Sociosomatics and illness in CFS, 1999, Bohr

[Dolphin]

I was just clearing out some files and came across this horrific letter.
I think somebody would be much less likely to put their name to such a letter these days, thankfully.

 

[Hutan]

Anecdotally, patients with "CFS" idealise their motivations and efforts, fitting themselves with halos. I don't consider self-report to be valid or useful in patients with somatoform disorders.

The irony is that it is the psychosomatic clinicians' dedicated use of self-reports from the participants in their trials, to the exclusion of objective outcomes, that has propped up their empire.

 

[Eleanor]

Meanwhile the first letter makes several points which haven't dated at all:

... some embarrassment in clinicians causing them to label the illness as "functional" or "psychosomatic," and to assign a demeaning label to the nonconforming patient

we should not shun the patient for having a disease we cannot treat

we can advance both research and the healing arts by acknowledging openly that today's functional disorders are simply the ones we do not as yet understand.

The only part that is out of date is his suggested definition of "Functional disorder: an illness for which the clinician has not found an explanation using his/her own frame of reference", since for some clinicians "functional disorder" has become a frame of reference in itself.

 

[BrightCandle]

The contrast in views between the Psychiatrist who recognises they have no idea what is causing the patients symptoms and the future will likely expose more and the neurologist who thinks he knows everything and what he knows is that patients can't even tell when they are ill is quite something to behold. Neurology is regularly rated by ME patients the worst of the fields in medicine for a reason.

 

[postviral?1971]

I suppose it's the same old story -if the symptoms don't fit into the accepted pattern they can't be physical. It's strange that some specialists appear to believe that diagnosis and treatment has reached the point of perfection and that nothing can change or add to it.

 

[rvallee]

The irony is that it is the psychosomatic clinicians' dedicated use of self-reports from the participants in their trials, to the exclusion of objective outcomes, that has propped up their empire.

And, frankly, at least equal parts their own self-reports of their own perceptions of some of the outwardly visible aspects of our behaviours. In fact, mostly that.