Opinion What is the Role of “the Psyche”? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psych..., 2026, Schomerus

rvallee

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What is the Role of “the Psyche”? Long COVID and ME/CFS as Test Cases for Evidence-Based and Patient-Centered Psychiatry and Psychotherapy
Only available in German: https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-2866-9127.pdf

Posted in the psychosomatic forum but is sympathetic and argues about its harms.


Abstract

The role of psychological factors in the development and course of Long Covid (LC) and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) remains a subject of controversial debate. We argue that psychologizing LC and ME/CFS carries significant risks: it leads to potentially harmful therapies, invalidates the patients' experience of illness, hinders effective interventions such as pacing, diverts focus from necessary physical diagnostics and treatment, disadvantages patients in
medical assessments, and places a considerable additional burden on the families of affected children or other relatives.

We show that many of the arguments presented for a psychological contribution are nonspecific or insufficiently supported by empirical evidence. Our essay therefore advocates for extreme caution in attributing psychological factors to these conditions, in the interest of a specific, evidence-based, and patient-centered psychiatry and psychotherapy
 
What I find damning is that I perceive these narratives about psychological factors as an invasion of my life by zealots who are unable to respond positively to a difficult situation, don't understand it and aren't interested in learning more. This perception is the result of interaction with this ideology.

It has a flavour of a witch hunt and a moral panic, of an ignorant mob wanting to punish the deviant for the sins they imagine he has committed.

If you don't understand an illness, the behaviour adopted by the patient can seem nonsensical, immoral, self-defeating. This could be overcome by curiosity and willingness to listen and listen.
 
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