Non-effective effective treatments

Although there is generally agreement that fibromyalgia treatment is unsatisfactory, most articles that discuss treatment list a whole series of ‘effective’ treatments. Often the treatments are extolled because they address specific pathways hypothesized to be important or for which drugs have been developed. As we have noted previously, many authors of treatment recommendations have received …

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If you think this is valid research, sit on your hands

I came across ‘A patient survey of the impact of fibromyalgia and the journey to diagnosis’ while performing a Google Scholar search.1 There were some interesting data in this open access paper, but also many problems—the type you might expect in a retrospective, highly selected sample. And the results were pretty much what one might …

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Some thoughts on why there is no simple solution to the perceived dualism problem

There appears to be a modern obligation to eschew Cartesian Dualism and to and rail against it as the cause of multiple ills. According to Cohen and Quinter, ‘When seen through this Cartesian dualistic frame, pain sufferers appear to a clinician either as a disordered bodily machine or as a disturbed mind.’ In the absence …

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Before the Beginning – When does Illness Start?

Previously, I raised the questions, ‘What is fibromyalgia?’ ‘When does fibromyalgia begin? Based on data that suggests strongly that fibromyalgia represents the end of a continuum of polysymptomatic distress, I stated that people who didn’t quite reach the end of the continuum could be considered to be on the pathway to criteria positive fibromyalgia. I …

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Milton Cohen & John Quintner on Chronic Pain and the Negation of Empathy

Below, I have posted an article by Milton Cohen & John Quintner. It is a much shortened version of their 2011 publication [Cohen, M., Quintner, J., Buchanan, D., Nielsen, M. & Guy, L. Stigmatization of patients with chronic pain: the extinction of empathy. Pain Medicine (2011)]. The original article is, I believe, rather better, conveying …

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Somatization: the Word that Dare not Speak its Name

As it evolved, somatization became a way to think about and classify unexplained symptoms. The word somatization fell out of favor because it always implied psychogenicity. It was an hypothesis that was often inconsistent with observed data, and was mired in different schools of psychiatric thought and argument. For better or worse, it lacked face …

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Fibromyalgia: On the Take – Pharma, Physicians and Professional Organizations

Pharma pays off physicians and professional organizations all the time. But money doesn’t influence them, so say my physician friends and the organization that I belong to. The American College of Rheumatology (ACR) takes in large amounts of money from Pharma through gifts, advertising and sponsorships at national meetings, and through advertising in professional journals. …

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A Brief History and Critique of Somatization

As originally proposed by the Viennese neurologist and psychoanalyst Wilhelm Stekel (1886-1940), somatization referred to a bodily disorder thought to originate from a deep-seated “neurotic” cause, and is identical with the Freudian concept of conversion. Used in this psychodynamic sense, somatization denotes an immature defence mechanism whereby psychic derivatives are “converted” into bodily symptoms. The …

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