Evil deeds and common ground

The media is continuing to churn out articles about how a few beleaguered psychiatrists have received death threats from patients with myalgic encephalomyelitis. The psychiatrists, who claim they can treat ME with talk therapy and exercise, say these patients are angered by any assertion that their disease is psychological.

In response, Dr. Malcolm Hooper has written a letter offering more backstory and a reality check. It begins:

No right-minded person condones any campaign of vilification against psychiatrists but equally, no right-minded person can condone what psychiatrists like Wessely have done to the UK ME community over the last 25 years.

There's a lot of good stuff in that letter. Stuff about how ME—a neurological illness that attacks the immune system and leaves many sufferers completely incapacitated—is not in any way psychological. But the thing that stands out to me is that first sentence. Before he goes on the attack, he states in no uncertain terms that death threats are bad.

That's been the response I've seen everywhere in the ME blogosphere. While most patients and advocates suspect that these psychiatrists are exaggerating their claims, everyone has taken care to say that IF the threats are happening, they shouldn't be.

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In related news, the public was recently treated to a first-person account by Simon Wessely, a primary target of the alleged death threats. I could spend several pages debating his main arguments, but I'll set them aside for now and focus on this statement:

Our critics have devoted much energy (irony intended) to denouncing us as pawns of the drug or insurance industries. I have been called a new Dr Mengele, the next Dr Shipman ... I am frequently accused of having thrown a CFS-suffering child into water to see if he would sink or swim.

Ah yes. The kid in the pool.

Dr. Wessely is referring to Ean Proctor. At age 12, Ean was taken from his parents and placed in an institution. Those responsible for his care believed his symptoms of near paralysis weren't real. To prove it, they threw him facedown into the deep end of a swimming pool. Their experiment failed, and they had to rescue him when he couldn't move his limbs to save himself.

Wessely almost certainly didn't pick up Ean Proctor with his own hands and toss him into the water. I've never seen anybody accuse him of doing so. What he is accused of—what is a matter of record—is his involvement in Ean's case. As a senior registrar in psychiatry, he declared Ean's disease to be psychological and recommended that the boy be removed from his family.

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The "death threats" story, presented unquestioningly in article after article, has become a source of frustration for ME patients and advocates. As one sufferer noted in a comment to my last post on the subject,

The truth of the situation is that even if death threats have been sent, it is by a tiny minority of the hundreds of thousands of people with ME in this country - yet it's the whole community who is being attacked here. And of course, the whole story just increases people's belief that we're somehow psychologically unbalanced.

Which leads to an interesting question: How would psychiatrists react if the tables were turned?

ME advocates can cite a number of cases where children and adults with ME were forced into institutions for believing they were sick. Do all therapists think this is appropriate or helpful? Hopefully not. But what if a series of articles were published describing what happened to Ean Proctor, Sophia Mirza, Brian Nicholson, Ryan Baldwin, the child from Spain, and others in gory detail? What if these articles referred to "psychiatrists" who pushed for such measures without mentioning any of them by name?

Psychiatrists who do not agree with such measures might feel unfairly singled out.

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In a 1994 lecture, Simon Wessely said, "I will argue that ME is simply a belief, the belief that one has an illness called ME." He and others in the "Wessely School" have since backed off of that proposition, arguing instead that ME is a genuine, serious disease with a psychological component.

The ME community still disagrees with this watered-down version of the psychiatric perspective. That said, the watering down has significant real-world implications. If ME is fully psychological, then you can make an argument for institutionalizing people whose "illness beliefs" have rendered them completely dysfunctional. If ME is a real disease with psychological factors thrown in, then forcing patients into a psych ward because they believe they have a real disease doesn't make a lot of sense.

So here's my proposal.

ME advocates will publicly oppose death threats, harassment, and abuse, as we have done from the beginning.

In return, psychiatrists will publicly oppose the involuntary commitment of ME patients into psychiatric units.

What do you think, psychiatrists? Do we have a deal?