The Science Bit: Post-Covid syndrome, Myalgic Encephalomyelitis, and the recurring pseudoscience of mass hysteria, July 2020, by Brian Hughes

Kalliope

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Article by prof Brian Hughes at his blog The Science Bit: Post-Covid syndrome, Myalgic Encephalomyelitis, and the recurring pseudoscience of mass hysteria

People with ME have been waiting decades for their dignity. It is a tantalising but poignant reality that COVID-19, in creating a cohort of post-viral long-haulers, may now be the event that finally brings attention to their plight. The resources and attention of global science might at last uncover the true physiology of their symptoms, and in so doing consign the psychogenic worldview (and its related treament approaches) to the annals of academic history.

Gaps in understanding are what make science worth doing in the first place. We should not presume to fill them with clinical lore, academic intuition, or outdated theoretical tropes.
 
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It’s like that old cliché about having a hammer in your hand and then seeing all your problems as nails. But in clinical academia, such DIY-based deduction creates a massive conflict-of-interest problem. The people with the hammers derive their professional standing — and make their living — from nail-related paranoia. They become VIPs (very important psychologists) precisely because they articulate every conceivable social challenge in behavioural terms, thereby positioning themselves in the role of saviour.

eta: maybe 'they' should release a new version of 'If I had a hammer'
 
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That section of the JBC document is spectacularly badly worded. The main issue is use of the term "mass psychogenic illness" when they (JBC) are really talking about population anxiety about COVID. I don't think they were ever going as far as McEvery and Beard (and hopefully they never will). And the document was defo not talking about longCOVID. However, I recognise the danger that that might be the natural destination. Just hope all the talk about it doesn't speed it on its way...
 
That section of the JBC document is spectacularly badly worded. The main issue is use of the term "mass psychogenic illness" when they (JBC) are really talking about population anxiety about COVID

To me, they seem to make a fairly clear reference to mass hysteria.

As far as I understand, conceptually the difference between heightened anxiety and mass hysteria that one is just people worrying more, having heightened awareness and being more likely to seek out tests etc. The other is people having anxiety and through their mind producing the bodily symptoms of the disease. The use of the term psychogenic is not a mistake.
 
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Does it actually matter what they meant, or that it's badly worded - what matters is that some people may see what they have written as justification, and an opportunity, for various unhelpful policies, 'treatments' and media coverage.

Much as NICE's 'exercise may not be the best option for those recovering from covid-19' has seemly morphed into lets get 'em cycling around a velodrome, as exercise is good for everyone.
 
I'd really love to see a TV or radio programme with strong input from a female contributor (given that women are most likely to be labelled hysterical), based on the issues in this excellent article. I don't think it's too niche a discussion to be of general interest, as the fallout from Covid-19 is going to be high in the public's consciousness for a long time yet, and there is also plenty of interest in the sexist attitudes that underlie the 'mass hysteria' approach.

There has also been some limited discussion in public spaces about issues in the field of psychology. Setting aside financial conflicts of interest, there are at least two major discussion points: people who want and need psychotherapy are not getting access to it anything like quickly enough, whilst at the same time, there's this bizarre overreach into illnesses that are highly unlikely to respond to these therapies. It almost makes you wonder whether people who're actually struggling with mental ill-health are just too difficult for some academics and clinicians...
 
The only upside to people trying to push their woo in this context is that it will expose how utterly mediocre and vapid it is. It will be terrible for the credibility of medicine, experts are simply not supposed to blatantly make stuff up like that, it breaks the entire premise of expertise. Once you have a medical expert blatantly lie or BS you to your face, it really breaks a lot of trust and many people will rightfully argue that there is little difference between real medicine and alternative medicine in the end. People are OK with "I don't know" and expect that from experts. BSing is what charlatans do.

I'm just not sure medicine will react wisely to the blowback, so far it never has. At a time when trust in expertise is critical, this is foolish to the extreme. It's literally just a belief system, I don't understand why some people are so attached to it beyond their self-interest. This thing "succeeded" because it happened in darkness, to people nobody cares about, unseen, invisible, buried. It cannot withstand scrutiny. Going in under the spotlight, unprepared and unequipped, really shows that hubris is the common feature here. Never get high off your own supply, whether you're a drug dealer or a woo peddler.
 
@Brian Hughes, could you clarify this bit?

"And COVID-19 would never be transmitted if these people thought about or perceived their situation in ways that naturally encouraged pro-social behaviour."

I don't know whether it's just my post-breakfast lack of comprehension!

I take his use of ‘pro-social behaviour’ to mean something similar to the golden rule, that we try and treat others as we would ourselves. By wearing a mask I’m primarily helping protect others.
 
I'd really love to see a TV or radio programme with strong input from a female contributor (given that women are most likely to be labelled hysterical), based on the issues in this excellent article. I don't think it's too niche a discussion to be of general interest, as the fallout from Covid-19 is going to be high in the public's consciousness for a long time yet, and there is also plenty of interest in the sexist attitudes that underlie the 'mass hysteria' approach.

There has also been some limited discussion in public spaces about issues in the field of psychology. Setting aside financial conflicts of interest, there are at least two major discussion points: people who want and need psychotherapy are not getting access to it anything like quickly enough, whilst at the same time, there's this bizarre overreach into illnesses that are highly unlikely to respond to these therapies. It almost makes you wonder whether people who're actually struggling with mental ill-health are just too difficult for some academics and clinicians...

I think you hit the nail on the head

Joan Crawford
Counselling Psychologist
 
The only upside to people trying to push their woo in this context is that it will expose how utterly mediocre and vapid it is. It will be terrible for the credibility of medicine, experts are simply not supposed to blatantly make stuff up like that, it breaks the entire premise of expertise. Once you have a medical expert blatantly lie or BS you to your face, it really breaks a lot of trust and many people will rightfully argue that there is little difference between real medicine and alternative medicine in the end. People are OK with "I don't know" and expect that from experts. BSing is what charlatans do.

I'm just not sure medicine will react wisely to the blowback, so far it never has. At a time when trust in expertise is critical, this is foolish to the extreme. It's literally just a belief system, I don't understand why some people are so attached to it beyond their self-interest. This thing "succeeded" because it happened in darkness, to people nobody cares about, unseen, invisible, buried. It cannot withstand scrutiny. Going in under the spotlight, unprepared and unequipped, really shows that hubris is the common feature here. Never get high off your own supply, whether you're a drug dealer or a woo peddler.

The psychologisation of medical mystery has a long history and I have only heard of one sincere attempt at apology.

A friend of mine's mother was diagnosed with hysteria by a neurologist back in the 70s. She was later diagnosed with MS in the 1980s. Before he retired in the 90s the neurologist wrote to her, copying her GP, to apologise for his earlier behaviour and sharing his regret. The lady passed away not long after and she was so touched by the letter that she was buried with it. That's how important this was for her and I think gives an idea of the hurt psychologisation can cause. Often this is seen and experienced as an assault on their sense of self which can be worse than a physical assault. Nasty.
 
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