Thomas Easley

Herbalist, Author, Educator, Eclectic, Skeptic

[Thomas Easley @eclecticherbal]

You’ve named the criterion plainly. A medical condition is one caused by specific bodily processes, and mental disorders, you say, can’t be explained at the level of biological processes. Fine. Apply it to IBS. Nobody doubts IBS is medicine. Gastroenterology diagnoses it and treats it. But no specific bodily process has been identified as its cause. It’s defined by symptom criteria, not by a mechanism. So which do you mean by “caused by specific bodily processes”? If you mean an identified mechanism, then IBS leaves medicine, and so does fibromyalgia, interstitial cystitis, and more. If you mean only that there’s some bodily process involved because we’re biological creatures, that’s the same claim you call vacuous when Aftab makes it. Also gastroenterology already worked through this. Rome IV renamed the functional GI disorders to disorders of gut-brain interaction back in 2016, because “functional” was being heard as nonorganic, psychiatric, not quite real. The field threw out the organic/functional split you’re now reasserting. So apply your criterion to IBS and tell us. Either it throws out conditions every gastroenterologist treats as illness, which means you’re not describing what “medical condition” means but rewriting it against the field, or it lets them in on grounds that let psychiatry back in too. Which is it?

[Dr Joanna Moncrieff @joannamoncrieff]

Aligning mental health problems with medical conditions is both incoherent and problematic, as illustrated by Aftab's recent piece. Here is my short blog explaining why. https://t.co/HS0YH3Mxd5. @awaisaftab

[Thomas Easley @eclecticherbal]

@awaisaftab @sanilrege It’s a reoccurring move across time. Describe the suffering, map it onto whatever physiology the culture has, explain it there, then harden the explanation into a thing. Humors, nerves, neurotransmitters, now metabolism.

[Thomas Easley @eclecticherbal]

@northHealer @AlobhaPatrick Dualism is deeply ingrained in our culture. Really does a number on us somatically sensitive hysterics :)

[Thomas Easley @eclecticherbal]

@AlobhaPatrick 👋🏼

[Thomas Easley @eclecticherbal]

@northHealer @AlobhaPatrick Conversely, some of us can readily conceptualize distress, and still have emotions that internalize into sensations (and not always vague).

[Thomas Easley @eclecticherbal]

Psilocybin assisted therapy completely resolved my chronic severe low back pain, brain fog, and lethargy. But then 8 weeks later I started experiencing low back pain, fatigue, and brain fog again. A 1.5 g “tune up dose” resolved the symptoms again. This pattern continued every 4-8 weeks for a couple of years with gradual increases in the time between necessary dosing. Do you have any good resources on differentiating psilocybin withdrawal from depression relapse?

[Eric Topol @EricTopol]

For medical information, general AI frontier models (Google, OpenAI, Anthropic) outperformed specialized @EvidenceOpen and @UpToDate as assessed by 12 US clinicians, randomized and blinded to which model and extensive testing/benchmarks. This was not anticipated. @NatureMedicine
https://t.co/KCH1ADfQWz

[Thomas Easley @eclecticherbal]

@matthewbaszucki I have certainly seen influencers with vested financial or ideological interest fanning the flames you’re talking about. Back to you. How are you checking your bias and preventing yourself from spreading misinformation?

[Thomas Easley @eclecticherbal]

@internetuserf12 As if our response to danger is confined to one system

[Thomas Easley @eclecticherbal]

Apologies, I might have talked myself around the point I was trying to make. Whether moving the line is good isn’t in the blood pressure reading — it’s a judgment about which costs and benefits matter. My point was this isn’t just a psychiatry problem. Even hypertension, the most “just measure it” disease there is, has its normal/pathological boundary drawn by human values. Same vascular system on Oct 31 and Nov 1. Only the values moved.

[Thomas Easley @eclecticherbal]

@DrHannahBelcher In November of 2017, 30 million people developed hypertension overnight. When the line between normal and pathological moved. Canguilhem rolled in his grave.

[Thomas Easley @eclecticherbal]

@vauntedrevelrie We depressed folks are experts in our own lived experience. That expertise doesn’t automatically generalize to other areas of understanding.

[Thomas Easley @eclecticherbal]

@LadyRimbaud Yes sorry, the authors conclusion. And I also think it’s an important study! It’s just aggravating to me when a studies conclusions reach beyond what the design allows.

[Thomas Easley @eclecticherbal]

This conclusion is way stronger than the design of the study allows. A retrospective EHR algorithm study with no control group can’t establish attributable risk. I am happy this group is advancing their ai algorithm, and I hope their next study can provide real insight into risks.

[Thomas Easley @eclecticherbal]

Dennett. Excellent. But I thought he drew that as two levels of explanation of one system, not two kinds of condition. So which level is a migraine — personal or subpersonal? Which is diabetes? Each is both. How does a distinction that runs through every condition sort them into two domains? And finally: what makes a subpersonal process pathological rather than merely a process?

[Thomas Easley @eclecticherbal]

Joanna — as a history of medicine fan , I have to ask where I’d find this. “Of the body” isn’t medicine’s foundation. Galen wrote treatises on diagnosing and curing the passions of the soul.

More recently, Gastroenterology renamed its largest symptom category “disorders of gut-brain interaction” in 2016 — dropping “functional” specifically to reject the organic-versus-psychiatric dualism you’re calling fundamental. If a core medical field retired your distinction as scientifically inaccurate and stigmatizing, on what grounds are you reinstating it?

[Thomas Easley @eclecticherbal]

@emollick I just say use all the skills, teams subagents and workflows you need to meet /goal. But I have taken an hour to define goal. Seems to work really well for large knowledge projects.

[Thomas Easley @eclecticherbal]

Margins” presupposes a center. Bald has fuzzy edges because we know it’s about hair. What is medicine about, such that IBS sits at its edge? IBS isn’t dubiously medical; your criterion is what’s dubious. And a vague boundary can’t license a sharp expulsion: once you concede fuzziness, you’ve forfeited the right to place depression cleanly on the far side. Name the dimension, or drop “margins.

[James Barnes MSc., MA @psychgeist52]

The existence of ambiguous conditions within medicine doesn't show that there is no distinction between medicine and psychiatry. It shows that medicine has boundary problems at its margins—as every discipline and every definition does. That fact does not merge everything and preclude distinctions and definitions.