United Kingdom: Dr Suzanne O’Sullivan (BPS neurologist)

Jonathan Edwards said:
Agreed, but surely its is builds showing us what scientific life is like. I get the impression that it is a bit like people being shown what life is like in the abbey with the abbott and monks all having a jolly time exchanging the same myths and singing by the same hymn sheet. Heretics burning at the stake are conveniently left out, despite the fact that it is the true heretics who build science.

After all what do Wessely and O'Sullivan have to do with the real life scientific?

My problem is that it is a sell out to the younger generation.
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Agreed. Trouble is these sort of programmes are targeted strongly as informative entertainment, with no real attempt to validate the information content. I doubt the BBC gives a fig really, so long as the viewing figures are good. Even worse, they may be more than happy to have people like SW on, given his kind of emotive rhetoric involves the sort of shock/horror entertainment that probably lifts the viewing figures; truth unfortunately is doubtless low on their priority list. Maybe JAK is the kind of person who is scientifically educated, but more comfortable interviewing others who actually do it, with little regard to how well they do it.
 
strategist said:
Of course the symptoms are real. Whether the hypothesis that they are caused principally by the psyche is correct or not remains to be seen (looking at history, it's unlikely).
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The psychologists have been proved wrong over and over again. Lots of diseases have been claimed as psychosomatic, Asthma, cerebral TB, MS, Rheumatoid Arthritis, the list goes on.

A disease being caused by the psyche has no mechanism for how it would work so the default position, especially in the light of how often they have been mistaken, should be that a disease is physical until it is proved to be psychosomatic.
 
I wish I could come to terms with and understand this idea of the mind.

The end of the talk brought to mind the comments by Arthur Kleinman at the end of the 1993 book Chronic Fatigue Syndrome, the report on the Ciba Foundation Symposium 173.

If we were to meet again even four years from now in another symposium on chronic fatigue syndrome, I suggest that there would be as many social scientists present as there are virologists , immunologists and psychiatrists now. Although some of you may see things differently, I think increased social science attention to this subject will be a good thing.

It hasn't helped.
 
The real problem as I see it is that terms like dissociative are just clever sounding words for popular prejudices with the advantage that they can mean whatever the 'expert' wants them to mean at the time. In this case 'part of them is just making it up except that it isn't really part of them because they don't know they are making it up'. The trouble is that nobody knows what 'them' means in scientific terms, or to indeed in 'what actually happens' terms.

I cannot see quite what a psychiatric training would do to help. Identifying non-epileptic seizures requires high skill in neurology, to make sure there is no epileptic focus. If everything suggests there is none then it is reasonable to diagnose a non-epileptic seizure. But as far as I know psychiatry can provide no substantiated theories of explanation (we can forget Freud and childhood trauma) and has no evidence-based treatments to offer. There is just make-things-up-as-you-go-along psychotherapy.
 
Jonathan Edwards said:
The real problem as I see it is that terms like dissociative are just clever sounding words for popular prejudices with the advantage that they can mean whatever the 'expert' wants them to mean at the time. In this case 'part of them is just making it up except that it isn't really part of them because they don't know they are making it up'. The trouble is that nobody knows what 'them' means in scientific terms, or to indeed in 'what actually happens' terms.

I cannot see quite what a psychiatric training would do to help. Identifying non-epileptic seizures requires high skill in neurology, to make sure there is no epileptic focus. If everything suggests there is none then it is reasonable to diagnose a non-epileptic seizure. But as far as I know psychiatry can provide no substantiated theories of explanation (we can forget Freud and childhood trauma) and has no evidence-based treatments to offer. There is just make-things-up-as-you-go-along psychotherapy.
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That's very interesting because this was an argument often put to Wessely about ME: that to determine whether there was an underlying biological cause was not something a psychiatrist was best qualified to do. It was in fact a task for a neurologist, immunologist, etc. It was often phrased poorly as 'What would you know? You're just a psychiatrist.' Used by Wessely of course as evidence ME patients were anti-psychiatry and dismissive of psychiatrists.
 
JohnTheJack said:
That's very interesting because this was an argument often put to Wessely about ME: that to determine whether there was an underlying biological cause was not something a psychiatrist was best qualified to do. It was in fact a task for a neurologist, immunologist, etc. It was often phrased poorly as 'What would you know? You're just a psychiatrist.' Used by Wessely of course as evidence ME patients were anti-psychiatry and dismissive of psychiatrists.
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Nevermind so many of us have seen one, as well as psychologists, and it's just a waste of time.

I have the exact same attitude towards podiatrists. Nothing against them, they just can't do much to help me and that's fine, no hard feelings.
 
It was interesting that she effectively brought up the question of mass hysteria, with mention of some fainting episode in a Yorkshire school. It occurred to me, is this an example of what they regard as maladaptive behaviour? If such behaviour had some evolutionary purpose it seems to have long since passed. It seems to be like some form of "shock" response which may help in certain circumstances, but not in this. It would be unfortunate if mass hysteria were linguistically connected to ME, in the minds of some.

Incidentally, I noticed that the first paper on SW's list of publications was on the subject of mass hysteria. I have not read it and do not comment on its contents, merely that it was a matter of interest to him.
 
Jonathan Edwards said:
Hmm. I forget who has been on this but the programmes I dipped into were awful. Kalili does not have the mind of a scientist - he is a pretend scientist. And I suspect many of his guests are the pals of you know who's or daughters of whatsanames who become the darlings of the media despite contributing little. But I'm a bit of a crusty old stick.
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I know nothing about Jim Al-Khalili, he may be a great guy, for all I know, but his unchallenging interviews of both Wessely and O'Sullivan were fluffy tosh. I recall he described Wessely and his wife Gerada as the ultimate power couple. Made me want to weep/ throw up.
 
Merged thread: The reality of imaginary illness


I replied on YouTube with:
@10:48 "resistance to the diagnosis is about the stigma". This is a strawman argument against ME patients who suffer worsening of symptoms (in some cases permanently) from exercise or exertion. Under a psychological model worsening of symptoms are not believed by doctors, friends, family, and employers. As a result patients are treated unfairly, are given the wrong advice, and in some cases have their disability made permanently worse. There have even been cases of patients being forcibly sent to mental institutions and children with ME being taken away from their parents. Suzanne O'Sullivan dedicated a chapter in her book (It's All in Your Head: True Stories of Imaginary Illness) to ME which she claims is psychosomatic.
 
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interview
It's not 'all in your head' — neurologist Suzanne O'Sullivan on psychosomatic illness

Medicine has a long and ignominious history with conditions for which they cannot find a physical cause, often dismissing them with sexist terms such as "hysteria." But that is a fundamental misunderstanding of how these very real illnesses manifest.

While many people with these conditions are told "it's all in your head," or dismissed as hypochondriacs, that's problematic, says O'Sullivan, a consultant neurologist at the National Hospital for Neurology and Neurosurgery and the author of "The Sleeping Beauties: And Other Stories of Mystery Illness" (Pantheon, 2021).

As part of her work, O'Sullivan aims to reduce the stigma and clear up misunderstandings about psychosomatic illness.

Live Science talked to O'Sullivan about why these conditions are so poorly understood, how they're diagnosed, and why treatments for them so often fail.
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It's not 'all in your head' — neurologist Suzanne O'Sullivan on psychosomatic illness (msn.com)
 
Some people complain by ringing their mother and complaining for hours or some people cry, some people take to their beds, and this is just a way that some people express their distress. And if you do express it that way, you will probably express it that way in multiple forms, and you probably always will. So even if I am able to deliver the diagnosis perfectly to that person so that they understand it and are able to work with it and get better, in the future, they will get another psychosomatic symptom. But the difference will be that the next time they feel it, that sort of attention cycle, that fear and avoidance cycle, they can stop it so they get the symptom, and it doesn't lead to disability.
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:banghead::banghead::banghead::mad::banghead::banghead::banghead:
This idea that PwME are 'taking to their beds', in an 'attention/fear avoidance cycle'...

Oh bugger off. I may well have psychiatric illness, we dont yet know what causes ME/CFS, but its not 'fear/avoidance' or attention seeking.
All that happens when i am in bed is i get vastly less attention than i do when i am up & downstairs on the settee, because it means i can see people and engage with them.

There is no 'avoidance' available from being in bed when ill, because i still have to deal with all the sh*t that life throws at me, i just have to deal with it while feeling dreadful. In addition it would be a pretty useless adaptive mechanism to coping with stress, because when the symptoms get so bad i cant speak or move and things have no choice but to get left until i can at least communicate - the problem is usually worse when i eventually get to it than it was when it first arose. So what they see as "avoidance" of it would be very strange coping mechanism wouldnt it - 'lets make everything worse, and while you are laid there completely incapacitated you can add the stress & worry of whats happening and how things are worseing while you cant deal with them'.

:banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead::banghead:
 
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