Opinion Conceptual competence in medicine: promoting psychosomatic awareness in clinics, research and education 2025 Dirk von Boetticher

[jnmaciuch]

Here's a PDF of Van Oudenhove & Cuypers (reference 5) if anyone wants to read it

 

[Utsikt]

our argument is that there's no strong evidence of "stress management" having the power to reverse changes that have already occurred on a cellular or systemic level in ME/CFS.

I’ve seen many BPS proponents that argue that

• There are no changes on a cellular or systemic level
• If there are changes, they are continuously maintained by the CNS, i.e. downstream effects of unhelpful beliefs, a stuck stress response, a mismatch between perceived capabilities and actual capabilities, an effort preference, etc.

When I’ve asked about how the CNS can cause such changes, the answer is always a bit handwavy or something like ‘the CNS regulates the immune system, so the changes must have come from the CNS’.

 

[Peter T]

I haven't a clue what all the long jargon words and philosophical stuff quoted from the article iis about, but I can wholeheartedly agree with these two statements. I wish the BPS people had your clarity.

Being cynical, are people only motivated to dig into philosophical underpinnings of an approach to medical intervention when there are no unambiguously successful treatments?

 

[Utsikt]

Being cynical, are people only motivated to dig into philosophical underpinnings of an approach to medical intervention when there are no unambiguously successful treatments?

In this specific case it would be because it has caused a tremendous amount of harm, not just because it isn’t successful.

Edit: but it’s an interesting question!

 

[jnmaciuch]

I’ve seen many BPS proponents that argue that

• There are no changes on a cellular or systemic level
• If there are changes, they are continuously maintained by the CNS, i.e. downstream effects of unhelpful beliefs, a stuck stress response, a mismatch between perceived capabilities and actual capabilities, an effort preference, etc.

When I’ve asked about how the CNS can cause such changes, the answer is always a bit handwavy or something like ‘the CNS regulates the immune system, so the changes must have come from the CNS’.

Agreed. All the explanations I've seen rely on just the possibility of CNS interactions with the rest of the body rather than anything concrete. I see a lot of this with the "diet changes can cure any disease" camp too. Like sure, there's the possibility that specific neural pathways might be affected by gut microbiota. But it's a big leap between that and claiming that cutting out gluten and processed sugars will cure severe depression (and then claiming that someone didn't actually cut out all sugars because "it's in everything even if it's not labeled" when someone conforms to their strict diet and is still severely depressed).