First, please don't use "hypochondriac" - it's a horribly outdated term and no-one here is trying to diminish the suffering that people feel from this condition, even if they think it's somataform.

> Here is why it computes. Empty Nose Syndrome, as described from various sources, has a common set of symptoms and is linked to one specific surgical procedure. Now let us suppose your theory is correct and it is caused solely by anxiety focused on the surgical intervention. If that were the case, you would expect many people to express this same set of symptoms from other nose-related surgeries. You would expect that the description of Empty Nose Syndrome would then expand to be linked to a number of different nasal surgeries. After all, if these patients are hypochondriacs whose anxiety causes physical discomfort, why would this anxiety be limited to only turbinate reduction?

But these things tend to self limit. Ann says she has chronic fatigue. She undergoes some psychological therapy. She gets some relief from her symptoms. A bunch of people in the CFS organisation now shun Ann, and tell her that she didn't have real CFS.

I believe and trust that no one is trying to diminish the suffering. But within that I still feel there is condescension when someone describes the idea of investigating a person's symptoms as directly reported "Chasing down rabit-holes by pretending the anxiety is something /else/". There is way more certainty and dismissal in that attitude than anybody has justified in my opinion.

Don't get me wrong, I understand if investigating the direct symptoms might not be practical under some circumstances. But saying it's useless and "pretending" goes too far IMO.

> But these things tend to self limit. Ann says she has chronic fatigue. She undergoes some psychological therapy. She gets some relief from her symptoms. A bunch of people in the CFS organisation now shun Ann, and tell her that she didn't have real CFS.

I don't see how this scenario answers my question. Your story suggests that their is social pressure to resist the idea that the condition is treatable. It doesn't explain what would prevent an expanding scope for where the condition is identified.

Sorry but I can't keep up with you. You're trying to reason about things you don't even know happened, based on an account in an article you read on the internet, and on things that people report. That's no way to make sense of anything.

I'll give you an example. Where I come from, people believe in the Evil Eye: that if you stare at someone or something with a bad intention, if you're jealous etc, you can cause real, physical harm to that person, thing etc.

I've been accused of it a couple of times (I got scary eyes). Once a friend got a headache and then called her mom and asked her to say a special prayer people say that supposedly banishes the Evil Eye, then made a big todo about how a certain person always gave her the Evil Eye (it didn't take rocket science to figure out she was talking about me).

So, my friend obviously had an ailment, if you like: her head hurt. She felt bad, she blamed it on me. It helps that we were having an argument at the time it happened. We often had arguments. She often had headaches. She believed I was giving her the Evil Eye.

You can take the events themselves and try to reason about them. Did I give my friend the Evil Eye? Was the headache unrelated? Which happened first? What tells us they were cause-and-effect? What tells us they weren't?

Except, there is no such thing as the Evil Eye and you're basing your whole reasoning process on empty air- and convincing yourself that you're on firm ground.

The thing to ask is not "did I give my friend the Evil Eye?". The thing to ask is "is there such a thing as the Evil Eye?". Equally, you should be asking whether ENS is real in the first place. But you jump immediately in discussions of cause-and-effect, symptoms and accounts. If you're already convinced that ENS is real, those are not that important. But you have to ask yourself: why do you think it's real? Just because people say they have it? There doesn't seem to be anything else at the moment.

Like others say, I don't doubt for a moment that people suffer from - something. But I'm not convinced that it's what they say it is. I don't blame people for going mad about it, I do blame their doctors for not listening to them, but I don't blame ENS, because it sounds like the Evil Eye, or Morgellon's or whatever similar crazy thing people latch on to in their desperation.

And of course the worse thing is: by latching onto ENS (or whatever), people deprive themselves of the chance to have what ails them treated.

> If you're already convinced that ENS is real, those are not that important. But you have to ask yourself: why do you think it's real?

I don't know how many times I have to say it. I don't claim positively to know it is real.

I'm going to write it just once more so that hopefully you don't miss it this time: I don't claim to positively know that ENS is real.

Here is what I do know. Nobody on this thread has presented enough information to categorically deny that it exists. So if I see people who appear to be doing that, I'm going to call them on it.

>> Here is what I do know. Nobody on this thread has presented enough information to categorically deny that it exists. So if I see people who appear to be doing that, I'm going to call them on it.

That's not how it works. The side that makes a claim has to show that it's real. Everyone else has every right to doubt the veracity of the claim until that time. Otherwise we'd all be endlessly bogged down in pointless conversations.

Anyone can come up with a wild, fantastical idea. That doesn't mean everyone else has to waste their time trying to disprove it.

Btw, if you've made such a big todo just because you don't get that, I'll be a bit upset 'cause I've been wasting my time here.

> Anyone can come up with a wild, fantastical idea

The idea that a person's physical symptoms might have a physical cause is not wild or fantastical. By Occam's Razor it is (absent other information) the most likely explanation.

That's not Occam's Razor. That's an egregious misunderstanding of Occam's Razor. The simplest explanation is indeed that those people suffer from anxiety, which is a very common condition that covers all their symptoms, as others have said. You need to make too many assumptions to be convinced of the contrary.