9 Comments
May 20·edited May 20

Thanks very much for this. It is unfortunately an crazily ingrained response in our societies. I had the typical experience of being dismissed as imagining things for years (gaslighting rather than direct insults - don't ask which is worse) only to be diagnosed with Ehlers-Danlos Syndrome and persistent migraine aura. People looked for structural neurological problems, and realising that this could not be the cause of some of the problems, such as my frequently falling over, looked no further but assumed it must be imaginary. The falls are mostly the result of dysfunctionally hypermobile feet and ankles, and simple orthotics and a bit of specialist physiotherapy have mostly put a stop to them (thankfully), but it was ten years before it occurred to anyone to examine that possibility.

Stress may be a genuine aspect of the efficient cause of some illness by causing biochemical changes, but that is not what doctors, or the general public, mean when they attribute physical illness to stress in the manner concerned in this article. They do not respond by treating the person's symptoms and the physical illness (in as far as possible) and any anxiety disorder present, which would be the approach if it was a genuine theory. They are using the notion that an illness is caused by stress as a reason why they don't have to bother with it. Saying, "stress," or "psychosomatic," amounts to, "Just pull yourself together and stop wasting our time." It's a way of saying it is the patient's fault in a way they cannot refute. Including the biochemical realities of stress in a specific, tangible cause-and-effect theory, such as, "Stress weakened immune system led to this infection," is, I would argue, a completely different thing. I don't know how much evidence there is for that, but it is an actual theory that can be examined properly, and doctors don't, as far as I know, refuse antibiotics and other appropriate intervention with regard to the infection in that type of case! I don't think it is true that sort of thing could not be proved: it should be possible to see if stress hormones downregulate the immune system, for example.

I think one of the main underlying problems is that the medical profession (and others) are much too optimistic about how much they know about physical illness. So when they come across something they don't understand, they say, "this must be imaginary," rather than, "here is something I don't understand," because they think their system knows almost everything. A more genuine acceptance that we still actually understand very little about what can go wrong with the human body, and what causes it to happen, would probably help a lot.

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Hey Paul do you really think cancer will be solved before fibromyalgia? Also, stress being a factor, but stress is not just psychological right? Stress can produce physical changes especially in the genetically vulnerable? Stress shouldn't cause health meltdowns but maybe in some people they do but since there was no way to ever prove so it never entered the collective psyche. Popular theory among CFS patients who seemed to develop their symptoms during stressful periods is that stress weakened their immune systems, leaving it vulnerable to asymptomatic infections. Though I agree it's a useless idea.

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Dec 14, 2022·edited Dec 14, 2022

Actually idk what I meant by collective psyche part. Just wanted to express the idea that as medically unexplained patients, we don't even exist in the collective psyche. And psychosomatic means neuro somatic right? Rather than psycho. As in physical brain rather than state of mind.

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Dec 6, 2022Liked by Paul Ingraham

"It’s not going to make me any more eager to make my life less stressful. I’m already very eager for that" hehehe..

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Dec 6, 2022Liked by Paul Ingraham

Growing up with asthma and allergies, I've had 56 years of 'maybe it's 'psychosomatic' '. You're right it is gaslighting. I've even had smokers get angry because I move away to avoid the very real and troublesome effects their smoke causes me.

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Dec 5, 2022Liked by Paul Ingraham

Excellent post. Thanks Paul.

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I am reminded of the old-timey notion that stress causes ulcers.

Turns out Helicobacter pylori causes ulcers, and having the interior of your stomach lining eaten away by pathogens is ~really fucking stressful~.

Barry Marshall got a Nobel for proving this by drinking a bunch of H. pylori and getting gastritis, but the notion that ulcers are just a consequence of being a "Type A" person is still bizarrely persistent

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Great point!

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Dec 4, 2022Liked by Paul Ingraham

I love both the content and tone of this entire post.

My mental health is, frankly, shockingly robust, thanks to my hard work and persistence. Sometimes I think I take such good care of it largely out of spite so that whenever some quack says "it's your mental health" I can say "fuck you." But also because it's one of the few things I have some degree of control over, and like you said... it's worth doing anyway.

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