Biopsychosocial Model Or Bio-Political Ideology? Medically unexplained symptoms, welfare reform and the implications for Long-COVID, 2022, Hunt

https://citizen-network.org/library/biopsychosocial-model.html

Biopsychosocial Model Or Bio-Political Ideology?
Medically unexplained symptoms, welfare reform and the implications for Long-COVID
Author: Joanne Hunt

There is a growing awareness of the epistemic injustice created by the application of the biopsychosocial model to myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). More people are starting to realise that the biopsychosocial model lacks empirical support, that its application to people with ME/CFS is without foundation and that its misuse has had a damaging impact on the lives of many people.

But how has this happened?

This important paper examines the combination of academic, political and commercial factors that has created these entangled injustices. There has been a serious breakdown of integrity and the misuse of money, power and influence which has encouraged far too many people and organisations to distort evidence or to present stigmatising prejudices as facts.

Read and download the free pdf in your browser, link below.

Below you will also find an appendix of letters and papers from many of those involved in the efforts to undermine the reality of ME/CFS and which are referenced in the paper.




The publisher is Citizen Network Research. Biopsychosocial Model or Bio-political Ideology? © Joanne Hunt 2022.

Documents

• Biopsychosocial Model or Bio-political Ideology? https://citizen-network.org/uploads/attachment/826/biopsychosocial-model-or-biopolitical-ideology.pdf PDF | 800kb
• Appendix: Biopsychosocial Model or Bio-political Ideology? https://citizen-network.org/uploads/attachment/829/appendix-biopsychosocial-model.pdf PDF | 3.65MB

 

On first reading, this strikes me as Joanne Hunt’s best argued expression of her analysis.

It is a valuable to have this account, though I am not sure of her intended audience. Not knowing who is reading it I am unsure how much detail is required, for example she indicates that the PACE study is deeply problematic, but gives no detail of the problems other than the NICE conclusion of low or very low quality. I would have thought demonstrating that full cannon of ME related BPS research is deeply unreliable, despite its widespread acceptance, is essential to demonstrating her central thesis. Not only is that research ideologically motivated but it is bad science, however I am not sure we are yet at a point where many readers would accept this as a given.

 

Indeed, never had any. The problem isn't just with us, the BPS model is simply the new name for psychosomatics, it's all bad. For everyone, no matter the purpose. It's just legacy nonsense, grandfathered beliefs invented in a backward culture.

But one thing I would dispute is bio-political: there is no biology to be found in the BPS model. It is a purely political and ideological model, always has been, always will be. Maybe medico-political would be more accurate.

Good framing to call this a breakdown of integrity, the model is built on lying and uses lying to achieve outcomes that clearly don't exist, and thus have to be lied about. Frankly this ideology is one of the main reasons why medicine is performing so poorly.

 

There is a growing awareness of the epistemic injustice created by the application of the biopsychosocial model to myalgic encephalomyelitis

The current version of the BPS model, at any rate.

I have no problem with the generic principle of BPS, which is really nothing more than the standard bedrock scientific principle of needing to take into account all significant factors to understand a phenomena.

Which doesn't mean everything that is currently claimed by BPS to be one of those factors.

 

In all her recent work, Hunt is compelling and assured when she unpicks the network of people and interests involved in redefining ME in the UK, but she is offputting when she attempts to contextualise this scandal within a wider sociopolitical narrative.

This particular paper has much more of the former and hardly any of the latter, which makes it a very useful and shareable document, although the snippet below caused an eyeroll (maybe a newspaper editor had rejected an article proposal?)

“It may well be asked whether a publishing prohibition, similar to that inferred by Hooper and Williams (2010) in the context of sourcing for press stories on ME/CFS, also exists for media discussion of academic-state-corporate agendas - in particular given that these subjects are inextricably linked.”

 

I agree with you and with Hunt on all of that, and I’ve said similar things about the politicisation of ME and chronic illness on the Rule 12 discussion thread.

My problem with Hunt is that she wants to turn all this into an exemplar of neoliberal stitch-ups and academic-political-private sector malfeasance which she perceived as ubiquitous. And that makes her very easy to dismiss, which is a shame, given how coherent she is on ME-related stuff.

And the SMC is and was widely mistrusted. No-one likes Frank Furedi’s cabal, and they certainly aren’t part of any media establishment.

 

They have been very effective at controlling the ME narrative in the mainstream media. No way around that.

 

“Control” goes too far. The mainstream media is heterogeneous. Individual newspapers are heterogeneous, with dozens upon dozens of commissioning editors. Hacks have various biases, but under deadline pressure are easily convinced by the first source they stumble across.

No-one really controls any narratives, outside of North Korea and internal employee communications. They merely seek to influence an uncontrollable hydra-headed beast. But it’s still absolutely worthwhile to see who is pushing particular narratives, and to establish whether they are acting in concert.

 

It may make her very easy to dismiss for people that are reflexively opposed to the structural and analytical frameworks she uses, but I think a rebuttal that substantively addresses her arguments, which I think are made coherently, would not be “very easy”.

 

She makes some arguments coherently. Elsewhere, she argues that the behaviour of psychiatrists is itself a matter of psychopathology, which surely is always going to be a minority opinion, and is evidence that the totality of her frameworks is neither coherent, nor structured, not sufficiently analytical.

I’m not sure quite what work you want “reflexively” to be doing in yoir post, so I’ll leave it alone.

 

'Control' seems closer to the truth than what Sean was replying to though:

For a topic few journalists have detailed knowledge of, an organisation able to place a couple of strong propaganda pieces and brief a load of other journalists is certainly able to have an important impact on the 'received wisdom'. I'd say that the SMC were very much a part of the science media establishment.

 

I am with you on this Trish. Let us not forget what preceded Malcolm Hooper's efforts in Magical medicine, Jerome Burne
Sat 30 Mar 2002

Battle fatigue
https://www.theguardian.com/society/2002/mar/30/health.lifeandhealth

 

https://www.theguardian.com/society/2002/mar/30/health.lifeandhealth

2002

And here we are, 20 years later, still having to deal with the same denial and arguments and tactics and abuse.