The Distinction Between Psychiatric and Somatic Illness as a Conceptual Restriction on Chronic Fatigue Syndrome

I argue that the distinction between psychiatric and somatic illness unhelpfully restricts conceptual understandings of chronic fatigue disorders. I offer two reasons for rejecting the distinction in this particular case. The first is that chronic fatigue appears to be aetiologically diverse such to suggest that we should be suspicious of the idea that the distinction applies clearly and consistently. Second, the distinction is employed with inadequate sensitivity to the phenomenology: a tentative exploration into first-person accounts suggests that attempts to draw clear boundaries between the two fundamental illness categories will not prove effective here either. I consider the problems of ‘psychologisation’ and ‘somatisation’ that surround chronic fatigue in order to illustrate one way in which lessening the grip of this distinction might facilitate a more constructive approach to understanding chronic fatigue. In adopting this phenomenological attitudinal shift, the condition need not be reduced to either exclusively biological or psychological explanation, and the condition can stop being batted between psychiatrists and other medics.