Society, mind and body in chronic fatigue syndrome: an anthropological view

An anthropological view of chronic fatigue syndrome places the study of illness in social context. Data from an interview study of 50 chronically fatigued patients demonstrate the relation of local social worlds--families, workplaces, communities--to the meaning and experience of illness. Negative life events and difficulties, multiple commitments, and a hectic pace are among prominent themes in the subjects' local worlds. These themes are reflected in: (1) attributions of illness onset to social sources, (2) the symbolism of the core complaint of fatigue, and (3) an illness-induced, positively valued lifestyle transformation suggesting the rejection of culturally prescribed 'busyness'. Dichotomous definitions of the relation of mind and body are shown to be part of culture, not Nature, in the paper's second section. The 'mind-body dichotomy' and the differing values attached to physical and psychological disorders by a naturalistic scientific paradigm explain the delegitimizing experiences of sufferers, who find their illness dismissed as psychosomatic and therefore 'not real'. A conceptualization of chronic fatigue syndrome which links local social worlds to psychological distress, felt bodily sensation and biological changes is proposed. Collaborative teams of social scientists and medical researchers might fruitfully pursue aspects of social context in relation to psychiatric, immunological and viral dimensions of the illness.