The concept of ‘illness without disease’ impedes understanding of chronic fatigue syndrome: a response to Sharpe and Greco, 2020, Lubet & Tuller

Mod note: The reply by Lubet and Tuller was in response to an article by Sharpe and Greco, discussed here:
Michael Sharpe: Mind, Medicine and Morals: A Tale of Two Illnesses (2019) BMJ blog - and published responses

By Steven Lubet & David Tuller.

Abstract:

Link: https://dx.doi.org/10.1136/medhum-2019-011807
Sci-Hub: https://sci-hub.tw/https://dx.doi.org/10.1136/medhum-2019-011807

 

Excellent brief article by Lubet & Tuller

I love this line "Given psychiatry’s long history of mistaken theories of disease causation, there is an almost wondrous grandiosity to Sharpe and Greco’s proposed solution to the supposed ‘paradox’ that troubles them."

Wondrous grandiosity - fabulous

Bw
Joan
Counselling
Psychologist

 

Sharpe needs a history lesson if he thinks that not being able to explain illness is unusual.

There have been many claims of psychogenic illness that all ended when the biological mechanisms of some at the time unexplainable illness became sufficiently explained. Then proponents of the idea of psychogenic illness moved on to some other illness that was poorly understood. This ideology is an explanation in search of a problem.

 

That was a great response. Clear and, unlike the original piece, coherent. Also unlike the original piece: actual facts. Bold move.

My mind more or less exploded when I found out that Greco has an MA in Critical Theory. Seriously. I just can't wrap my head around being this bad at my chosen profession, it's simply unimaginable to never have a moment of self-awareness for this long to seriously produce actual god of the gaps arguments. I have second hand cringe from it.

Though the idea that tens of millions of lives can be written off based on cheap incoherent and inconsistent philosophy is a crime of gargantuan proportion that I also cannot wrap my head around. It's not the suggestion that is insane but that it is considered credible to the point of putting it into practice through near (as we can tell) universal approval and support despite documented evidence that it is disastrous on a level comparable to detonating nuclear bombs in large cities simply to observe the effects. It's no less immoral than deciding on prison sentences based on a random Facebook quiz, a Bingo draw or a skull measurement.

A philosophical question does deserve to be asked: if we continue to this day with barbaric practices, does that not make us barbarians still? I would argue barbarians are defined by committing barbarian acts and this is a clear act of savage barbarism, to erase millions by discriminating against specific health problems, to even categorically reject the idea that we can solve this particular problem. Not much different from abandoning (though this was by necessity) a member of the tribe if they can't follow because of a broken leg.

If we are judged by how we treat the most vulnerable among us, even medicine frankly fails this critical test because of this moral blind spot. We can and have to do so much better than this.

 

Nicely put.

 

see also this thread
https://www.s4me.info/threads/micha...-published-responses.9729/page-18#post-264575

 

Slowly or (hopefully) more quickly understanding of our illness and others will move on without Sharpe et al. But when a better grasp of the physiological underpinnings of this illness and appropriate treatment happen IMO this will not change anything for BPS true believers.

I think they will continue to suggest that 'it is complex' in their sense meaning that personality, mental disturbances etc contribute in a way that makes their treatment still valid (at least CBT and perhaps a GET that will have morphed into pacing).

There is no undermining this theory. We know so little about how the mind / brain functions. They can continue to flaunt vague ill defined concepts using the language of science to convince the general public that they know far more then they do.

Ultimately, society needs to develop antibodies against propaganda.

 

Really excellent article Steven and David.

To my mind there is genuine and much more pressing paradox:

• Medical scientists, by definition, are always aware there is still much yet to discover; what purpose would they have if there wasn't?
• Researchers implying that physiological medical knowledge is fully understood for some illnesses, claim to be scientists.

Just as for Sharpe and Greco, this seeming paradox is not really paradoxical at all of course. I don't think it needs any great wisdom to spot why. But it does of course need just a touch of that essential quality for any real scientist - humility.

 

This seems relevant to the topic and rather smart:

Improving Diagnostic Accuracy: Medical Mimicry, Part 2

https://pro.psychcentral.com/new-th...g-diagnostic-accuracy-medical-mimicry-part-2/

Another article from the same author, again pretty smart on the topic:

Improving Diagnostic Accuracy: One Symptom Isn’t Enough, Part 2

https://pro.psychcentral.com/new-th...-diagnostic-accuracy-one-symptom-isnt-enough/

 

Definitely relevant to the confluence of MUS/FND, ME, COVID-19 and medical gaslighting as a standard operating procedure created by the concept of conversion disorder. This is particularly relevant as it highlights the reality of creating trauma, through medical gaslighting, even as the BPS brigades are pushing in many places to put COVID-19 post-viral illness under PTSD: literally creating the problem they present as the cause.

It also basically presents all the features of the ME debate unfolding over the last few decades, the exact same objection to being gaslighted, simply because it's wrong and thus a pointless waste of effort, and how it only amplifies the problem. The same language and frustrations. The same consequences, too.


Dismissed, unsupported and misdiagnosed: Interview with a COVID-19 ‘long-hauler’

https://www.pslhub.org/learn/coronavirus-covid19/patient-recovery/resources-for-patients/dismissed-unsupported-and-misdiagnosed-interview-with-a-covid-19-‘long-hauler’-r2461/

The "mental health" focus of ME has been nothing but disastrous for the mental health of those it locked in the chokehold of the conversion disorder ideology. Like firefighters burning down the whole city and celebrating how good of a job they are doing since there's nothing left to burn and thus no more fire. No more buildings, or life, either.