Sickness is often a murky soup of ingredients. Imprecise pinches of environmental, genetic and lifestyle factors often with an added splash of stress combine to create the concoction of crook.
Now, Australian journalist and author Sarah Wilson's latest blog, adding self-hate into the mix, has stirred it up even further.
In the blog titled "Could female self-hatred be the real cause of autoimmune disease?", Wilson, who suffers from an autoimmune disease, says she believes that anxiety, underpinned by self-hate, caused her disease.
She says that, when asked about the root of her illness, her response is:
"I have to be frank and say – once all angles are ironed out – everything points to … anxiety. Or as I like to put it, a profound, visceral, itchy dis-ease with myself."
Wilson, best-selling author of I Quit Sugar, goes on to say that self-hate leads women, who are three times more likely than men to suffer from an autoimmune disease, to neglect themselves.
"Illness is what happens when women, the nurturers of humanity, forget how to nurture themselves," she says, quoting New York neurosurgeon Dr Habib Sadeghi, who discusses the impact of emotion on health.
Her post was subsequently republished on News.com.au and then one MamaMia writer drew a very long bow and accused Wilson of claiming that all illness in women is caused by self-hatred.
Some angry readers and media went on to label the blog as dangerous and "conspiracy theory madness".
Suggestions that we are, in any way, culpable for making ourselves sick or that we can feel ourselves into or out of illness are often met with outrage.
Happy, healthy people get sick just as those gnarled with bitterness and unhealthy habits remain unfathomably well.
There is also the risk, when talking emotions and illness, that if only we will it enough we can cure ourselves. In this way there is a tacit apportioning of blame on to the unwell.
Finally, there is the valid concern that those who are vulnerable and unwell and desperate for answers will latch on to such concepts and abandon conventional treatments that might save their lives.
The trouble is, this wasn't in fact what Wilson was saying, as she reiterated in a response piece on Tuesday.
"Genetics is also a 'cause' of my autoimmune disease [AI]," she wrote, in the blog titled "Female illness is not all in the mind".
"I say as such in most of my AI posts and, indeed, in the News Ltd [sic] post. I can't speak for others … that's the thing about AI, it's different for everyone.
"I have also previously discussed the role of environment, gluten, cosmetic toxins and sugar. I refer to there being a clusterf--- of factors that can contribute to AI."
More and more researchers are unravelling the links between psychology and sickness.
Chronic psychological stress, for instance, is associated with the body losing its ability to regulate the inflammatory response and can promote the development and progression of disease, including autoimmune disease, which affects about one in 20 Australians.
Professor Fabienne Mackay, chairwoman of the department of immunology at Monash University, agrees that many factors influence disease, including stress.
"There are many, many studies that show stress is a modifier of your immune system," she says. "Some factors are immunosuppressants and those factors are produced during stress."
That said, she admits that a "very difficult problem" with disease is that different factors can cause the same symptoms or diagnosis in people.
"To go to one disease there are many different routes," she explains.
This means that "personalised medicine" may be required because what works for one person will not work for the next, as Wilson states in her blog.
Mackay, therefore, says she cannot comment on Wilson's experience or what has worked for her.
She does, however, say that while stress and distress can impact our chemistry, they should be treated separately from physical illness such as autoimmune disease.
"To make a causal relationship between self-hatred and autoimmune disease is, in my opinion, far fetched and premature," she says.
"Any psychological or medical problem should be treated. Self-hatred is by no means normal and should be treated. But linking that to a disease is not scientifically supported and we can't treat the problems together."
We can, however, start to sift through the soup and begin to address the ingredients it contains, one at a time.
