“It is all in your head”. An assessment that is all too familiar to many patients with little understood emergent diseases such as ME, PANS or Lyme. Together with the rise of complex chronic illnesses caused by stealth pathogens, we witness a rise of the invention of so-called ‘somatic disorders’. This is of concern to both patients, who are often declared to be suffering from psychiatric illnesses without a proper evaluation of potential biological causes of their symptoms, as well as to their treating physicians. An interview with psychiatrist Robert Bransfield to provide a better understanding of the brain and body interaction and a critical analysis of the real function of these new somatic syndromes.
I am a psychiatrist practicing in New Jersey, USA. Like many psychiatrists trained in the early 70s my initial training was psychoanalytic. I have always had an interest in attempting to explain and treat the cases we refer to as being “treatment resistant”. It was clear that neither psychodynamic nor biologically based explanations alone were sufficient to explain these cases and a more comprehensive approach was needed.
First experience with psychiatric complaints caused by infections
Although I am sure I have been seeing psychiatric illness caused by Lyme and tick-borne diseases for my entire career, I became much more involved after an infectious disease colleague referred an extremely ill patient to me.