Psychologization

Psychologization or psychiatrization is the interpretation of all symptoms as being the result of psychological issues or mental illness by doctors and clinicians, particularly in cases where no physical illness has been identified.

Evidence
The best known example of psychologization can be found in the treatment of stomach ulcers, where were assumed to always have a psychological cause until the discovery of the bacteria responsible.

In 1956 Engel, creator of the biopsychosocial model of illness, according to historian Edward Shorter, Engel "asked why patients with ulcerative colitis often seemed to develop headaches when the bowel illness was quiescent. His theory was that when headaches appeared in these patients, 'there was evidence of strong conscious or unconscious aggressive or sadistic impulses. When bleeding occurred, 'the patient was feeling to varying degrees helpless, hopeless, or despairing. The bottom line, not entirely convincing to all gastro-enterologists, was 'Bleeding... characteristically occurs in the setting of a real, threatened, or fantasized loss, leading to psychic helplessness.'13"

"McLaren notes that some psychiatrists repeatedly invoke Engel's biopsychosocial "model" and that they accept without demur (or references) that it is a reality, when nothing could be further from the truth."

Psychologization in ME/CFS
Patients with ME/CFS have reported that clinicians often trivialize their symptoms and psychologize too much, and that this can lead to long term medical neglect and abuse.

Notable studies

 * 1993, All in her mind! Stereotypic views and the psychologisation of women's illness (Full text)


 * 1996, Bio-psycho-social reasoning in GPs' case narratives: The discursive construction of ME patients' identities (Full text)
 * 2002, The myth of the biopsychosocial model (Abstract)


 * 2008, Obstructions for quality care experienced by patients with chronic fatigue syndrome (CFS)—A case study (Abstract)


 * 2017, Contesting the psychiatric framing of ME/CFS (Full text)

Book chapters

 * 2005, The biopsychosocial approach in medicine: before and after Engel.

Letters, articles and talks

 * 2000, Functional somatic syndromes
 * 2013, Disease-modifying therapies for nonrelapsing multiple sclerosis: Absence of evidence does not constitute evidence of absence

Learn more

 * The Model of the Myth
 * More on the Myth?