I disagree that the psychosomatics debate isn't that relevant to ME/CFS, or that the UK is an exception. In my country, I would bet on most doctors thinking that health anxiety/hypochondria/conversion disorder is a substantial part of ME/CFS. It's the same across the world, I know it's the same in parts of South East Asia.I actually think that, by and large, the whole psychosomatics debate is not that relevant to ME. The UK is an exception, with powerful lobbying psychiatrists, but in most other countries it's mostly just a bunch of people with a confused look on their faces at best, and completely unaware of the problem at worst. You see sometimes talk of psychosomatics but it's mostly because they don't know what else to say, rather than truly having conviction in it.
And also, psychosomatics is a concept from medical culture, in the pharma world nobody cares about such a thing, they are pragmatic businessmen that only care about treating something tangible. Most of the innovation biotech wise comes from that world, not from your GP or neurologist blabbering about psychosomatics.
I wonder, then, if the key out of this stalemate, would have been to involve a group of high level scientists, engineers and physicists to try and find something measurable about the illness, symptoms wise, to be able to put us in a firm category. I don't think my symptoms are subjective, they just haven't been measured yet.
And, that lack of belief that there's anything of substance is what has led to the lack of careful description of symptoms and the lack of the sort of quality preliminary research that would provide the foundation for big Pharma to become interested. That lack of belief has meant that what patients say is dismissed. For example, intermittent muscle weakness could be a clue as to what is going on, but instead all sorts of symptoms are wrapped up in the general term of 'fatigue'.