#biopsychosocial — Public Fediverse posts
Live and recent posts from across the Fediverse tagged #biopsychosocial, aggregated by home.social.
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DATE: May 11, 2026 at 12:00PM
SOURCE: PSYPOST.ORG** Research quality varies widely from fantastic to small exploratory studies. Please check research methods when conclusions are very important to you. **
-------------------------------------------------TITLE: The testosterone myth? Large analysis finds no link between the “macho” hormone and risk-taking
A meta-analysis of 52 studies found no link between testosterone levels and risk-taking. In general, only studies where participants completed specific lottery-based economic tasks showed a modest association between testosterone levels and risk-taking, while other types of behavioral studies did not. Furthermore, the lack of association did not depend on participants’ sex. The paper was published in Neuroscience and Biobehavioral Reviews.
Testosterone is a hormone that belongs to a group of hormones called androgens. It is present in both males and females, but it is usually found in much higher levels in males. In males, testosterone is produced mainly in the testes; in females, smaller amounts are produced in the ovaries and adrenal glands.
Testosterone plays an important role in the development of male reproductive organs before birth and during puberty. During puberty, it contributes to changes such as a deeper voice, facial and body hair growth, increased muscle mass, and the growth of the penis and testes. In adults, testosterone helps regulate sexual desire, sperm production, bone density, red blood cell production, and muscle strength. Testosterone levels naturally vary by age, time of day, health status, sleep, stress, body fat, and the use of certain medications.
Study author Irene Sánchez Rodríguez and her colleagues note that, on average, men tend to be more prone to taking risks than women. Various hypotheses have been proposed to explain this gender gap. One prominent biological theory states that the gap is produced by differences in testosterone levels. Another theory, the “dual-hormone hypothesis,” suggests that the behavioral effects of testosterone actually depend on concurrent levels of cortisol, the body’s main stress hormone.
However, studies have not clearly supported the link between testosterone and risk-taking. While some studies have reported that individuals with higher testosterone levels were somewhat more prone to taking financial or physical risks, other studies have found absolutely no association.
The authors of this study conducted a meta-analysis aimed at synthesizing the existing findings to clarify the association between testosterone levels and risk-taking. They searched scientific databases—Google Scholar, PubMed, and Scopus—using “risk seeking,” “risk attitude,” and “risk aversion” as search terms. They looked for studies conducted on humans and sought to include studies examining testosterone alone as well as those testing the dual-hormone hypothesis.
To be included, studies needed to report a statistical association between testosterone and risk preference, to either measure or administer testosterone, and to use at least one behavioral or self-report measure of risk preference. Studies also needed to be written in English, Spanish, or Italian, and provide sufficient data to allow the researchers to calculate an “effect size” (the strength of the link between testosterone levels and risk-taking). In the end, 52 studies comprising 17,340 participants were included in the analyses.
These studies measured risk in various ways, such as gambling games, balloon-popping tasks, or self-reported questionnaires. They also measured testosterone in different ways: some studies used direct blood or saliva tests, some administered experimental doses of the hormone, and some relied on “morphological proxies” (like the ratio of a person’s index and ring fingers, which is theoretically linked to testosterone exposure in the womb).
When the researchers aggregated the data, the results showed that the overall association between testosterone levels and risk-taking across all 52 studies was practically zero. In other words, having high or low testosterone did not reliably predict whether a person would take a risk.
While the overall effect was zero, the data reported by individual studies were very heterogeneous—some studies reported a positive association (higher testosterone – higher risk-taking), while others reported a negative association (higher testosterone – lower risk-taking).
Further analyses revealed why the results varied so wildly. The researchers found that the method of measurement heavily influenced the outcome. For example, only studies that used lottery-based economic tasks to measure risk-taking showed a modest positive association, while studies measuring risk-taking via other methods (like impulsive games or self-reporting) did not. Similarly, the researchers noted that studies relying on indirect finger measurements sometimes hinted at a link, while highly rigorous studies using direct hormone measurements or administration did not.
Importantly, the lack of an association between testosterone levels and risk-taking did not depend on sex, meaning the relationship (or lack thereof) was no different in males than in females.
“Overall, the evidence challenges the notion that testosterone provides a general hormonal basis for human risk preferences,” the study authors concluded. “Instead, findings support a biopsychosocial framework in which ‘risk taking’ reflects the interaction of task demands, cognitive–affective processes, and situational context, with endocrine effects appearing narrow, context-dependent, and method-specific.”
The study contributes to the scientific knowledge surrounding the behavioral effects of testosterone, suggesting that societal and psychological factors likely play a much larger role in risk-taking than single hormones. However, the study authors note that their search did not yield a sufficient number of appropriate studies to reliably examine the dual-hormone hypothesis (whether a specific interaction between cortisol and testosterone might predict risk-taking).
The paper, “No relationship between testosterone and risk aversion: A meta-analytic review,” was authored by Irene Sánchez Rodríguez, Luca Bailo, Folco Panizza, Emiliano Ricciardi, and Francesco Bossi.
-------------------------------------------------
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Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: https://www.nationalpsychologist.com
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It's primitive... but it works... mostly...
-------------------------------------------------
#psychology #counseling #socialwork #psychotherapy @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #psychiatry #healthcare #depression #psychotherapist #no relationship between testosterone and risk taking #testosterone myth debunked #risk taking meta-analysis #biopsychosocial factors #endocrine effects context dependent #lottery tasks risk study #gender differences risk taking not hormone driven #dual hormone hypothesis inconclusive #testosterone measurement methods matter #neuroscience and biobehavioral reviews study
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DATE: May 11, 2026 at 12:00PM
SOURCE: PSYPOST.ORG** Research quality varies widely from fantastic to small exploratory studies. Please check research methods when conclusions are very important to you. **
-------------------------------------------------TITLE: The testosterone myth? Large analysis finds no link between the “macho” hormone and risk-taking
A meta-analysis of 52 studies found no link between testosterone levels and risk-taking. In general, only studies where participants completed specific lottery-based economic tasks showed a modest association between testosterone levels and risk-taking, while other types of behavioral studies did not. Furthermore, the lack of association did not depend on participants’ sex. The paper was published in Neuroscience and Biobehavioral Reviews.
Testosterone is a hormone that belongs to a group of hormones called androgens. It is present in both males and females, but it is usually found in much higher levels in males. In males, testosterone is produced mainly in the testes; in females, smaller amounts are produced in the ovaries and adrenal glands.
Testosterone plays an important role in the development of male reproductive organs before birth and during puberty. During puberty, it contributes to changes such as a deeper voice, facial and body hair growth, increased muscle mass, and the growth of the penis and testes. In adults, testosterone helps regulate sexual desire, sperm production, bone density, red blood cell production, and muscle strength. Testosterone levels naturally vary by age, time of day, health status, sleep, stress, body fat, and the use of certain medications.
Study author Irene Sánchez Rodríguez and her colleagues note that, on average, men tend to be more prone to taking risks than women. Various hypotheses have been proposed to explain this gender gap. One prominent biological theory states that the gap is produced by differences in testosterone levels. Another theory, the “dual-hormone hypothesis,” suggests that the behavioral effects of testosterone actually depend on concurrent levels of cortisol, the body’s main stress hormone.
However, studies have not clearly supported the link between testosterone and risk-taking. While some studies have reported that individuals with higher testosterone levels were somewhat more prone to taking financial or physical risks, other studies have found absolutely no association.
The authors of this study conducted a meta-analysis aimed at synthesizing the existing findings to clarify the association between testosterone levels and risk-taking. They searched scientific databases—Google Scholar, PubMed, and Scopus—using “risk seeking,” “risk attitude,” and “risk aversion” as search terms. They looked for studies conducted on humans and sought to include studies examining testosterone alone as well as those testing the dual-hormone hypothesis.
To be included, studies needed to report a statistical association between testosterone and risk preference, to either measure or administer testosterone, and to use at least one behavioral or self-report measure of risk preference. Studies also needed to be written in English, Spanish, or Italian, and provide sufficient data to allow the researchers to calculate an “effect size” (the strength of the link between testosterone levels and risk-taking). In the end, 52 studies comprising 17,340 participants were included in the analyses.
These studies measured risk in various ways, such as gambling games, balloon-popping tasks, or self-reported questionnaires. They also measured testosterone in different ways: some studies used direct blood or saliva tests, some administered experimental doses of the hormone, and some relied on “morphological proxies” (like the ratio of a person’s index and ring fingers, which is theoretically linked to testosterone exposure in the womb).
When the researchers aggregated the data, the results showed that the overall association between testosterone levels and risk-taking across all 52 studies was practically zero. In other words, having high or low testosterone did not reliably predict whether a person would take a risk.
While the overall effect was zero, the data reported by individual studies were very heterogeneous—some studies reported a positive association (higher testosterone – higher risk-taking), while others reported a negative association (higher testosterone – lower risk-taking).
Further analyses revealed why the results varied so wildly. The researchers found that the method of measurement heavily influenced the outcome. For example, only studies that used lottery-based economic tasks to measure risk-taking showed a modest positive association, while studies measuring risk-taking via other methods (like impulsive games or self-reporting) did not. Similarly, the researchers noted that studies relying on indirect finger measurements sometimes hinted at a link, while highly rigorous studies using direct hormone measurements or administration did not.
Importantly, the lack of an association between testosterone levels and risk-taking did not depend on sex, meaning the relationship (or lack thereof) was no different in males than in females.
“Overall, the evidence challenges the notion that testosterone provides a general hormonal basis for human risk preferences,” the study authors concluded. “Instead, findings support a biopsychosocial framework in which ‘risk taking’ reflects the interaction of task demands, cognitive–affective processes, and situational context, with endocrine effects appearing narrow, context-dependent, and method-specific.”
The study contributes to the scientific knowledge surrounding the behavioral effects of testosterone, suggesting that societal and psychological factors likely play a much larger role in risk-taking than single hormones. However, the study authors note that their search did not yield a sufficient number of appropriate studies to reliably examine the dual-hormone hypothesis (whether a specific interaction between cortisol and testosterone might predict risk-taking).
The paper, “No relationship between testosterone and risk aversion: A meta-analytic review,” was authored by Irene Sánchez Rodríguez, Luca Bailo, Folco Panizza, Emiliano Ricciardi, and Francesco Bossi.
-------------------------------------------------
DAILY EMAIL DIGEST: Email [email protected] -- no subject or message needed.
Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Unofficial Psychology Today Xitter to toot feed at Psych Today Unofficial Bot @PTUnofficialBot
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @PsychResearchBot
Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: https://www.nationalpsychologist.com
EMAIL DAILY DIGEST OF RSS FEEDS -- SUBSCRIBE: http://subscribe-article-digests.clinicians-exchange.org
READ ONLINE: http://read-the-rss-mega-archive.clinicians-exchange.org
It's primitive... but it works... mostly...
-------------------------------------------------
#psychology #counseling #socialwork #psychotherapy @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #psychiatry #healthcare #depression #psychotherapist #no relationship between testosterone and risk taking #testosterone myth debunked #risk taking meta-analysis #biopsychosocial factors #endocrine effects context dependent #lottery tasks risk study #gender differences risk taking not hormone driven #dual hormone hypothesis inconclusive #testosterone measurement methods matter #neuroscience and biobehavioral reviews study
-
DATE: May 11, 2026 at 12:00PM
SOURCE: PSYPOST.ORG** Research quality varies widely from fantastic to small exploratory studies. Please check research methods when conclusions are very important to you. **
-------------------------------------------------TITLE: The testosterone myth? Large analysis finds no link between the “macho” hormone and risk-taking
A meta-analysis of 52 studies found no link between testosterone levels and risk-taking. In general, only studies where participants completed specific lottery-based economic tasks showed a modest association between testosterone levels and risk-taking, while other types of behavioral studies did not. Furthermore, the lack of association did not depend on participants’ sex. The paper was published in Neuroscience and Biobehavioral Reviews.
Testosterone is a hormone that belongs to a group of hormones called androgens. It is present in both males and females, but it is usually found in much higher levels in males. In males, testosterone is produced mainly in the testes; in females, smaller amounts are produced in the ovaries and adrenal glands.
Testosterone plays an important role in the development of male reproductive organs before birth and during puberty. During puberty, it contributes to changes such as a deeper voice, facial and body hair growth, increased muscle mass, and the growth of the penis and testes. In adults, testosterone helps regulate sexual desire, sperm production, bone density, red blood cell production, and muscle strength. Testosterone levels naturally vary by age, time of day, health status, sleep, stress, body fat, and the use of certain medications.
Study author Irene Sánchez Rodríguez and her colleagues note that, on average, men tend to be more prone to taking risks than women. Various hypotheses have been proposed to explain this gender gap. One prominent biological theory states that the gap is produced by differences in testosterone levels. Another theory, the “dual-hormone hypothesis,” suggests that the behavioral effects of testosterone actually depend on concurrent levels of cortisol, the body’s main stress hormone.
However, studies have not clearly supported the link between testosterone and risk-taking. While some studies have reported that individuals with higher testosterone levels were somewhat more prone to taking financial or physical risks, other studies have found absolutely no association.
The authors of this study conducted a meta-analysis aimed at synthesizing the existing findings to clarify the association between testosterone levels and risk-taking. They searched scientific databases—Google Scholar, PubMed, and Scopus—using “risk seeking,” “risk attitude,” and “risk aversion” as search terms. They looked for studies conducted on humans and sought to include studies examining testosterone alone as well as those testing the dual-hormone hypothesis.
To be included, studies needed to report a statistical association between testosterone and risk preference, to either measure or administer testosterone, and to use at least one behavioral or self-report measure of risk preference. Studies also needed to be written in English, Spanish, or Italian, and provide sufficient data to allow the researchers to calculate an “effect size” (the strength of the link between testosterone levels and risk-taking). In the end, 52 studies comprising 17,340 participants were included in the analyses.
These studies measured risk in various ways, such as gambling games, balloon-popping tasks, or self-reported questionnaires. They also measured testosterone in different ways: some studies used direct blood or saliva tests, some administered experimental doses of the hormone, and some relied on “morphological proxies” (like the ratio of a person’s index and ring fingers, which is theoretically linked to testosterone exposure in the womb).
When the researchers aggregated the data, the results showed that the overall association between testosterone levels and risk-taking across all 52 studies was practically zero. In other words, having high or low testosterone did not reliably predict whether a person would take a risk.
While the overall effect was zero, the data reported by individual studies were very heterogeneous—some studies reported a positive association (higher testosterone – higher risk-taking), while others reported a negative association (higher testosterone – lower risk-taking).
Further analyses revealed why the results varied so wildly. The researchers found that the method of measurement heavily influenced the outcome. For example, only studies that used lottery-based economic tasks to measure risk-taking showed a modest positive association, while studies measuring risk-taking via other methods (like impulsive games or self-reporting) did not. Similarly, the researchers noted that studies relying on indirect finger measurements sometimes hinted at a link, while highly rigorous studies using direct hormone measurements or administration did not.
Importantly, the lack of an association between testosterone levels and risk-taking did not depend on sex, meaning the relationship (or lack thereof) was no different in males than in females.
“Overall, the evidence challenges the notion that testosterone provides a general hormonal basis for human risk preferences,” the study authors concluded. “Instead, findings support a biopsychosocial framework in which ‘risk taking’ reflects the interaction of task demands, cognitive–affective processes, and situational context, with endocrine effects appearing narrow, context-dependent, and method-specific.”
The study contributes to the scientific knowledge surrounding the behavioral effects of testosterone, suggesting that societal and psychological factors likely play a much larger role in risk-taking than single hormones. However, the study authors note that their search did not yield a sufficient number of appropriate studies to reliably examine the dual-hormone hypothesis (whether a specific interaction between cortisol and testosterone might predict risk-taking).
The paper, “No relationship between testosterone and risk aversion: A meta-analytic review,” was authored by Irene Sánchez Rodríguez, Luca Bailo, Folco Panizza, Emiliano Ricciardi, and Francesco Bossi.
-------------------------------------------------
DAILY EMAIL DIGEST: Email [email protected] -- no subject or message needed.
Private, vetted email list for mental health professionals: https://www.clinicians-exchange.org
Unofficial Psychology Today Xitter to toot feed at Psych Today Unofficial Bot @PTUnofficialBot
NYU Information for Practice puts out 400-500 good quality health-related research posts per week but its too much for many people, so that bot is limited to just subscribers. You can read it or subscribe at @PsychResearchBot
Since 1991 The National Psychologist has focused on keeping practicing psychologists current with news, information and items of interest. Check them out for more free articles, resources, and subscription information: https://www.nationalpsychologist.com
EMAIL DAILY DIGEST OF RSS FEEDS -- SUBSCRIBE: http://subscribe-article-digests.clinicians-exchange.org
READ ONLINE: http://read-the-rss-mega-archive.clinicians-exchange.org
It's primitive... but it works... mostly...
-------------------------------------------------
#psychology #counseling #socialwork #psychotherapy @psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #psychiatry #healthcare #depression #psychotherapist #no relationship between testosterone and risk taking #testosterone myth debunked #risk taking meta-analysis #biopsychosocial factors #endocrine effects context dependent #lottery tasks risk study #gender differences risk taking not hormone driven #dual hormone hypothesis inconclusive #testosterone measurement methods matter #neuroscience and biobehavioral reviews study
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Pop-therapy speak is problematic because it dilutes the “epistemic authority” and therefore efficacy of actual-therapy speech 👇
#therapyspeak #pop #diagnosis #transpersonal #psychology #mentalhealth #narratives #narcisissm #gaslighting #biopsychosocial #epistemology #philosophy #culture #bypassing
which I appreciate – as someone who tends to flagrantly over-indulge in pop-therapy speech –because it is essentially in the same category as over/mis-diagnosis, 1/n 🧵
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Pop-therapy speak is problematic because it dilutes the “epistemic authority” and therefore efficacy of actual-therapy speech 👇
#therapyspeak #pop #diagnosis #transpersonal #psychology #mentalhealth #narratives #narcisissm #gaslighting #biopsychosocial #epistemology #philosophy #culture #bypassing
which I appreciate – as someone who tends to flagrantly over-indulge in pop-therapy speech –because it is essentially in the same category as over/mis-diagnosis, 1/n 🧵
-
Pop-therapy speak is problematic because it dilutes the “epistemic authority” and therefore efficacy of actual-therapy speech 👇
#therapyspeak #pop #diagnosis #transpersonal #psychology #mentalhealth #narratives #narcisissm #gaslighting #biopsychosocial #epistemology #philosophy #culture #bypassing
which I appreciate – as someone who tends to flagrantly over-indulge in pop-therapy speech –because it is essentially in the same category as over/mis-diagnosis, 1/n 🧵
-
Pop-therapy speak is problematic because it dilutes the “epistemic authority” and therefore efficacy of actual-therapy speech 👇
#therapyspeak #pop #diagnosis #transpersonal #psychology #mentalhealth #narratives #narcisissm #gaslighting #biopsychosocial #epistemology #philosophy #culture #bypassing
which I appreciate – as someone who tends to flagrantly over-indulge in pop-therapy speech –because it is essentially in the same category as over/mis-diagnosis, 1/n 🧵
-
Pop-therapy speak is problematic because it dilutes the “epistemic authority” and therefore efficacy of actual-therapy speech 👇
#therapyspeak #pop #diagnosis #transpersonal #psychology #mentalhealth #narratives #narcisissm #gaslighting #biopsychosocial #epistemology #philosophy #culture #bypassing
which I appreciate – as someone who tends to flagrantly over-indulge in pop-therapy speech –because it is essentially in the same category as over/mis-diagnosis, 1/n 🧵
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頭痛醫頭也要醫心？政大楊啟正談「腦震盪」的臨床神經心理學
精選轉載 2026-01-06 16:00:00 CST
許多腦震盪患者的臨床表現，遠遠超出輕微的腦部損傷所能解釋：從偶發的劇烈頭暈、頭痛，到記憶力減退、反應變遲鈍，某些患者連情緒和性格都變了，出現憂鬱、焦慮、失眠等情況。 這些現象不禁使人好奇「腦震盪會不會還有更多因素在作怪？」
https://www.thenewslens.com/article/262145
#大腦 #憂鬱 #腦震盪 #腦震盪後症候群 #焦慮 #臨床神經心理學 #失眠 #生理－心理－社會模型 #往日美好偏誤 #健康 #楊啟正 #bio-psycho-social model #Good-old-days bias -
A newer more succinct version of yesterday’s cartoon. #ME #Disability #Psychiatry #Biopsychosocial @meassociation.org.uk @longcovidsupport.bsky.social #Justice4ME #Plan4ME #HumanRights @ashleydaltonmp.bsky.social @decodemestudy.bsky.social
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If you find this too much to read click on +Alt for a description of the cartoon about a forthcoming comic strip #ME #LongCovid #Biopsychosocial @meassociation.org.uk @longcovidsupport.bsky.social @chronicillness.bsky.social @nhsengland.bsky.social @nhsengland.bsky.social @bmauk.bsky.social
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Oxford Scholars Blame Biomedical Research Hegemony for Fibromyalgia “Chronicity Rhetoric”
By David Tuller, DrPH
Social Science & Medicine (SSM) is a prominent interdisciplinary journal that publishes social science research related to health. A recently published SSM paper is called “Chronicity rhetoric in health and welfare systems inhibits patient recovery: a qualitative, ethnographic study of fibromyalgia care.” Part of a larger, multi-partner, Oxford-based project called Patient-centred Care for Fibromyalgia: New pathway Design, or PACFiND, the new paper is based on 59 interviews with health care providers as well as field notes from observation of service provision. The providers interviewed are from a range of specialties, but they share one characteristic: They offer services and interventions categorized as “biopsychosocial.”
In this context, “biopsychosocial” includes not just standard psycho-behavioral treatments like cognitive behavior therapy (CBT) and graded exercise therapy (GET)—the treatments recommended in the fraudulent PACE trial for ME/CFS–but also so-called “mind-body” programs. These approaches tend to toss together, in various combinations, elements of meditation, relaxation exercises, positive affirmations, neurolinguistics programming, cognitive behavior therapy, health coaching, and other modalities. Well-known examples include programs like the Lightning Process, the Gupta Program, Dynamic Neural Retraining System, and the Chrysalis Effect, the latter mentioned specifically in the paper.
The three main authors are from Oxford University; the corresponding author is a health services researcher and the senior author is a medical sociologist. (Perhaps they are colleagues of Professor Michael Sharpe, lead PACE investigator and Oxford’s self-styled “harassment” victim?) They reveal their view of the insidious nature of “chronicity rhetoric” from the start. “We focus on representations of fibromyalgia as a ‘chronic condition,’ which infiltrate and disrupt healing work,” the paper declares.
Basically, the argument goes something like this: Any approach to fibromyalgia focused on biopsychosocial “healing” is good. The rigid evidentiary demands of biomedical research’s “hegemonic position” disadvantage biopsychosocial healers, who are unfairly barred from making claims about “recovery” based solely on anecdotal accounts. Advocacy organizations are grifters who hype the “chronicity rhetoric” for fundraising purposes. The welfare benefits system further reinforces the need for fibromyalgia to be constructed as “chronic.” And so on.
This is the premise grounding the paper:
“New service models for people with fibromyalgia recognise that people are complex and integrated body-minds that are responsive to, and interactive with, their social/material environments. In other words, “everyone’s disease is the product of the individual history of exposures [including a wide range of psychosocial stressors], superimposed on their underlying genetic susceptibilities”. Psychosocial pressures get “under the skin” and need addressing to mitigate symptoms. Neurobiological concepts of Central Sensitisation and Central Sensitivity Syndrome (CSS) are important to such models, providing mechanistic explanations of fibromyalgia, and opportunities for treatments that involve desensitising (or “dampening down”) a person’s nervous system.”
Note the presumption here that any new service model presenting itself as holistic or involving “body-minds” should essentially be accepted as valid and legitimate. The same goes for the “neurobiological concepts” that offer “mechanistic explanations” and “opportunities for treatment.” The paper includes no discussion of actual evidence for these theoretical constructs and the interventions based on them beyond the pronouncements and opinions of the interviewees.
Qualitative research fulfills important functions, but being able to reach definitive conclusions about the effectiveness of interventions is not among them. So it seems rash for the authors to take at face value that whatever someone might frame as biopsychosocial “healing work” is in fact “healing work.” They have no credible grounds for making broad judgments about whether “healing work” is taking place.
All they can do repeat is anecdotal accounts. While interesting and informative, such accounts do not constitute proof of effectiveness. And in this paper, the anecdotal accounts are from biopsychosocial healers, who have an obvious interest in framing their work as successful.
Which brings us to the Chrysalis Effect.
**********
Advertising regulators ban Chrysalis Effect “recovery” claims
In the paper, the authors write:
“A major obstacle faced by practitioners working in biopsychosocial services is that they lack established, ‘evidence-based’ ways of demonstrating that they work (as established through gold standard clinical trials)…We illustrate how the hegemonic position of EBM [evidence-based medicine] within Biomedical Research helps to construct fibromyalgia as a chronic condition with detrimental consequences for new service development.”
From this viewpoint, the issue is not that fibromyalgia is—in reality–a chronic condition. The issue is that this perception of fibromyalgia is, I guess, a sort of illusion, even a deception, since the disease is only “constructed” as a chronic condition by larger outside forces. (Reminds me of the famous line spoken by the voluptuously illustrated cartoon character Jessica Rabbit, the wife of the eponymous character in the 1988 comedy “Who Framed Roger Rabbit”: “I’m not bad, I’m just drawn that way.”)
The paper’s example involves the Chrysalis Effect, a mind-body intervention with a history of making extravagant boasts about “recovery” from complex illnesses like fibromyalgia and ME/CFS. As a result, the UK ME Association complained to the Advertising Standards Authority (ASA), an independent regulatory body. In a 2023 decision, the ASA barred the Chrysalis Effect and its practitioners from repeating such statements.
The paper’s stance is that clinical trials are not appropriate for assessing the benefits of biopsychosocial treatments. And the authors appear to blame the lack of documented benefit in such trials on deficiencies in the patients, not the interventions. As they write:
“The ASA’s determination (that there was not enough trial evidence to support claims about recovery) is hooked into a dominant biomedical infrastructure, in which clinical trial evidence is the gold standard. Within these governing systems, biopsychosocial (and often locally-developed) services find it difficult to demonstrate benefit (i.e., that healing work works)…The benefits of supporting this kind of work through individualised and therapeutic coaching is difficult to prove. Clinical trials cannot account for, or control for, such diverse social challenges or the individual neurobiology that may be involved in addressing them. In practice, trials of biopsychosocial models of care may not demonstrate improved outcomes, not because the interventions (care practices) involved are unfounded (non-evidence-based), but because patients do not have the social or psychological resources to maximise benefit from them.”
I guess one could refer to the standard approach to evidence as biomedical hegemony. From my perspective, it’s just a matter of requesting some sort of convincing data to support assertions of “recovery” rather than hyping anything labeled as “biopsychosocial.”
The paper also includes a slam at advocacy organizations, including the ME Association, for adhering to the biomedical paradigm and its accompanying “chronicity rhetoric.” This position is framed as a big grift:
“In order to secure donations, patient charities and affiliated researchers emphasise that conditions such as fibromyalgia have no cure. Donations fund (almost exclusively) pharmaceutical research so that ‘one day we hope we might discover a diagnostic marker and effective treatments’ (The ME Association, 2024). It therefore makes sense for such organisations to assert that ‘getting better’ or ‘recovering’ from fibromyalgia is rare, and that chronicity is the more probable trajectory.”
Contrast that, I guess, with an approach designed to convince desperately ill people to pursue anything that promotes “recovery” and is called “holistic” or said to relate to “body-minds.” The ME Association issued a robust response to these accusations.
The paper makes similar points about the structures involved with the provision of welfare benefits. I have more sympathy for some of the concerns raised in this section. It is not a new complaint that disability programs can be so inflexible in their demands and requirements that they undermine genuine efforts by patients to return to work. In the US, for example, such restrictions have long been a problem for people with HIV/AIDS and other chronic illnesses on long-term disability.
So yes, there is a larger question about the best way to organize these systems. But that is very different from blaming the provision of benefits for generating purportedly harmful “chronicity rhetoric.”
Putting that aside, however, the major flaw in the paper’s entire argument is this–the true source of any “chronicity rhetoric” involving fibromyalgia is reality, not the coercive demands of biomedical research and the welfare benefits system. The investigators themselves note that “chronicity does accurately reflect the findings of published epidemiological research and the experience of many people with the condition.” Ok, then.
But that view, they continue, “is also challenged by practitioners and patients attempting to harness (new) understandings of neurobiology, with emancipatory goals of improvement and/or recovery…Practitioners and patients argue from practical experience that improvement and/or recovery are possible with the right support and individual resources to make changes.”
That might be. And who could possibly be opposed to “emancipatory goals of improvement and/or recovery”? But—luckily for the safety and well-being of the general public—such claims still generally require more convincing proof than glowing testimonials about “healing” on websites and in qualitative studies.
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Oxford Scholars Blame Biomedical Research Hegemony for Fibromyalgia “Chronicity Rhetoric”
By David Tuller, DrPH
Social Science & Medicine (SSM) is a prominent interdisciplinary journal that publishes social science research related to health. A recently published SSM paper is called “Chronicity rhetoric in health and welfare systems inhibits patient recovery: a qualitative, ethnographic study of fibromyalgia care.” Part of a larger, multi-partner, Oxford-based project called Patient-centred Care for Fibromyalgia: New pathway Design, or PACFiND, the new paper is based on 59 interviews with health care providers as well as field notes from observation of service provision. The providers interviewed are from a range of specialties, but they share one characteristic: They offer services and interventions categorized as “biopsychosocial.”
In this context, “biopsychosocial” includes not just standard psycho-behavioral treatments like cognitive behavior therapy (CBT) and graded exercise therapy (GET)—the treatments recommended in the fraudulent PACE trial for ME/CFS–but also so-called “mind-body” programs. These approaches tend to toss together, in various combinations, elements of meditation, relaxation exercises, positive affirmations, neurolinguistics programming, cognitive behavior therapy, health coaching, and other modalities. Well-known examples include programs like the Lightning Process, the Gupta Program, Dynamic Neural Retraining System, and the Chrysalis Effect, the latter mentioned specifically in the paper.
The three main authors are from Oxford University; the corresponding author is a health services researcher and the senior author is a medical sociologist. (Perhaps they are colleagues of Professor Michael Sharpe, lead PACE investigator and Oxford’s self-styled “harassment” victim?) They reveal their view of the insidious nature of “chronicity rhetoric” from the start. “We focus on representations of fibromyalgia as a ‘chronic condition,’ which infiltrate and disrupt healing work,” the paper declares.
Basically, the argument goes something like this: Any approach to fibromyalgia focused on biopsychosocial “healing” is good. The rigid evidentiary demands of biomedical research’s “hegemonic position” disadvantage biopsychosocial healers, who are unfairly barred from making claims about “recovery” based solely on anecdotal accounts. Advocacy organizations are grifters who hype the “chronicity rhetoric” for fundraising purposes. The welfare benefits system further reinforces the need for fibromyalgia to be constructed as “chronic.” And so on.
This is the premise grounding the paper:
“New service models for people with fibromyalgia recognise that people are complex and integrated body-minds that are responsive to, and interactive with, their social/material environments. In other words, “everyone’s disease is the product of the individual history of exposures [including a wide range of psychosocial stressors], superimposed on their underlying genetic susceptibilities”. Psychosocial pressures get “under the skin” and need addressing to mitigate symptoms. Neurobiological concepts of Central Sensitisation and Central Sensitivity Syndrome (CSS) are important to such models, providing mechanistic explanations of fibromyalgia, and opportunities for treatments that involve desensitising (or “dampening down”) a person’s nervous system.”
Note the presumption here that any new service model presenting itself as holistic or involving “body-minds” should essentially be accepted as valid and legitimate. The same goes for the “neurobiological concepts” that offer “mechanistic explanations” and “opportunities for treatment.” The paper includes no discussion of actual evidence for these theoretical constructs and the interventions based on them beyond the pronouncements and opinions of the interviewees.
Qualitative research fulfills important functions, but being able to reach definitive conclusions about the effectiveness of interventions is not among them. So it seems rash for the authors to take at face value that whatever someone might frame as biopsychosocial “healing work” is in fact “healing work.” They have no credible grounds for making broad judgments about whether “healing work” is taking place.
All they can do repeat is anecdotal accounts. While interesting and informative, such accounts do not constitute proof of effectiveness. And in this paper, the anecdotal accounts are from biopsychosocial healers, who have an obvious interest in framing their work as successful.
Which brings us to the Chrysalis Effect.
**********
Advertising regulators ban Chrysalis Effect “recovery” claims
In the paper, the authors write:
“A major obstacle faced by practitioners working in biopsychosocial services is that they lack established, ‘evidence-based’ ways of demonstrating that they work (as established through gold standard clinical trials)…We illustrate how the hegemonic position of EBM [evidence-based medicine] within Biomedical Research helps to construct fibromyalgia as a chronic condition with detrimental consequences for new service development.”
From this viewpoint, the issue is not that fibromyalgia is—in reality–a chronic condition. The issue is that this perception of fibromyalgia is, I guess, a sort of illusion, even a deception, since the disease is only “constructed” as a chronic condition by larger outside forces. (Reminds me of the famous line spoken by the voluptuously illustrated cartoon character Jessica Rabbit, the wife of the eponymous character in the 1988 comedy “Who Framed Roger Rabbit”: “I’m not bad, I’m just drawn that way.”)
The paper’s example involves the Chrysalis Effect, a mind-body intervention with a history of making extravagant boasts about “recovery” from complex illnesses like fibromyalgia and ME/CFS. As a result, the UK ME Association complained to the Advertising Standards Authority (ASA), an independent regulatory body. In a 2023 decision, the ASA barred the Chrysalis Effect and its practitioners from repeating such statements.
The paper’s stance is that clinical trials are not appropriate for assessing the benefits of biopsychosocial treatments. And the authors appear to blame the lack of documented benefit in such trials on deficiencies in the patients, not the interventions. As they write:
“The ASA’s determination (that there was not enough trial evidence to support claims about recovery) is hooked into a dominant biomedical infrastructure, in which clinical trial evidence is the gold standard. Within these governing systems, biopsychosocial (and often locally-developed) services find it difficult to demonstrate benefit (i.e., that healing work works)…The benefits of supporting this kind of work through individualised and therapeutic coaching is difficult to prove. Clinical trials cannot account for, or control for, such diverse social challenges or the individual neurobiology that may be involved in addressing them. In practice, trials of biopsychosocial models of care may not demonstrate improved outcomes, not because the interventions (care practices) involved are unfounded (non-evidence-based), but because patients do not have the social or psychological resources to maximise benefit from them.”
I guess one could refer to the standard approach to evidence as biomedical hegemony. From my perspective, it’s just a matter of requesting some sort of convincing data to support assertions of “recovery” rather than hyping anything labeled as “biopsychosocial.”
The paper also includes a slam at advocacy organizations, including the ME Association, for adhering to the biomedical paradigm and its accompanying “chronicity rhetoric.” This position is framed as a big grift:
“In order to secure donations, patient charities and affiliated researchers emphasise that conditions such as fibromyalgia have no cure. Donations fund (almost exclusively) pharmaceutical research so that ‘one day we hope we might discover a diagnostic marker and effective treatments’ (The ME Association, 2024). It therefore makes sense for such organisations to assert that ‘getting better’ or ‘recovering’ from fibromyalgia is rare, and that chronicity is the more probable trajectory.”
Contrast that, I guess, with an approach designed to convince desperately ill people to pursue anything that promotes “recovery” and is called “holistic” or said to relate to “body-minds.” The ME Association issued a robust response to these accusations.
The paper makes similar points about the structures involved with the provision of welfare benefits. I have more sympathy for some of the concerns raised in this section. It is not a new complaint that disability programs can be so inflexible in their demands and requirements that they undermine genuine efforts by patients to return to work. In the US, for example, such restrictions have long been a problem for people with HIV/AIDS and other chronic illnesses on long-term disability.
So yes, there is a larger question about the best way to organize these systems. But that is very different from blaming the provision of benefits for generating purportedly harmful “chronicity rhetoric.”
Putting that aside, however, the major flaw in the paper’s entire argument is this–the true source of any “chronicity rhetoric” involving fibromyalgia is reality, not the coercive demands of biomedical research and the welfare benefits system. The investigators themselves note that “chronicity does accurately reflect the findings of published epidemiological research and the experience of many people with the condition.” Ok, then.
But that view, they continue, “is also challenged by practitioners and patients attempting to harness (new) understandings of neurobiology, with emancipatory goals of improvement and/or recovery…Practitioners and patients argue from practical experience that improvement and/or recovery are possible with the right support and individual resources to make changes.”
That might be. And who could possibly be opposed to “emancipatory goals of improvement and/or recovery”? But—luckily for the safety and well-being of the general public—such claims still generally require more convincing proof than glowing testimonials about “healing” on websites and in qualitative studies.
-
Oxford Scholars Blame Biomedical Research Hegemony for Fibromyalgia “Chronicity Rhetoric”
By David Tuller, DrPH
Social Science & Medicine (SSM) is a prominent interdisciplinary journal that publishes social science research related to health. A recently published SSM paper is called “Chronicity rhetoric in health and welfare systems inhibits patient recovery: a qualitative, ethnographic study of fibromyalgia care.” Part of a larger, multi-partner, Oxford-based project called Patient-centred Care for Fibromyalgia: New pathway Design, or PACFiND, the new paper is based on 59 interviews with health care providers as well as field notes from observation of service provision. The providers interviewed are from a range of specialties, but they share one characteristic: They offer services and interventions categorized as “biopsychosocial.”
In this context, “biopsychosocial” includes not just standard psycho-behavioral treatments like cognitive behavior therapy (CBT) and graded exercise therapy (GET)—the treatments recommended in the fraudulent PACE trial for ME/CFS–but also so-called “mind-body” programs. These approaches tend to toss together, in various combinations, elements of meditation, relaxation exercises, positive affirmations, neurolinguistics programming, cognitive behavior therapy, health coaching, and other modalities. Well-known examples include programs like the Lightning Process, the Gupta Program, Dynamic Neural Retraining System, and the Chrysalis Effect, the latter mentioned specifically in the paper.
The three main authors are from Oxford University; the corresponding author is a health services researcher and the senior author is a medical sociologist. (Perhaps they are colleagues of Professor Michael Sharpe, lead PACE investigator and Oxford’s self-styled “harassment” victim?) They reveal their view of the insidious nature of “chronicity rhetoric” from the start. “We focus on representations of fibromyalgia as a ‘chronic condition,’ which infiltrate and disrupt healing work,” the paper declares.
Basically, the argument goes something like this: Any approach to fibromyalgia focused on biopsychosocial “healing” is good. The rigid evidentiary demands of biomedical research’s “hegemonic position” disadvantage biopsychosocial healers, who are unfairly barred from making claims about “recovery” based solely on anecdotal accounts. Advocacy organizations are grifters who hype the “chronicity rhetoric” for fundraising purposes. The welfare benefits system further reinforces the need for fibromyalgia to be constructed as “chronic.” And so on.
This is the premise grounding the paper:
“New service models for people with fibromyalgia recognise that people are complex and integrated body-minds that are responsive to, and interactive with, their social/material environments. In other words, “everyone’s disease is the product of the individual history of exposures [including a wide range of psychosocial stressors], superimposed on their underlying genetic susceptibilities”. Psychosocial pressures get “under the skin” and need addressing to mitigate symptoms. Neurobiological concepts of Central Sensitisation and Central Sensitivity Syndrome (CSS) are important to such models, providing mechanistic explanations of fibromyalgia, and opportunities for treatments that involve desensitising (or “dampening down”) a person’s nervous system.”
Note the presumption here that any new service model presenting itself as holistic or involving “body-minds” should essentially be accepted as valid and legitimate. The same goes for the “neurobiological concepts” that offer “mechanistic explanations” and “opportunities for treatment.” The paper includes no discussion of actual evidence for these theoretical constructs and the interventions based on them beyond the pronouncements and opinions of the interviewees.
Qualitative research fulfills important functions, but being able to reach definitive conclusions about the effectiveness of interventions is not among them. So it seems rash for the authors to take at face value that whatever someone might frame as biopsychosocial “healing work” is in fact “healing work.” They have no credible grounds for making broad judgments about whether “healing work” is taking place.
All they can do repeat is anecdotal accounts. While interesting and informative, such accounts do not constitute proof of effectiveness. And in this paper, the anecdotal accounts are from biopsychosocial healers, who have an obvious interest in framing their work as successful.
Which brings us to the Chrysalis Effect.
**********
Advertising regulators ban Chrysalis Effect “recovery” claims
In the paper, the authors write:
“A major obstacle faced by practitioners working in biopsychosocial services is that they lack established, ‘evidence-based’ ways of demonstrating that they work (as established through gold standard clinical trials)…We illustrate how the hegemonic position of EBM [evidence-based medicine] within Biomedical Research helps to construct fibromyalgia as a chronic condition with detrimental consequences for new service development.”
From this viewpoint, the issue is not that fibromyalgia is—in reality–a chronic condition. The issue is that this perception of fibromyalgia is, I guess, a sort of illusion, even a deception, since the disease is only “constructed” as a chronic condition by larger outside forces. (Reminds me of the famous line spoken by the voluptuously illustrated cartoon character Jessica Rabbit, the wife of the eponymous character in the 1988 comedy “Who Framed Roger Rabbit”: “I’m not bad, I’m just drawn that way.”)
The paper’s example involves the Chrysalis Effect, a mind-body intervention with a history of making extravagant boasts about “recovery” from complex illnesses like fibromyalgia and ME/CFS. As a result, the UK ME Association complained to the Advertising Standards Authority (ASA), an independent regulatory body. In a 2023 decision, the ASA barred the Chrysalis Effect and its practitioners from repeating such statements.
The paper’s stance is that clinical trials are not appropriate for assessing the benefits of biopsychosocial treatments. And the authors appear to blame the lack of documented benefit in such trials on deficiencies in the patients, not the interventions. As they write:
“The ASA’s determination (that there was not enough trial evidence to support claims about recovery) is hooked into a dominant biomedical infrastructure, in which clinical trial evidence is the gold standard. Within these governing systems, biopsychosocial (and often locally-developed) services find it difficult to demonstrate benefit (i.e., that healing work works)…The benefits of supporting this kind of work through individualised and therapeutic coaching is difficult to prove. Clinical trials cannot account for, or control for, such diverse social challenges or the individual neurobiology that may be involved in addressing them. In practice, trials of biopsychosocial models of care may not demonstrate improved outcomes, not because the interventions (care practices) involved are unfounded (non-evidence-based), but because patients do not have the social or psychological resources to maximise benefit from them.”
I guess one could refer to the standard approach to evidence as biomedical hegemony. From my perspective, it’s just a matter of requesting some sort of convincing data to support assertions of “recovery” rather than hyping anything labeled as “biopsychosocial.”
The paper also includes a slam at advocacy organizations, including the ME Association, for adhering to the biomedical paradigm and its accompanying “chronicity rhetoric.” This position is framed as a big grift:
“In order to secure donations, patient charities and affiliated researchers emphasise that conditions such as fibromyalgia have no cure. Donations fund (almost exclusively) pharmaceutical research so that ‘one day we hope we might discover a diagnostic marker and effective treatments’ (The ME Association, 2024). It therefore makes sense for such organisations to assert that ‘getting better’ or ‘recovering’ from fibromyalgia is rare, and that chronicity is the more probable trajectory.”
Contrast that, I guess, with an approach designed to convince desperately ill people to pursue anything that promotes “recovery” and is called “holistic” or said to relate to “body-minds.” The ME Association issued a robust response to these accusations.
The paper makes similar points about the structures involved with the provision of welfare benefits. I have more sympathy for some of the concerns raised in this section. It is not a new complaint that disability programs can be so inflexible in their demands and requirements that they undermine genuine efforts by patients to return to work. In the US, for example, such restrictions have long been a problem for people with HIV/AIDS and other chronic illnesses on long-term disability.
So yes, there is a larger question about the best way to organize these systems. But that is very different from blaming the provision of benefits for generating purportedly harmful “chronicity rhetoric.”
Putting that aside, however, the major flaw in the paper’s entire argument is this–the true source of any “chronicity rhetoric” involving fibromyalgia is reality, not the coercive demands of biomedical research and the welfare benefits system. The investigators themselves note that “chronicity does accurately reflect the findings of published epidemiological research and the experience of many people with the condition.” Ok, then.
But that view, they continue, “is also challenged by practitioners and patients attempting to harness (new) understandings of neurobiology, with emancipatory goals of improvement and/or recovery…Practitioners and patients argue from practical experience that improvement and/or recovery are possible with the right support and individual resources to make changes.”
That might be. And who could possibly be opposed to “emancipatory goals of improvement and/or recovery”? But—luckily for the safety and well-being of the general public—such claims still generally require more convincing proof than glowing testimonials about “healing” on websites and in qualitative studies.
-
Oxford Scholars Blame Biomedical Research Hegemony for Fibromyalgia “Chronicity Rhetoric”
By David Tuller, DrPH
Social Science & Medicine (SSM) is a prominent interdisciplinary journal that publishes social science research related to health. A recently published SSM paper is called “Chronicity rhetoric in health and welfare systems inhibits patient recovery: a qualitative, ethnographic study of fibromyalgia care.” Part of a larger, multi-partner, Oxford-based project called Patient-centred Care for Fibromyalgia: New pathway Design, or PACFiND, the new paper is based on 59 interviews with health care providers as well as field notes from observation of service provision. The providers interviewed are from a range of specialties, but they share one characteristic: They offer services and interventions categorized as “biopsychosocial.”
In this context, “biopsychosocial” includes not just standard psycho-behavioral treatments like cognitive behavior therapy (CBT) and graded exercise therapy (GET)—the treatments recommended in the fraudulent PACE trial for ME/CFS–but also so-called “mind-body” programs. These approaches tend to toss together, in various combinations, elements of meditation, relaxation exercises, positive affirmations, neurolinguistics programming, cognitive behavior therapy, health coaching, and other modalities. Well-known examples include programs like the Lightning Process, the Gupta Program, Dynamic Neural Retraining System, and the Chrysalis Effect, the latter mentioned specifically in the paper.
The three main authors are from Oxford University; the corresponding author is a health services researcher and the senior author is a medical sociologist. (Perhaps they are colleagues of Professor Michael Sharpe, lead PACE investigator and Oxford’s self-styled “harassment” victim?) They reveal their view of the insidious nature of “chronicity rhetoric” from the start. “We focus on representations of fibromyalgia as a ‘chronic condition,’ which infiltrate and disrupt healing work,” the paper declares.
Basically, the argument goes something like this: Any approach to fibromyalgia focused on biopsychosocial “healing” is good. The rigid evidentiary demands of biomedical research’s “hegemonic position” disadvantage biopsychosocial healers, who are unfairly barred from making claims about “recovery” based solely on anecdotal accounts. Advocacy organizations are grifters who hype the “chronicity rhetoric” for fundraising purposes. The welfare benefits system further reinforces the need for fibromyalgia to be constructed as “chronic.” And so on.
This is the premise grounding the paper:
“New service models for people with fibromyalgia recognise that people are complex and integrated body-minds that are responsive to, and interactive with, their social/material environments. In other words, “everyone’s disease is the product of the individual history of exposures [including a wide range of psychosocial stressors], superimposed on their underlying genetic susceptibilities”. Psychosocial pressures get “under the skin” and need addressing to mitigate symptoms. Neurobiological concepts of Central Sensitisation and Central Sensitivity Syndrome (CSS) are important to such models, providing mechanistic explanations of fibromyalgia, and opportunities for treatments that involve desensitising (or “dampening down”) a person’s nervous system.”
Note the presumption here that any new service model presenting itself as holistic or involving “body-minds” should essentially be accepted as valid and legitimate. The same goes for the “neurobiological concepts” that offer “mechanistic explanations” and “opportunities for treatment.” The paper includes no discussion of actual evidence for these theoretical constructs and the interventions based on them beyond the pronouncements and opinions of the interviewees.
Qualitative research fulfills important functions, but being able to reach definitive conclusions about the effectiveness of interventions is not among them. So it seems rash for the authors to take at face value that whatever someone might frame as biopsychosocial “healing work” is in fact “healing work.” They have no credible grounds for making broad judgments about whether “healing work” is taking place.
All they can do repeat is anecdotal accounts. While interesting and informative, such accounts do not constitute proof of effectiveness. And in this paper, the anecdotal accounts are from biopsychosocial healers, who have an obvious interest in framing their work as successful.
Which brings us to the Chrysalis Effect.
**********
Advertising regulators ban Chrysalis Effect “recovery” claims
In the paper, the authors write:
“A major obstacle faced by practitioners working in biopsychosocial services is that they lack established, ‘evidence-based’ ways of demonstrating that they work (as established through gold standard clinical trials)…We illustrate how the hegemonic position of EBM [evidence-based medicine] within Biomedical Research helps to construct fibromyalgia as a chronic condition with detrimental consequences for new service development.”
From this viewpoint, the issue is not that fibromyalgia is—in reality–a chronic condition. The issue is that this perception of fibromyalgia is, I guess, a sort of illusion, even a deception, since the disease is only “constructed” as a chronic condition by larger outside forces. (Reminds me of the famous line spoken by the voluptuously illustrated cartoon character Jessica Rabbit, the wife of the eponymous character in the 1988 comedy “Who Framed Roger Rabbit”: “I’m not bad, I’m just drawn that way.”)
The paper’s example involves the Chrysalis Effect, a mind-body intervention with a history of making extravagant boasts about “recovery” from complex illnesses like fibromyalgia and ME/CFS. As a result, the UK ME Association complained to the Advertising Standards Authority (ASA), an independent regulatory body. In a 2023 decision, the ASA barred the Chrysalis Effect and its practitioners from repeating such statements.
The paper’s stance is that clinical trials are not appropriate for assessing the benefits of biopsychosocial treatments. And the authors appear to blame the lack of documented benefit in such trials on deficiencies in the patients, not the interventions. As they write:
“The ASA’s determination (that there was not enough trial evidence to support claims about recovery) is hooked into a dominant biomedical infrastructure, in which clinical trial evidence is the gold standard. Within these governing systems, biopsychosocial (and often locally-developed) services find it difficult to demonstrate benefit (i.e., that healing work works)…The benefits of supporting this kind of work through individualised and therapeutic coaching is difficult to prove. Clinical trials cannot account for, or control for, such diverse social challenges or the individual neurobiology that may be involved in addressing them. In practice, trials of biopsychosocial models of care may not demonstrate improved outcomes, not because the interventions (care practices) involved are unfounded (non-evidence-based), but because patients do not have the social or psychological resources to maximise benefit from them.”
I guess one could refer to the standard approach to evidence as biomedical hegemony. From my perspective, it’s just a matter of requesting some sort of convincing data to support assertions of “recovery” rather than hyping anything labeled as “biopsychosocial.”
The paper also includes a slam at advocacy organizations, including the ME Association, for adhering to the biomedical paradigm and its accompanying “chronicity rhetoric.” This position is framed as a big grift:
“In order to secure donations, patient charities and affiliated researchers emphasise that conditions such as fibromyalgia have no cure. Donations fund (almost exclusively) pharmaceutical research so that ‘one day we hope we might discover a diagnostic marker and effective treatments’ (The ME Association, 2024). It therefore makes sense for such organisations to assert that ‘getting better’ or ‘recovering’ from fibromyalgia is rare, and that chronicity is the more probable trajectory.”
Contrast that, I guess, with an approach designed to convince desperately ill people to pursue anything that promotes “recovery” and is called “holistic” or said to relate to “body-minds.” The ME Association issued a robust response to these accusations.
The paper makes similar points about the structures involved with the provision of welfare benefits. I have more sympathy for some of the concerns raised in this section. It is not a new complaint that disability programs can be so inflexible in their demands and requirements that they undermine genuine efforts by patients to return to work. In the US, for example, such restrictions have long been a problem for people with HIV/AIDS and other chronic illnesses on long-term disability.
So yes, there is a larger question about the best way to organize these systems. But that is very different from blaming the provision of benefits for generating purportedly harmful “chronicity rhetoric.”
Putting that aside, however, the major flaw in the paper’s entire argument is this–the true source of any “chronicity rhetoric” involving fibromyalgia is reality, not the coercive demands of biomedical research and the welfare benefits system. The investigators themselves note that “chronicity does accurately reflect the findings of published epidemiological research and the experience of many people with the condition.” Ok, then.
But that view, they continue, “is also challenged by practitioners and patients attempting to harness (new) understandings of neurobiology, with emancipatory goals of improvement and/or recovery…Practitioners and patients argue from practical experience that improvement and/or recovery are possible with the right support and individual resources to make changes.”
That might be. And who could possibly be opposed to “emancipatory goals of improvement and/or recovery”? But—luckily for the safety and well-being of the general public—such claims still generally require more convincing proof than glowing testimonials about “healing” on websites and in qualitative studies.
-
The Body's Drama: Emotions, Allergies, and the Wild Ride of Responses
#Allergies #Emotions #ImmuneSystem #CognitiveTherapy #Histamine #Biopsychosocial #HealthJourney #EmotionalBalance #AllergyAwareness #Asthma #FoodAllergies #Wellness #MentalHealth #ChronicIllness #SelfCare #HealthEducation
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The Body's Drama: Emotions, Allergies, and the Wild Ride of Responses
#Allergies #Emotions #ImmuneSystem #CognitiveTherapy #Histamine #Biopsychosocial #HealthJourney #EmotionalBalance #AllergyAwareness #Asthma #FoodAllergies #Wellness #MentalHealth #ChronicIllness #SelfCare #HealthEducation
-
The Body's Drama: Emotions, Allergies, and the Wild Ride of Responses
#Allergies #Emotions #ImmuneSystem #CognitiveTherapy #Histamine #Biopsychosocial #HealthJourney #EmotionalBalance #AllergyAwareness #Asthma #FoodAllergies #Wellness #MentalHealth #ChronicIllness #SelfCare #HealthEducation
-
The Body's Drama: Emotions, Allergies, and the Wild Ride of Responses
#Allergies #Emotions #ImmuneSystem #CognitiveTherapy #Histamine #Biopsychosocial #HealthJourney #EmotionalBalance #AllergyAwareness #Asthma #FoodAllergies #Wellness #MentalHealth #ChronicIllness #SelfCare #HealthEducation
-
The Body's Drama: Emotions, Allergies, and the Wild Ride of Responses
#Allergies #Emotions #ImmuneSystem #CognitiveTherapy #Histamine #Biopsychosocial #HealthJourney #EmotionalBalance #AllergyAwareness #Asthma #FoodAllergies #Wellness #MentalHealth #ChronicIllness #SelfCare #HealthEducation
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Urban Minds & Green Remedies: The Connection Between Environment and Mental Health
#EnvironmentalNeuroscience #MentalHealthMatters #UrbanLiving #NatureHealing #IndoorPlants #GreenRemedies #Psychology #SocialDrift #SocialCausation #MentalWellness #Biopsychosocial #Mindfulness #IntergenerationalMobility #PlantTherapy #NatureInspiration #WellbeingJourney
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Urban Minds & Green Remedies: The Connection Between Environment and Mental Health
#EnvironmentalNeuroscience #MentalHealthMatters #UrbanLiving #NatureHealing #IndoorPlants #GreenRemedies #Psychology #SocialDrift #SocialCausation #MentalWellness #Biopsychosocial #Mindfulness #IntergenerationalMobility #PlantTherapy #NatureInspiration #WellbeingJourney
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In Which We Answer Some Questions
Here are some questions posed to us for inclusion in an allied organization’s newsletter. We cover community art, direct giving, research, ableism, and more.
Table of Contents
- The artwork on your website is amazing, where does it come from?
- Featured Art
- It’s gonna be an art party.
- What is your latest research on?
- What does direct support look like for your organization? The website mentions a lot about mutual aid?
- How can individuals reading get involved in mutual aid in their communities?
- What are some wins you want to share with the community at large?
- What are some barriers you want the community at large to know about regarding ableism?
- How can we best support Stimpunks.org?
- How can Non-Disabled People show up better? And love better?
- I love how activist research is also about transformative action. Can you speak more to this?
- The ideas of community, interdependence, and the political really spoke to me, can you speak more on this?
- “We recognize that there is no justice that neglects disability.” (Philosophy – Stimpunks Foundation)
- I really like these ideas: Community is resistance. Asking for help. Showing up to give help. Collaboration.
The artwork on your website is amazing, where does it come from?
Our art comes from our community. We practice constructionism and actively engage in constructing things in the world. Practicing our art makes our souls grow.
Featured Art
“Floralis (Flourite Spheralite)” by Adriel Jeremiah Wool is licensed under CC BY-SA 4.0 About the art: Floralis (Flourite Spheralite)Description: A bursting kaleidoscopic geometrical form with 4 sides of symmetry pointing angularly to each of the four corners of a square shaped canvas against a dark grey textured wall. There is a small red shaped plus at the very center, surrounded by orangish-peach and periwinkle butterfly like shapes at 45 degree angles from each other aligned to the mid center going up and also to the sides. The butterfly shapes are encased in a deeper red flower like shape before a region of light blue geometric textures. Near the corners are feathered white, dark grey-purple, burgundy and orange feather like edges.
About the artist: Adriel Jeremiah WoolOur featured artist is Adriel Jeremiah Wool.
Adriel Jeremiah is an computer programmer with a deep background in origami and folding. This artwork is an extension of a world view involving folding; often involving higher dimensional spaces. Many of these designs contain the mathematical magic of the transcendental numbers of nature, and all of them are the extension of the provisions of space itself; to be both physically folded, and conceptually folded, circularily and across many levels of expression.Shop Art by Adriel
His spectacular new piece derives its color stream from a fluorite crystal that has a spheralite imperfection / inclusion (the red, purple, and orange).
AJ describes what these fractal pieces are in this accordion. Their construction will broaden your perspective on perspective.My artwork is digital photography in a world where objects exist in more than 3 dimensions, and where no known means of physical representation has yet been discovered to exist.
AJ is a regular contributor at Stimpunks. He kindly licenses his work as free cultural work. He helps us tell our stories with his art, music, photography, videos, audio engineering, poetry, prose, and lived experience.
AJ has a gallery in Ketchum, Idaho. Drop by if you’re around. He tries to make it a welcoming third place.
About the process: My artwork is digital photography in a world where objects exist in more than 3 dimensions, and where no known means of physical representation has yet been discovered to exist.Stimpunks is gently debugging society.
The charity protects, helps and comforts individuals, while pointing out library-level flaws in some of the concepts that end up harming those individuals.
This help is profoundly wonderful, morally and functionally coherent to great need, and as true as a pure circle in its cause-and-effect form.
The artist hopes to convey this: that the universe is given forth folded and unfolded. Although explicit understanding helps, it is too cumbersome, and should only provide refinement to something already greater that exists.
That greater thing is what was given to the artist first by the practice of origami. An enlivening of the intuitive mind, experience with a universe of many dimensions, and the promise of creation revealed when one folds a flat square into the likeness of a higher dimensional thing. That inspiration reaches a young mind in a powerful way.
The artist wants the viewer to see proof of what their intuitive mind already knows is true, the universe is a multidimensional phenomenon and the ability to understand its nature already exists within us each.The artist hopes the viewer will be inspired to seek the understanding of freedoms available to the individual inspired by the exposure to artistic expressions, and of a nature of dimensionality unimaginably greater than the object presented here.
A time has come to again look at changes in the way technology allows us to see the world and experience it. First was the human eye, with a lens made of flesh. Later humans developed a replacement for the eye but in the form and fashion of the lens of the eye; this time it was made of glass doped with metals to enhance its control of light. To see, the human eye has a retina filled with responsive cells which look for contrast and color.
Technology has allowed us to create a replacement for the retina called a CCD with metals which respond to color and report those values to a microchip which converts them to bits and bytes for storage. I will present to you the same extension of sight by explaining how the images you will see come into existence.
In my artwork the landscape is created via the execution of a seed of a formula, allowed to grow and flourish in a mathematical set of steps. In a similar way, crystals grow underground in a cave over many millennia but they follow a seed of a universal pattern related to their atomic structure and facilitated by the chemical nature of their environments. In our regular world, we have 3 directions we can move, forward-back, up-down and left-right, but these crystals can move in another set of directions allowed by the universe and mathematics. They are, and must be considered elements of nature, and it follows that the methods used to convey them must be considered legitimate tools of expression.
A crystal starts at a virtual geometric position, a virtual center, then it mathematically and procedurally grows outward and inward according to a seed formula. However it exists in a dark world devoid of light and color; it is only a cloud of form. As an artist, I create an eye with a lens which follows the same mathematical processes as the lens of a camera and the eye itself. I situate the virtual eye to be gazing upon the crystal as I create sources of light which will illuminate the crystal and reflect light back to the lens.
As an artist I imbue color to the crystal, I imbue reflectivity, I imbue refractability, and I imbue density or transparency exactly towards the same purpose as a painter would do, in combining pigmented oils on canvas with a brush in his or her hand.
My artwork is digital photography in a world where objects exist in more than 3 dimensions, and where no known means of physical representation has yet been discovered to exist.
Adriel Jeremiah Wool
It’s gonna be an art party.
https://www.youtube.com/watch?v=ZZRFkJsGNjI
We’re gonna make, make something great for
All of us to see and appreciate
It’s gonna be an art party
It’s gonna be an art party
Come on over it’s time to start
It’s a great big party where we make and share artArt Party (feat. Portugal. The Man & Paul Williams) – YouTube
What is your latest research on?
Monotropism, neuroqueer learning spaces, and Cavendish Space.
What does direct support look like for your organization? The website mentions a lot about mutual aid?
Direct support includes, first and foremost, giving people money with no strings attached. Folks know what they need and how best to spend the money. We also help people navigate our systems by filling forms and making calls for them. We provide warm lines and peer respite. We practice library economies, competency networks, sharing spoons, and support swapping.
“Mutuality is a feeling, an action, and a relationship based on shared benefit between individuals and groups in a society. It materialises in many, many ways and is arguably a universal constant of our human nature. We rely on mutuality to survive and progress through our day to day life.” (Andrewism)
“When systems of power fail, it is mutuality—neighbours helping neighbours—that holds communities together.” (Andrewism)
How can individuals reading get involved in mutual aid in their communities?
Start with pod mapping.
- Find a few people.
- Identify your zone.
- Invite neighbors.
- Get a name.
- Have conversations.
- Support each other.
Source: Mutual Aid 101 – Google Slides
What are some wins you want to share with the community at large?
Our Map of Monotropic Experiences has been widely shared and incorporated into care settings and training.
What are some barriers you want the community at large to know about regarding ableism?
We live in an age of mass behaviorism. Behaviorism such as ABA and PBS are rife in education and healthcare settings. “Behaviorism is a dehumanizing mechanism of learning that reduces human beings to simple inputs and outputs. There is an ever-growing body of research suggesting that behaviorism is not only harmful to how we learn, but is also oppressive, ableist, and racist.” (Human Restoration Project)
Behaviorist education is ableist education. Behaviorist healthcare is ableist healthcare.
How can we best support Stimpunks.org?
- Read our website.
- Share our website.
- Amplify us on social media.
- Give whatever you can, be it time or money or attention.
- stimpunks.org
- RSS Feed
- WordPress
- Bluesky
- Gravatar
- Threads
- Mastodon
- Tumblr
- GitHub
- Twitter/X
- Patreon
- YouTube
- TikTok
- Counter Social
- Raindrop.io
How can Non-Disabled People show up better? And love better?
We exist as friction. Load-share the burden of existing as friction.
- Promote and practice access intimacy instead of forced intimacy.
- Question the narratives of wellness, and engage in critical wellness instead.
- Reframe yourself and others. Help people reframe from the pathology paradigm and medical model to the neurodiversity paradigm and biopsychosocial model. This is hard and important work necessary to all other work. Change the narrative. Start reframing.
- Advocate for accessibility at school, work, and in your community.
- Be a threat to inequity in your spheres of influence.
- Combat the myths.
- Use and promote Identity First Language.
- Elevate care as infrastructure. Stimpunks exists because our systems effectively don’t.
- Celebrate our interdependence!
I love how activist research is also about transformative action. Can you speak more to this?
“three characteristics that delineate activist research from other types of research:”
(1) combination of knowledge production and transformative action;
(2) systematic multi-level collaboration; and
(3) challenges to power.
(Denisha Jones)
A hallmark of good research is that it embraces epistemic justice and rejects scientism.
Another hallmark of good research is naming the systems of power. If you’re not naming the systems of power in your research, you’re missing a vital component.
The ideas of community, interdependence, and the political really spoke to me, can you speak more on this?
In the past, the disability rights movement focused on independence, including it as one of the pillars of the ADA. Disability Justice moves away from independence framing, because independence is a myth.
“I am fighting for an interdependence that embraces need and tells the truth: no one does it on their own and the myth of independence is just that, a myth.” (Mia Mingus)
“Access intimacy is interdependence in action.” (Mia Mingus)
“It is time to celebrate our interdependence!” (Jorn Bettin)
“We recognize that there is no justice that neglects disability.” (Philosophy – Stimpunks Foundation)
Working at my org I really believe this and feel that everyone who works here also believes this. We cannot neglect disability in our policy and conversations and our care. If you have anything to add to this.
There is no path to justice that does not involve direct confrontation with ableism and inaccessibility. To neglect disability is to neglect two of the major forces of injustice.
Ableism is at the root of all -isms.
“Ableism is what makes all other “isms” effective.
White supremacy is the goal, ableism is the toolkit.” (Imani Barbarin)
“…so much of what disability actually is, is just humanity; and so much of what ableism is, is a humanity heist.” “Ableism enables all forms of inequity and hampers all liberation efforts.” (Talila A. Lewis)
Disabled and neurodivergent people are always edge cases, and edge cases are stress cases.
We choose the margin, because design is tested at the edges.
“Living as we did on the edge we developed a particular way of seeing reality. We looked both from the outside in and from the inside out. We focused our attention on the centre as well as on the margin. We understood both.” (bell hooks)
“No one knows best the motion of the ocean than the fish that must fight the current to swim upstream.” “By focusing on the parts of the system that are most complex and where the people living it are the most vulnerable we understand the system best.” (Tressie McMillan Cottom)
I really like these ideas: Community is resistance. Asking for help. Showing up to give help. Collaboration.
I think if we’re going to have a future we need to embrace and act in these ideas. How would someone start if they are new to these ideas and new to community engagement?
Find people with which you share a concern or passion. You can do this via the pod mapping described above.
“Communities of Practice are groups of people who share a concern or passion for something they do and learn how to do it better as they interact regularly.” (Wenger-Trayner, E. & Wenger-Trayner, B. 2015)
“Through free association, people will find those of mutual interests in every sphere of life to form groups on the basis of their affinity.” (Andrewism)
#ableism #accessIntimacy #accessibility #activistResearch #affinityGroups #art #behaviorism #biopsychosocial #care #cavendishSpace #community #competencyNetwork #constructionism #criticalWellness #directSupport #disabilityJustice #edgeCases #edges #education #epistemicInjustice #equity #forcedIntimacy #framing #identityFirst #interdependence #libraryEconomy #monotropism #mutualAid #mutuality #neuroqueerLearningSpaces #pathologyParadigm #peerRespite #podMapping #power #scientism #sharingSpoons #supportSwapping #warmLines #wellness
- The artwork on your website is amazing, where does it come from?
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Recognised by #WHO since 1969 as a #DiseaseOfTheNervousSystem:
Despite efforts of the #BioPsychoSocial brigade to have it reclassified, it remains categorised as a neurological illness.
#pwME #MyalgicEncephalomyelitis #MECFS #CFS #ChronicFatigueSyndrome #PVFS #PostViralFatigueSyndrome #ELCI #PostViralDisorder
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Recognised by #WHO since 1969 as a #DiseaseOfTheNervousSystem:
Despite efforts of the #BioPsychoSocial brigade to have it reclassified, it remains categorised as a neurological illness.
#pwME #MyalgicEncephalomyelitis #MECFS #CFS #ChronicFatigueSyndrome #PVFS #PostViralFatigueSyndrome #ELCI #PostViralDisorder
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Recognised by #WHO since 1969 as a #DiseaseOfTheNervousSystem:
Despite efforts of the #BioPsychoSocial brigade to have it reclassified, it remains categorised as a neurological illness.
#pwME #MyalgicEncephalomyelitis #MECFS #CFS #ChronicFatigueSyndrome #PVFS #PostViralFatigueSyndrome #ELCI #PostViralDisorder
-
Recognised by #WHO since 1969 as a #DiseaseOfTheNervousSystem:
Despite efforts of the #BioPsychoSocial brigade to have it reclassified, it remains categorised as a neurological illness.
#pwME #MyalgicEncephalomyelitis #MECFS #CFS #ChronicFatigueSyndrome #PVFS #PostViralFatigueSyndrome #ELCI #PostViralDisorder
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The causes of mental health issues go far deeper than chemistry.
We need to shift from a medical model that purely looks at medical and individual issues and towards a biopsychosocial model that really takes into account not only our biology, but how the environment and systemic issues shape mental health.
#mentalhealth #biopsychosocial #mentalwellness #environmentalhealth #mentalhealthawareness
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@DocMCohen sorry this just ticks me off. #Naturopaths keep making this claim as if it’s something special they do.
This is the #BioPsychoSocial approach that _all_ #FamilyPhysicians practice.
“Their approach is to look at the whole person. So not just their physical aspects, but mental, emotional, social, environmental (factors)," [O’Reilly] said.
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Loneliness worse than smoking, alcoholism, obesity; study suggests primary care clinicians can offer solutions
https://www.regenstrief.org/article/clinicians-can-offer-loneliness-solutions/
#science #health #mentalhealth #neuroscience #psychology #biopsychosocial #stress #depression #lonliness
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An exploration of victim blaming in ‘medically unexplained symptoms’: Neoliberalism and the need to justify the self, group and the system - Jo Hunt.
Only abstract free:
https://rb.gy/ar8bgIn this article, Hunt argues that "Narratives within mainstream psy disciplines around ‘medically unexplained symptoms’ (MUS), as constructed through (bio)psychosocial theorising, have been charged with promoting victim blaming."
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🧵
'Media silence on the politics driving 'one of the biggest medical scandals of the 21st century'
by
Joanna Hunt------
Tom:
There are a few slightly "difficult" words in this but I think it should be understandable for people who, say, finished high school/secondary education or equivalent. My impression was it gets a bit easier to read as it goes along#psychobabble @CFS #biopsychosocial #MyalgicEncephalomyelitis #ChronicFatigueSyndrome #MEcfs #CFS #PwME
1/ -
Great points about what a reasonable, non-Strawmanning view of the mainstream #psychiatric conceptualization of mental health looks like - I remember in my psychology course the #biopsychosocial model was taken as received wisdom like 20 years ago already. Very much the same for #addiction and misrepresenting #Leshner's paper on the brain disease model, which very very explicitly included psychosocial factors, the ignorance of which annoys me no end.
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The #ICD-11 includes a new #chronicpain section. #AntoniaBarke et al. introduce new #pain diagnoses that are now based on the #biopsychosocial model and highly relevant for #clinical #psychologists.