Psychologization

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Psychologization or psychologisation or psychiatrization is the overemphasis or exaggeration of the role of psychological factors in illness when there is "little or no evidence to justify it".[1]

"Psychologisation is a common practice but one which can put patients' lives at risk and undermine the general population's confidence in medicine and those who practise it".[2] — Goudsmit and Gadd (1981)

Evidence[edit | edit source]

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.[3]

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"[4]

"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." [5]

Psychologization in ME/CFS[edit | edit source]

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.[6]

Lupus, multiple sclerosis, AIDS, and Lyme disease suffered similar fates before “tissue evidence” was available. Patients were belittled by armchair speculators masquerading as scientists. Who among us believes this was helpful? A simple “I don’t know” would have been better than specious speculation.
The authors confuse absence of evidence with evidence of absence. They are not the same. Absence of evidence may reflect insufficient research, inadequate technology, poor methods, flawed paradigms, closed minds, or lack of clinical experience; for example, in 1980, there was no clear evidence that AIDS was viral—blood products were considered “safe.”[7] — Thomas English, Annals of Internal Medicine (2000)

Notable studies[edit | edit source]

  • 1993, All in her mind! Stereotypic views and the psychologisation of women's illness[8](Full text)
  • 2002, Bio-psycho-social reasoning in GPs' case narratives: The discursive construction of ME patients' identities[9](Full text)
  • 2002, The myth of the biopsychosocial model[5](Abstract)
  • 2008, Obstructions for quality care experienced by patients with chronic fatigue syndrome (CFS)—A case study[6](Abstract)

Book chapters[edit | edit source]

Letters, articles and talks[edit | edit source]

  • 2000, Functional somatic syndromes[7]
  • 2013, Disease-modifying therapies for nonrelapsing multiple sclerosis: Absence of evidence does not constitute evidence of absence[10]

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.01.1 Spandler, Helen; Allen, Meg (Aug 16, 2017). "Contesting the psychiatric framing of ME/CFS" (PDF). Social Theory & Health. 16 (2): 127–141. doi:10.1057/s41285-017-0047-0. ISSN 1477-8211. 
  2. Goudsmit, EM; Gadd, R (1991). "All in the mind? The Psychologisation of Illness". The Psychologist. 4: 449–453. is the overemphasls and exaggeration of the role of psychological factors in illnesses which are generally considered to have a physiological and/or blochemical aetiology 
  3. "Psychosomatic explanations for disease (MPKB)". The Marshall Protocol Knowledge Base. Retrieved Aug 19, 2019. 
  4. Shorter, Edward (2005). White, Peter, ed. "Biopsychosocial medicine: An integrated approach to understanding illness": 1–19. 
  5. 5.05.1 "The myth of the biopsychosocial model". Australian and New Zealand Journal of Psychiatry. 36 (5): 701–701. Jan 1, 2002. doi:10.1046/j.1440-1614.2002.01076.x. ISSN 0004-8674. 
  6. 6.06.1 Gilje, Ann Marit; Söderlund, Atle; Malterud, Kirsti (Oct 2008). "Obstructions for quality care experienced by patients with chronic fatigue syndrome (CFS)—A case study". Patient Education and Counseling. 73 (1): 36–41. doi:10.1016/j.pec.2008.04.001. 
  7. 7.07.1 English, T. L. (Feb 15, 2000). "Functional somatic syndromes". Annals of Internal Medicine. 132 (4): 329. ISSN 0003-4819. PMID 10681297. Lupus, multiple sclerosis, AIDS, and Lyme disease suffered similar fates before “tissue evidence” was available. Patients were belittled by armchair speculators masquerading as scientists. Who among us believes this was helpful? A simple “I don’t know” would have been better than specious speculation.
    The authors confuse absence of evidence with evidence of absence. They are not the same. Absence of evidence may reflect insufficient research, inadequate technology, poor methods, flawed paradigms, closed minds, or lack of clinical experience; for example, in 1980, there was no clear evidence that AIDS was viral—blood products were considered “safe.”
     
  8. Goudsmit, Ellen M (1993). "All in her mind! Stereotypic views and the psychologisation of women's illness". Health Psychology Update. 12: 28–32. 
  9. Horton-Salway, Mary (Oct 1, 2002). "Bio-Psycho-Social Reasoning in GPs' Case Narratives: The Discursive Construction of ME Patients' Identities". Health. 6 (4): 401–421. doi:10.1177/136345930200600401. ISSN 1363-4593. 
  10. Dunn, J. (Oct 31, 2013). "Disease-modifying therapies for nonrelapsing multiple sclerosis: Absence of evidence does not constitute evidence of absence". Neurology: Clinical Practice. 3 (6): 515–518. doi:10.1212/01.cpj.0000436215.95884.89. ISSN 2163-0402. 

Myalgic encephalomyelitis or chronic fatigue syndrome

Myalgic encephalomyelitis or M.E. has different diagnostic criteria to chronic fatigue syndrome; neurological symptoms are required but fatigue is an optional symptom.<ref name="ICP2011primer">{{Citation


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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history