She truly doesn't seem to understand that her symptoms might stem from psychological distress rather than a somatic condition. I read somewhere that back in the day Kandi Barbour went from doctor to doctor with vague somatic symptoms in search of a somatic diagnosis. I suspect that many PWs in between Kandi and Kacey have trod similar paths. Having watched young Kacey recount her sorrows, I doubt that she can muster the insight that often the brain is the controlling factor. If she could only attain that insight, then she might stop doing the things (PWing, drug and/or alcohol abuse, etcetera) that are probably fucking her up and causing these symptoms.