Misinformation By Celebrities

I’ll admit it–I love Dr. Drew. I’ve watched most of the episodes of Celebrity Rehab and can’t wait for a new season. If you don’t know, Dr. Drew is an internist with a focus on addiction medicine (although I’m not sure if he’s board certified in that specialty or not). He does not focus on neurologic conditions as far as I know, so when I heard him misspeaking about multiple sclerosis, I was bothered. I think celebrities do have a certain obligation to use their fame responsibly. That’s why I find it irritating when I hear celebrities, in particular celebrities who are physicians–which there are a few–who speak authoritatively on topics while providing wrong information!

This started recently while I was browsing the National MS Society website, which had a link to Dr. Drew’s blog, back in May when he interviewed Phil Keoghan (the host of Amazing Race, one of the better reality shows out there). Apparently Phil Keoghan biked across the country and raised half a million dollars–it’s not clear why he picked MS as his charity cause (as he notes in the interview, he only found out afterwards that he has a cousin with MS), but whatever, he was trying to do a good thing with his celebrity. What really bothered me was Dr. Drew’s use of the term “la belle indifference.” He explained it as the “positive attitude” that so many people with multiple sclerosis seem to have.

First of all, that term refers to the indifference (or unawareness) that patients have with something called “conversion disorder.” I find this term very offensive when misapplied to MS patients for a couple of reasons. The thing is, a lot of MS patients walk around and look perfectly healthy, because their symptoms are neurologic. You can’t necessarily see numbness, tingling, fatigue, depression, dizziness, or weakness. So–when you don’t look sick, there’s a sort of pressure to act like you’re not sick. It seems that if you act like you’re sick, people around you don’t really get it.

Now–this term, la belle indifference, refers to people who are converting psychiatric symptoms like anxiety, for example, into a neurologic symptoms. An example is the “hysterical” woman who believes her legs are paralyzed and she can’t walk. When she’s tested, her muscles work fine, though. It used to be thought that this was “all in the head,” and not necessarily in the brain, but recent research is starting to show that certain neurologic circuits are impaired in this disorder. Usually conversion disorder is short-lived (hours to days), and improves when the underlying stress improves. Patients with this disorder typically have poor insight, and use a defense mechanism called “la belle indifference” in which they feel like everything is okay, in order not to deal with the distress that would accompany acknowledging their problem.

I don’t know if that explanation makes sense, but I’ll tell you, that as a psychiatrist who is very familiar with MS, it is particularly bothersome to hear this term misapplied because of the implications of the term–that MS symptoms are “in someone’s head,” and the reinforcement of the pressures MS patients have to pretend that everything is fine. No one can tell someone how to feel, but making assumptions about one’s feelings makes it harder to express them.

Just some food for thought–thanks for reading.

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Explore posts in the same categories: Multiple Sclerosis, Psychiatry in the Media, Psychosomatic medicine

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