The Problem With ‘Medically Unexplained’ Symptoms
In my most recent blog post over at Psychology Today, I explore what mainstream medicine gets so wrong about persistent physical symptoms.
Unhelpful assumption 1: Analyzing biological phenomena at a microscopic level is the only way to understand and cure illness
Medicine is reductionistic. That’s not me being mean about it. Reductionism is the very word that medicine uses to describe its core project of analyzing human biology at a microscopic level in search of a single pathophysiological cause of illness.
However, in the 21st century, much human suffering, especially in the Western world, is caused by chronic health conditions that do not have a single underlying cause. Instead, chronic illness typically has multiple interacting causes, including chronic stressors, exposure to toxins, and lifestyle factors, like diet, smoking, alcohol, and poor sleep.
Unhelpful assumption 2: All physical symptoms must have a single biological cause
Mainstream medicine also tends to presume that physical symptoms must always be reduced to a single biological cause. In other words, some kind of damage is done to the tissue of the body, and this directly results in symptoms, like pain, fatigue, nausea, or brain fog.
This model is logical and intuitive. But as my patients, and millions of others around the world know, sometimes it falls down. Commonly, there are symptoms, but tests indicate that the body is healthy.
Unhelpful assumption 3: Physical problems with a structural biological cause are more real and legitimate than physical problems without one
Very much standing on the shoulders of the first two assumptions, there is a strange implicit hierarchy in modern medicine. This hierarchy states that the suffering of people whose symptoms can be explained by lab tests is somehow more valid than that of individuals whose symptoms cannot be.
Unhelpful assumption 4: The mind and body are completely separate entities
In the words of some pioneering researchers on persistent physical symptoms:
The divide of Western medical systems into either ‘physical’ or ‘mental’ health disciplines is arguably responsible for most controversies regarding MUS [medically unexplained symptoms], with physical and mental health specialists favoring distinct terms, diagnostic criteria and illness narratives for an overlapping set of complaints.
Unhelpful assumption 5: You can only hope to cope with persistent physical conditions
On the back of the failure of mainstream medicine to make sense of persistent physical symptoms, there has emerged a culture of overwhelming pessimism surrounding the expected health outcomes of people living with chronic fatigue, pain, and countless other symptoms.
Unhelpful assumption 6: Recovery from illness is a passive process
Finally, a medical model founded on acute, communicable illnesses teaches us that simply being prescribed the right antibiotic or antiviral medication is sufficient to get us back to health.
But for people living with persistent physical symptoms, which tend to have multiple interacting causal and sustaining factors, recovery from illness often requires a multi-pronged approach. The patient cannot afford to be a passive recipient of medical treatment; instead, they must take active ownership of their recovery.
Head to Psychology Today to read the full post.
