Investigating Morgellons Syndrome

The Psychological Origin of Symptoms

With no infectious entity as yet, Morgeloons is strictly speaking a syndrome. A syndrome is a group of symptoms that occur together for which no cause has yet been clinically established. Without a cause there can be no cure. Two of the most well-known syndromes in the present day are Chronic Fatigue Syndrome and Gulf War Syndrome, both of which have vociferous supporters and detractors in equal measure for their claims to be recognised as legimate diseases.

The question for medical science is 'where do these symptoms originate?' - do they have an organic, or psychosomatic origin?

The term psychosomatic is a much misunderstood term and is regarded with suspicion by many patients who view it as a medical term which essentially means ‘imaginary’.

Edward Shorter, in his 1993 book From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era, notes in his introduction that psychosomatic symptoms have always existed – the conversion of stress into physical symptoms is nature’s way of coping with mental distress. He goes on to point out that somatization (the conversion of mental stress into physical symptoms) comes in two forms.

In one no physical lesion of any kind exists and the symptoms are literally psychogenic; that is to say, they arise in the mind. In the second an organic lesion does exist, but the patient’s response to it – his or her illness behaviour – is exaggerated or inappropriate.

One can argue that there can often be a lack of insight on both sides of the doctor-patient relationship. For doctors to dismiss patient’s symptoms as being ‘all in the head’ or ‘there is nothing physically wrong’ is tantamount to an act of cruelty. Whilst for patients to take offence at a psychosomatic diagnosis represents both an ignorance of its true meaning and a formidable barrier to getting well.

A well used and instructively simple example of the nature of somatic (organic) complaints is as follows; after eating a bad oyster one awakes in the morning with a stomachache quickly followed by diarrhea. Now imagine that exactly the same symptoms occur on the morning of an important examination – upset stomach followed by diarrhea.

Whilst the first situation represents an organic problem, caused by a physically real entity (bacteria in a past-its-sell-by-date oyster), in the second instance there is no physical entity responsible, however the reality of the symptoms and their effects are undeniable in both cases. Therefore it is clear that just because a set of symptoms has a psychological cause, ie. are psychosomatic; it does not make them any less real.

The nervous tension caused by the impending examination in the first instance is, strictly speaking, ‘all in the mind’, so why is it that this medical response is anathema to patients?

The link between the ‘nerves’ caused by the impending examination and the resultant stomach upset is direct and very immediate and therefore a very easy connection to make. However, when the same mechanism is at work subconsciously, often built up slowly, and much more intensely, over a period of years, then the link between mental state and physical symptoms is much less apparent to the sufferer and this situation has never been properly addressed by the medical community.

The (Un)Psychological Century

The public has never been educated as to the nature of a very significant proportion of medical ailments. Edward Shorter's view is that whilst the medical profession itself had, by the start of the 20th Century, accepted the psychological origin of symptom formation, it never entered the public consciousness to the same extent and thus patients avoided psychiatry and instead gravitated towards forms of medical treatment that took the organic origin of symptoms as a given, as medicine had traditionally done. He notes;

“The original rise of the psychological paradigm … was not communicated to patients … psychologically orientated physicians continued to let patients believe they were receiving organic therapy.”

Following the rise of psychoanalysis the term ‘psychosomatic’ was closely, if erroneously, associated with ‘psychiatric’ rather than ‘neurological’ and the overall result was that;

Psychoanalysis, which had set out to inform the public … about the unconscious roots of neurosis, thus achieved the paradoxical result of strengthening the public’s conviction of organacity … Thus at the end of the 20th Century, the century of psychology, somatisizing patients tend to shun any psychological explanation of bodily illnesses.

Conclusion

Contemporary patients then are still very uncomfortable with the concept of psychosomatic illness, primarily due to a lack of understanding of both the term itself and the mechanism it describes. The result of this is that patients will consult with a succession of doctors until they find one who will diagnose them according to their own self-expectations.

Morgellons patients have expressed great dissatisfaction with doctors who refuse to acknowledge the reality of the disease and it is here that the two ends of the ontological view cause friction: From the medical professionals standpoint, without an identifiable infectious agent there can be no disease, but from the patients point of view, given that they are suffering from very real symptoms, the doctors’ psychosomatic diagnosis is unacceptable.

Despite historical evidence to the contrary, beliefs about illness have developed in such a way that it is difficult for a great many patients to accept that their mental state can cause a wide range of physical symptoms.

'The History of Symptoms'.