An exploration of victim blaming in ‘medically unexplained symptoms’: Neoliberalism and the need to justify the self, group and the system

ABSTRACT Narratives within mainstream psy disciplines around ‘medically unexplained symptoms’ (MUS), as constructed through (bio)psychosocial theorising, have been charged with promoting victim blaming. Psychosocial discourse and practice within this field are also critiqued on grounds of inadequate empirical support and associated with patient harms, yet (bio)psychosocial hegemony persists. Understanding what drives current practice and attendant victim blaming in the field of MUS is therefore important in challenging dominant discourse and changing psychotherapy practice, thus precluding patient harm. In this article, practitioner psychology is explored through a critical lens, locating this within a context of organisational and biopolitical influences which likely reinforce mainstream theory and practice. It is argued that victim blaming tendencies within dominant discourse around MUS may serve relational, existential and epistemic needs for practitioners and social actors more broadly, alongside fulfilling a need to assert moral value in the face of social injustices that threaten the neoliberal ‘just world’ view. In other words, (bio)psychosocial constructions of MUS satisfy society’s need to create and ascribe to a shared reality, dominated by a belief in a just, meaningful and relatively predictable world that justifies the status quo. Critical reflexivity is emphasised as a starting point for transforming practice.