

As time went on throughout the years, my close friends sometimes complained about the relatively small but annoying lies person A would get caught telling. It caused friction in their relationship. As time went on, they had less contact with person A.

Many years later, one day, person A showed up at their home saying they had a baby that unfortunately passed away. While one of my friends consoled person A, my other friend came into the room and asked what was going on. The person comforting person A relayed the story and showed her the picture of the late baby. My friend said they were shocked and disturbed at what they saw because the image was of a baby belonging to another friend. At this stage, my friend asked person A to leave their home.

Over the years, more people began to report other strange stories person A would tell. One that sticks out is where person A told a man who left the UK that they had fallen pregnant before he had left. My friend said they walked in on person A, imitating a child's voice. When the call was over, they asked person A what it was all about and person A confessed to pretending they had a child for the man.

The most recent news I've heard about person A was around a year ago. My friend told me person A had shown up at their parent's house, saying their mother, who lived in a different country, had died after being sick for a while. My friend's parents were very saddened by the news and felt greater empathy for person A due to the history of difficulties. One day, my friend's father bumped into the uncle of person A and passed on his condolences for losing his sister. Person A's uncle was startled and grew concerned as he explained he wasn't informed of his sister's death. He immediately called his sister, who answered the phone and told her he was relieved she was okay, but person A had been telling people she wasn't alive.

I can't say for sure person A was not actually ill during all of the above instances, but their frequently lying behavioural patterns make me sceptical. Even so, there will be plenty of occasions when person A is genuinely ill and they should receive medical attention and appropriate testing each time it is deemed necessary.

I wanted to share this account as it might provide an idea of MUS/FND patient characteristics. Would it be expected for a patient only to fabricate or exaggerate symptoms, or would this pattern happen in other areas?

The neurology literature outside of BPS research I've read where functional cognitive symptoms are sometimes referred to recommends neuropsychological evaluation for screening because of the ability to interview someone who knows the person well check for brain structural deficits, mental & physical illness symptoms and behavioural presentation.

https://elmirmohammedmemorypsy.file..._s-guide-to-neuropsychological-assessment.pdf




[Edited for clarity]

 

Maybe that's the point it's a only in the eyes of the doctor not in any physical evidence.
So there is limited research into the early detection of disease when physical and imaging testing is negative. So more effort should be in into research to devise more robust tests.
So they should give up the idea of fnd or psychosomatic diseases.

 

That would be malingering or Factitious disorder which is not what MUS/FND/Psychosomatic are claimed to mean, however in practice some medical professionals often use FND Etc as a euphemism for malingering or hypochondria.

 

Out of curiosity, how close can you come to proving a physical symptom has a psychological cause. Is there ever a case you can be 100% certain about this?

 

Nope. It's not provable. It's always absence of evidence and the use of a default explanation. Used to be demons/spirits, now it's the magical mind-body thing. Same idea, really.

I've seen more than enough proponents writing about this, it's always justified by not figuring out the real cause, or like with us, using cheap trials of psychological therapy that boast of working, despite the data never supporting it.

Otherwise it's just vague examples of generic known effects, such as heart rate increasing when people face stressful situations, or how people lose appetite when they're depressed or anxious, terms that have pretty much lost all meaning now. All generic, non-specific, the medical equivalent of arguing that astrology is real because the Sun has an obvious and enormous influence on all life on Earth. Which is true, except that it doesn't make astrology real.

While it's possible that some odd cases do exist, it's at least 90% who rely on this flawed reasoning, probably up to 99%, and I wouldn't be surprised if we have to use decimals here.