What the Heck are They Talking About: Neurological CFS: The Therapists corner: A study in leather; Act I

neurasthenia
[nyoor"usthē'nēa]

a condition characterized by general lassitude, irritability, lack of concentration, worry, and hypochondria. The term was introduced into psychiatry in 1869 by G. M. Beard, an American neurologist.

Used by Freud to describe a fundamental disorder in mental functioning, the term was incorrectly applied to almost any psychoneurosis and has been largely abandoned.

The curtain slowly rises showing a professional therapist comfortably ensconced in a huge leather wing chair.

Next to him, a professional psychiatrist reclines on a tufted chaise done up in the same rich, dark, buttery leather as the chair.

what’s that? you say you think the couch would look better in red velvet? pardon me a moment someone else is trying to talk also: Eames? did I hear you say Eames? you would prefer an Eames look? Weeellllll, it’s a little late to be discussing staging at this point, the curtain is rising after all, but if i can figure out how to run a poll on this blog, we might be able to reach consensus at a much later point in time. no i don't know if it can be done. it took me months just to figure out i needed to use a separate browser to make hotlinks. shh as it stands now this is mah blog, mah scene, mah chair, and mah couch got that? okay back to the individuals in the scene.

what? does he have a beard like Freud? does who? i don’t know, is it really relevant? okay, real quick, this is what I’m picturing Ala Victor/Victoria. Now, stop talking and pay attention - please. there is supposed to be a Haydn work softly playing in the background and I can't figure out continuous obnoxious sound and listen to you yammer at the same time! Oh nevah mind.

Ahem

Professional in chair: Now tell me a little bit more about this so-called undifferentiated psychiatric cfs.

Professional on couch: It has been my life’s work.

Professional in chair: Why don’t you tell me a little more about this.

Professional on couch: Well, I and a relatively small network of influential psychiatric colleagues, have single handedly resurrected a theory from the 1880s, dusted it off and …

cough, cough, cough, hack, cough, cough. quick, cough, cough, get the respirators, cough cough, we don't want the audience, cough, cough, cough, to stop breathing, choke, hack, cough ... in the back left hand drawer in the red cabinet in the garage, no no not the wooden one, the metal one on the west wall...what do you mean my west or your west, puhleeze hurry, no no wait, get the leaf blower too, the dust cloud is obscuring the scene cough,cough, i told you to hurry, no wait come back here, i think we have to comply with OSHA standards coughhhhhhhh, watch out - don't slip on the green phlegm, just grab the respirators since you're up anyway, red, blue, orange with pink polka dots, no, i said no, it doesn't hhhhhhhhhhhaaaaaaaaaaaccccccccccck really matter which color. grab them all, well what are you waiting for? i told you to hurry

Professional in chair: I’ve read that this concept is considered archaic and is no longer in scientific use?

Professional on couch: What do dictionary compilers know anyway? As a professional psychiatrist, and as such, I must insist that neurasthenia is a quite apt description of this modern hysteria.

Professional in chair: Hysteria? I guess I wasn’t aware that hysteria is a disease.

Professional on couch: Why yes. Not an organic disease of course. However, it is well known that this is a functional somatic disorder, affecting women almost without exception, and since everyone knows women are prone to hysteria, ergo our single hypothesis theory makes utter sense. Any organic connection is simply a minor footnote.

Professional in chair: Well, I suppose it does if you believe women to be pathologically hysterical based solely on gender as I believe the originator of this term did… just to make sure we are communicating clearly, are you using pathological as an adjective meaning uncontrolled or unreasonable or as relating to disease or arising from disease?

Professional on couch: Well said. I couldn’t have described it better myself. That is what I am telling you, this theory is based entirely on social construct from the 1800s and my colleagues and myself have researched and fully verified that this is so. As for arising from biological disease I believe one of our colleagues clearly stated in The Guardian back in March of 1997, there is no physical basis for ME/CFS.

Professional in chair: How do you define rigorous scientific inquiry?

Professional on couch: Why any of our research studies supporting our hypothesis. Unfortunately this isn’t the case with the few studies that purport to show an organic basis for this neurasthenia. As I’ve stated publicly numerous times, even if a biolobical basis for neurasthenia is found, the biological basis is usually minor, exaggerated and perpetuated by illness behavior.

Professional in chair: Ah, I see. So these biological studies have poor construct, uncontrolled variables, less than ten subjects…?

Professional on couch: Why not at all! We publish studies like that, like clockwork. Just churn them puppies out. Those studies simply do not fit our single hypothesis theory, so we ignore them.

Besides, the sheer volume of studies published, not valid construct, are what proves a hypothesis. Old advertising trick that, if you repeat something often enough and publicly enough in the popular press, people will believe anything.

Professional in chair: Doesn’t that tie into your theory regarding the prevalence of this psychiatric disorder as you see it?

Professional on couch: Good catch that. I can see you are quite trig. Yes, yes exactly. The reason this notion is so popular and now equals “mass hysteria” is because it is spread through news reports, broadcast media, the Internet. This is why it remains a problem today!

Professional in chair: So what I’m hearing you say is that if women didn’t know about cfs or this fibromyalgia, they wouldn’t have either one …

Professional on couch: Ah, I can tell you have read the works of psychiatrist Donna B. Greenberg: quite an influence on our network really.

Professional in chair: Well our time is up. I’ll have Marjorie schedule you for another session.

Professional on couch: Marjorie you say. Sounds like a woman’s name. Is she hysterical also? No? Well, best keep an eye on the reading materials anyway.

Professional in chair: Thank you for the warning. We can explore this in further depth in our next session.

be·lief n
1. acceptance by the mind that something is true or real, often underpinned by an emotional or spiritual sense of certainty
3. a statement, principle, or doctrine that a person or group accepts as true
4. an opinion, especially a firm and considered one

the·o·ry n

1. the body of rules, ideas, principles, and techniques that applies to a             particular subject, especially when seen as distinct from actual practice
2. abstract thought or contemplation
3. an idea of or belief about something arrived at through speculation or                conjecture
4. a set of circumstances or principles that is hypothetical
5. a set of facts, propositions, or principles analyzed in their relation to one          another and used, especially in science, to explain phenomena

The World Health Organization specifically excludes the concurrent classification of neurological ME/CFS (ICD 10 G93.3) under (ICD 10 F48) as neurasthenia.The clinical appropriateness of the inclusion of neurasthenia in the ICD 10 is also questioned.

In view of questionable clinical validity, neurasthenia was omitted from the 3rd edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980.

Clinical Validity of ICD-10 Neurasthenia; Bettina Bankier, Martin Aigner, Michael Bach Department of Psychiatry, Division of Social Psychiatry, University of Vienna, Austria
Psychopathology 2001;34:134-139 (DOI: 10.1159/000049296)

And yes, I know I can't do a proper British accent to save my life. I just write by ear. Words just have a certain meter in my brain. Honestly, I'm having enough trouble just teaching my spell check a British accent and if it's any consolation, even my Southern drawl has a Yankee twang... stick around. More acts to follow.

If you wish to comment on the staging please, please do. (The "email me" button is right under my picture) LOL. I get awfully tired of listening to myself and you never know when I'll just plop you right in. Or not. Sometimes the exhaustion is rather overwhelming I'm afraid. And sometimes I just feel cranky, wondering at what point you accidently overdose trying to beat back yet another migraine, and not at all in a humorous mood. And life goes as life goes....Be well

What the Heck are They Talking About: Neurological CFS

The Therapists corner: A study in leather; Act I

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