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"Mass Sociogenic" Infection Explains MSbP
- Barbara Bryan (23 October 2001)
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"All the world is queer...."
- Gurli Bagnall (24 October 2001)
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The reality of chemical and biological warfare.
- Tom McGlynn (19 November 2001)
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Unspeakable Weapons
- Meng-Kin Lim (29 November 2001)
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Bioterrorism, the BMJ and the Nature Medicine
- Abhijit Chaudhuri (1 December 2001)
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Barbara Bryan, family advocate USA (Roanoke, Virginia)
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Coming from observant scholars in UK, USA, and Australia, cogent concerns that long term social and psychological effects may be potentially worse than acute ones remind me of the contagion effect of one small article in Lancet nearly a quarter-century ago. (http://web.tiscali.it/humanrights/articles/meadow77.html) Citing examples in their current article of alarms sounding without revealing an actual problem (in Washington, D.C. subway system, Gulf War alerts), Professor Wessely and colleagues note "The long term social and psychological effects of an episode of chemical or biological attack, REAL OR SUSPECTED (emphasis mine), would be as damaging as the acute one, if not more so." Wholly agreeing with their reasoning from both research and experience, I note that behaviors put into motion on suspicion of Munchausen Syndrome by Proxy--removal of a child from any member of the natural extended family--creates lifelong trauma foremost in the child but as well in each concerned family member and friend. There are many other parallels regarding overreaction to presumed cause that creates more damaging effects than the supposed original problem. One particularly appropriate is: "Because health officials cannot provide blanket assurances that no harm will result from"... (here's where I would replace with my words following: attention to the mother rather than competent diligence in discovering the cause of the child's health problems)"...then a growing distrust of medical experts and government officials may result, robbing state institutions of the trust they need to manage recovery." Believing the sociogenic spread among professionals and adjuncts of the notion of mother as homicidal liar caused fear which today allows removal newborns from innocent parents, I note the brightest and best of health care pros apparently are not immune from inhaling and then practicing with untested imaginative ideas. Mothers relentlessly pursuing health care for ill children may be annoying or obnoxious, but left with those worse social and psychological effects of an explained and exposed idea on some paeds, who does the epidemiology to unravel the damage from MSbP labels? Who creates a cure for overkill? The "implications" piece by Wessely et al. is timely in more ways than the most obvious. Barbara Bryan Competing Interest - Steadfast determination to find accepted scientific methodology supporting MSbP; or, in the breach, to explain how and why the imaginative idea spread. |
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Gurli Bagnall, Patients' Rights Campaigner
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It would have been more reassuring if scientists in the field rather than opinionists, had stated that biological agents and chemical weapons have limited uses and are ineffective. Mass sociogenic illness is apparently the latest term for the diagnosis, mass hysteria. Human beings respond individually to circumstances rather than in identical robotic manner which Wessely et al deem to be normal behaviour - robotic behavour which, ironically, others might consider to be sociogenic illness. Name changes are not new. "Beard's neurasthenia.... provided the most respectable label.... one that conferred many of the benefits - and fewest of the liabilities - associated with illness .... it was preferable to the alternatives - hypochondria, malingering and insanity." ("Old wine in new bottles: neurasthenia and ME" - Wessely S. Psychological Medicine 1990: 20:35- 53) From their position of comfort and safety, Wessely et al dismiss long term physical adverse effects of exposure to chemical weapons and biological agents as being of considerably less concern than the long lasting psychological effects of the fear they instill. Fear is a protective mechanism. It makes us alert to danger and allows us to take evasive action. Lull authorities and communities into a false sense of security, and should the worst happen, governments will have a hard time explaining their lack of preparation. They will have an even harder time when confronted by the affected to justify their acceptance of opinions such as: "The description given by a leading gastro -enterologist at the Mayo Clinic remains accurate: 'the average doctor will see they are neurotic and he will be disgusted with them'." (Chronic fatigue and myalgia syndromes. Wessely S. - Psychological Disorders in General Medical Settings 1990) The editorial reminds me of an article published in the Sydney Morning Herald on 16 July, 2001, which reported that a well known Australian psychiatrist had made a startling discovery. "Sixty per cent of people who visit general practitioners have a mental disorder...." he said. He recommended that each patient should fill in a questionnaire before seeing the doctor so that, irrespective of whether the complaint was a headache or a stubbed toe, the doctor would, at a glance, know whether or not to prescribe a pyschotropic drug along with the aspirin. The trouble was that the questionnaire upon which the study was based, could have applied to anyone in the community. "In the last few weeks, have you suffered (a) a headache (b) muscle or joint pains....etc." Should doctors also fill out daily questionnaires for patient safety? Or is this a case of: "All the world is queer save thee and me....and even thou art a little queer."? I looked for two things in the editorial by Wessely et al. (1) Upon what scientific evidence was the study based and (2) did the language show respect and concern for the potential victims of biological and chemical warfare? I was disappointed on both counts. Indeed, in line with opinions expressed by Wessely about ME and the GWS, I saw only contempt for the sick. Unfortunately, contempt breeds contempt. Gurli Bagnall |
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Tom McGlynn, Director (Tasmania), National ME/CFS Association of Australia
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I refer to your October 20th editorial 'Psychological Implications of Chemical and Biological Weapons' by S Wessely, KC Hyams and R Bartholomew, which stated that the principal threats of such weapons are outbreaks of 'mass sociogenic illness. Missing from the editorial and subsequent correspondence has been an adequate asessment of the non-psychological dangers of biological and chemical weapons in current stockpiles. Chemical Weapons There has so far been only 'localised' use of chemical weapons, involving a few tens of thousands of dead and injured. Poison gas was liberally used in World War One but has since 1918 generally been used only on 'technical inferiors' in Africa and Asia. Italy used 'gas-bombs' in Ethiopia and Libya pre-war, by which time the RAF had also used them on rebellious Iraqis as well as, reportedly, on the North West Frontier. Though only occasionally used, mainly in colonies and ex-colonies, development and stockpiling of chemical weapons has continued since 1918. Iraq's Saddam Hussein, possibly prompted by Arthur Harris's 1920's experiments, has used chemical weapons on Iran and Kurdistan. Professor Wessely may wish to note that the effects on the Kurds of Halabja, like those on 1915-1918 Western Front gas victims, appear to have been of a kind irreversible via CBT or any other form of psychotherapy. Germ Weapons The USSR may have had the largest programme but the US funded comparable efforts, while UK research at Porton Down has a sinister past that is still largely secret and probably not over. In the 1940's Britain's 'germ-war' research included preparing for anthrax raids on Germany. The Scots island of Gruinard is still a prohibited zone 60 years after the activities that rendered it permanently anthrax-contaminated. In Manchuria in 1935-1945, many luminaries of the postwar Japanese medical establishment conducted gruesome gas, microbiological and 'temperature experiments' on Chinese and other Allied prisoners, while the USAAF may also have used biological weapons in Korea. Problems of Chemical and Germ Warfare The most obvious risk arises if the victims of such attacks are capable of retaliating in kind. The UK rationale for Porton Down and Gruinard was presumably that as Hitler had or could make such weapons, Britain had to develop them too as a deterrent. The most serious problems arise from microbiological warfare, especially with smallpox or plague. Such weapons are unstoppable and may well 'blow back' after affecting even remote target populations, slaughtering the uninnoculated in one's own and other countries. For this reason the most menacing news reportable would be if State X, Y or Z were to be detected in the act of quietly, systematically innoculating its entire population. Current weapon-stocks of diseases are probably sufficient to wipe out Homo Sapiens plus, probably, many mammals. More to the point, the potential for 'backward' polities (and even non-State groups such as Al Qaida) to obtain toxins and chemicals, in order to brew up microbiological weapon-stocks comparable to those of major states, grows daily. As an 'Adviser to the UK Armed Forces' Professor Wessely can scarcely be unaware of these facts and considerations, so for him to omit the obvious and to tell a well informed medical audience that the 'main risk of germ and chemical warfare is mass sociogenic illness' is, to say the least, very remarkable. Yes, there are problems of delivery, retaliation and 'blowback' but against these hitherto supposedly insuperable impediments to the use of biological and chemical weapons must now be set the dire precedent of 11th September - a new, chiliastic readiness to meticulously plan and commit mass suicide as well as mass murder in pursuit of 'metaphysical ends'. This development, surely, is the truly novel 'sociogenic phenomenon' - one which might have provided the basis for an editorial more informative than 20th October's thinly disguised puff-piece for the universal blessings of psychiatry? Indeed, the editorial reminded me of the famous 'US Furniture Industry Nuclear Circular' of about 1955 which encouraged manufacturers 'not to dwell on the downside of a nuclear assault on the USA' but to cheerfully anticipate a vast post-war demand for new furniture! Instructive parallels to the views expressed in the 20th October editorial,
in regard to real risks for human beings and to the very different risks
that contrary viewpoints may present to certain Government and Corporate
interests, lie in Simon Wessely's roles in current controversies over the
essential character of (at least) 3 medical conditions:-
In the latter contexts, a psychiatrist asserts that three often crippling and sometimes fatal physical conditions are esssentially psychogenic or at least are 'perpetuated by false etiological beliefs, while the same individual now plays down clear risks to human survival itself by trying to focus our attention on alleged 'mass sociogenic illness'! A common thread in these assertions is a claim that much physical illness is esentially psychiatric while another is the consistent but presumably inadvertent promotion of Military, Corporate, Insurance, Treasury and professional interests against the better founded claims of many tens of thousands of severely ill patients and ex-servicemen. Readers of the BMJ should be in no doubt that in the real world - as opposed to the brave, psychiatrically manageable planet presented to us in the editorial of October 20th - the capacity of States, as well as of non-State groups, to produce 'A, B and C' weapons is growing inexorably, particularly as disaffected 3rd World intellects gain better access to scientific knowledge and capital. Moreover, ME/CFS, MCS and GWS are all serious, chronic and demonstrably non-psychiatric - even if puzzlingly heterogeneous - medical conditions. Lastly, as has been true of nuclear materials since 1945,there is virtually no security against accidents to the proliferating stockpiles of such weapons (whether biological, chemical or nuclear) nor to their raw materials; nor against their theft by terrorists or criminals; nor against legal or criminal sale of such weapons; nor against the spread of the technology that permits ever smaller states and non-state groups to make their own, as occurred in 1995 after 'Aum Shinrikyo' obtained sarin from hard-up Russian scientists. Tom McGlynn. Westwood, Tasmania. |
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Meng-Kin Lim, Associate Professor Department of Community, Occupational and Family Medicine, National University of Singapore, 117597
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Unspeakable weapons Meng-Kin Lim National University of Singapore Wessely, Hyams and Bartholomew (BMJ 2001;323:878-9) speculate that a major reason why “armies have generally acquiesced in international treaties to contain" biological and chemical agents is they are “particularly ineffective as military weapons (and) have only limited uses” anyway. This piece of reasoning does not do justice to the intelligence and serious intent of the drafters and signatories of the 1925 Geneva Protocol, the 1972 Convention on Biological and Toxin Weapons, and the 1993 Chemical Weapons Convention, nor does it explain why the use of spears and stones are not similarly prohibited. Terror weapons (biological, chemical and nuclear) are so called, not because they are capable of wreaking psychological destruction far in excess of their actual destructive capacity, but because their use is considered inherently abhorrent. Somehow, in the collective psyche of our civilized world, killing and maiming with conventional weapons has always been considered more acceptable and less inhumane. Why should that be so? Unthinkable or not, the events of September 11 and the subsequent spread of deadly anthrax by civilian mail in the United States have upset our mental equilibrium and jolted our complacency. We suddenly realise that international treaties do not bind terrorist bands – they apply only to sovereign states – and international opprobrium will not constrain the individual with a bent mind. Numbed by new talk of a “different” war, and stalked by ominous microbes and suspicious canisters lurking in every shadow, the entire civilised world (not just those in the Maryland subway) feels nauseous not because of mass sociogenic illness, but because the resort to “unspeakable weapons” proves that despite all the signs pointing to the progress of the species, man’s inhumanity to man has not diminished. Why do biological, chemical and nuclear weapons have such an “unspeakable” quality? Far from being “ineffective” and “limited” in use, they invoke feelings of revulsion and strike terror in our minds precisely because we recognise their true potential as weapons of mass destruction (imagine the Black Death, Bhopal, and Hiroshima on a grander scale). Unlike conventional weapons, they do not leave the victor a hospitable earth to inherit. Weight for weight, aided by technologically enhanced dispersal mechanisms, deadly pathogens and poisonous gases have the power to wreak as much havoc as nuclear bombs and annihilate the human species. Their use raises questions as to whether the human condition can be helped at all. |
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Abhijit Chaudhuri, Clinical Senior Lecturer in Neurology University of Glasgow
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It came as a great comfort to learn from the psychologists that the perceived threat of the biological and chemical weapons is unreal, probably in itself a mass sociogenic illness, since these weapons are "weak and ineffective". I was rudely shaken up however while reading the current issue of the Nature Medicine (11 November 2001), a journal no less prestigious than the BMJ. The editorial ("A battle cry for biomedicine") points out that the Defense Advanced Research Projects Agency (DARPA), the Pentagon's central research organization, spent just $166.8 million on biological defence research while the Centers for Disease Control and Prevention (CDC) was allocated $46.6 million in the last fiscal year and that the answer to bioterrorism "will lie in prevention and protection through science"(p1163). Widescale production of the anthrax vaccine has recently become a priority because the current mortality rate from the anthrax bioterror attacks suggests it is anything but ineffective ("Bioterrorism threat becomes reality", p1167). And finally, a UK based biotechnology company has been awarded the contract for large scale development of a new small pox vaccine for $343 million because "a spreading, highly lethal epidemic in an essentially unprotective population, with limited supplies of vaccine, no therapeutic drugs and with shortages of hospital beds suitable for patient isolation is an ominous specter... as few as 50-100 cases would invoke larg-scale, perhaps national emergency control measures" ("Smallpox vaccine development quickened", p1167). It is a pity that the authorities in the US did not have the opportunity to see the views of Wessely et al because the research should have been funded for mass scale surveys of questionnaires to find out "how to manage your symptoms when you believe you are a victim of ineffective bioterrorism". I also wonder why the editorials in the BMJ and the Nature Medicine are so divergent in their expressed views on the bioterrorism threats: does this difference reflect the editorial policy of the journals? |
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