Psychosocial chapters from Ciba Foundation Symposium 173

From the book Osler's Web by Hillary Johnson,
Ciba Foundation Symposium 173d, summary.

Page 571
  • The Ciba Foundation was an independant academic institution funded by the giant, Switzerland-based pharmaceutical company Ciba-Geigy
  • The conference had only 25 participants
  • Elaine DeFreitas was invited (she did retrovirus research in patients)
  • Other invitees included Stephen Straus, Peter Manu (who maintained CFS was a psychiatric problem) and Peter Behan (who had cast DeFreitas as a fraud during a US visit previous September)
  • The conferences organisers had invited Edward Shorter to moderate the conference. Shorter was a history professor and pop author, "whose recent book had ridiculed the disease and its sufferers". (In it, he also called CFS "a sham", p 589) Gregory Bock, the deputy director of the Cibi Foundation later defended his choice with: "He's a perfectly respectable medical historian."
  • When DeFreitas discussed her invitation with David Bell he said: "It sounds like a turkey shoot - and you're the turkey."

Page 588/589

  • The conference began May 11th 1992 at Ciba headquarters, 41 Portland Place, London
  • Stephen Straus was appointed co-chairman of the event, along with Harvard psychiatrist Arthur Kleinman, who, like Straus, had written a paper on depression* in CFS.
  • Shorter held his opening talk:
"Invited to place chronic fatigue in historical perspective, Sorter inaugurated the meeting by portraying CFS as a contemporary manifestation of the "hysterical" diseases afflicting women in every century, supporting his argument with slides of centuries-old illustrations. Walter Gunn, in London to describe the CDC's surveillance data, was sickened by Shorter's contribution. "He showed pictures of naked women with their limbs twisted in paralysis. If I had been a woman, I would have walked out," Gunn said, adding, "It was all opinion. He has no data. His take is that the epidemic is due to press publicity."
The symposium was top-heavy with psychiatrists. "It was very tedious listening to all the bullshit," Gunn commented later with uncharacteristic abandon. "I said that if we listened to the psychiatrists, we'd still be treating lupus with psychotherapy," he added. "Occasionally people would get up and present evidence to show that it's an organic disease. What seemed to be coming up was that maybe there's something organic about mental illness."​

  • DeFreitas couldn't make it to the symposium. Tom Folks from the CDC went in her stead. He held a talk about the retroviruses they looked for. In short, they hadn't found any so far and couldn't replicate DeFreitas' findings. (Gunn challenged that due to other findings.) Folks emphasised that even though he hadn't found anything yet, it didn't mean it wasn't there. (It could e.g. be ceause the retrovirus was unknown/undiscovered, or hiding in white blood cells or other tissues.) However Gunn reported that DeFreitas standing was destroyed there in the eyes of all those present.


*Norma C. Ware and Arthur Kleinman, Depression in Neurasthenia and Chronic Fatigue Syndrome, Psychiatric Annals 22 (1992)
 
One of the early chapters is by Peter Manu et al., [....]

Throughout the symposium, he is the one who downplays any biological evidence and champions psychosomatic explanations. His paper seems to be strongly influenced by Wessely & Powell's 1989 study on post-viral fatigue.

Peter Manu, together with T.J. Lane and D.A. Matthews, wrote a piece called "The frequency of the chronic fatigue syndrome in patients with symptoms of persistent fatigue" for Annals of Internal Medicine in 1988. This was one of the references for the Oxford criteria (published February 1991), that were devised to pull CFS firmly into the psychiatry camp.
 
I really wouldn't be surprised if Kendell is the origin of those. He is after all the spewer of other such nonsensical gems like: "In reality, neither mind nor bodies develop illness." and "Pain, the most characteristic feature of so-called bodily illness, is a purely psychological phenomenon."

As is often the case, the ones who frequently talk about the failure of cartesian dualism are closet dualists themselves.
 
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