Systems Thinking about Chronic Illness: Scientific Controversies and Gatekeeping

University of Innsbruck, 8–9 July 2025
Faculty of Catholic Theology, Karl-Rahner Platz 1, Dekanatssitzungssaal

Organizers: Katherine Dormandy, University of Innsbruck; Bruce Arroll, University of Auckland.

With thanks for generous funding to EPoS and the University of Innsbruck's Public Relations Office.

Health science is vulnerable to infiltration by bad science or pseudoscience, and relies heavily on gatekeeping to maintain its integrity. Gatekeeping, though necessary, is perilous. The history of science shows that gatekeepers may let in bad science or pseudoscience while keeping out important new ideas, due to cultural waves or commitment to entrenched frameworks. In the science of chronic illness, there is reason to think that just this is happening. The orthodox “biomedical model”, which posits body-mind dualism and sharp disciplinary boundaries, falls short in understanding and treating chronic illnesses, especially those for which clear physical causes are elusive. Yet promising systems-thinking alternatives, which posit mind-body unity and strong interdisciplinarity, are often dismissed by gatekeepers – including scientists, regulators, patient advocacy groups, and the media – as bad science or pseudoscience. Poor gatekeeping in health science can have disastrous consequences for patients and society. This interdisciplinary workshop brings together health psychologists, medical scientists, and philosophers of science to understand the situation and explore a way forward – both for chronic-illness research, and for illuminating the promise and pitfalls of gatekeeping in health science. (Program)

Tuesday 8 July

Wednesday 9 July

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Abstracts

Michael Sharpe

Title: Mind, Morals, Medicine and ME
Abstract: How did we come to separate the mind and the body in medicine, why is it so hard to put them back together and what can we learn from controversy over the nature and treatment of CFS/ME?

Rebecca Kennedy

Title: Rewiring Belief: Changing Minds About Mind-Body Medicine
Abstract: Dr. Rebecca Kennedy, a U.S. family physician and former lead of the long COVID clinic at Kaiser Permanente, explores why it’s so difficult to communicate brain-based models of chronic symptoms — even when they’re grounded in science. This talk examines the barriers to acceptance, from institutional bias to cognitive dissonance, and offers new strategies for how we might reach clinicians, patients, and the public in more effective ways. 

Phil Parker

Title: Can New Ideas Overcome Outdated Ones? A Case Study of The Lightning Process - A Systems Thinking Approach to Health
Abstract: Healthcare is starting to move beyond outdated Mind-Body Dualism as growing research highlights the benefits of Brain-Mind-Body approaches. In this talk, Dr. Phil Parker shares how research backed systems thinking approaches, exemplified by the Lightning Process (LP), are demonstrating significant benefits for people with chronic illnesses. While the persistence of dualistic thinking still creates barriers to patient choice and access, there is a clear shift towards more integrated, empowering healthcare models. We'll explore how with continued research and collaboration, the future looks hopeful for transforming chronic illness care and helping more people recover.

Enno Fischer

Title: “Excited Delirium Syndrome” or Asphyxiation? Evidential Practices in Forensic Medicine
Abstract: “Excited Delirium Syndrome” (ExDS) is sometimes considered a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In my talk, I examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. I will also focus on studies examining the main competing diagnosis: asphyxiation. In particular, I will address the role that experimentation plays in assessing associated causal claims.
This talk is based on joint work with Saana Jukola (University of Twente).

Katherine Dormandy

Title: Gatekeeping the Science of Chronic Illness
Abstract: New scientific paradigms have a hard time getting accepted. Rightly so: most revolutionary claims in science fall flat. Yet when new ideas prove their mettle, the gatekeepers of science should acknowledge them. This is easier said than done, not least because proving the mettle of a new paradigm may require upending the assumptions, even the vocabulary, of mainstream science itself. One obstacle is sheer lack of understanding of new paradigms. Piggybacking on this, however, are incredulity and motivated reasoning. I’ll explore how such factors are preventing the uptake of systems-thinking about chronic illness among gatekeepers of science – where these include scientists themselves, but also regulators, the media, and patient advocacy groups who most stand to benefit from systems-thinking.

Jason Busse

Title: Challenges and (Potential) Solutions to Management of Persistent Physical Symptoms
Abstract: Management of persistent physical symptoms is often challenged by patient-related and environmental factors. This presentation will explore some of these barriers, as well as potential solutions to optimize patient care.

Daniel Wehinger

Title: Reuniting Body and Soul: The Cartesian Legacy and Contemporary Philosophy of Mind
Abstract: No one wants to be a Cartesian today. Yet our thinking about the relationship between body and soul remains deeply shaped by the Cartesian framework. I will point to the ongoing influence of Cartesian intuitions in contemporary philosophy of mind and examine both current and historical approaches that move beyond this framework.

Diana Walther

Title: Electromagnetic hypersensitivity: the condition, the controversy and an exploration of a way forward
Abstract: Electromagnetic Hypersensitivity (EHS) remains a condition surrounded by considerable debate and controversy. This presentation will delve into the current scientific understanding of EHS, the lived experiences of those affected, and the efforts of the Swiss Medical Advisory Network for Non-Ionising Radiation in addressing this issue. We will introduce a conceptual framework for understanding EHS, along with treatment recommendations. Finally, we will explore what EHS can teach us about other chronic conditions, and reflect on its broader implications for health communication.

Karin De Punder

Title: Early life stress-induced accelerated biological aging as a risk factor for disease susceptibility over the lifespan
Abstract: Stressful events in early life, including prenatal stress and childhood abuse, represent significant risk factors for the onset of many chronic physical and mental conditions that are associated with changes in neuroendocrine stress and immune system function, as well as with accelerated (immuno)cellular aging. This is further reflected in a large body of human research linking early exposure to psychosocial and environmental stressors to shortened telomeres in immune cells. The shortening of telomere length is a hallmark of both cellular and organismal aging and is considered to have widespread consequences for the overall fitness and health span of the organism. In contrast, biopsychosocial resilience factors and positive health behaviors have been linked to longer telomeres and a slower rate of telomere shortening. Hence, interventions targeting these factors appear to be a promising approach to promoting health. Together, the transdisciplinary research findings presented here support the potential benefits of a systems thinking approach to better understand the etiology of stress- related health conditions and to develop multifaceted therapeutic interventions combining conventional, social, psychotherapeutic and lifestyle strategies to attenuate chronic disease.

Bruce Arroll

Title: Concluding Remarks
Abstract: I draw together the thoughts from the workshop so far, in preparation for further brainstorming about the way forward.