A view of the violence contained in Chronic Fatigue Syndrome (CFS)

In this paper I ask whether there might be any one particular

psychopathology likely to be linked specifically with the

physical illness known as chronic fatigue syndrome (CFS) or

myalgic encephalomyelitis (ME), and whether CFS/ME aids and

abets and “fits’ an original mental state. I think the

question cannot yet be answered. However it is my hypothesis

that in some personality structures the onset of CFS/ ME

following a physical illness exacerbates negativity and is an

aspect of ordinary depression where there is a lowering of

energy levels and a loss of zest for life, or it may reveal

the pathological aspect of unresolved rage. Depending on the

degree of pathological disturbance, working with and through

the rage may or may not result in a resolution of the symptoms

of ME. In this paper I consider some of the problems in the

transference and countertransference relationship, which make

it extremely difficult to separate out reality from phantasy.

There is then the further problem of the denial of the psyche

by the patient as part of the violence inherent in the

illness. One case is presented, an example of ME in a

borderline male patient in whom resolution could not be


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