Academic critique of the "functional" concept

[Liie]

I have for a long time been wondering about academic criticism about the term "functional" from withing medicine itself.

The psychosomatic proponents try to launch this distinction between "functional" and "structural" aspects of the body. This seems to clearly be just a way to obscure the fact that they see medical conditions as psychosomatic. In factual terms the distinction seems more or less nonsensical.

I came across an article with the title "Avoid the concept 'functional' in pain healthcare" by processors and physicians (sorry, only Swedish):

Undvik att använda begreppet »funktionell« vid smärttillstånd

Denna webbplats vänder sig till läkare

lakartidningen.se

The term "functional" has different meanings along a spectrum, the extremes of which consist of a fairly unproblematic emphasis on how the patient "functions" in their everyday life (a biopsychosocial perspective) on the one hand, to a problematic "psychiatrating" of long-term pain on the other. We interpret the text from Maroti et al as leaning strongly towards the latter. Underlying this, the terms "pathology" and "pathophysiology" are used unclearly and without connection to the state of research on pain conditions.

In order for a scientific discussion to be able to take place and confusion and controversy to be avoided, it is necessary to agree on definitions of basic concepts within the academic subject in question. A considerable conceptual fog surrounds the term “functional” and its underlying assumptions, and we therefore suggest that it not be used for common pain conditions, such as fibromyalgia, chronic non-specific back pain, or IBS, as it risks misleading thinking.

This is a bit like what I was interested in. But there is probably a lot more like this.

Maybe for example Brian Hugues has published something about this?

Please post discussion and links to other academic criticism of the concept "functional"!

 

[Lou B Lou]

Richard Sykes (of Westcare), in one of his publications, addressed use of the term 'Functional'. He identified something like 14 separate definitions/interpretations of the term Functional across various medical and therapy disciplines. I have the book somewhere here, but all my papers are in boxes atm. So I may be able to find it, but it will take some time.
.

 

[Nightsong]

This is, I think, the Sykes paper on the "functional" term & psychogenicity:

https://philpapers.org/rec/SYKFRN

 

[Lou B Lou]

This is, I think, the Sykes paper on the "functional" term & psychogenicity:

https://philpapers.org/rec/SYKFRN

Possibly/likely. The version I have is a soft loose bound book.

 

[rvallee]

how the patient "functions" in their everyday life (a biopsychosocial perspective)

I have never seen anything out of biopsychosocial ideology that has anything to do with how a person "functions", and none of this is a spectrum of any kind. It's just generic propaganda gobbledygook. This is a completely imaginary version of what biopsychosocial means.

 

[Liie]

I have never seen anything out of biopsychosocial ideology that has anything to do with how a person "functions", and none of this is a spectrum of any kind. It's just generic propaganda gobbledygook. This is a completely imaginary version of what biopsychosocial means.

Yes, I also think that part was a bit confusing. Maybe the authors are not aware of how the term "biopsychosocial" has been used to simply camouflage psychosomatic theories, in the same way as "functional".

When I myself first saw that term I thought it sounded okay. That for example it could mean to also consider how a biomedical condition influences a patients psychological health and social situation. I have since learned that it is constructed specifically to mean "psychosomatic".

But the authors are active in pain research so they should know better.