Mind and Body in the Guardian again

He's a pretty good, Stanford-educated one. Why ad hominem instead of addressing the point?
Xi = C + Yi => delta = Y.

 

How would a vision loss improve over time?

 

You said the eye muscle contraction was a structural change. I said that the muscle action is happening without physical intervention or my intention. Tumor is nonquitter: it is not sensory or motor function.

 

Ophthalmic problems can heal. Central nervous blindness can improve. And we have no idea what causes these unexplained problems so we have no idea whether or not they can improve.

 

It isn't ad hominem. It is pointing out that simple explanations tend to be more likely to apply than complicated ones. Opticians often get things suboptimal.

 

I asked AI too: "The prognosis for organic vision loss depends entirely on the underlying cause, but generally, if left untreated, most cases of organic vision loss will result in permanent vision impairment,..." I would think ophthalmologists preclude things like organic or central nervous blindness before diagnosing functional blindness.

 

I am very unclear what you are trying to argue. We are probably agreed that there are cases of blindness not currently explained by structural pathology. It would be fair to call them functional but that term has been appropriated by doctors who use it to mean conversion disorder, even if they often deny that.

I think you were suggesting that certain treatments based on theories of functional disorder (whatever they might be) might be helpful and that that indicated that the disorder really was 'functional'. But without proper controlled trials we have no real idea what went on or whether the treatment had any specific efficacy.

There are people who are apparently blind who recover in all sorts of situations - including visiting shrines at Lourdes. What that tells us I don't know. I doubt it represents intervention by the Virgin Mary.

 

If only we could at least get strudels out of this. Would be so much better than anything they've done. Combined.

 

I just want to chime in and say that the left and liberal academia in humanities really likes ideas of psychosomatic illness and the like. I wrote an essay on trauma in lit when I first had undiagnosed ME and the main secondary sources were all big on Freud and that.

The Guardian also loves to publish this crap. And as someone who used to read a lot of guardian articles I probably absorbed a lot of it from there.

All this no doubt helped my doc convince me my symptoms were psychosomatic.

So this stuff is dangerous because a) it provides a background layer of legiticimacy to BPS arguments in the clinic (oh I read about that in the Guardian...), and b) it reduces our potential pool of allies by bigging up these ideas in the minds of the liberal intelligensia.

I remember in my first year severe I was convinced that the solution to awareness might be to write about this situation to a lefty sociologist/economist (and Guardian columnist) I admired who writes fairly popular books criticising the exact kind of factors that have led to BPS dominance. Then I got to a part in one of his books where he uncritically repeats BPS ideas about pain and expectation to explain why Americans have more chronic pain that Eastern Europeans. It sounds silly now but I was crushed.

 

I don't follow FND, so I'll have to take your word if you are saying there hasn't been any RCT. Googling seems to indicate otherwise, however (The role of evidence-based guidelines in the diagnosis and treatment of functional neurological disorder - ScienceDirect).

What I'm guarding against is a blanket denial of the existence of functional disorder and the possibility of non-physical interventions bringing relief to patients in certain cases. I may be an exception in my view, but a blanket FND-denial ("it's all in your body") is not that far from MECFS-denial ("it's all in your head") and would do disservice to certain people. Does FND have an implication on ME/CFS, other than the imposition of ineffective or harmful treatment? None of us think so. But that does not have to mean that functional disorder is not real. And, as much as we are convinced, we can't be 100% sure either that there is absolutely no functional aspect in ME/CFS since nothing is known about the etiology. So, the blanket denial might even have an implication on us, however small that possibility may be.

 

Fair enough but it is unclear to me exactly what you are meaning by functional disorder. There are certainly people with unexplained neurological problems without structural change. And some of them fall Ito fairly stereotyped patterns.

What I am less convinced of is that putative benefits of interventions maybe through talking (although that is of course physical) tell us anything.

 

Two of the authors of that are Stone and Carson and we have pages of posts here detailing their poor quality arguments and evidence. I haven't read through but as far as I got is the usual vague reference to randomised trials - which are almost certainly unblinded and full of other problems.

 

Three letters about the article from emeritus professor of medical humanities Alan Bleakley, an anonymous psychiatrist and an Julie Black who misses the mention of LC and ME.

https://www.theguardian.com/society...source=dlvr.it&utm_medium=bluesky&CMP=bsky_gu

 

I'm referring to so called "software" problem. There are instances of maladaptive automatic motor responses to sensory input. That's not too controvertible, I don' think. But, no, I'm definitely not talking about things like "false belief".

 

The “software” problem basis of FND is more a “meme” / “trope” than something that has much evidence behind it. In fact even the most zealous believers in it published a study showing “hardware” abnormalities too.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6484222/

 

That's probably true insofar as the brain circuitry is made of neurons.

 

Whoever made the decision to print that last letter has blood on their hands. The Guardian editorial team cannot keep both sidesing this. People rightly or wrongly trust them to give them an accurate representation of science and this is the polar opposite.

 

OK, so we probably agree roughly on that.
But why is it 'software', since it is going to be neuronal microstructure presumably that mediates response patterns - I don't mind but it gives the impression of some sort of understanding I am not sure we have.
And maladaptive motor response sounds awfully as if we know what is being responded to and what is wrong. I am not even sure this is a validated model. Again maybe better to say we don't know?
Did you mean controversial? Controvertible presumably means something you can argue about and we are.