The biopsychosocial model

[Liie]

he also thought that ME/CFS was still some form of mental illness, even while criticising the biopsychosocial framing of it.

After web searching I didn't find much connecting McLaren and ME/CFS at all. Only a few old texts from ME/CFS advocates that referenced his critique of BPS.

However, the views he expresses are certainty compatible with thinking ME/CFS is a mental illness. He -- and Mad in America -- criticize BPS from the opposite position compared to us, which I find interesting in itself.

We want our condition to be treated as being biomedical and we protest being psychologized by BPS; they protest mental illness being biomedicalized by BPS.

 

[nataliezzz]

After web searching I didn't find much connecting McLaren and ME/CFS at all. Only a few old texts from ME/CFS advocates that referenced his critique of BPS.

However, the views he expresses are certainty compatible with thinking ME/CFS is a mental illness. He -- and Mad in America -- criticize BPS from the opposite position compared to us, which I find interesting in itself.

We want our condition to be treated as being biomedical and we protest being psychologized by BPS; they protest mental illness being biomedicalized by BPS.

I don't know about McLaren specifically, but having spent a fair amount of time in iatrogenic harm spaces on Twitter, I would say the general Mad in America audience would not be inclined to label ME/CFS as a mental illness (or psychiatric disorder). Many of them reject the term/idea of "mental illness" entirely and think that psychiatric disorders are always just a natural/expected reaction to difficult/traumatic life circumstances/events. A lot of these people have been badly harmed (long-term neurological effects: "protracted withdrawal," PSSD, etc.) by psychiatric drugs like antidepressants and benzodiazepines that they were put on when they probably were just experiencing transient/"natural" reactions to difficult life circumstances, and would have been much better treated with counseling/etc. But many of these people end up extending this to all cases of psychiatric disorders and say that there are never any biological causes/contributors to them.

Anyways, from my personal experience, all of the patients in this community definitely viewed ME/CFS as a biological illness that was wrongly psychologized by psychiatry. But I'm less confident about how doctors in the "critical psychiatry" space view it.

 

[bobbler]

After web searching I didn't find much connecting McLaren and ME/CFS at all. Only a few old texts from ME/CFS advocates that referenced his critique of BPS.

However, the views he expresses are certainty compatible with thinking ME/CFS is a mental illness. He -- and Mad in America -- criticize BPS from the opposite position compared to us, which I find interesting in itself.

We want our condition to be treated as being biomedical and we protest being psychologized by BPS; they protest mental illness being biomedicalized by BPS.

Yes, good points.

I came to realise when reading some of the articles by psych itself that what psychiatry mean by biomedical is a limited alternative compared to the layperson biomedical. Which is a whole different debate.

In that it is only in contexts to psychiatric drugs often vs the idea of getting to the bottom of what is going on in the whole body type 'biomedical'.

Which has other points to be made on it but brings alive even if you had an illness that was for sure purely psychiatric in 'area/part of body' whether you'd want things that fell into the 'normal reaction to abnormal situation' - the most obvious I guess being labelling someone with anxiety as an illness based on them not being chilled out when about to do a bunjy jump or walking across a skyscraper etc, but the most likely being where people are treated angrily daily in society and then blamed for 'seeming upset' by calling that upset 'pathology' when no healthy person wouldn't be if they were being accused or shouted at for something someone else misunderstood as being their choice/behavour or whatnot'

Plus of course the issue of if the drugs themselves come with only so much 'upside' and a lot of side effect for the actual patient and aren't really moving on because there is upside as far as society sees (less of a problem in their 'behaviours' but eg an old person is being chemically coshed so no longer really 'living') vs addressing a life situation that reduces 'stressors' vs a 'behavioural therapy' that suggests someone should be changing their reaction to said stressors, whether they are things others would have to experience or not.

 

[Hoopoe]

When I suffered from depression it was related to life circumstances, life style, relationships, lack of support to live with ME/CFS. The relationship problems were related to lack of understanding or acceptance of ME/CFS. In this kind of situation, ignoring the context and prescribing drugs feels like injustice on top of injustice, as if they were saying that these things don't matter and I didn't deserve anything better and the only problem is me complaining, having needs, etc.

I had needs but wasn't fully aware of them, couldn't quite define or express them because I was too young, didn't understand well how human being work despite being one, and was maybe raised in a way that discouraged expressing needs.

What I needed in this situation was a safe space, exploration of needs, communication, assertiveness and things like that. Drugs and psychotherapy felt like victim-blaming, like I was labelled as bad and wrong for the distress signals of needs going unmet.

 

[richie]

My depressions 1) Overwork , exhaustion , worry about the situation (resolved with rest over 10mths 82-83) No CFS/ME symptoms, 2) 1991 After 6 yrs fight with fatigue despair, hopelessness. Living on momentum and "adrenaline". Despair about future, grief for loss, sick of bleakness of existence. 3) 9 years on after 3 years rest and 3 1/2 work not even momentum nor "adrenaline" left, "wires burnt-out", 7 years anhedonia, avolition with few breaks. Colloquially "finished" and mot imo suprising.

Gaps filled 1991-94 by "eat drink and be merry coz you are already dead", a kind of pre gallows attitude which helped me survive. The doctor who toled me I needed soem fun was right unlike Prince's. But the physical symptoms/signs largely remained. The avolitional period ca 99-07 was resolved by emotional crisis, after which I was like a kind of lame cow (ongoing ME/Lyme/sarcoid?) come out of the shippun (cowshed) in spring and mad for it after 8 yrs avolition and ahedonia high on the release from that state.but still lame with CFS/sarc/Lyme???
Plus in may case high probability of ongoing inflammatory activity of sarcoid/or Lyme.
How can any single theory of depression accommodate that.? Barebones theory, OK, but most of the flesh is in what I say.
(Plus two short-lived but horrible bouts of agitation depression the first which resolved on pretty low doses of diazepam and occurred at transition from avolition and anhedonia) and the second of which occurred when sarcoid and hemophagocytosis appeared and may havealso been related to lead and nickel poisoning and perhaps a "false" hypoxia.
If there's a textbook I probably wrote it. One thing I am sure of none was health anxiety. Anxiety about consequences of failing helath, yes but all that gumph about overmonitoring symptoms etc? My answer, well someone has to.