Research Commentaries

A Review of ME/CFS: Past, Present and Future

Science’s rejection of psychological dogma

Doctors with M.E. Honorary Fellows Dr. William Weir and Dr. Nigel Speight co-author a newly published opinion piece that discusses the past, present and possible future of ME/CFS. In order to give context as to how ME/CFS came to be incorrectly viewed as a psychological disorder, the article draws on previous historical examples of where a dogma has existed, only to later be replaced by rational scientific understanding.

Weir and Speight highlight the damage caused to ME/CFS patients by treatments based on the view that ME/CFS results from abnormal illness beliefs and exercise phobia, and give hope that this view will soon be replaced with scientific evidence-based medicine.

[There is] a tendency to assume that, if no pathological mechanism can be demonstrated, then, by default, psychological disorder must be the problem. Inherent in such an assumption is the arrogant belief that routine laboratory tests infallibly exclude physical disorder. The story of ME/CFS is a prime example of such dogma.

The damage caused by GET, in particular, has unfortunate historical precedents. As previously stated, bloodletting was particularly dangerous for cholera; likewise GET has caused significant harm for many ME/CFS patients.

…the belief that ME/CFS is “psychological” will eventually be consigned to the dustbin of medical history…Compelling evidence of physical causation is now accumulating.”

Weir and Speight (2021)


This review raises a number of compelling issues related to the condition of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Some historical perspective is necessary in order to highlight the nature of the controversy concerning its causation. Throughout history, a pattern tends to repeat itself when natural phenomena require explanation. Dogma usually arrives first, then it is eventually replaced by scientific understanding. The same pattern is unfolding in relation to ME/CFS, but supporters of the psychological dogma surrounding its causation remain stubbornly resistant, even in the face of compelling scientific evidence to the contrary. Acceptance of the latter is not just an academic issue; the route to proper understanding and treatment of ME/CFS is through further scientific research rather than psychological theorisation. Only then will a long-suffering patient group benefit.


Weir, W., Speight, N. ME/CFS: Past, Present and Future. Healthcare. 2021; 9(8):984.

Dr. Nigel Speight

Honorary Fellow

Paediatric Physician, Co- Author, International Consensus Criteria, Co-Author, Pediatric Primer in Frontiers in Pediatrics, Advisor, 25% ME Group, Researcher

Dr. William Weir

Honorary Fellow

Infectious Disease Physician, Harley Street, London, Retired NHS Consultant, Royal Free Hospital, Committee Member, NICE ME/CFS Guideline Development Committee, Researcher