Paper short abstract:

We take a dynamic systems approach to medically unexplained illness using "Long Covid" as a case study. Applying a "biolooping" model, we explore how individual, social, and political processes interact with biological ones to shape bodily states and how they are perceived and made meaningful.

Paper long abstract:

Functional Neurological Disorder (FND), also known as Conversion Disorder, is distinguished by symptoms that mimic those of other neurological disorders like epilepsy or Parkinson's disease, but without apparent pathophysiology. FND is surprisingly widespread, yet notoriously poorly treated, with long term studies showing that over half of patients do not recover. As with many other "medically unexplained illnesses," sufferers of FND are disproportionately female (80%) and are often greeted with doubt and the suggestion that their symptoms are "merely" psychological in origin. In this paper, we use a dynamic systems approach to better understand the complex biosocial processes through which medically unexplained symptoms materialize. We explore how such states of illness emerge from the interactions of multiple subsystems within the individual, which are themselves part of a larger system that includes the lived environment. Using FND as a case study, we specifically propose what we call a "biolooping" model for understanding how individual, social, and political processes interact with biological ones to shape both bodily states and the way they are perceived and made meaningful by people, in continuous, reinforcing cycles. We analyze data from studies of FND, support group websites and patient narratives, and apply concepts from cutting edge research in the neurosciences, to explore the processes through which bodily sensations come to be perceived as symptoms of a particular illness, and the dynamic feedback through which their meanings come to affect underlying bodily states.