you gotta love how quickly people will downvote anyone who provides any sort of evidence for the existence of psychosomatic syndromes. they'll probably claim it's because you didn't read the article. but this can't be it because the article very clearly said the etiology is still up for debate (despite focusing on the one medical doctor's claims). there's something inherently offensive about the proposition of psychogenic disorders. neurotics will not so easily give up their jouissance.

i greatly admire schubiner and sarno for exploring this issue but their limits are clear, and they admit it themselves. relatively few patients (i think for sarno it was like 20%?) will "accept the diagnosis." and why should they? again, in 80% of patients the crisis of jouissance is not sharp enough to really investigate their unconscious. and of course in many of those 20% of patients (yourself and myself included) the jouissance is displaced elsewhere, perhaps to somewhere much less obvious than chronic lower back pain.

The problem is that we are terrible at dealing with cognitive dissonance.

When someone believes they have a disorder for many years/decades it becomes a part of their identity. Admitting they were wrong means that they needlessly caused suffering to themselves. It is embarrassing and emotionally painful.

They become instantly defensive, and hostile towards anyone offering alternative explanations.

indeed the syndrome can take on a life of its own (become part of their identity), and perhaps that's when it's at its most fragile. it's why after 10 years of suffering your pain could vanish immediately after learning it may serve a psychological purpose.

but i think for many neurotic people (and most of us are indeed neurotic) the syndrome (i use lacan's jouissance) serves its purpose just fine. so don't you dare take it from them.

Plus, they might then have to think about what is actually bothering them, and that could be very upsetting.

The article states that CFS is not psychosomatic and this was a misconception held by physicians previously.

That statement is certainly debatable.

It is, but keep in mind that there are biological markers that are correlated with having chronic fatigue syndrome at p < 0.001 kind of levels.

e.g. if you happen to have blood work from a patient pre-CFS and post-CFS it's very, very common to see a raised T-cell count and an immune response against the Epstein-Barr virus (or some other retrovirus) in the post-CFS that isn't there pre-CFS.

Of course, it's not a great diagnostic tool because you need the patient to have had some blood work just before they got sick. But it does make the "it's all just psychosomatic for everyone" argument a bit unlikely.

None of those biomarkers has been replicated, and stress causes ENV reactivation.

Does EBV reactivation implies fatigue and full mononucleosis symptoms or it just means T-cells count increases ?

And nothing about it being psychosomatic means it is any less serious or real a problem. The placebo effect regularly accounts for ~20% of treatment effects, it is extremely clear that our minds have significant power to influence the functioning of our bodies.

But the stigma attached to mental illness is real, so many/most sufferers are not at all receptive to this advice.

Just a short period of observing people who suffer from these syndromes makes it very clear that this is a psychological issue. There is a whole cluster of these vague illnesses that afflict a subset of the population with predictable psychological and demographic attributes. Nothing about their physical mechanics is in any way similar; the common mechanism is psychological.

Psychosomatic medicine is about as credible as emails from a Nigerian prince that needs help transfering large sums of money.