Examining the psychology of practitioners, institutions and structures:

‘Medically unexplained symptoms’ and biopsychosocial discourse reflexively revisited


  • Joanne Hunt Independent researcher




medically unexplained symptoms, biopsychosocial model, social injustice, victim blaming, reflexivity, welfare reform, gains from illness, critical theory


‘Medically unexplained symptoms’ (MUS), through the lens of the biopsychosocial model, are understood in mainstream psy disciplines and related literature as a primarily psychosocial phenomenon perpetuated by ‘dysfunctional’ psychology on the part of people labelled with such. Biopsychosocial discourse and practice in this field, underpinned by little empirical foundation and lacking theoretical coherency, are associated with harms sustained by people labelled with MUS. Yet, little  attention is paid to the psychology of social actors and institutions whose practice and policy derives from biopsychosocial theorising, or whose vested interests (re)produce such theorising. This article contends that lack of reflexivity among psy practitioners and other social actors on individual, institutional and structural levels furthers biopsychosocial hegemony and contributes to harms. Non-reflexive behaviour on the part of practitioners within clinical and ‘therapeutic’ encounters and on the part of social actors within institutions and broader power structures is examined, and possible psychological underpinnings of non-reflexivity are explored. Notably, the concept of gain, drawn from dominant discourse around MUS, is applied broadly to explore what might be gained from eschewing reflexivity and from adhering to biopsychosocial narratives. Implications for practice, supervision, training and research are discussed, notably highlighting a need for critical reflexivity in all domains.


Anderson, E. (2012). Epistemic justice as a virtue of social institutions. Social Epistemology, 26 (2), 163–173.

Anderson, V. R., Jason, L. A., Hlavaty, L. E., Porter, N., & Cudia, J. (2012). A review and meta-synthesis of qualitative studies on Myalgic Encephalomyelitis/chronic fatigue syndrome. Patient Education and Counseling, 86(2), 147–155.

Anthony A (2019, July 28). ME and the perils of internet activism. The Guardian. https://www.theguardian.com/society/2019/jul/28/me-perils-internet-activism-michael-sharpe-myalgic-encephalomyelitis-chronic-fatigue-pace-trial

Åsbring, P. & Närvänen, A. (2002). Women's experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia. Qualitative Health Research, 12(2), 148-160.

Åsbring, P., & Närvänen, A. (2003). Ideal versus reality: physicians perspectives on patients with chronic fatigue syndrome (CFS) and fibromyalgia. Social Science & Medicine, 57(4), 711–720.

Beach, M. C., & Inui, T. (2006). Relationship-centered Care: A Constructive Reframing. Journal of General Internal Medicine, 21(Suppl1), S3–S8.

Bentall, R. P., Powell, P., Nye, F. J., & Edwards, R. H. T. (2002). Predictors of response to treatment for chronic fatigue syndrome. The British Journal of Psychiatry, 181(3), 248–252

Blease, C., Carel, H., & Geraghty, K. (2017). Epistemic injustice in healthcare encounters: Evidence from chronic fatigue syndrome. Journal of Medical Ethics: Journal of the Institute of Medical Ethics, 43(8), 549–557.

Breuer, J., & Freud, S. (2004). Studies on hysteria. Penguin (Original work published 1893–1895)

Briant, E., Watson, N., & Philo, G. (2013). Reporting disability in the age of austerity: The changing face of media representation of disability and disabled people in the United Kingdom and the creation of new ‘folk devils.’ Disability & Society, 28(6), 874–889.

Brown, R. J. (2004). Psychological Mechanisms of Medically Unexplained Symptoms: An Integrative Conceptual Model. Psychological Bulletin, 130(5), 793–812.

Browne, T. & Chalder, T. (2006). Chronic fatigue syndrome. Psychiatry 5, 48–51.

Brown, N. & Leigh, J. (2018). Ableism in Academia: Where Are the Disabled and Ill Academics? Disability & Society 33(6), 985–89.

Buchman, D. Z., Ho, A., & Goldberg, D. S. (2017). Investigating trust, expertise, and epistemic injustice in chronic pain. Journal of Bioethical Inquiry, 14(1), 31–42.

Chalder, T., Patel, M., James, K., Hotopf, M., Frank, P., Watts, K., McCrone, P., David, A., Ashworth, M., Husain, M., Garrood, T., Moss-Morris, R., & Landau, S. (2019). Persistent physical symptoms reduction intervention: a system change and evaluation in secondary care (PRINCE secondary) - a CBT-based transdiagnostic approach: study protocol for a randomised controlled trial. BMC Psychiatry, 19(1), 307.

Chew-Graham, C. A., Cahill, G., Dowrick, C., Wearden, A., & Peters, S. (2008). Using multiple sources of knowledge to reach clinical understanding of chronic fatigue syndrome. Annals of Family Medicine, 6(4), 340–348.

Chew-Graham, C. A., Heyland, S., Kingstone, T., Shepherd, T., Buszewicz, M., Burroughs, H., & Sumathipala, A. (2017). Medically unexplained symptoms: continuing challenges for primary care. The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 67(656), 106–107.

Colby, J. (2014). False Allegations of Child Abuse in Cases of Childhood Myalgic Encephalomyelitis (ME). https://www.tymestrust.org/pdfs/falseallegations.pdf

Crawford, J. (2014). Misdiagnosing the unexplained [Letter], Psychologist, 27(4), 219.

Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum, 1989(1), 139–167.

Dansak D. A. (1973). On the tertiary gain of illness. Comprehensive Psychiatry, 14(6), 523-34.

Deary, V., Chalder, T., & Sharpe, M. (2007). The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review, 27(7), 781–797.

Devendorf, A. R., McManimen, S. L., & Jason, L. A. (2020). Suicidal ideation in non-depressed individuals: The effects of a chronic, misunderstood illness. Journal of Health Psychology, 25(13–14), 2106–2117.

Dersh, J., Polatin, P. B., Leeman, G., & Gatchel, R. J. (2004). The management of secondary gain and loss in medicolegal settings: strengths and weaknesses. Journal of Occupational Rehabilitation, 14(4), 267–279.

Dwamena, F. C., Lyles, J. S., Frankel, R. M., & Smith, R. C. (2009). In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms. BMC Family Practice, 10, 67.

Edwards, C. R., Thompson, A. R., & Blair, A. (2007). An “overwhelming illness”: Women’s experiences of learning to live with chronic fatigue syndrome/myalgic encephalomyelitis. Journal of Health Psychology, 12(2), 203–214.

Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136.

Etherington, K. (2017). Personal experience and critical reflexivity in counselling and psychotherapy research. Counselling & Psychotherapy Research, 17(2), 85–94.

Faulkner, G. (2016). “In the Expectation of Recovery": Misleading medical research and welfare reform. Centre for Welfare Reform. https://www.centreforwelfarereform.org/uploads/attachment/492/in-the-expectation-of-recovery.pdf

Fawcett, B. (2000). Feminist perspectives on disability. Pearson Education Ltd.

Ferrari, R., & Kwan, O. (2001). The no-fault flavor of disability syndromes. Medical Hypotheses, 56(1), 77–84.

Ferrari, R., Kwan, O., & Friel, J. (2001). Cognitive theory and illness behavior in disability syndromes. Medical Hypotheses, 57(1), 68–75.

Festinger, L. (1962). Cognitive dissonance. Scientific American, 207, 93–102.

Finlay, L. (2002). Negotiating the swamp: The opportunity and challenge of reflexivity in research practice. Qualitative Research, 2, 209–230.

Fishbain D. (1994). Secondary gain concept: Definition problems and its abuse in medical practice. APS Journal, 3(4), 264–273.

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC Medical Ethics, 18.

Foucault, M. (1988). Madness and Civilization; A history of insanity in the age of reason. Vintage Books (Original work published 1961)

Foucault, M. (1995). Discipline and Punish: The Birth of the Prison. Vintage Books (Original work published 1975)

Freire, P. (1993). Pedagogy of the oppressed: 20th anniversary edition. Continuum.

Freud, A. (1957). The ego and the mechanisms of defence. International Universities Press. (Original work published 1936)

Freud, S. (1965). New introductory lectures on psycho-analysis. The Standard Edition. W.W. Norton & Company. (Original work published 1933)

Fricker, M. (2007). Epistemic injustice: Power and the ethics knowing. Oxford University Press.

Geraghty, K.J. (2020). The negative impact of the psychiatric model of chronic fatigue syndrome on doctors’ understanding and management of the illness. Fatigue: Biomedicine, Health & Behavior, 8(3), 167-180.

Geraghty, K.J. & Blease, C. (2019). Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model: a review of patient harm and distress in the medical encounter. Disability & Rehabilitation: An International, Multidisciplinary Journal, 41(25), 3092-3102.

Geraghty, K., Hann, M., & Kurtev, S. (2019). Myalgic encephalomyelitis/chronic fatigue syndrome patients’ reports of symptom changes following cognitive behavioural therapy, graded exercise therapy and pacing treatments: Analysis of a primary survey compared with secondary surveys. Journal of Health Psychology, 24(10), 1318–1333.

Geraghty, K., Jason, L., Sunnquist, M., Tuller, D., Blease, C., & Adeniji, C. (2019). The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model. Health Psychology Open, 6(1).

Geraghty, K., & Scott, M. J. (2020). Treating medically unexplained symptoms via improving access to psychological therapy (IAPT): major limitations identified. BMC Psychology, 8(1), 13.

Ghaemi, S. N. (2009). The rise and fall of the biopsychosocial model. The British Journal of Psychiatry, 195(1), 3–4.

Hale, C., Benstead, S., Lyus, J., Odell, E. & Ruddock, A. (2020). Energy Impairment and Disability Inclusion: Towards an advocacy movement for energy limiting chronic illness. Centre for Welfare Reform. https://www.centreforwelfarereform.org/uploads/attachment/681/energy-impairment-and-disability-inclusion.pdf

Hale C., Brough, J., Allam, A., Lydiard, S., Springfield, F., Fixter, A., Wright, N., Clutton V. & Bole, K. (2021). Submission to the Department of Health and Social Care’s Inquiry into Women’s Health and Wellbeing in England. Chronic Illness Inclusion. https://chronicillnessinclusion.org.uk/wp-content/uploads/2021/06/CII.DHSC-Womens-Health-England-June-2021.pdf

Halligan, P.W., Bass. C. & Oakley D.A. (Eds.) (2003). Malingering and Illness Deception. Oxford University Press.

Haraway, D. (1988). Situated Knowledges: The Science Question in Feminism and the Privilege of Partial Perspective. Feminist Studies, 14(3), 575-599.

Harding, S. (1992). After the Neutrality Ideal: Science, Politics, and “Strong Objectivity.” Social Research, 59(3), 567–587.

Hawkins, P. and Shohet, R. (2007). Supervision in the helping professions (3rd ed.). Open University Press.

Hooper, M. & Williams, M. (2010). Magical Medicine: How to make a disease disappear. http://www.investinme.org/Article400%20Magical%20Medicine.shtml

Horton-Salway, M. (2002). Bio-psycho-social reasoning in GPs’ case narratives: The discursive construction of ME patients’ identities. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 6(4), 401–421.

Hughes, B. (2015). Disabled people as counterfeit citizens: The politics of resentment past and present. Disability & Society, 30(7), 991–1004.

Huibers, M. J. H., & Wessely, S. (2006). The act of diagnosis: Pros and cons of labelling chronic fatigue syndrome. Psychological Medicine, 36(7), 895–900.

Invest in ME Research (2021). Statement from Invest in ME Research: NICE Updated Guideline on the Diagnosis and Management of Myalgic Encephalomyelitis (ME or ME/CFS). https://www.investinme.org/IIMER-Statement-20210817-1.shtml

Jackson, C. (1995). UNUM Life Insurance Company Southern Regional Benefits: Chronic Fatigue Syndrome Management Program. https://pacegranskaren.files.wordpress.com/2016/09/unum-chronic-fatigue-manqement-program.pdf

Moore, (2021, October, 18). Austerity was a killer long before Covid-19. Independent. https://www.independent.co.uk/voices/austerity-social-care-deaths-covid-b1939559.html

Johansen, M.-L., & Risor, M. (2017). What is the problem with medically unexplained symptoms for GPs? A meta-synthesis of qualitative studies. Patient Education and Counseling, 100(4), 647–654.

Jolly, D. (2012, April, 8). A Tale of two Models: Disabled People vs Unum, Atos, Government and Disability Charities. DPAC. http://dpac.uk.net/2012/04/a-tale-of-two-models-disabled-people-vs-unum-atos-government-and-disability-charities-debbie-jolly/

Kersten, J., Baumhardt, M., Hartveg, P., Hoyo, L., Hüll, E., Imhof, A., Kropf-Sanchen, C., Nita, N., Mörike, J., Rattka, M., Andreß, S., Scharnbeck, D., Schmidtke-Schrezenmeier, G., Tadic, M., Wolf, A., Rottbauer, W., & Buckert, D. (2021). Long COVID: Distinction between Organ Damage and Deconditioning. Journal of Clinical Medicine, 10(17).

Kornelsen, J., Atkins, C., Brownell, K., & Woollard, R. (2016). The meaning of patient experiences of medically unexplained physical symptoms. Qualitative Health Research, 26(3), 367–376.

Kwan, O., & Friel, J. (2002). Clinical relevance of the sick role and secondary gain in the treatment of disability syndromes. Medical Hypotheses, 59(2), 129–134.

Kwan, O., Ferrari, R., & Friel, J. (2001). Tertiary gain and disability syndromes. Medical Hypotheses, 57(4), 459–464.

Langer, E. J. (1975). The illusion of control. Journal of Personality and Social Psychology, 32, 311-328.

Layard, R., Clark, D., Knapp, M., & Mayraz, G. (2007). Cost-benefit analysis of psychological therapy. National Institute Economic Review, 202, 90–98.

Lerner, M.J., & Miller, D.T. (1978). Just world research and the attribution process: Looking back and ahead. Psychological Bulletin, 85(5), 1030–1051.

Liddle, R. (2019, March 17). Always fatigued — yet they never tire of claiming their malady really is a virus. The Sunday Times. https://www.thetimes.co.uk/article/always-fatigued-yet-theynever-tire-of-claiming-their-malady-really-is-a-virus-d7s7qlvbk

Loewenthal, D. (Ed.). (2015). Critical psychotherapy, psychoanalysis and counselling: Implications for practice. Palgrave MacMillan.

Luca, M. (2011). A qualitative study of psychodynamic and cognitive behavioural therapists’ conceptualisations of medically unexplained symptoms in their clients. Counselling & Psychotherapy Research, 11(4), 291–299.

Luca, M. (2012). Therapeutic activities and psychological interventions by cognitive behavioural and psychodynamic therapists working with medically unexplained symptoms: A qualitative study. Counselling & Psychotherapy Research, 12(2), 18-127.

Maizels, J. & Adamson, F. (2017). Chronic pain: A neurosomatic approach. Therapy Today, 28(1), 22-26

McCartney, G., Dickie, E., Escobar, O., & Collins, C. (2021). Health inequalities, fundamental causes and power: towards the practice of good theory. Sociology of Health & Illness, 43(1), 20–39.

Metzl, J. M., & Hansen, H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science & Medicine, 103, 126–133.

Muhammad, M., Wallerstein, N., Sussman, A. L., Avila, M., Belone, L., & Duran, B. (2015). Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes. Critical Sociology, 41(7–8), 1045–1063.

Ng, S. L., Wright, S. R., & Kuper, A. (2019). The Divergence and Convergence of Critical Reflection and Critical Reflexivity: Implications for Health Professions Education. Academic Medicine :Journal of the Association of American Medical Colleges, 94(8), 1122–1128.

NHS (2021). Medically unexplained symptoms. https://www.nhs.uk/conditions/medically-unexplained-symptoms/

NHS (n.d.). Bedfordshire Chronic Fatigue Service. East London NHS Foundation Trust. https://www.elft.nhs.uk/service/419/Bedfordshire-Chronic-Fatigue-Service

NICE (2018). NICE guideline CG53. Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): Diagnosis and management. https://www.nice.org.uk/Guidance/CG53 (original published 2007)

NICE (2020a). Myalgic encephalomyelitis (or encephalopathy) / chronic fatigue syndrome: diagnosis and management. Evidence reviews for the non- pharmacological management of ME/CFS. https://www.nice.org.uk/guidance/GID-NG10091/documents/evidence-review-7

NICE (2020b). Myalgic encephalomyelitis (or encephalopathy) / chronic fatigue syndrome: Diagnosis and management. Draft for consultation, November 2020. https://www.nice.org.uk/guidance/GID-NG10091/documents/draft-guideline

NICE (2021a). NICE pauses publication of updated guideline on diagnosis and management of ME/CFS. https://www.nice.org.uk/news/article/nice-pauses-publication-of-updated-guideline-on-diagnosis-and-management-of-me-cfs

NICE (2021b). Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management NICE guideline [NG206]. https://www.nice.org.uk/guidance/NG206

Olkin, R. (2017). Disability-affirmative therapy: A case formulation template for clients with disabilities. Oxford University Press.

O’Neill, S. (2020, June, 24) Chronic fatigue syndrome: ME families accused of child abuse. The Times. https://www.thetimes.co.uk/article/chronic-fatigue-syndrome-me-families-accused-of-child-abuse-np968v9dt

Paradis, E., Nimmon, L., Wondimagegn, D., & Whitehead, C. R. (2020). Critical Theory: Broadening Our Thinking to Explore the Structural Factors at Play in Health Professions Education. Academic Medicine : Journal of the Association of American Medical Colleges, 95(6), 842–845.

Parsons, T. (1951). The social system. Routledge & Kegan Paul.

Pemberton, M. (2011, August 29). Protestors have got it all wrong about ME. The Times. https://www.telegraph.co.uk/news/health/8641007/Protesters-have-got-it-all-wrong

Penman, J. (2021). Messages from the body. Therapy Today, 32(1), 30-33.

Pilecki, B., Thoma, N., & McKay, D. (2015). Cognitive behavioral and psychodynamic therapies: Points of intersection and divergence. Psychodynamic Psychiatry, 43(4), 463–490.

Pritlove, C., Juando-Prats, C., Ala-Leppilampi, K., & Parsons, J. A. (2019). The good, the bad, and the ugly of implicit bias. Lancet (London, England), 393(10171), 502–504.

Proctor, G., Brown, M., Cohen, S. & Mckelvie, S. (2019, April) Culture clash: the challenges of working as a counsellor in IAPT. Healthcare Counselling and Psychotherapy Journal, 19(2).

RCP (1996). Chronic Fatigue Syndrome: Report of a joint working group of the Royal Colleges of Physicians, Psychiatrists, and General Practitioners. CR54. Royal College of Physicians, Royal College of Psychiatrists and Royal College of General Practitioners. https://me-pedia.org/images/7/71/1996_UK_Chronic_Fatigue_Syndrome_report.pdf

Rogers, C. (2003). Client-Centered Therapy. Constable. (Original work published 1951).

Rose, N. S. (1998). Inventing our selves: Psychology, power and personhood. Cambridge University Press.

Rothschild, Z. K., Landau, M. J., Sullivan, D., & Keefer, L. A. (2012). A dual-motive model of scapegoating: displacing blame to reduce guilt or increase control. Journal of Personality and Social Psychology, 102(6), 1148–1163.

Rutherford, J. (2007a) Jonathan Rutherford writes on the link between the US disability insurance company Unum and UK welfare reform. https://www.moStewartresearch.co.uk/wp-content/uploads/2018/05/Jonathan-Rutherford-US-dis-ins-co-Unum-UK-welfare-reform.pdf

Rutherford, J. (2007b). New Labour, the market state, and the end of welfare. Soundings: A Journal of Politics and Culture, 36, 38-52.

Ryan, W. (1971). Blaming the victim. Vintage Books.

Salmon, P. (2000). Patients who present physical symptoms in the absence of physical pathology: a challenge to existing models of doctor-patient interaction. Patient Education and Counseling, 39(1), 105–113.

Sata M.J. & Munday C.C. (2017). Primary and Secondary Gain. In: V. Zeigler-Hill & T. K. Shackelford (Eds.), Encyclopedia of Personality and Individual Differences. Springer. https://link.springer.com/referenceworkentry/10.1007%2F978-3-319-28099-8_619-1

Shakespeare, T., Watson, N., & Alghaib, O. A. (2017). Blaming the victim, all over again: Waddell and Aylward’s biopsychosocial (BPS) model of disability. Critical Social Policy, 37(1), 22–41.

Sharma, A. E., Mann, Z., Cherian, R., Del Rosario, J. B., Yang, J., & Sarkar, U. (2020). Recommendations From the Twitter Hashtag #DoctorsAreDickheads: Qualitative Analysis. Journal of Medical Internet Research, 22(11), e25511.

Sharma, S. S., Rath, B. N., & Devpura, N. (2021). Pandemics and their impact on global economic and financial systems. MethodsX, 8, 101274.

Sharpe, M. (2002). Functional symptoms and syndromes: Recent developments. In: Unum Provident: Trends in Health and Disability [Brochure] (pp.14-21) https://issuu.com/maxhead/docs/unum_cmo_report_2002/18

Sharpe, M. (2021). Post-Covid-19 syndrome (long-Covid). https://www.swissre.com/dam/jcr:788aa287-7026-430a-8c14-f656421b6e71/swiss-re-institute-event-secondary-covid19-impacts-presentation-michael-sharpe.pdf

Sharpe, M., Chalder, T., Palmer, I., & Wessely, S. (1997). Chronic fatigue syndrome: A practical guide to assessment and management. General Hospital Psychiatry, 19(3), 185–199.

SMC (Science Media Centre) (2020, November 10). Expert reaction to NICE draft guideline on diagnosis and management of ME/CFS. https://www.sciencemediacentre.org/expert-reaction-to-nice-draft-guideline-on-diagnosis-and-management-of-me-cfs/

SMC (Science Media Centre) (2021, October, 29). Expert reaction to updated NICE guideline on diagnosis and management of ME/CFS. https://www.sciencemediacentre.org/expert-reaction-to-updated-nice-guideline-on-diagnosis-and-management-of-me-cfs/

Spandler, H., & Allen, M. (2018). Contesting the psychiatric framing of ME/CFS. Social Theory & Health, 16(2), 127–141.

Stanley, I., Salmon, P., & Peters, S. (2002). Doctors and social epidemics: the problem of persistent unexplained physical symptoms, including chronic fatigue. The British Journal Of General Practice: The Journal Of The Royal College Of General Practitioners, 52(478), 355–356.

Stewart, M. (2019). Influences and consequences: The conclusion to the preventable harm project 2009-2019. The Centre for Welfare Reform. https://www.centreforwelfarereform.org/uploads/attachment/668/influences-and-consequences.pdf

Teo, T. (2015). Critical psychology: A geography of intellectual engagement and resistance. American Psychologist, 70(3), 243–254.

Thomas, A., Kuper, A., Chin-Yee, B., & Park, M. (2020). What is “shared” in shared decision-making? Philosophical perspectives, epistemic justice, and implications for health professions education. Journal of Evaluation in Clinical Practice, 26(2), 409–418.

Tuller, D. (2018, August, 13). Trial By Error: Open Letter to The Lancet, version 3.0. Virology Blog: About viruses and viral disease. https://www.virology.ws/2018/08/13/trial-by-error-open-letter-to-the-lancet-version-3-0/

Tuller, D. (2019, November, 22). Trial By Error: Open Letter to Dr Godlee about BMJ’s Ethically Bankrupt Actions (2) Virology Blog: About viruses and viral disease. https://www.virology.ws/2019/11/22/trial-by-error-open-letter-to-dr-godlee-about-bmjs-ethically-bankrupt-actions-2/

Turan, J. M., Elafros, M. A., Logie, C. H., Banik, S., Turan, B., Crockett, K. B., Pescosolido, B., & Murray, S. M. (2019). Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Medicine, 17(1), 7.

Turner-Stokes, L. (2002). “Medically Unexplained Symptoms” - an approach to rehabilitation [PowerPoint]. https://meagenda.wordpress.com/2009/05/18/the-elephant-in-the-room-series-two-more-on-mups/

Turner-Stokes, L., & Wade, D. T. (2020). Updated NICE guidance on chronic fatigue syndrome. BMJ (Clinical Research Ed.), 371, m4774.

van Egmond, J. (2003). Multiple Meanings of Secondary Gain. The American Journal of Psychoanalysis, 63,(2), 137 ‐ 147

Waddell, G. & Burton, K. (2004). Concepts of rehabilitation of the management of common health problems. London: The Stationery Office.

Waddell, G. & Aylward, M. (2005). The Scientific and Conceptual Basis of Incapacity Benefits. The Stationery Office.

Waddell, G. & Aylward, M. (2010). Models of Sickness and Disability: Applied to Common Health Problems. Royal Society of Medicine.

Wade, D.T., & Halligan, P.W. (2007). Social roles and long-term illness: Is it time to rehabilitate convalescence? Clinical Rehabilitation, 21(4), pp.291–298.

Wendell, S. (2006). Toward a feminist theory of disability. In L. J. Davis(Ed.), The disability studies reader (pp. 243–256). Taylor and Francis.

Wessely, S. (1994). Neurasthenia and chronic fatigue: Theory and practice in Britain and America. Transcultural Psychiatric Research Review, 31(2), 173–209

Wessely, S. (1997). Chronic fatigue syndrome: A 20th century illness? Scandinavian Journal of Work, Environment & Health, 23(Suppl 3), 17–34.

Wessely, S., David, A., Butler, S., & Chalder, T. (1989). Management of chronic (post-viral) fatigue syndrome. The Journal Of The Royal College Of General Practitioners, 39(318), 26–29.

White, P. (Ed.) (2005). Biopsychosocial medicine: An integrated approach to understanding illness. Oxford University Press

White, P. D., Chalder, T., Sharpe, M., Angus, B. J., Baber, H. L., Bavinton, J., … Wilks, D. (2017). Response to the editorial by Dr Geraghty. Journal of Health Psychology, 22(9), 1113–1117.

Wileman, L., May, C., & Chew-Graham, C. A. (2002). Medically unexplained symptoms and the problem of power in the primary care consultation: A qualitative study. Family Practice, 19(2), 178–182.

Wilkinson, S. (1988). The role of reflexivity in feminist psychology. Women’s Studies International Forum, 11, 493– 502.

Wilkinson, S. & Kitzinger, C. (1996). Theorizing representing the other. In S. Wilkinson & C. Kitzinger (Eds.)., Representing the other: A Feminism & Psychology Reader (pp.1-32). Sage.

Willis, C. & Chalder, T. (2021). Concern for Covid-19 cough, fever and impact on mental health. What about risk of Somatic Symptom Disorder? Journal of Mental Health (Abingdon, England) 1–5. DOI 10.1080/09638237.2021.1875418

Woolgar, S. (Ed.). (1988). Knowledge and reflexivity: New frontiers in the sociology of knowledge. Sage.



2022-10-18 — Updated on 2022-10-22

How to Cite

Hunt, J. (2022). Examining the psychology of practitioners, institutions and structures: : ‘Medically unexplained symptoms’ and biopsychosocial discourse reflexively revisited. Outlines. Critical Practice Studies, 23(1), 06–49. https://doi.org/10.7146/ocps.v23i1.129191