Your comment about psychogenic illnesses and ‘military guys’ got me thinking of an absolute brain-changer of a book (didn’t you have a newsletter about those some time ago?): Elaine Showalter’s Hystories: Hysterical Epidemics and Modern Culture, which makes you see the world in a wholly different way. She’s especially good on Gulf War Syndrome and sublimation (if that’s the word I want) of unacceptable and “unmasculine” war trauma into much less stigmatisable physical symptoms.
Whilst psychogenic illnesses certainly do exist, I would be wary about the confidence with which certain medical professionals claim they are widespread. Speaking as somebody who has had three family members misdiagnosed as such: one who had an (admittedly rare) autoimmune condition, a spouse whose doctor packed her off for three years of CBT because he missed the family history of epilepsy, and a sister whose nursing training meant she was able to bully her GP into getting a blood test for her ongoing fatigue ('you're just stressed') and was then rushed into hospital because her thyroid levels were such that 'we're surprised you're not in a coma'.
There is a long history of medicine writing off anything they can't explain as hysteria, especially in women* - later repackaged as 'conversion disorder', 'functional neurological disorders' or 'medically unexplained symptoms'. Given how often these diagnoses turn out to be wrong (the pre-Pylori view of stomach ulcers, the pre-MRI literature on the 'multiple sclerosis personality'), and how ineffective treatments to correct 'false illness beliefs' are (see the recent NICE rowback on treatments for ME), one would think the profession wouldn't still immediately leap to a psychological explanation if they can't immediately explain something. Yet still they do.
*I can't remember the exact statistic, but it's something like a 3:1 female/male ratio for 'functional' diagnoses; interestingly the rate of autoimmune conditions is a similar ratio, and many of those with systemic autoimmune conditions spend years having their concerns written off as just anxiety. Beware the medical misogyny here.
Your comment about psychogenic illnesses and ‘military guys’ got me thinking of an absolute brain-changer of a book (didn’t you have a newsletter about those some time ago?): Elaine Showalter’s Hystories: Hysterical Epidemics and Modern Culture, which makes you see the world in a wholly different way. She’s especially good on Gulf War Syndrome and sublimation (if that’s the word I want) of unacceptable and “unmasculine” war trauma into much less stigmatisable physical symptoms.
Whilst psychogenic illnesses certainly do exist, I would be wary about the confidence with which certain medical professionals claim they are widespread. Speaking as somebody who has had three family members misdiagnosed as such: one who had an (admittedly rare) autoimmune condition, a spouse whose doctor packed her off for three years of CBT because he missed the family history of epilepsy, and a sister whose nursing training meant she was able to bully her GP into getting a blood test for her ongoing fatigue ('you're just stressed') and was then rushed into hospital because her thyroid levels were such that 'we're surprised you're not in a coma'.
There is a long history of medicine writing off anything they can't explain as hysteria, especially in women* - later repackaged as 'conversion disorder', 'functional neurological disorders' or 'medically unexplained symptoms'. Given how often these diagnoses turn out to be wrong (the pre-Pylori view of stomach ulcers, the pre-MRI literature on the 'multiple sclerosis personality'), and how ineffective treatments to correct 'false illness beliefs' are (see the recent NICE rowback on treatments for ME), one would think the profession wouldn't still immediately leap to a psychological explanation if they can't immediately explain something. Yet still they do.
*I can't remember the exact statistic, but it's something like a 3:1 female/male ratio for 'functional' diagnoses; interestingly the rate of autoimmune conditions is a similar ratio, and many of those with systemic autoimmune conditions spend years having their concerns written off as just anxiety. Beware the medical misogyny here.