I put a lot more trust in a single study with ground-truth data than in a giant pile of studies with data which is confounded in various ways. So, I trust the study with the antibody tests more than I’d trust basically-any number of studies relying on self-reports. (A different-but-similar application of this principle: I trust the Boston wastewater data on covid prevalence more than I trust all of the data from test results combined.)
I probably do have relatively high prior (compared to other people) on health-issues-in-general being psychosomatic. The effectiveness of placebos (though debatable) is one relevant piece of evidence here, though a lot of my belief is driven by less legible evidence than that.
I expect some combination of misattribution, psychosomaticity, selection effects (e.g. looking at people hospitalized and thereby accidentally selecting for elderly people), and maybe similar issues which I’m not thinking of at the moment to account for an awful lot of the “long covid” from self-report survey studies. I’m thinking less like 50% of it, and more like 90%+. Basically, when someone runs a survey and publishes data from it, I expect the results to mostly measure things other than what the authors think they’re measuring, most of the time, especially when an attribution of causality is involved.
Even if long covid is entirely psychosomatic, it’s worth avoiding those psychosomatic effects. One way to avoid them is to debunk (potentially at the gut intuition level, which is harder to reliably do) non-psychosomatic causes of it. Another way is to avoid covid in the first place. I expect the most effective strategy will include some combination of these.
I see “psychosomatic” often used as a semantic stopsign. Once something is called “psychosomatic”, people typically stop trying to figure out a way to solve the problem. I don’t know of any reliable and credible ways to resolve psychosomatic issues, it’s mostly meditation guys and alternative medicine quacks who even try.
If it’s really true that a large amount of health-issues-in-general are psychosomatic, then that’s a really huge problem which we don’t have an adequate solution for! (I expect that you agree with this, I just am trying to push against the weight of the semantic stopsign that people have around this concept.)
Psychosomatic is a word that’s gets often used as if that would mean that illnesses aren’t real.
If you tell someone with an allergy to cats to imagine that they are stocking a cat, that can be enough to trigger the allergy symptoms. The fact that an imagined cat is good enough to trigger the allergy shows quite clearly that the allergy is partly psychosomatic as it can be triggered psychologically.
The underlying mechanisms of such an immune response are however deep. One model of long COVID is, that it’s partly about autoimmune issues. Those might be as psychosomatic as the above example of cat allergy. There’s a neuronal pattern that gets the body to trigger defenses in a misaligned way.
Good points. Some responses:
I put a lot more trust in a single study with ground-truth data than in a giant pile of studies with data which is confounded in various ways. So, I trust the study with the antibody tests more than I’d trust basically-any number of studies relying on self-reports. (A different-but-similar application of this principle: I trust the Boston wastewater data on covid prevalence more than I trust all of the data from test results combined.)
I probably do have relatively high prior (compared to other people) on health-issues-in-general being psychosomatic. The effectiveness of placebos (though debatable) is one relevant piece of evidence here, though a lot of my belief is driven by less legible evidence than that.
I expect some combination of misattribution, psychosomaticity, selection effects (e.g. looking at people hospitalized and thereby accidentally selecting for elderly people), and maybe similar issues which I’m not thinking of at the moment to account for an awful lot of the “long covid” from self-report survey studies. I’m thinking less like 50% of it, and more like 90%+. Basically, when someone runs a survey and publishes data from it, I expect the results to mostly measure things other than what the authors think they’re measuring, most of the time, especially when an attribution of causality is involved.
Even if long covid is entirely psychosomatic, it’s worth avoiding those psychosomatic effects. One way to avoid them is to debunk (potentially at the gut intuition level, which is harder to reliably do) non-psychosomatic causes of it. Another way is to avoid covid in the first place. I expect the most effective strategy will include some combination of these.
I see “psychosomatic” often used as a semantic stopsign. Once something is called “psychosomatic”, people typically stop trying to figure out a way to solve the problem. I don’t know of any reliable and credible ways to resolve psychosomatic issues, it’s mostly meditation guys and alternative medicine quacks who even try.
If it’s really true that a large amount of health-issues-in-general are psychosomatic, then that’s a really huge problem which we don’t have an adequate solution for! (I expect that you agree with this, I just am trying to push against the weight of the semantic stopsign that people have around this concept.)
Psychosomatic is a word that’s gets often used as if that would mean that illnesses aren’t real.
If you tell someone with an allergy to cats to imagine that they are stocking a cat, that can be enough to trigger the allergy symptoms. The fact that an imagined cat is good enough to trigger the allergy shows quite clearly that the allergy is partly psychosomatic as it can be triggered psychologically.
The underlying mechanisms of such an immune response are however deep. One model of long COVID is, that it’s partly about autoimmune issues. Those might be as psychosomatic as the above example of cat allergy. There’s a neuronal pattern that gets the body to trigger defenses in a misaligned way.