“Since Engel, medicine has understood dualism as something we do, or choose not to do.” | Modern medicine’s bad philosophy is an obstacle to health, safety, pain relief and a full participation in life.

  1. Yeah the term used to describe how the mind and matter relate to one another is usually "non-reductive naturalism" or "functionalism", not just straight up cartesian dualism.

  2. I found this article very interesting as an endometriosis patient who struggled with chronic but intermittent pain for 10+ years before pushing for a diagnosis and treatment that alleviated my symptoms. I was told that it was normal to have cramps, it was all in my head and I just couldn’t deal with it, that getting pregnant would make it better. Because it is such a difficult diagnosis which involves laparoscopic investigation, many doctors would prefer to prescribe birth control (which can cause further mental/emotional turmoil) and not pursue it further. Chronic pain from a purely biological source as in my case can affect your mentation and then in turn, overly sensitize you to the biological pain. When I finally did get a surgery, it relieved quite a bit of my pain. But then I spent the next year telling myself that if I did feel pain, it was reactionary and not real even though I knew endometriosis can recur after excision (and usually does).

  3. Had to double check the username to make sure I hadn’t posted this! The sad truth is that our stories are one in the same for hundreds and thousands of women who have suffered under the dismissive “care” of doctors who assume the fault is with the patient’s mental status if there is nothing “obviously” wrong.

  4. I have a genetic joint disorder (EDS), and spent nearly a decade being told it was psychosomatic. I knew it couldn't be, because how the hell did I lose the ability to move a limb (or any particular joint) while I was feeling good and just going about my day? Suddenly, I be stopped, sometimes in serious problematic situations (like being outside a doctor's office for an hour unable to go in, or stuck on my own bathroom floor because my hip locked up after i used the bathroom, etc). I knew that wasn't in my head. I could literally feel my joints moving out of place, but I had trouble describing this. And to make things worse, it started with one shoulder, and then slowly affected other joints - and I was in the exact age range for hypermobility disorders to be commonly diagnosed.

  5. The article makes several unsupported stances against the medical institution. It is just wrong, medicine does not discard the mind or its intimate connection to the body. “ It’s time for medicine to stop flying by the seat of its philosophical pants.” Come on!!!!

  6. And 4) the actual ability of care providers to do anything about it. Been in serious pain for like 8 years now but no therapist has helped a iota.

  7. I would agree with you if most medical professionals did not treat psychosomatic disorders like the client was faking it and if every cluster of symptoms that don’t match a known diagnosis weren’t automatically given the psychosomatic treatment - which is to tell you to go to therapy, with no guidance or instructions on finding a mental health professional who specializes in this specific psychosomatic disorder because someone who works with non epileptic seizures might not be great with a functional neurological disorder or ulcers.

  8. You're missing the whole point. It's not a wholistic approach. Patients are "turfed" to mental health without any ongoing measure of the symptomatic treatment you described. Some of this is arguably born of a desire to avoid government scrutiny, for instance in prescribing pain medication without a provable diagnosis of pain etiology. However, this excuse ignores the role of the larger medical community in forming those legal and social judgements by guiding the philosophical approach to pain management and the interpretation of reseach results in the first place. If the APA, for instance, didn't take such a misguidedly patronizing, overtly cruel, and unjustifiably overconfident public stance on many of these issues: they wouldn't be issues of governmental concern. It is only because these organizations claim deeply biased opinion as "knowledge" that such interference is ever socially justified to begin with. Individual physicians bear responsibility as well: they largely support these organizations, or at least tacitly enable their power by refusing to offer a contrary voice.

  9. Yep all good points. I developed something called PPPD from a severe panic attack. Basically it makes you dizzy/feel drunk and many other symptoms.

  10. As a patient who lost sensation in my thighs and groin along with bladder and bowel function in 2006, then progressively more of my legs over time, I have still not received a diagnosis after 16 years of solid trying. Dismissal is one of the biggest issues, and neurologists have absolutely been the worst in this regard. It's not that the neurological science is lacking, exactly - it's a lack of knowledge about that science by neurologists in the clinic. Most neurologists i have seen have done nothing except an MRI of the spine, then said 'Well your MRI doesnt show anything so that means you are fine. Usually this stuff comes from the mind. The mind can do some problematic things can't it?' Trying to get answers repeatedly results in 'well it's not exactly killing you, is it?' too. There are obviously many more tests they could do, but they won't. They have zero intellectual curiosity. Their thought is not 'wow i wonder what is causing this? I am so curious about the answer'. It is 'lunch is coming soon, im hungry, yeah whatever. Another MRI. This is just a job'. It makes me wonder why they got into this career if they don't have any intellectual passion or interest in actually figuring out challenging diagnoses and helping other human beings.

  11. The whole disconnect of mind and body is pure bullshit. There are psychologists and psychiatrists in most hospitals. They aren’t there just to work the psychiatric ward. They’re pivotal for mental well-being. Even spriritual advisors are present at most hospitals for that aspect. Shit, even in things like motor vehicle accidents, there is a payout specifically for suffering that includes mental distress- which has to be accounted for through medical treatment.

  12. Your theory is great, but the practice is, "Oh your body is self destructing, here's some pills and a bill for $500. The pills aren't covered by your insurance, but there's always SSRIs!"

  13. Regardless of the mind-body debate, this article makes an important error in its historical analysis: it confuses an ideology, that arose from very real material conditions for their cause, when it's really just an effect.

  14. Oh and obviously to really change things, patients, doctors, nurses and others involved in healthcare would need to band together and organize. Waiting for some heroic philosophers to "bring in" (where to?) new/old ideas that's may then slowly trickle down through text books to someday hopefully effect a small shift in consciousness in practicing doctors? That just won't do it.

  15. This is an interesting article, but I’m not sure exactly what they are advocating for. Bear in mind that my training is in emergency medicine, so in my clinical practice there is no real difference between psychosomatic disorders and undiagnosed, non-emergent disorders. In the emergency room the pathway is the same: treat symptomatically and discharge for outpatient follow up.

  16. As a person with a physiological illness that's not easy to treat, what I want is doctors simply admitting they don't know. I don't think the article is advocating for over testing, just for using the same scientific standards for psychosomatic diagnoses and not just handing them out when you don't find anything better.

  17. A bit unrelated but it's also an obstacle in participating in death as some would choose otherwise. I don't agree with much of the article other than the rampant conservative morality in medicine.

  18. Medicine is surely confused about the relationship between mind and body, but to imply that philosophy has it all figured out and if only medicine would listen to us is honestly ridiculous! Philosophy is at least as confused over the issue as medicine, if not more so simply because it spends more time talking in circles instead of looking at the actual cause and effect of treatments.

  19. I think the article is over-complicating things. Doctors aren't misdiagnosing diseases as psychosomatic because they have a confused understanding of what the word "dualism" means. They're doing it because it's a convenient blanket explanation for something that would otherwise be difficult to explain, and because the idea that mental health can have physical impacts on the body is somewhat new and trendy. In other words, they just have a new excuse to be lazy and some of them lack the self-awareness to realize that that's what they're doing. This has happened before, they just used to use words like "hysterical" and "schizophrenic" instead.

  20. If the problem requires two (or more) sets of expertise, why not simply insist on a policy of holistic, collaborative diagnosis? Would that not address the false understanding of duality that is at the center of this issue?

  21. The author seems to have limited understanding of modern medicine. This article is a bit more in depth of current practices

  22. How, when modern medicine just looks to solve physical problems directly. It's literally been worked up to do, the exact opposite, of your concerns. Lolz

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