Thread by @_Lucibee

I hope Prof Reicher won't mind if I try to explore this further, because this is one of the things that has been so problematic (and toxic) in discussions around ME/CFS.

https://twitter.com/ReicherStephen/status/1487383493135024133

The problem here is that this has been weaponised by certain people to imply that it is those with ME who are doing the demeaning, by complaining that they have been told that it is "only in their mind".

It is the implication that is incorrect. Because those making the complaint are not demeaning mental health conditions, but are complaining about a misdiagnosis that means they will not be treated appropriately.

In fact, the whole dichotomisation argument is a straw man to deflect from the harm caused by such misdiagnosis. As such, it needs to be struck down at every opportunity, and not brought up as a trope.
To do so shows failure to learn from the past.

It simply isn't relevant anymore. The best way to help the mental health of those with ME or #LongCovid or *any* condition, is to acknowledge it and to listen to the patient. No condition should be "psychologised".

It's so hard to discuss, because the very language we use to talk about it has been poisoned by the dichotomy - the distinction between medical/physical/somatic and psychological/behavioural.
There is no distinction, they are all part of the same thing.

I have always understood psychological/behavioural sx to be manifestations of physical processes. That they happen in the brain as opposed to anywhere else in the body shouldn't make a difference to the way they are treated.

If a drug helps to alleviate perceived psychological symptoms, is that "medicalisation"?
If meditation helps alleviate perceived physical symptoms, is that "psychologisation"?
The important thing is that it helps. If it doesn't, then it is inappropriate.

The problem has been that those complaining about dichotomisation and pushing for so-called "integrated" medicine are themselves pursuing a very one-sided psychologised agenda, aimed at minimising medical input and downplaying underlying biological processes.

The very thing that is so demeaning for those with misdiagnosed conditions is also demeaning for those (of us) with MH conditions: the implication that they are somehow responsible for their condition, that believing they are ill makes them ill.

And by further implication, that thinking yourself better will make you well again.
Because it simply isn't true.

Just to reiterate, the question was about how to avoid the mistakes of the past.

https://twitter.com/RobertHMcMullen/status/1484554728994672642

I've just rewatched it again.
I didn't want to let the other answerers off the hook.

This question of Acknowledgement, particularly acknowledging past mistakes, is really important here, and I felt that it was somewhat brushed aside in some of the answers given

https://twitter.com/longcovidadvoc1/status/1487366400142413830

But first, Daniel Glaser made an good point when he said:
"As scientists, we should put ourselves out there and be held to account by people who have experience of the things that we are working on"

I was disappointed with Danny Altmann and Martin McKee, who both seemed quite reluctant to acknowledge past mistakes that were specific to ME/CFS, either generalising them to research as a whole...

...or putting them down to "fashion and randomness and all sorts of things", rather than calling it out for what it is, an outrageous scandal of neglect and professional opportunism

To learn from the past, you really do have to "get into the details of the ME debate" (although I'm not sure what "debate" McKee means here), because until you understand *why* things have gone wrong, you are destined to keep making the same mistakes.

I sense that those who've "followed the twists and turns" are keen to move on without upsetting those who have been more actively involved in "the debate".
But that won't do.
They need to not just listen to patients, but believe and support them too.