The reach of Wessely’s theories

Picture of Lynn Gilderdale, a young white woman lying in a hospital bed. She is wearing a light blue nightgown, has a feeding tube in her nose and Hickman lines on her chest.Last Friday I wrote here about Simon Wessely, the psychiatric professor at King’s College Hospital in London who is notorious for promoting psychological theories about certain chronic illnesses, won an award for “courage” presented by an organisation he is on the board of. The organisation was Sense About Science, which claims to champion sound science over “dodgy science” as well as campaigning for the rights of scientists (such as by campaigning to reform libel laws so that scientists are not caught up in libel suits as a result of debate). I actually know of a few people in the chronic illness community who are strong supporters of most of what SAS stand for, and this made their endorsement of Wessely all the more disappointing to these people. However, a conversation with an activist friend last Thursday brought home how much damage Wessely’s theories have really done.

The friend has a bowel disease which has caused her an awful lot of pain and required repeated surgery. She has been in a number of hospitals and had a number of extremely frightening experiences, including with abusive doctors and nurses. She told me of one registrar she came across while on a bowel ward who was obsessed with the idea that chronic illnesses were all in the mind. Keep in mind, this was a bowel ward so it wasn’t full of ME or fibromyalgia sufferers; these people had Crohn’s disease, colitis and other diseases of the lower digestive system. He kept asking the female patients (my friend didn’t see the male ones, so she didn’t see how he treated them) about what was going on in their lives, and when one of them told him her daughter was getting married, he said, “ah yes, stress”, as if that was the cause of her colitis, which led to her being found collapsed on the floor and requiring a massive blood transfusion.

The same registrar also disobeyed his consultant, refusing to order tests and scans he had demanded, while harassing the women on his ward to find excuses to reduce their illnesses to stress. My friend alerted his hospital after her discharge, and the consultant said they knew about this man and his preoccupation, but at least they no longer had to deal with him — he had been dealt with like an abusive Catholic priest, and simply moved to a faraway hospital. She also told me about a teenage girl she knew of who had been sectioned because her chronic weight loss was misdiagnosed as anorexia nervosa; she also had a bowel disease and the pain to prove it, but the doctors were so blinded by their psychological theories and social stereotypes that they were unable to consider any alternative explanation: young girl, weight loss, anorexia. I have also heard from an ME sufferer — again, female and, at the time, a teenager — whose weight loss was interpreted as such (although she was given tube feeding which did not have to be forced) when in fact she could not eat because of the nausea which is a known symptom of that disease.

This vulnerability of women to false psychological diagnoses for physical illness goes back a long way in the medical profession, and particularly psychoanalysis which was heavily influenced by Freud’s misogynistic assumptions about girls’ feelings of inferiority and “penis envy”. Indeed, it has been observed that some doctors seem to regard being female as itself, effectively, a disease: women get aches and pains, and are neurotic, so if a woman comes with aches and pains, even if she says these are unusual even for her, the presumption is that it’s really nothing.

A further ill consequence of the influence of Wessely’s theories is that they empower professionals at the expense of ordinary people, and when professionals mess up, they often have the backing of other professionals who will not speak up, at least in public. Social workers who are told by doctors that a child’s parents are resisting treatment that could make their child better, or are making their child sick or encouraging “illness beliefs” will initially assume that the doctors are right, and it will often take the intervention of other doctors to persuade them that the illness they were earlier told was a myth was in fact real and that the parents were doing what they knew to be in the child’s interests. The upshot is that many children have been taken into care and isolated from their parents so that they cannot be “encouraged” to persist in their “illness behaviour”. The Tymes Trust, the major organisation that assists parents in that situation, has reported a number of scandalous incidents of parents being threatened with care proceedings if they do not get their children into school (which their illness counter-indicates) or agree to harmful graded exercise treatment.

If someone promoted theories that justified male violence or abuse against women and this resulted in a substantial expression of anger and a few nasty emails, he would not be praised for his ‘courage’ except on a few fringe “men’s movement” websites. In particular, there have been religious leaders pilloried in the media and, in some places, charged with crimes for justifying men hitting their wives. Yet, this is what Simon Wessely’s theories have done: to empower healthy adult professionals to be abusive and coercive to sick adults and children, and to undermine the right of sick and disabled people to be heard, respected and treated appropriately. Even assuming the threatening emails are genuine, the damage he has done to sufferers’ welfare over the years considerably outweighs the tiny amount of stress his work, and the reaction of justly angered patients and their friends, has caused him.

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  • kellylatta

    There are some missing pieces in here.

    These are not Dr. Wessely’s theories. You give him far too much credit.

    The field of psychosomatic medicine was alive and well long before he was even born or even his parents. Nor is misogyny limited to doctors or psychiatrists. In WWI soldiers, who were all male, were often diagnosed with shell shock - a diagnosis that later followed soldiers from the Gulf War.

    Even before that, people were bickering over the possible division of the mind and body since before the days of Des Cartes in the 1600s. And biomedical researchers and psychiatrists of both genders have continued the argument for centuries.

    Stigmatization of patients isn’t new either. Cancer patients in the early part of the last century were heavily stigmatized and there was very little funding available for research.

    The breakthroughs in which diseases were no longer considered psychosomatic are almost always the result of technology. Many times the concept of psychosomatic medicine flourishes best in areas where technology has not yet caught up with a disease or diseases. It’s nothing new. And it is hardly exclusive to Dr. Wessely. Nor he is by no means the first or only clinicians or researcher to have confirmation bias.

    This isn’t to say that considerable harm has not been done by Dr. Wessely and his point of view, but it needs to be kept in perspective.

  • Tony Mach

    I wanted to add something along the very same lines – but you have done it so well.

    One should not give too much credit to Wessely, this idealistic psychosomatic BS was well alive before his days.

    Besides: I don’t know the context nor the doctor, and I haven’t been there, but just saying “ah yes, stress” may just be meant as as a little relieving small talk. But then again the psychosomatic school with their idealistic BS is strong in the gastrointestinal field…

  • Rebecca Swanstrom

    Wow. What a great article. I often wonder why doctors don’t get the sexism that is their beliefs about CFS and Fibromyalgia.