1/ Yesterday I highlighted the difference btwn the public's take on hysteria & the way it's seen in MH care. The ensuing debate was an eye opener! Ppl working in #WomensHealth often emphasize that medicine has rejected the construct of hysteria as sexist and dangerous.... 🧵

https://twitter.com/DianeOLeary/status/1783244499117854787

2/ but that never happened! In fact hysteria continues to be central in psychiatry & psychosomatic med. I knew this, but I did not know that those in MH care are actually uninformed abt the damage hysteria does to women's healthcare here & now...

@IMEstudents 1/ Wessely has written 1 paper involving ethics, "To Tell or Not to Tell", where he states that he's uninformed abt the field. Then he considers hysteria ("a tough old bird"), and asks whether drs should tell patients the truth abt that diagnosis... google.com/url?sa=t&rct=j… @IMEstudents 2/ He concludes by advising that drs should deliberately mislead patients so they'll comply w treatment, w advice on how best to deceive. (That advice led to the construct of #FND.) Wessely never considers the right to informed consent...

Another article trying to tie #longcovid to mental illness. Incredibly, @grace_huckins quotes 2 leading LC scientists stating that it’s dangerous to encourage a tie to mental illness in media, but Huckins thinks she's qualified to reject that concern...🧵 slate.com/technology/202… 2/ The article opens with a horrendous misunderstanding about the word "psychosomatic". Roberts, a scientist studying ties between mental illness & bio disease, put a disclaimer on her LC research stating that it does not support the idea that LC is psychosomatic. Bizarrely...

This editorial is nonsense. To be clear, the claim here is that #LongCovid is psychosomatic. Authors' spin on that term does not arise from "progress". It arises from a plan in research to rebrand the term so that patients won't get angry & object...🧵 theglobeandmail.com/opinion/articl… 2/ "Progress" in psychosomatic research in the last 20 years has primarily been about rebranding. Convince people that psychosomatic conditions are brain problems, then they'll comply with psych treatment. Is it true that we "now know" these are problems w brain function? No...

1/ I’ve been concerned that journalists have decided they’re fit to make credible contributions to medical issues like #longcovid – and this piece by @nataliesurely convinces me the problem is both bizarre & directly threatening to public health... newrepublic.com/article/168965… 2/ Shure has done a lot of research, but w no academic rigor or caution. More than that, she's got a decisive ax to grind in support of @awgaffney’s #longcovid agenda. You couldn’t grind this ax through peer review, but you can grind away in @newrepublic, so here we are...

There are 3 problems w Gaffney’s article, each one obvious enough, and dangerous enough, for @TheAtlantic to flag before publication. First, how could any editor publish the sentence, “a false separation of brain and body has long plagued medicine”?...
theatlantic.com/ideas/archive/… People, the brain is a body part! No one in medicine or philosophy has ever been plagued by separation of body parts. We struggle with mind & body because mind is NOT a body part. Does it matter that Gaffney is terrible at amateur philosophy?... 2/

I'm very happy to report that @awgaffney has been silenced on the question of what causes Long Covid, at least for today. This thread got pretty disjointed so here's the conversation in order, without editing, for all to see...

https://twitter.com/awgaffney/status/1530942410104180741

G: I have no overarching monocausal theory about LC. I’ve consistently contended that symptoms are likely propagated by different mechanisms/mediators in different patients. Yes I’ve said that psychosocial processes could be a contributing factor for some. True for many illnesse

Everyone involved here is well meaning & clear that LC is bio disease. It’s impossible to overstate, though, how damaging this material is to LC patients. First, you have no science to support the claim that LC patients are more often traumatized or type A than anyone else…1/

https://twitter.com/doctorasadkhan/status/1521910285988073474

It’s damaging to the cause for you to publicly engage in unscientific speculation. Second, for you @doctorasadkhan and @gezmedinger to concede high prevalence of trauma & type A in LC patients is for you to openly sanction the psychosomatic approach to LC…2/

1/6 The 11th-hour halt to publication of the #ME/CFS guideline has been so very difficult for the patient community. It's particularly hard that there's been so little clarity about why this has happened and what it will take to move forward. Imho...
nice.org.uk/news/article/n… 2/6 it might be useful for patients & professionals to consider how immense the ramifications of this guideline are. NHS management of medically unexplained symptoms is based on the CFS example & consensus that psych care works via CBT & GET. That consensus is now shattered...

1. This is a very useful thread #MedTwitter because it tracks common reasoning errors that lead doctors to readily accept psychosomatic dx for #MEcfs and other contested conditions like #EhlersDanlos, #mito, #dysautonomia, #LymeDisease, etc.

https://twitter.com/strauss_matt/status/1138522655701835776

2. Start with the duty that defines your profession @strauss_matt - to ensure that every patient with a need for med care (medical testing, treatment, or support) receives it when she seeks it from you. Mistaken psychosomatic dx violates that duty in every case where it occurs.