In any disease, a person is confronted with two very different entities. One, the person is faced with the actual disease process itself - a broken bone, a case of influenza, a heart attack, a malignant tumor. Call this aspect of disease 'illness'. [...] Illness is more or less value free; it's not true or false, good or bad, it just is - just like a mountain isn't good or bad, it just is. But two, the person is also faced with how his or her society or culture deals with the illness - all the judgments, fears, hopes, myths, stories, values and meanings that a particularly society hangs on each illness. Call this aspect of disease 'sickness'. [...] Science tells you when and how you are ill, society tells you when and how you are sick.
[page 40]
Taken in this context, the international "Change the name of CFS" movement makes a lot more sense. The 'sickness' part of this illness is heavy with connotations of laziness, lack of motivation, 'it's all in your head', and being burned out yuppies - by changing the name we would (hopefully) have a chance to start anew building up another societal view of the illness, which now that we have so much evidence of biological problems, would hopefully be a lot less condemning of the patients!
Humans have physical, emotional, mental, existential and spiritual dimensions, and I would guess that problems in any and all of these levels can contribute to illness. Physical causes: diet, environmental toxins, radiation, smoking, genetic predisposition, and so on. Emotional causes: depression, rigid self-control and hyperindependance. Mental: constant self-criticism, constant pessimistic outlook, especially depression, with seems to affect the immune system. Existential: exaggerated fear of death causing exaggerated fear or life. Spiritual: failure to listen to one's inner voice.
Maybe all of those contribute to physical illness. My problem is, I don't know how much weight to give each level. Is the mental or physiological cause of cancer worth 60% or 2%?
[page 49-50]
I think very few people manage even a reasonable guess at how much each of these areas is 'worth' ... I had one doctor tell me - as I was informing him that seeing a psychiatrist was highly unlikely to cure me - that even a broken leg had a psychological component and therefor the psychiatrist would cure me. Well, maybe broken legs do, but I'd still rather go for the plaster cast! He'd jumped from 'a component' to 'the only component' without a shred of justification. Personally, if only 1% of CFS is caused or perpetuated by emotional problems (even if they're problems - like secondary depression - which are caused by the illness itself) then I still want to deal with that 1% because I figure that to get better I need every single bit of help that I can get! Well, actually, I only believe this when I'm feeling OK about stuff and haven't recently been attacked by somebody telling me 'it's all in my head', but it's a good general theory!
1. The standard argument from perrenial philosophy is that men and women are grounded in the Great Chain of Being. That is, we have within us matter, body, mind, soul and spirit.
2. In any disease, it is extremely important to try to determine on which level or levels the disease primarily originates - physical, emotional, mental, or spiritual.
3. It is most important to use a 'same level' procedure for the primary (but not necessarily sole) course of treatment. Use physical interventional for physical diseases, use emotional therapy for emotional disturbances, use spiritual methods for spiritual crises, and so on. If a mixture of causes, then use a mixture of appropriate-level treatments.
4. This is especially important because if you misdiagnose the disease by thinking it originates on a level higher than it in fact does, then you will generate guilt; if on a lower level, you will generate despair. Either way, the treatment will be less than effective, and will have the added disadvantage of burdening the patient with guilt or despair caused solely by the misdiagnosis.
[Page 261]
