IS IT ALL IN YOUR HEAD?

True Stories of Imaginary Illness


Winner of the 2016 Wellcome Prize, a neurologist’s insightful and compassionate look into the misunderstood world of psychosomatic disorders, told through individual case histories

It’s happened to all of us: our cheeks flush red when we say the wrong thing, or our hearts skip a beat when a certain someone walks by. But few of us realize how much more dramatic and extreme our bodies’ reactions to emotions can be. Many people who see their doctor have medically unexplained symptoms, and in the vast majority of these cases, a psychosomatic cause is suspected. And yet, the diagnosis of a psychosomatic disorder can make a patient feel dismissed as a hypochondriac,

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Winner of the 2016 Wellcome Prize, a neurologist’s insightful and compassionate look into the misunderstood world of psychosomatic disorders, told through individual case histories

It’s happened to all of us: our cheeks flush red when we say the wrong thing, or our hearts skip a beat when a certain someone walks by. But few of us realize how much more dramatic and extreme our bodies’ reactions to emotions can be. Many people who see their doctor have medically unexplained symptoms, and in the vast majority of these cases, a psychosomatic cause is suspected. And yet, the diagnosis of a psychosomatic disorder can make a patient feel dismissed as a hypochondriac, a faker, or just plain crazy.

In Is It All in Your Head? neurologist Suzanne O’Sullivan, MD, takes us on a journey through the world of psychosomatic illness, where we meet patients such as Rachel, a promising young dancer now housebound by chronic fatigue syndrome, and Mary, whose memory loss may be her mind’s way of protecting her from remembering her husband’s abuse. O’Sullivan reveals the hidden stresses behind their mysterious symptoms, approaching a sensitive topic with patience and understanding. She addresses the taboos surrounding psychosomatic disorders, teaching us that “it’s all in your head” doesn’t mean that something isn’t real.

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  • Other Press
  • Hardcover
  • January 2017
  • 352 Pages
  • 9781590517956

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About Suzanne O'Sullivan, MD

Suzanne O’Sullivan, MD, has been a consultant in neurology since 2004, working first at The Royal London Hospital and currently as a consultant in clinical neurophysiology and neurology at The National Hospital for Neurology and Neurosurgery. She has developed an expertise in working with patients with psychogenic disorders, alongside her work with those suffering from physical diseases, such as epilepsy.

Praise

“Doctors’ tales of their patients’ weirder afflictions have been popular since Oliver Sacks … Few of them, however, are as bizarre or unsettling as those described in this extraordinary and extraordinarily compassionate book.” —James McConnachie, Sunday Times

Discussion Questions

1. Before reading Is It All in Your Head?, did you know anything about psychogenic disorders, or about physical responses to emotional stimuli more generally? What did you learn that you didn’t know before? What surprised you?

2. O’Sullivan emphasizes the importance of believing her patients—of acknowledging that their physical pain is in fact real, even though she believes it to have a psychological origin. Do you believe them? If you were in O’Sullivan’s place, what would it take to convince you that your patient isn’t “faking it”?

3. Even after rigorous medical testing, most of O’Sullivan’s patients are initially reluctant to accept her diagnosis of a psychogenic disorder. Why do you think that is? How do you think you would react to such a diagnosis?

4. Have you ever experienced a psychosomatic illness or affliction? How did you know that it was mental rather than physical?

5. What did you think of O’Sullivan’s relationship with her patients? Does her experience and understanding of psychogenic disorders make it easier or harder for them to accept her diagnoses?

6. Were there any particular patients in Is It All in Your Head? that you could relate to? Who? Why?

7. The absence of a definitive medical cause of illness or pain does not prove that it is “all in your head.” If you were one of O’Sullivan’s patients, what would it take to convince you that your symptoms might stem from psychological trauma rather than physical trauma?

8. Do you agree with O’Sullivan that a stigma exists against sufferers of psychogenic illness or pain? Has reading Is It All in Your Head? changed the way you think about these disorders and those who suffer from them?