Anxiety Causes Cancer?! The History Behind Gaslighting Patients
"[This disease] may also serve as a means of getting attention which would otherwise be diverted to others, and will finally become an unconscious reaction if the individual is deprived of what he thinks is his due"
What disease do you think this is referring to?
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Did you guess asthma?
Sounds ridiculous right?
This is a quote from Helen Dunbar the first editor of the Journal of Psychosomatic Medicine.
Not only did Dunbar believe that asthma was a cry for attention, she believed in personality types for all sorts of diseases such as
-Rheumatoid Arthritis Personality
-Hypertension Personality
-A Diabetic Personality
-An "Accident Prone" Personality
-A Cancer Personality
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She wasn't alone. In fact, one of the most influential psychologists of the 20th century Hans Eysenck promoted the idea that cancer was due to repressed emotions such as anxiety and anger. He proposed behavior therapy (just as CBT is now proposed as a treatment for MECFS) as a way to prevent cancer, and put out a study suggesting that certain personality types had a 40-70x increased risk of dying from cancer!
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Why did he do this? Well at the same time as he was promoting the link between personality and cancer he was casting doubt on the increasing evidence that smoking causes lung cancer writing for instance "it is clear that simplistic formulations like ‘Smoking causes cancer’ have no part to play in the scientific study of this disease."
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Nowadays you will be hardpressed to find someone defending the idea that a woman's breast cancer is due to resentment towards an aloof husband. But why? Not because it's "too ridiculous," but because we know what causes cancer now. Because we understand that tumor cells with flaws in their division create cancer.
In contrast, you will find lots of doctors who will claim a patient's fibromyalgia is due to undue stress at work or being in an unhappy relationship. Why? Because we do not have the science to explain these conditions fully.
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Here's the thing: I don't know is a lot better of an answer than "psychosomatic." Why? Because of the evidence. Every other disease that started out as an unknown has become known. Every time patients say something is physically wrong with their body we find things physically wrong with their bodies. Sometimes it takes a while, sometimes we need to invent new technology, but that's no reason not to try. Otherwise, you are just setting yourself up to be the next fool claiming anxiety causes cancer.
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Even more so: just as in Eysenck's time lung cancer and smoking were just becoming linked preliminary evidence supports biomedical explanations of Fibromyalgia and MECFS. From immune cell dysregulation to the nanoneedle test, to hypo-oxygenation of the brainstem on SPECT imaging more and more evidence is coming in to support patients' claims of physical disability. But just like before, there will always be those who profit from supplements and GET and CBT and keeping people off of disability. There will always be someone waiting to line the pockets of those willing to dismiss patients.
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So what do we do?
-Tell the stories! Remind people that just decades ago MS, Epilepsy, and more were considered psychosomatic. Those brain tumors were dismissed as mental illness prior to MRI. That science is not over and being late in line doesn't make your illness any less valid.
-Follow the motives and the money. Remember to always check who funded research and for what cause. Be suspicious of studies that are funded completely independently of patient advocacy groups, even if a big study does get a government grant if it is being well run advocacy groups should be supporting it.
-Believe patients. Learn from history. History says that patients don't lie and that physicians who listen will do better for their patients. So listen.
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Acknowledgment: Much of the research for this post comes from the excellent blog ME/CFS Skeptic. Please check them out for more great content including "A New Series On The Dark History of Psychosomatic Medicine."
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Myalgic Encephalomyelitis is only the most recent in a long line of psychosomatic illnesses. Learn from history and remember that the past supports the patients.
While many may know that diseases like epilepsy and MS were once brushed off in women as "hysteria" (a term with a whole other legacy worth posting about) I think far fewer people realize just how ambitious the psychosomatic school of medicine was at its inception.
Physicians really did blame everything from lung cancer to asthma to heart Disease on repressed emotions and personality types. As the domain of science has expanded to find real bodily explanations for all of these phenomenons the psychosomatic school of medicine has been forced further and further into the dark corners of neglected and unexplored patient groups such as mecfs, fibromyalgia and FND.
However, time and time again history has shown that these explanations fail when faced with real biomedical evidence around a disease. Currently, the invention of f-MRI and SPECT scans has the potential to prove the brain damage and real neurological dysfunction present in #ME and more. Tests like Workwells 2-Day CPET testing provide tangible evidence of the metabolic dysfunction present in PEM, and work like the Open Medicine Foundations Nanoneedle opens the door to future blood tests for ME.
Let us always remember that science is not absolute knowledge. It is not the peak of knowledge. It is the discovery of knowledge. Therefore, it is the nature of science to always have more to discover. With any luck in hundreds of years times, our view of the brain will be as a stethoscope is to a modern EKG. Our medications as crude and terrible in side effects as lobotomy. But when we know harm is being done as it is with GET, CBT, and the constant gaslighting of patients labeled psychosomatic by this outdated and constantly mistaken field of theories perhaps it is time to acknowledge our ignorance. To recognize that sometimes the best answer to severe unexplained suffering really is "I don't know".
Because only when you admit you do not know an answer can you get about to find it.
