What the concept of psychosomatic disorders really is

[Hoopoe]

Psychosomatic disorder is a defense by the medical system against health problems that it cannot deal with. What it really means is "undesirable case".

Labelling these problems as psychosomatic has the function of removing patients from the system or at least marginalizing them into a diagnostic ghetto.

The narrative of the symptoms being caused by emotions, thinking and behaviours has the purpose of shifting the responsibility for the problem onto patients. That's why there is so much emphasis on getting patients to accept that narrative. Whether it is true or not, is not of interest. The goal is control. The other function of that narrative is indoctrination of healthcare professionals so that they go along with all this. Disempowerment of the undesirable cases is also achieved by promoting the idea that these patients lack various qualities that give credibility to a person.

If the scientific evidence on allegedly psychosomatic disorders was held to any reasonable standard, the psychosomatic approach would collapse. The fact that poor quality research is not questioned shows that pseudoscience is welcome by medicine as long as it serves a useful purpose.

A psychosomatic approach in practice also often includes elements that could be useful for managing an unexplained illness or living healthier, for example focusing more on better sleep, or taking breaks to manage fatigue. These things have little to do with treating illness by altering the psychological state of patients and are something that can work just as well in explained illness.

Ironically in my experience the psychosomatic approach leads to the patient behaviours that it seeks to prevent, such as doctor shopping. The psychosomatic view of patients is highly effective at causing the strong sensation of disconnect between patient and doctor, the feeling that the doctor does not want to understand or cannot grasp the severity of the impact of the illness... what's the logical response to that by the patient? For some it will be finding a new doctor, for others it will be giving exaggerated description of symptoms to make up for the doctor's indifference. If the doctor minimizes and appears strangely passive, a logical response is also to take the matter into your own hands... that can lead to self diagnosis and other problems.

An approach involving honesty and humility would work much better I think.

Ultimately, the only good solution is to meet the need for treatment of the illness. The psychosomatic view is an obstacle to progress because the resources it consumes could be used to advance research and make unexplained illness explained.

 

[Creekside]

I think it's less the intent of the medical system and more the intent of "professionals" whose careers and income depends on convincing people of whichever beliefs. It seems no different from religions or other belief systems that claim to provide luck, good health, seeing the future, etc. I think diagnosis and treatments for psychiatric ailments would exist even if they weren't supported by the medical system. However, since those beliefs do exist, it's all too tempting for overly busy doctors to use them to avoid having to deal with difficult patients. Also, doctors are human, and vulnerable to baseless, unsupported claims, so some might honestly believe that their patients would find help there.

I think there were people selling psychosomatic diagnoses and treatments before there was a medical system, back in the stone age.

 

[rvallee]

Sums it up pretty well. It's about as perfect an example of the banality of evil as it gets. And of pseudoscience. And of what "throwing out the babies with the bath water" is all about. Humans can be awful in groups, but they can be truly evil when they are organized in institutions detached from any stakes in the outcomes they oversee.

Even if the concept were valid, and I doubt it is, this is the worst possible way of handling it, it has exactly zero chance of achieving anything.

 

[dratalanta]

The somatisation approach takes a situation in which we have no clear evidence. It then asserts that an unevidenced theory of mind, and a treatment hypothesis which has been proven ineffective, are rational and must be true. With equal conviction it asserts that the hypothesis that there may be aspects of physiology which we do not yet fully understand, and which could cause currently unexplained disease, is irrational, and must be false.

It is completely bizarre and can only be explained by the psychosocial needs of doctors, the financial imperatives of healthcare, and a pseudo-intellectual form of the “law of attraction” belief.

We will look back on this period in medicine with the same wry incredulity with which physicists regard the view, held by some in their profession at the end of the nineteenth century, that every natural law of importance had already been discovered.

 

[bobbler]

I agree that it starts with what the person who chooses to either invent or follow the rhetoric/propaganda wants or doesn't want to do, ie their needs first.

It becomes really obvious when you come across laypersons, or people off-duty showing their true colours. They just don't like having to be considerate in as far as not putting themselves first and acting in a way that coerces those around them to also make sure their needs trump their own. And pretending not to notice or acknowledge when an ill/disabled person is left stranded or hurt by that behaviour is one of their key tactics.

Pyschosomatic is just the word-salad version of their gaslighting and refusing to acknowledge reality to make it a cultural 'message' that all can be in on.

It's permission to allow these reality-dodgers to say the issue is in the disabled person's head rather than in their head. Same people who break their toys and then get upset with their toy for being broken. It doesn't make the 'in the head' any different that these people are referring to 'if you just acted as I coerce you to for my needs and ignored it then you wouldn't be broken by it' rather than 'it doesn't exist'.

SO the disability bigotry definition is actually explicitly the BACME/rehab refusing to measure harms or acknowledge proper outcomes from the harmful 'treatment' they enforce rather than their pretend reason behind it which is just changing the storytelling on what it is so they can pretend to be surprised that they are making a disabled person more disabled repeatedly doing the same thing to them.

And then of course so that they can abandon and take no responsibility for, or worse obsess over them and target making them more ill so that they can't be seen or heard anymore, as well of course as smearing them - which is the psychosomatic rhetoric really 'just telling the world it is OK because they are mad'. But they needed to make it sound more sanitised because after all they believe they aren't mental health bigots/bullies too. But yes they use false rumour spreading of certain people 'being mad' only for that reason.

Yes it has sprung up some industry of peple also happily taking advantage with their fake treatment for those people's madness, to really reinforce that label whilst the poor so and so's go along thinking if they do it and it makes no change they will be given freedom because they will have proven 'it can't have been that' (oh how fooled they are). But those people are just a different version of the above, using different wrapping and picking up victims and targeting the vulnerable at a different point.

 

[bobbler]

And ghetto-ising is a good term because as we have now all confirmed from the documents we have managed to find from health systems and 'research' etc, despite having known from experience already, the whole 'movement' is indeed about taking rights from certain people and silo-ing them off not just regarding that particular condition they claim to be psychosomatic but trying to place a 'treat special' label onto the person for everything.

That is why they are so keen to distract with phrases like 'there are no treatments for/no known cause' because it pretends the whole thing begins with an illness they looked into properly and all people with this illness despite hard work from everyone they find there is nothing that they can do to help. WHich is of course untrue. And so is the idea that for all those dumped into these buckets that even anything was looked into properly.

Everyone knows these labels get bunged onto people's records for vindictive or having a bad day or just not a nice person and/or don't realise how destructive it is reasons even outside of things like ME/CFS. Just standard bullying they get away with veiling as concern, and the safeguarding stuff being put in the hands of people who normally are not of the correct personality type or qualification or position/time to be making any of these assessments doesn't help along with the classic scattering of responsibility that uses as a process (like the shooting ranges use 5 shooters so noone has to think it was them)