[quote="Pink_Lemonade, post:15, topic:279434"]
Be very careful when making judgments about others' pain. Living with a chronic pain condition is debilitating, especially when you do not know from one day to the next how you are going to feel or how you'll be able to function. Pain is a subjective thing, so whether you as a social worker think someone is "faking it" is not really relevant.
There have been a few studies in which fibromyalgia patients were given MRIs- their brains were shown to be different than those patients who did not have the disease. Hopefully, as you said, it will be better understood over time, but until then the medical community has given it a name and found it worthy of study and treatment, so it's best not to speculate about whether it's "real" or think that people are just making it up. A lot of people are in a lot of real pain and to make such comments undermines their person and experience. There are people who fake pain, sure. But those who are not far outnumber those who do.
I think he only means that there are few ailments that no one has tried to fake, that this is where people in his specialty (psychology) are called in by other clinicians. Because of the absence of a laboratory test confirming or ruling out fibromyalgia, the possibility of deception with regards to this particular disorder poses a real difficulty for medical clinicians. How does one know? It is not as if you can ethically give treatments with real side-effects to everyone who asks for them. You have to be diligent in confirming that patients are giving honest histories and that the most obvious diagnosis is actually correct.
This is compounded by the issue of co-morbidity and the prevalence of people who are chronic seekers of prescription pain medications. For instance, a person with Munchausen syndrome really has a real problem, just not the problem(s) the patient claims to have. On top of that, of course a patient with Munchausen syndrome might actually get fibromyalgia, just as a patient with Munchausen syndrome might really get cancer. Mental illness is not a prophylactic against physicial illness. Likewise, a person with real pain can still become addicted to pain killers and become prone to the willingness to twist the facts that addiction elicits from people whose honesty was unassailable before they became addicted. And again: Being an addict hardly means you won't have a real physical ailment that causes real physical pain. The real problem that lead to the addiction in the first place is not magically cured when one becomes addicted to the treatment!
It is really a thorny problem, because a person who would fake something like this still is, from a therapist's point of view, in need of some help. Concluding that the person is merely a liar trying to get pain medications or trying to profit from the sympathy of others would be the diagnosis of exclusion. Faking a disease like this isn't something that leads to an optimal quality of life, after all. Sometimes, the faking itself is a symptom of a mental condition in need of treatment.