Thursday, May 11, 2023

Scott Siskind on Psychosomatic Illness

Scott Siskind reported, based on his reader survey, that Long Covid seemed to be partly psychosomatic. This led to quite a discussion in his comments. Part of his reponse was this:

Almost all organic conditions have a psychosomatic shadow. Consider heart attacks. These are as organic as they come. But about a third of cases where people come into the emergency room with sudden-onset sharp chest pain are having a psychosomatic issue, usually a panic attack.

You’ll find the same thing across almost any condition. Seizures? Probably about 25% of them are psychosomatic. Headaches? These can be caused by a host of organic issues (brain cancer, meningitis, dehydration, etc) but also by stress. Leg paralysis? Can be caused by leg injuries or conversion disorder. Blindness? Psychosomatic blindness has fallen out of style these days, but used to be quite popular - the British commander in the Revolutionary War had it. Having insects crawling all over your body? Can be caused by insects crawling all over your body, or by delusional parasitosis.

If there were no organic cases of Long COVID, it would make COVID one of the only coronaviruses in its family not to have a postviral syndrome. But if there were no psychosomatic cases of Long COVID, it would make Long COVID maybe the only condition in history with zero psychosomatic shadow. So when responsible people have this discussion, they’re not asking “are any cases real?” or “are any cases psychosomatic?”. They’re asking what percent are in which category. People really want to root for “Team It’s All Psychosomatic, If You Say It’s Organic You’re Gullible” or “Team It’s All Organic, If You Say It’s Psychosomatic You’re A Monster”, but that’s not how any of this works.

There are links for all the claims at the original post.

But right now I am mainly wondering how I managed to read half a dozen books about the Revolutionary War without ever learning that Henry Clinton had repeated attacks of hysterical blindness.

2 comments:

Anonymous said...

Hahaha, denying anything at all about "Long COVID" is a minefield. You're worse than Hitler if you suggest that anybody can have COVID without being crippled for life. Go over to the COVID subreddit if you don't believe me. There are people that cling to long COVID like a religion. It's really strange.

David said...

A problem that one of Siskind's interlocutors mentions but that he doesn't deal with, as far as I can tell, is paying for treatment. Insurance companies use a different, less generous system when calculating how much they will pay for mental health treatment. For them this is about the bottom line, but cultural biases and the fact that mental health problems are hard to bring to a clear end (or, if you will, "cure") are what give them permission to decide mental health is something they won't hand out much money for. One could say the same about voters and their influence on public expenditure.

I'm sure some sufferers develop a fetishistic devotion to proving they have a "real" illness, and that doesn't help scientific progress. But some of this is about money. I suspect not a few sufferers find that, if their illness is labeled psychosomatic, they are SOL as far as any treatment that costs money (or that costs money and takes more than say, six weeks to solve) is concerned.