ABSTRACT
Patients with symptoms that are unexplained by disease are particularly likely to be affected by the naming process. Many will have their own views on how that illness should be named. Certain labels carry strongly negative connotations for many patients, implying in their minds that symptoms are imagined or 'put on' or that they are 'mad'. 'Hysteria' is a term that specifically excludes malingering, yet it is entirely unacceptable to most patients. The naming of possibilities gives structure to perceptions and forms the description for behaviour that leads to 'fibromyalgia'. The patient, having gone through this process in the early stage of illness, then has to constantly grow into conformity with classification criteria. Narratives of early illness may often be given in a fairly vestigial form, with description of symptoms being fragmentary. Not all matters of health or illness are expressed in words or gestures. Sometimes it is silence that speaks loudest.
