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It's All in Your Head: True Stories of Imaginary Illness

Suzanne O'Sullivan

4.06 · Rating details · 2,422 ratings · 261 reviews

A neurologist's insightful and compassionate look into the misunderstood world of psychosomatic disorders, told through individual case histories ...more

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Paperback, 315 pages

Published April 14th 2016 by Vintage (first published June 4th 2015)

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Nov 23, 2019 Petra-X Off having adventures rated it really liked it · review of another edition

Shelves: 2019-100-reviews, 2019-read, medicine-science, reviewed, psycho-neurology-crime

I well knew the power of the mind over the body since I was 13 and 'gave' myself appendicitis. I had a test on Anna Karenina and hadn't read the 800 page book. I said I had a tummy ache and went to the school sick room and read all day.

That night I had to go to Hebrew school and I had forgotten about a test so I said I had a tummy ache and drew a picture until my father came to pick me up and I went straight to bed to read Anna Karenina for the test next day still feigning pain.

At midnight I wo ...more

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Jun 06, 2015 Nasim rated it did not like it · review of another edition

I imagine the publisher was excited by Dr O'Sullivan's 'ideas' - I saw the words 'groundbreaking' and 'controversial' in one of the blurbs. Imaginary illness carries notions of madness across the centuries, as readers we are intrigued - and seduced. However, having read in detail the chapter 'Rachel', which deals with a young woman with 'ME/CFS', I can say that the book is certainly not groundbreaking, but rather, in the case of ME, an irresponsible recycling of a dying - very dangerous - narrat I imagine the publisher was excited by Dr O'Sullivan's 'ideas' - I saw the words 'groundbreaking' and 'controversial' in one of the blurbs. Imaginary illness carries notions of madness across the centuries, as readers we are intrigued - and seduced. However, having read in detail the chapter 'Rachel', which deals with a young woman with 'ME/CFS', I can say that the book is certainly not groundbreaking, but rather, in the case of ME, an irresponsible recycling of a dying - very dangerous - narrative which has been perpetuated by psychiatrists since the nineties. And having dipped into the other chapters, I'm afraid I find her style to be rather unengaging and toneless, though I wonder also if that is a kind of clinical constraint.

So her *ideas* must be sparkling and new if I am to be pulled in.

While vigorously suggesting that patients with myalgic encephalomyelitis (ME) have false illness beliefs, she then bases the entire chapter on her *own* beliefs. There is no evidence whatsoever to prove that ME is psychosomatic. There is however growing robust evidence that ME is a complex, multi-systemic neuroimmune illness, and the key to unlocking the puzzle is ever nearer - biomedical researchers worldwide are excited and hopeful about finding a unique biomarker. Dr O'Sullivan acknowledges that there is evidence of immune abnormalities but then chooses to ignore them completely and goes off on her wild somatisation spree. She seems not to *want* the science to progress, so zealous is she in her beliefs.

The whole chapter on 'Rachel' is manipulative and incoherent, illuminating only in what it omits. I know what the gaps are, so I can see the huge holes. She wrongly says that graded exercise (GET) is the most effective treatment, even although this treatment has been thoroughly discredited, it makes patients worse. This psychologising of ME is extremely harmful to patients, as patients and true specialists have been pointing out for years.

I have had virally-triggered ME since 1983 - I was nineteen years old, an undergraduate, unlucky to get a nasty enterovirus - and was diagnosed by a consultant neurologist, after EMG and muscle biopsy and many blood tests, which confirmed abnormalities. I had been ill for eighteen months at the time of diagnosis, steadily getting worse, and, of course, had never heard of ME then, few people had (I didn't go upstairs to my room and google). My initial treatments included a plasma exchange with immunosupression, and anti-viral drugs. And yet Dr O'Sullivan denies hotly in her book that immunotherapy is used for ME, anywhere. She also seems unaware of the anti-cancer drug trial going on in Norway just now. The scientists have recently been in London discussing their trial at an annual ME conference, which attracts scientists from all over world.

She also fails to mention the huge confusion caused by the different criteria for ME - the CFS (chronic fatigue syndrome) label was introduced in late eighties in UK and the criteria for ME were widened and diluted, with the result that anyone with unexplained 'chronic fatigue' was being diagnosed with ME. This conflation of 'classic ME' and CFS has caused a major headache for patients (no pun intended). Patients who *do* have psychiatric-based fatiguing illness are sometimes being misdiagnosed with ME. The conflation has, naturally, caused immense problems with research; moreover, severely ill/bedridden patients with actual ME are not being included in trials.

O'Sullivan also makes no reference to post-exertional malaise (PEM), which is unique to ME - exhaustion (physical and mental) after trivial exertion - she talks only generally of 'fatigue'. She ignores the disabling cognitive dysfunction - Rachel has some concentration problems but O'Sullivan does not describe the classic ME 'brain fog', which all of us w ME experience as a kind of 'dementia'. We routinely forget everyday words, we mix words up, we forget people's names, we cannot remember simple facts, we leave taps on. Neither does she mention orthostatic intolerance, the inability to be upright, stand for long, another cardinal feature. Indeed, many people with ME have full-blown POTS (postural tachycardia syndrome). She basically excludes all the symptoms of ME in her discussion, bar 'fatigue'. She seems to think managing ME is managing fatigue, and Rachel 'fails' in her management. Naughty Rachel.

I honestly wonder if Dr O'Sullivan truly believes what she has written or if she needed to pad out her book as she didn't have enough real psychosomatic illnesses for the pot. And she knows writing about ME as a psychiatric illness will be immediately controversial - even when she is wrong. Whatever her motive, she has failed spectacularly to keep up with the research and she has insulted not only ME patients but the whole scientific community engaged in ME research.

*I just want to add that this may be one of the most revealing passages in the ME/CFS chapter:

'In my early years training in neurology I encountered many patients with CFS, but more recently neurologists have distanced themselves from this disorder and patients are more likely to seek help from immunologists or endocrinologists. I do not currently see patients for the purpose of diagnosing or treating ME/CFS, but many of my patients with dissociative seizures have a history of ME/CFS, and there is something very interesting in that fact alone.'

There is something very interesting in the fact that Suzanne does not seem to have actually met (m)any patients with classic Ramsay-ME (in 1990s when she was training, the Wessely/CFS/psychiatry school was just taking root, so it's hard to know what was actually wrong with the 'CFS' patients she was seeing).

I reiterate: Rachel, the case study with ME/CFS is, to my mind, an artificial construct, a composite character with the 'behaviours' of ME patients - internet diagnosis, increasingly helpless, 'over-helpful' parents - that the Wessely school adores. Rachel rejects the psychiatric treatment offered her. We never find out what happens to her, though Suzanne says: 'The impact of our emotional well-being on our health is not a trifling problem. I only wish I could convince Rachel of this'.

O'Sullivan also fails spectacularly to describe the experience of probably all of us with ME, of pushing ourselves to 'recover' only to relapse catastrophically. Her apparent lack of contact with patients who actually have ME - coupled with not following the science - would perhaps explain why she felt that including ME in a book of imaginary illnesses was acceptable. ...more

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Jun 07, 2015 Maik Speedy rated it did not like it · review of another edition

It saddens me to see that a so badly researched chapter about ME/CFS, a disease which has been classified as a neurological disease by the WHO since 1969, was published in this book.

In February 2015 the IOM, the Institute of Medicine, a prestigious American Institute, came out with a report about ME/CFS concluding that ME/CFS "is a medical—not a psychiatric or psychological—illness"
http://www.ncbi.nlm.nih.gov/pubmed/25...

On the 2nd of April 2015 prof Newton published an article in which she let ...more

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Aug 05, 2019 Emily B rated it really liked it · review of another edition

A very interesting and informative read for sure. Many of the case studies in this book have stuck with me since I’ve read this book.
It wasn’t too scientific or medical and therefore was not too laborious to read. IT had a good balance between information and the telling of people’s stories

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Dec 05, 2016 Rebecca rated it liked it

Shelves: illness-and-death, science-tech, wellcome-prize-winner, newbury-library, free-other, disability

O’Sullivan is a UK-based neurology consultant. I picked this up from the bestsellers shelf of the library on a whim because I knew it had won the Wellcome Book Prize, awarded to a fiction or nonfiction book on a medical subject. The kinds of conditions she writes about go by many names: psychosomatic illnesses, conversion disorders, or functional conditions. In every case the patients have normal neurological test results – they do not have epilepsy or nerve damage, for instance – but still suff O’Sullivan is a UK-based neurology consultant. I picked this up from the bestsellers shelf of the library on a whim because I knew it had won the Wellcome Book Prize, awarded to a fiction or nonfiction book on a medical subject. The kinds of conditions she writes about go by many names: psychosomatic illnesses, conversion disorders, or functional conditions. In every case the patients have normal neurological test results – they do not have epilepsy or nerve damage, for instance – but still suffer from dissociative seizures or lose the use of limb(s). Their symptoms have an emotional origin instead.

“Psychiatric disorders manifesting as physical disease are at the very bottom of [the] pile,” O’Sullivan writes. “They are the charlatans of illnesses.” Indeed, early in her career she was likely to assume such patients were shamming. Although she does describe two patients who through video recordings were found to be faking seizures, in most cases the symptoms are real, but arise from the subconscious rather than a physical cause. Along with cases from her own career, the author writes about early doctors who developed the science of conversion disorders, including Jean-Martin Charcot and Sigmund Freud.

I read the book very quickly, almost compulsively; these are fascinating stories for anyone who’s interested in medical mysteries. That’s in spite of the fact that O’Sullivan does not strike me as a natural storyteller: her accounts of patients’ cases are often no more than just one thing after another, and in reports of her own conversations with patients she comes across as almost robotic and not always very compassionate. Ultimately I believe she does empathize with those with psychosomatic illnesses – otherwise she wouldn’t have written a whole book to illuminate their plight – but it would have taken the writing skill of someone like Atul Gawande for this to be a better book. I’m pretty surprised this won a major prize.

Note: Many of the low ratings you’ll see for this book are in relation to Chapter 7, about CFS/ME/fibromyalgia. These are controversial fatigue disorders, and O’Sullivan is aware that even mentioning them in a book about psychosomatic illnesses is “foolhardy to say the least.” I don’t think what she actually has to say about these conditions is offensive, though (and I say that as someone whose mother struggled with fibromyalgia for years). She allows that there may be physical triggers, but that emotional well-being and traumatic experiences or regular stress cannot be overlooked.

Chew on this: “More than seventy per cent of patients with dissociative seizures and chronic fatigue syndrome are women.” The author’s best guess for why this is? “On the face of it, women turn their distress inward and men turn it outward.”

Many of her patients are outraged by referral to a psychiatrist, as if they’re being told they’re making it all up, but it’s actually a holistic approach: acknowledging that the mind has a big influence on how we feel. ...more

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Feb 08, 2017 Petra rated it liked it · review of another edition

Shelves: uk, netgalley, psychology, non-fiction

Suzanne O'Sullivan is a neurologist consultant based in the UK. In It's All in Your Head: True Stories of Imaginary Illness she details the case histories of various patients who present with neurological symptoms. However, these patients have normal neurological test results, no organic cause can be found for their illness, but they still suffer from e.g. dissociative seizures or have lost the ability to move a limb. They suffer from a psychosomatic disorder. The cause of this is attributed to Suzanne O'Sullivan is a neurologist consultant based in the UK. In It's All in Your Head: True Stories of Imaginary Illness she details the case histories of various patients who present with neurological symptoms. However, these patients have normal neurological test results, no organic cause can be found for their illness, but they still suffer from e.g. dissociative seizures or have lost the ability to move a limb. They suffer from a psychosomatic disorder. The cause of this is attributed to the patients' subconscious, their emotional well-being relating to present or past emotional stress and/or trauma. As psychosomatic illness is still "a socially unacceptable disorder", many of O'Sullivan's patients react in a defensive, sceptical, or even furious manner when faced with the suggestion to consult a psychiatrist, "so I'm crazy (mad)/a psycho now?"
I was really interested in reading this book because the best and most useful internship I spent during my training were four months in a psychosomatic clinic. In the end, it took me forever to finish this book. That's not to say that it wasn't good, but Ms O'Sullivan isn't a natural storyteller. In addition, the structure of the book made it really difficult to stay with it. The case studies, which I was most interested in, are interrupted by long passages providing historical background covering Charcot, Freud etc.
By the time the author returned to talking about a particular patient again, I often had trouble remembering who that patient was. Ok, maybe my problem as well for having a rubbish memory, but I wish the book had been structured differently.
In general, this is an informative introduction to psychosomatic disorders, especially if you are also interested in gaining some insight into the history of medicine/psychology, but I was keen to find out more about how these patients fared once they were transferred to a psychiatrist and how they dealt with their diagnosis. But I guess that doesn't fall within Dr O'Sullivan's remit, so I appreciate that some information was missing.
Some chapters, as shown by some reviews of this book, are controversial depending on your opinion regarding psychosomatic illness. Overall, I found O'Sullivan's stance respectful and empathetic. She comes across as a compassionate and honest medical professional. The title of the book isn't particularly helpful because the point is that these are not "imaginary" illnesses, as O'Sullivan points out herself, but very real for the tormented patients.
Recommended if you're interested in finding out about the power of the mind over the body and you like a solid introduction to psychosomatic disorders.
I received an ARC via NetGalley.
...more

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Jan 02, 2019 Chris Steeden rated it really liked it · review of another edition

‘Psychosomatic disorders are conditions in which a person suffers from significant physical symptoms – causing real distress and disability – out of proportion to that which can be explained by medical tests or physical examination’.

I am guessing that this book is controversial in some people’s eyes even though O’Sullivan states ‘I hope to communicate to others what my patients have taught me. Perhaps then, future patients – people like you and me, our friends, families and colleagues – will not ‘Psychosomatic disorders are conditions in which a person suffers from significant physical symptoms – causing real distress and disability – out of proportion to that which can be explained by medical tests or physical examination’.

I am guessing that this book is controversial in some people’s eyes even though O’Sullivan states ‘I hope to communicate to others what my patients have taught me. Perhaps then, future patients – people like you and me, our friends, families and colleagues – will not find themselves so bewildered and alone’. Right now, ‘Society is judgemental about psychological illness and patients know that.’ Before she gets into the patients’ cases, which are set as different chapters, she says ‘some of the common preconceptions and judgements levelled at those with psychosomatic illness need to change’.

Dr O Sullivan

Dr Suzanne O’Sullivan has been a consultant in neurology since 2004 although she qualified as a doctor in 1991. She had always wanted to be a neurologist (Neurology is the branch of medicine concerned with the study and treatment of disorders of the nervous system). In this, her first book, she is looking at those people who ‘unconsciously think themselves ill’. How many of us are ‘aware of the frequency with which our emotions can produce serious disability where no physical disease of any sort exists to explain it?’. She tells us that ‘Psychosomatic disorders are not neurological disorders. They belong to the fields of psychology and psychiatry’. Through her work she has seen many patients who suffer in this way though. It is because the patient has a physical symptom that they seek help from a medical doctor. The physical symptom is masking emotional distress Sullivan states.

Is this book readable? Will I be able to keep up with the doctor writing this? Thankfully the answer is yes, to both. This is not an academic book in the way it is delivered. I found it absolutely fascinating. Some of the patient stories are incredible. These are not symptoms that are put on by the patient. There is something real going on. Well, the brain says there is. The doctors would say, ‘Your tests are normal. There is nothing we can do.’ What can be done though? As stated, each chapter is set out with a specific case and other cases that are like it. You will see the commonalities. The reviews on Goodreads are so insightful especially those that give the book one star. Read the book then read the reviews on Goodreads. It makes for interesting reading. I make no judgement either way. ...more

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Oct 19, 2015 Sergio Mori rated it it was ok · review of another edition

It has some interesting bits but all in all it has two massive flaws:
1) the title. She doesn't consider them to be imaginary. It's just an annoying marketing ploy.
2) the biggie for me: she doesn't follow up the cases so we don't know if they are success stories or not. For all we know, patients could have been leading a more functional and happier life with the alleged misdiagnosis.

Also, the chapter on ME/CFS feels undocumented and even preposterous, almost as if she had a bone to pick.

But I l ...more

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Jun 21, 2015 Damaskcat rated it it was amazing · review of another edition

I thought this book was a truly fascinating read. I have always accepted that there is a strong link between the brain and the body and that the brain can produce symptoms in the body which are wholly unrelated to any physical cause. When I was a child I always used to get a stomach upset on the first day of the school term. Once I was at school the upset disappeared completely. My mother sat me down and explained to me that sometimes the brain plays tricks on the body and that I would feel all I thought this book was a truly fascinating read. I have always accepted that there is a strong link between the brain and the body and that the brain can produce symptoms in the body which are wholly unrelated to any physical cause. When I was a child I always used to get a stomach upset on the first day of the school term. Once I was at school the upset disappeared completely. My mother sat me down and explained to me that sometimes the brain plays tricks on the body and that I would feel all right once I got to school. She did of course make sure there wasn't anything I was worrying about at school - and there wasn't because I actually enjoyed school. I did gradually grow out of it as I got older.

I suppose because of my own experiences I didn't find this book hard to accept at all. The author is at pains to distinguish between those patients who are real malingerers and who are making up their symptoms for reasons of their own but are consciously doing it and are in control of their symptoms and those who really do experience their symptoms but have no identifiable physical cause for them. So there is a huge difference between those two cases.

I think many of us have come across those people who can faint at will or who can produce tears on demand but these abilities are a long way away from those who faint for no apparent physical cause but are as distressed by the experience as are the onlookers. How can mental and emotional distress produce symptoms in the body? No one really knows but once the underlying distress is dealt with then the physical symptoms usually disappear.

Unfortunately many people confuse the idea of imaginary symptoms with the idea that an emotional trauma can cause perfectly genuine physical symptoms and see it as an insult if it is suggested to them that a psychiatrist might be able to help them.

The author describes the extreme reactions many people have to any suggestion that psychology might be able to help them. In any illness psychology might be able to help since the brain and the body are so closely linked that one is going to have an effect on the other. People who believe they have epileptic seizures are often very upset to be told that they do not have epilepsy and their seizures are caused by stress or trauma. They frequently do not believe this to be the case even when EEG readings and video footage show they are not having an epileptic seizure.

I think the best way to approach the book is at the very least with an open mind. I found it compelling reading. The author writes well and in an approachable style. I would have liked to see a bibliography included though there is an index. I recommend this book to anyone who is interested in the mind/body link and the way it can affect us.
...more

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Jun 17, 2016 Bonnie rated it did not like it · review of another edition

Shelves: non-fiction, medical, own

I was sadly, deeply disappointed by this book.

Her writing is fine, she's an obviously experienced doctor with many tales of interest and but if you know anything about psychiatry, psychology or modern neurology, you will find her stories a bit less than fulfilling. She tries really hard to seem compassionate and empathetic but it just appears like a long excuse for having horrible bedside manner and being really poorly versed in anything but her own specialty of seizures. In which case, I'd ask ...more

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Mar 20, 2016 Jon Morris smith rated it liked it · review of another edition

Now I like a good surgical memoire - my top recommendation is "when he air hits your brain" which is both a memoire, an insight into neurosurgery and an historical journey through the evolution of the discipline... ditto for "Do No Harm"

... however, while enjoyable, I felt that the patient accounts were somewhat incomplete - the conclusion of the cases and the patient's journey to recovery (or not) was often omitted. So these were more 'case studies' if you wish, to serve as illustrations of con ...more

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Jan 27, 2017 Monica Willyard Moen rated it it was amazing · review of another edition

Shelves: bookshare, kindle, medical

The chances are good that someone you know has a somatic illness and doesn't know it. This empowering, intriguing book explains how the mind can control parts of the body to create genuine symptoms such as pain, blindness, and paralysis, even when all test results are normal. The author doesn't excellent and compassionate job of explaining that while the symptoms are caused by the mind, they are still just as real as if something were physically wrong with the body. Now, scientists are performin ...more

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Feb 14, 2017 Liz rated it did not like it · review of another edition

I would like to give the book a much higher rating. I admire Dr. Sullivan's understanding and compassion for the very real suffering of patients with psychosomatic illness (but I cringe at the titles of both versions of her book with their long-standing negative connotations for the general public.)

However, applying the label of psychosomatic illness (even in a somewhat modified way as she does) to ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) is just wrong. To her credit, Dr. Su I would like to give the book a much higher rating. I admire Dr. Sullivan's understanding and compassion for the very real suffering of patients with psychosomatic illness (but I cringe at the titles of both versions of her book with their long-standing negative connotations for the general public.)

However, applying the label of psychosomatic illness (even in a somewhat modified way as she does) to ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) is just wrong. To her credit, Dr. Sullivan does say: "Do I know that for sure. No, nobody does." She says her reason for doing so is based on what she believes is the lack of evidence for an organic disease. In reality, (and despite the appalling lack of government funding in the US for research) there is a mountain of evidence which has been collecting since the 1980's from researchers dedicated to the study of this disease in the US and other countries, with some of the most profound research coming in the most recent years, some after the writing of this book.

Dr. Anthony Komaroff at Harvard Medical, both a researcher and clinician in ME/CFS since the 1980's, gives a summary of the evidence of biological disease from the 80's through 2013 in a video that can be googled entitled, "VIDEO: Dr. Anthony Komaroff - CFS Research: Recent Progress and Challenges".

For the sake of brevity in this review I will mention only a couple of recent highlights in research being done with new biological technologies.

Gene expression studies have demonstrated dramatic results in ME/CFS relative to fatigue and other major symptoms of the disease such as immune dysfunction and autonomic system dysregulation, as well as a new understanding of the complexity of the biology of fatigue. (An overview of some of this can be seen in a series of youtube videos by Prof. Alan Light, one titled "60. Gene expression markers of ME/cfs / " )

A name that must be mentioned is Dr. Ron Davis and his Open Medicine Foundation, End ME/CFS Project at Stanford University. Dr. Davis was recently named by Atlantic magazine as one of the 7 most outstanding innovators of the century for his landmark work in the field of genetics including the development of new research technologies (which led to the mapping of the human genome and more); he is presently working with 3 Nobel Laureates, 6 members of the National Academies of Science, and others creating new research technologies that are producing dramatic findings (work published 2016 and 2017).

Davis and his team have been examining energy production through metabolites (particularly relative to the mitochondria at the cellular level). They have found extensive alterations in the levels of over 100 metabolites in the serum of ME/CFS patients. Dr Robert Naviaux's research, according to Davis, marks the most "important and groundbreaking" development in ME research so far. Using 20 metabolites, Naviaux has discovered a 'diagnostic signature' for identification of ME/CFS at a more than 90% accuracy level. The disruptions in metabolism affect 7 systems in the body, not just the production of energy (giving biological evidence of the many other serious symptoms of the disease).

(For a brief insight, google the youtube video: Scientist Ron Davis Tells How We Are "Fast-Tracking" ME/CFS Research )

There is a saying in medicine (which Dr. Sullivan herself has used): FIRST DO NO HARM. ME/CFS patients have been grossly harmed for decades by the labeling of this devastating biological disease with the innocuous sounding name "chronic fatigue syndrome." The National Institute of Health in the US has all but ignored the funding of research. (AIDS gets 3 BILLION dollars; MS 250 million; ME/CFS 5 million--even though ME affects many more people than the other two). More inaccurate labeling of the disease as psychosomatic such as in this book, though I think well meant given Dr. Sullivan's level of information about the disease, is greatly adding to this harm.

If Dr. Sullivan and others are willing to revise their conclusion of psychosomatic disorder for ME/CFS based on the whole of biological research, my admiration for them will increase exponentially. Otherwise I fear, like the doctors of old clinging to their 'hysteria' explanations for epilepsy and multiple sclerosis, these doctors are doomed to come down on the wrong side of history, while ME/CFS patients needlessly suffer much more harm.

See also the outstanding TED talk from ME patient JENNIFER BREA "What happens when you have a disease doctors can't diagnose". Brea has produced a documentary called 'Unrest' which will be aired on Public Television the first part of next year. ...more

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Sep 28, 2017 Flapper72 rated it it was amazing · review of another edition

Shelves: medical

Spoiler alert (well, kind of!) - I'm a doctor and this book has been recommended to me by a colleague - having said that I think that this book should and could be read and appreciated by anyone, just as long as they're a human being! It continues to astound me that (especially the medical profession) think that our metal health and physical health are discrete entities. When we have a physical injury it's going to affect our minds so, similarly, when we're mentally unwell it makes sense that ou ...more

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Jun 15, 2015 Ian Kirkpatrick rated it it was amazing · review of another edition

I was tempted to purchase this book having read the extracts in the weekend Guardian magazine a few weeks ago. This accessible and insightful book provides a brief glimpse into some of the complexities of the human condition through the real-life stories of patients with a variety of psychogenic disorders.

Perceptive, engaging and really well-written, this gives a fascinating insight into the working practice of a neurophysiologist. O'Sullivan balances true stories of some of the many patients sh ...more

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Aug 30, 2015 Emily rated it it was ok

2.5 stars. I found a lot of things frustrating in this book. First of all, the doctor seemed very reluctant to believe anything her patients were saying and seemed determined to prove them wrong.

Also, many of the case studies ended abruptly and we weren't told whether or not the patient recovered. What's the point in only giving us half the story?! ...more

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Apr 21, 2016 Jackie (Farm Lane Books) rated it it was amazing · review of another edition

Stress affects us all. We are aware that we might have a racing heart during an important meeting, but few of us know that it can cause our bodies to react in more extreme ways. Some people can become completely disabled – unable to move a limb, or become overwhelmed by seizures.

Up to a third of all GP consultations are taken by people who are found to have no physical explanation for their symptoms. In this book Suzanne O’Sullivan, a consultant neurologist, investigates the root cause of some o Stress affects us all. We are aware that we might have a racing heart during an important meeting, but few of us know that it can cause our bodies to react in more extreme ways. Some people can become completely disabled – unable to move a limb, or become overwhelmed by seizures.

Up to a third of all GP consultations are taken by people who are found to have no physical explanation for their symptoms. In this book Suzanne O’Sullivan, a consultant neurologist, investigates the root cause of some of the more serious cases she has encountered; explaining how emotional issues can escalate to produce real and terrifying physical problems.

It’s All In Your Head was fascinating throughout. Each chapter dealt with a different patient and the difficulties of giving a psychosomatic diagnosis were sensitively explained; showing the impact they had on both doctor and patient. The structure of the book was particularly accomplished and I admired the way technical information was included without it becoming overwhelming.

The prevalence of psychosomatic illness around the globe was surprising and I was shocked by some of the statistics:

In 2005 a study carried out in Boston revealed that people with a tendency to develop psychosomatic complaints cost the health care system twice as much as those who do not. These results were extrapolated to estimate the yearly cost of psychosomatic disorders in the USA – $256 billion. To put this in perspective, in 2002 diabetes, a common disease with multiple life threatening complications, had a yearly cost of $132 billion.

I also loved the way this book included some historical detail, showing that psychosomatic symptoms are not a new phenomena.

This is a ground-breaking book that investigates a completely new area. It enabled me to see aspects of my own health which may have been exacerbated by emotional problems and its message will be useful to a wide range of people.

It’s All In Your Head highlights the need for increased mental health funding. I hope it helps to break down the stigma of mental illness and lead more people into recovery.

Highly recommended. ...more

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Jul 27, 2016 Catherine rated it it was amazing · review of another edition

A good read for understanding the experiences of living with psychosomatic disorders and how doctors work with them in clinics.

The author has managed to explain complex medically unexplained disorders and illnesses in a clear and simple manner without using medical or psychological jargon. The characters illustrated in the case studies were quite lively. She is trying to get people to understand the plight of this clinical group, and I think she has used the stories of some very interesting pat A good read for understanding the experiences of living with psychosomatic disorders and how doctors work with them in clinics.

The author has managed to explain complex medically unexplained disorders and illnesses in a clear and simple manner without using medical or psychological jargon. The characters illustrated in the case studies were quite lively. She is trying to get people to understand the plight of this clinical group, and I think she has used the stories of some very interesting patients to illustrate that. If people think these narratives are too "dramatic" - well, I can tell you, the clinic scene can be very dramatic, emotional and volatile. After all, we are dealing with people who are at their most distressed and most vulnerable times! Of course, it won't be a smooth sale!

I have also enjoyed the snippets about how an illness has been studied or perceived in the past and how these perceptions influenced our current views. That has provided the context to why we still have limited understanding of these conditions!

A lot of the comments pointed out how the author lacks compassion (despite trying hard) for the patients and that the accounts of the patients' struggles seemed to be solely from the author's perspective. However, I think that the author, given her status and job role as a consultant neurologist, is actually quite open and honest about her shortcomings, her mistakes and early misconceptions about psychosomatic disorders (see pg. 15-16).

I also wonder if the author was charting out her own learning curve in this book, and how her understanding of these illnesses improved following her own research, clinical experiences, and behavioural observations (see pg. 309).

Essentially, as explained by the author in her book, she hopes that these case studies will shed light on the suffering of patients living with poorly-understand and recognised illnesses, so that the public may be more compassionate towards them.

Took me longer than usual to finish this book as I was trying to digest the content carefully but a really enlightening and informative read overall. ...more

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Jan 19, 2017 Paula Maguire rated it really liked it · review of another edition

I enjoyed this book a lot and was glad to be given it by AS for my birthday as I had already bought it for A as she is studying medicine. I remember reading a review saying that anybody who is studying medicine should read it . I also related well to this book as I know I suffer from psychosomatic pain from time to time and its comforting to know that although there is no organic reason for my pain, there is still pain - though the cure is psychological - in my case body scans and relaxation - T ...more

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Jul 04, 2015 Patrick Carroll rated it it was amazing · review of another edition

I can imagine (irony?) the conversation between the author and the publisher, "It's a great book Suzanne so we thought the best title would be 'It's all in your Head - True Stories of Imaginary Illness'" and Dr O'Sullivan going, "But you've missed the point! The book is about how sufferers of disassociative seizures and other psychogenic disorders for which there aren't a medical explanation DON'T imagine anything, it is utterly real to them, as are the many physiological changes, in the way it ...more

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Sep 12, 2017 Stefania Panaetescu rated it liked it

First of all, I have to point out the huge marketing mistake it was made through the subhead of some editions of this book, "True stories of Imaginary Illness". This is so misleading and wrong, psychosomatic disorder is far from being imaginary! All the simptoms of this illness are real and very often debilitating. Just because they have a psychological cause and not an organic one, doesn't mean they are imaginary. What I cannot understand is how the author agreed to this blunder in the first pl ...more

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Jun 09, 2015 Shona Dickson rated it it was ok · review of another edition

It has the potential to be interesting but disappoints slightly. It's long winded at times and very repetitive. Having said that, it kept me reading to the end but some of the chapters were spoilt by alternating from patient story to neurology history (some of which was interesting) back to patient story. Sometimes I forgot what the original case study was about.
I've read more interesting books like this such as Henry Marsh's Do No Harm. ...more

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May 19, 2018 Laura rated it really liked it · review of another edition

Shelves: four-star

A fascinating glimpse at the world of psychosomatic illness, primary those affecting the brain and various neurological related issues, including epilepsy. Although this book has drawn criticism from the chronic fatigue syndrome community, I felt it was a well written and articulate account of how the mind and general psychological principles affect physical illness.

The author draws upon her experiences as a consultant of neurology to discuss issues surround so called imaginary illness and it’s ...more

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Aug 13, 2020 Maen rated it really liked it · review of another edition

The mind has magnificent power over the body! Not just the conscious, but the unconscious and it's much harder to know when the body struggle for physical reason or it's the unconscious mind screaming for help through the body.
The book is repeating stories that all leads to the same conclusion, it's a must read for everyone who thinks psychosomatic illness are not worthy of attention and proper treatment and consider psychiatrist only for "insane" people. ...more

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Jan 20, 2017 Paul rated it really liked it · review of another edition

A very interesting book about a rare and peculiar phenomenon: conversion hysteria as manifested by seizures with no organic genesis. Although the author figures that 30 percent of hysterical seizures have a root cause in dissociation from sexual or physical trauma, which is about all one regularly reads about this, the curious part to me is what causes the other 70 percent?

The author acknowledges these conversion seizures are real and can be measured by EEGs, EKGs, and other physical tools; she A very interesting book about a rare and peculiar phenomenon: conversion hysteria as manifested by seizures with no organic genesis. Although the author figures that 30 percent of hysterical seizures have a root cause in dissociation from sexual or physical trauma, which is about all one regularly reads about this, the curious part to me is what causes the other 70 percent?

The author acknowledges these conversion seizures are real and can be measured by EEGs, EKGs, and other physical tools; she just doesn't understand the causality of them. She offers several interesting case studies about persons who have this malady, and one fascinating thing is that the patients have often researched their symptoms online and have determined they have epilepsy, whereas when the author points out that no organic cause can be found, the patients often get furious and accuse her of thinking they are crazy ("mad" in UK vernacular). Strangely, the patients seem curiously insistent on a false definition of the cause of their seizures, no matter what the author, a neurologist, says.

The author is never able to find an etiology for these conversion hysterias, and the cases are very interesting in that some of the subjects retreat forever from life and just cling to their idea that they must have some undetectable epilepsy, and the few who resume normal living basically ignore their symptoms or dismiss them, and are able to have normal lives in spite of flare-ups.

One thing that I was curious about was how the Salem witchcraft girls, who also seemed to manifest these seizurelike symptoms--except in the beliefs of the time, only witchcraft could explain them--actually contracted them. What is there in the human subconscious that is willing to put up with these hideous, uncontrollable convulsions for no apparent reason? By the end of the book, the causality remains a mystery, which, to me, only makes it that more provocative. There HAS to be some causality for physical manifestations so intense, out of control, and frequently public. If they're not caused by epilepsy, what are they caused by? Surely no humans would put themselves through the embarrassment, exhaustion, and lack of bodily control for no reason. It's too horrible and painful. So if these people aren't epileptics, what causes the seizures? And they are verifiably, observably real.

I've always thought that the apostle Paul had hysterical blindness on the road to Damascus. Perhaps this is the same phenomenon. At any rate, both the sufferers and the observers seem not to be able to determine the causality. This will be a perpetually ongoing mystery until the reasons for it are discovered, and from this book, it appears that will never be anytime soon.

Still, a fascinating psychological phenomenon. ...more

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Sep 29, 2020 Elif rated it it was ok · review of another edition

The author paints neurologists in a realllllyyyyy bad light. Or at least just herself. I understand that psychosomatic disorders are still alien to the medical world, however, her personal stories involving LAUGHING at and mocking patients behind their backs is very unprofessional (even if it’s just a trainee doctor) and maybe something she should’ve left out, or maybe tried to cover it up. I’m saying this only because if anyone with psychosomatic disorders were to read this, they’ll probably fe ...more

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Jun 26, 2018 Bryce rated it it was ok · review of another edition

When I picked up O’Sullivan’s book, I assumed it would be something like Oliver Sacks’ The Man Who Mistook His Wife for a Hat: Case studies of people with rare and unexplained psychosomatic disorders. Fairly voyeuristic, but interesting for a layman reader.

This book is not that. Not funny or poignant anecdotes that an average person could enjoy and learn from. Instead, O’Sullivan shares stories of complicated patients she’s worked with, her reactions as a professional, and the history and perce ...more

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Jun 05, 2016 Isabel Losada rated it it was amazing · review of another edition

This book has completely changed my ideas about psychosomatic illness. To be fair to myself, I don't think those ideas were particularly well formed in the first place. I think I just thought that something psychosomatic was formed by the mind but 'made up' in some way - or worse still - did I imagine that a psychosomatic illness was in some way 'faked'? I wish I had been asked that question, in depth, before I'd started to clarify just how ill informed I was. Certainly I would not have expected ...more

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Feb 17, 2019 Essam Munir rated it liked it · review of another edition

Shelves: medical-literature

In this book she described what many physicians encounter but don't speak of. The struggle of trying to explain to patients what they have, they struggle of trying to cure them, and the struggle to show them that you want to help.
Psychosomatic or functional neurological disorders are common but reside in the dark corners of every physician.
The patients' struggles are real but accepting the diagnosis is difficult.
An interesting read for those who are interested in these disorder although you may ...more

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Aug 14, 2016 Jo rated it liked it

Shelves: non-fiction, memoirs, psychology

O'Sullivan is a neurologist who specialises in psychosomatic disorders. Here she recounts some of her more memorable cases. I found this fascinating; the human mind and body is such a complex organism and it amazes me what we're capable of, even when things are going wrong. A good introduction to this particular illness. ...more

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Has the author or her publishers appologised for the unresearched chapter she wrote on M.E./ C.F.S.?	4	51	Dec 12, 2018 08:46AM

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About Suzanne O'Sullivan

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Books by Suzanne O'Sullivan

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“All my patients are individuals with their own story to tell, their own set of problems and their own solution. Even where the symptoms of their distress are very similar, the roads that bring them to me are not. Each of them teaches me something important, just as each new patient I meet reminds me that there is always more to learn.” — 3 likes

“People look for explanations for changes in their bodies, something to account for every unpleasant feeling. There is an unwillingness to accept behavioural or emotional factors, or the effects of aging, as an explanation.” — 2 likes

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