Psychologization

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". Psychologization is also known as the Martha Mitchell effect.

"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". — Goudsmit and Gadd (1981)

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.

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.” — Thomas English, Annals of Internal Medicine (2000)

Notable studies

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

• 2002, 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

See also

• Psychosomatic illness
• Hypochondriasis (hypochondria or illness anxiety disorder)
• Contested illness
• Biopsychosocial model
• Martha Mitchell Effect
• Medically unexplained physical symptoms
• Functional Neurological Symptom Disorder (FND)
• Bodily distress disorder
• Wessely school

Learn more

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

See myalgic encephalomyelitis.

See chronic fatigue syndrome.

biopsychosocial model (BPS) - A school of thought, usually based in psychology, which claims illness and disease to be the result of the intermingling of biological, psychological and social causes. (Learn more: me-pedia.org)

An adjective relating to the physical body or physical symptoms. It is often contrasted with the adjective "psychological", which refers to the human mind or mental symptoms. In biology, "somatic cells" refer to all the cells of the body, except those which form an egg or sperm.

somatic An adjective relating to the physical body or physical symptoms. It is often contrasted with the adjective "psychological", which refers to the human mind or mental symptoms. In biology, "somatic cells" refer to all the cells of the body, except those which form an egg or sperm.

Concerning living organisms, such as cells or the human body.  Physio logical (as in physio) is not to be confused with psych ological (emotional stress).

physiological Concerning living organisms, such as cells or the human body.  Physio logical (as in physio) is not to be confused with psych ological (emotional stress).