Invisible Illness A History, from Hysteria to Long Covid, 2026, Mendenhall (book)

From her response about the threshold babble:
The thresholds metaphor helps us think about how people’s sickness emerges and is embodied. In my mind, thresholds are tipping points that occur when the bodymind cannot sustain a level of health due to the multiple insults that have tarnished its strength.
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These insults, or as a Chinese Medicine doctor Brooke Moen called them, “invaders” build upon one another through time and begin to unravel and dysregulate the body. These include viruses, bacteria, stress, trauma, fungi, parasites, foods, chemicals, and other things that manage to enter the bodymind through the mouth, skin, and emotions.
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In some ways, thresholds incorporate concepts from epidemiology and biology such as weathering, allostatic load, and exposomes that suggest cumulative burdens over the life course build upon one another to cause sickness.[1]
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People perceive and experience these threats differently and thus such perceptions and physiological responses can wildly differ and affect people in significant and divergent ways. Mixed and stirred with more material invaders, the bodymind can easily exceed an equilibrium it can easily bounce back to.
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I think it’s fair to say that this is what happens when people with no clue about medicine tries their hand at it. Ugh..
 
I’m reminded yet again of my belief that little good will come from trying to recruit people with a BPS foundation because for them to not cause harm, they would have to unlearn all of their ground truths. That is such a monumental task that it will very rarely be achieved, and it’s guaranteed to be preceded by many mistakes. It’s simply not worth it.

We will have far better outcomes by attempting to recruit neutral people that are scientifically minded. If the BPS folks learn something along the way, that will be a bonus.
 
Utsikt said:
From her response about the threshold babble:




I think it’s fair to say that this is what happens when people with no clue about medicine tries their hand at it. Ugh..
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Psychology provides the tools, but at the core of this is making up narratives about sick people that make sense to the people inventing the narratives. It's the old way of doing things, before science, and it has nothing to do with helping the sick. Those stories are by them, for them. They have nothing to do with us. They're not even about us, they're entirely about this imaginary version of us they prefer to fantasize about.
Utsikt said:
I’m reminded yet again of my belief that little good will come from trying to recruit people with a BPS foundation because for them to not cause harm, they would have to unlearn all of their ground truths. That is such a monumental task that it will very rarely be achieved, and it’s guaranteed to be preceded by many mistakes. It’s simply not worth it.

We will have far better outcomes by attempting to recruit neutral people that are scientifically minded. If the BPS folks learn something along the way, that will be a bonus.
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I agree. It's ironic that in trying this both sides approach, promoters of psychosomatic ideology have made it impossible to leave them any space. They so badly want to nudge psychology into every nook and cranny, always pretending that it deserves its small space in the corner, even though the idea is always to abuse this position and occupy the whole place, and as a result there is simply no future that even allows them in the room. They have been so radical with their methods that it will simply be non-negotiable to leave them any place at all.

The parallels with politics, especially with the extremes, is so loud, ostentatious even, and there the same rules apply: you don't try to get the extremists on board, you simply exclude them from everything and work on the majority/plurality of undecideds. There is literally no point trying in using energy to bring them around, they will never contribute anything anyway, and will continue to push their extremist positions anyway given the chance.
 
Actually, it is a good example of pseudoscience:

" This illustrates that Invisible Illness is not hampered by Mendenhall’s intention and positive wish to help - it is her research lens that is her Achilles heel.

While discussing CFS as largely a psychological problem as opposed to a biological one, Kleinman argued: “One thing I notice as an anthropologist is a very deep mind body split in our discussion. It is as if one must have a real, that is physical reason for having physical complaints…There’s a physiology associated with many social conditions. We must be careful about thinking a condition must be mind or body, it usually is mind and body.” (Mendenhall).
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"

Where have we heard that before?
Thou hypocrite, first cast out the mind-body split beam out of thine own eye; and then shalt thou see clearly to cast out the mote out of thy brother's eye.
 
From her response about the threshold babble:
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tipping points that occur when the bodymind cannot sustain a level of health due to the multiple insults that have tarnished its strength. […] These include viruses, bacteria, stress, trauma, fungi, parasites, foods, chemicals, and other things that manage to enter the bodymind through the mouth, skin, and emotions.
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:rolleyes:

(And aliens! Don't forget aliens and their darned anal probes. Those'll get you in the bodymind every time.)

Often in medicine, thinking in terms of comorbidity or even multi-morbidity are perceived as pushing the envelope.
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Writes somebody who is clearly clueless about medicine.
 
god save us from people with good intentions.

I think the Long Covid Advocacy article is excellent in revealing huge problems with the book, but too kind in attributing good intentions and allyship to Mendenhall. Why commend at all someone who has misused the suffering of sick people to set up a flawed and damaging model that will perpetuate harm to millions?

The comment that no very severely affected people were included in Mendenhall's study shows just how badly she did her research. Her confusion between IBS and IBD is another illustration of poor quality research. She has clearly been captured completey by psychobabble and is clueless about medicine.
 
Kalliope said:
Wessely, Mendenhall and the Reproduction of Medical Power
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We would go as far as saying that Mendenhall rushes hubristically to fill the gap of explanation with her dysregulation and thresholds theory. This ‘god of the gaps’ fallacy is precisely the same as those who propagated the psychiatric cognitive behavioural model for ME/CFS. It is this failure of restraint, humility and fidelity to evidence that is deeply problematic for the community.

Even though Mendenhall frames her theory in biological language, this is not biological evidence. She is insistent that because her framing is biological she is not psychologising - but this is a category error (see our article). Psychologisation has never meant “imagined” or “not real" or "not physical". There is no insistence on dualism, no insistence on mental purity from us - the issue is how these integrated bodymind/mind-body theories have been used to manage uncertainty, harm and dissent. This is the modus operandi of hysteria.
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well bacme.....
 
Kalliope said:
Excellent analysis and summary from Long Covid Advocacy. I hope it's ok to share a long quite:

Wessely, Mendenhall and the Reproduction of Medical Power

quote:

It is important to note that Invisible Illness has an admirable aim: to challenge the ways medicine dismisses, marginalises, and gaslights people with chronic, poorly understood conditions. Mendenhall positions herself as an ally and has been open to critique and dialogue - which is inherently valuable.

So to conclude, Mendenhall falls into three main traps:

The first is the unfalsifiable threshold framing, widening the scope through biological, psychological, and social entanglements. The book would have been an excellent addition to Long Covid literature without this framing.

Instead, she created an asymmetry: the authority of the theorist over the patient. Her interpretive narratives of a marginalised group moved into epistemic overreach. Patients became illustrations of theory rather than subjects whose accounts do not need premature closure. This is where her allyship falters.

The second is a category error as Mendenhall grouped a fluid, poorly delineated and wide range of conditions under a single holistic umbrella. Proceeding to speculate that:


Patients will argue that it is precisely this grey area of medicine where we do not want to be located. In fact, it is the proclaimed favourite area of Sir Simon Wessely, which leads us to the third trap.

Mendenhall holds a position of false balance when narrating the PACE trial. Placing each side as equally valid is a false equivalence and is damaging for the ME community. Yet, we know now that this was because of the silencing technique of legal threat that Professor Simon Wessely used.

There is a way forward, though; we would encourage Mendenhall to see this as a reflexive moment, where the analyst becomes part of the study, and the power dynamics can be narrated.

longcovidadvocacy.substack.com

Wessely, Mendenhall and the Reproduction of Medical Power

How Invisible Illness Missteps on Holism, Psychologisation and Epistemic Capture
longcovidadvocacy.substack.com longcovidadvocacy.substack.com
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The fact that Wessely is still acting like this behind the scenes in 2026 while proclaiming to be retired from ME research is disgraceful.

This is why I get angry when people downplay his role in this and turn their nose up at attempts to expose him.
 
V.R.T. said:
I probably don't need to say this but this is the kind of evidence that needs to be collected and preserved: a senior professional deliberately using their influence to suppress legitimate criticism of their work. There are a lot of examples of SW and other BPS eminents doing this and I think more will come to light once he is no longer in power.

I believe he and others have also used this influence to stop biomedical research into ME/CFS. Perhaps we would be further on if not for that.

And someone ranty attempted to neuter the NICE guidelines in a similar way.

This is important historically. But it may also be important in other ways too in the future.
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Are the institutions that award funding, subject to FOI? Interesting what would come up for ME funding and this person.
 
Thanks for providing your perspective, @dave30th.

I am horrified that anyone thinks it's appropriate to publish a book with misinformation in it forced on the author by bullying and legal threats.

The only honest and academically sound options should surely have been either to
scrap the book altogether, or publish your feedback and a copy of Wessely's entire review of her article including the legal threats. He needs to be exposed for what he is.
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I disagree with this statement of yours:

I will say that I do not find the construct of “bodymind”—frequently invoked by Mendenhall—to be helpful in assessing whether studies of behavioral and psychological interventions are robust or fraught with methodological and ethical flaws. But I understand that medical anthropologists communicate in such terms, for better or worse.
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In my opinion, social scientists have just as much responsibility to examine whether behavioural and psychological studies are robust as biological scientists do. After all, that's what your and our critiques of PACE are about - we can't allow different standards to be applied by social scientists. I think you are too ready to give her an excuse here. She got it wrong. She needs to own that. If she can't she has no business writing about ME/CFS. She has no business dressing up illnesses in these 'bodymind' terms just because other anthropologists use them.
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A minor side issue, can I ask you to reconsider this sentence in the section on CBT:
Of course CBT helps people cope–that’s the point.
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That is also completely unevidenced. In my case, and others I have been made aware of, CBT intended to help me cope did a lot of harm that took me several years to overcome.
 
The purpose of CBT isn’t to help people to cope, it’s whatever the therapist wants it to do. CBT has no standards, other than that it’s about attempting to change your thoughts or behaviours. It is not harmless by nature, nor is it inherently efficient for anything, other than employing the therapists.

And I agree with Trish about giving them an out with mindbody. We can’t lower the standards below the bare minimum just because it appears to be the norm to do so in certain areas.
 
Trish said:
I am horrified that anyone thinks it's appropriate to publish a book with misinformation in it forced on the author by bullying and legal threats.
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It is definitely problematic. Not sure what the professional repercussions might be.

Regarding the CBT helps thing, I've added an insertion that a reader has challenged the statement and linked to your post here.
 
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