All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache

by Paula Kamen

At the age of twenty-four, Paula Kamen's life changed in an instant. While she was putting in her contacts, the left lens disturbed a constellation of nerves behind her eye. The pain was more piercing than that of any other headache she had ever experienced. More than a decade later, she still has a headache-the exact same headache. From surgery to a battery of Botox injections to a dousing of Lithuanian holy water, from a mountain of pharmaceutical products to aromatherapy and even a vibrating hat, All in My Head chronicles the sometimes frightening, usually absurd, and always ineffective remedies Kamen-like so many others-tried in order to relieve the pain. Beleaguered and frustrated by doctors who, frustrated themselves, periodically declared her pain psychosomatic, she came to understand the plight of the millions who suffer chronic pain in its many forms. Full of self-deprecating humor and razorsharp reporting, All in My Head is the remarkable story of patience, acceptance, and perseverance in the face of terrifying pain.

Genres: Memoir, Nonfiction, Health, Medicine, Disability, Psychology, Biography

368 pages, Paperback

First published January 1, 2005

Reviews

[Katherine · Rating 2 out of 5]

I really wanted to like this book, but it just infuriated me. The one good part was how effectively she conveyed the effect this headache had on her life. There is a tendency to dismiss headaches as minor problems and migraneurs as neurotic whiners.

It's billed as a memoir, but it's more of a hybrid memoir-summary of medical information book. This could be good except that the medical information is not consistent (a drug will be one class in one chapter and another class in another) or flat-out inaccurate. (Allergies are not a symptom of migraine.) The memoir part is also disjointed and has some details I really don't need to know in a headache memoir.

Another problem is that she did try a lot of alternative therapies and isn't clear about when they're just plain woo. Some of her alternative healers are clearly just selling her a bridge in Brooklyn because she's desperate to stop the pain. In other cases, it's plausible that the treatment could be effective, but if you look it up, it turns out it's not.

She's also constantly repeating the assertion that chronic pain, seizure disorders and depression all arise from the same neurochemical imbalances. This would be an important point if it were accurate, but the best evidence that depression is a result of a chemical imbalance in the brain is the finding that in severe cases of depression, drugs that alter the levels of certain neurotransmitters in the synapses are more effective than placebos. I seriously haven't seen a technical paper that regards the chemical imbalance hypothesis as a serious mechanism for depression in 8-10 years.

I did appreciate the discussion about the higher prevalence of chronic pain in women and how women's chronic pain is more likely to be undertreated or dismissed as psychosomatic. Unfortunately, she then groups chronic pain, depression, chronic fatigue syndrome, Irritable Bowel Syndrome and fibromyalgia together as Tired Girl syndromes, and writes about how they're neglected by medicine as women's diseases and ignored by feminism because they highlight female vulnerability. It's an important point but it's kind of odd that while making the point, she doesn't talk about the concerns that these syndromes have become "dumpster diagnoses" -- the clinician can't figure out what's wrong, so it must be CFS. In some ways, they're used the same way that hysteria was used 150 years ago. If doctors are diagnosing CFS without ruling out diabetes or anemia, that's a serious problem and it shouldn't come as a surprise that many feminists are are concerned about it.

Overall, I was really disappointed. But I really hope she gets better, because her experience sounds horrible.

[Meaghan · Rating 5 out of 5]

I read this because I am myself a sufferer of chronic daily headache -- since last October -- and like Paula Kamen I'm going through the whole cycle of trying different stuff that doesn't work, or works only for awhile, or removes the pain but turns me into a zombie, etc. I feel I learned a lot from this book -- among other things, I'm going to stop taking Neurontin now, and I'm going to try some of the non-medical remedies that provided some relief for Kamen. I'm still pretty skeptical of alternative medicine and all those special diets and herbs and stuff, though.

I feel lucky compared to her. I haven't had this headache for twenty years (yet). And I haven't (yet) encountered too many arrogant and narcissistic doctors Kamen has, who won't listen to the patient and try to make it sound like they're not really sick and am just whining and being a drama queen. I think this may be because people know more about headaches than they did in the early nineties when Kamen first got hers. Or maybe I'm just lucky.

I would recommend this book to any chronic pain sufferer, especially those with chronic headaches. Although it's hardly a success story -- Kamen's still in a lot of pain, after all -- it's not a downer. It's very educational and some parts are outright laugh-out-loud funny.

[Holly · Rating 3 out of 5]

This book is right up my alley in a number of ways. Its basic subject matter is, as the title suggests, illness and pain, and it therefore examines a number of adjacent issues, such as: mainstream medicine; the way its practitioners often treat patients in general as well as specific types of patients, including women, people with chronic pain, and people who are unable or unwilling to hide the distress their illnesses cause (that is to say, generally with skepticism and contempt); the efficacy and limitations modern pharmacology, and the reluctance of most doctors to offer anything else except surgery and nothing as a treatment for disease; insurance companies and our shitty system for paying for medical care; the efficacy and limitations alternative medicine; the way physical illness affects a sufferer's psyche more than the way the psyche affects the illness.

But I found it very slow-going. It's not especially successful as a memoir; Kamen herself notes that other people's stories have a beginning, a middle and an end; but darn little "happens" in Kamen' story: she gets a headache that never goes away. The personal experience that prompts her research is not sufficiently compelling as narrative to warrant the lengthy discussion of treatments that fail to heal her.

It's much better as journalism and analysis. I'm grateful for insights like this one:

These drugs' resulting effect on public opinion reveals their secondary use in society as a sort of diagnostic test. If it can be treated effectively with drugs, then a malady is 'real.' If not, the patient is making it up (usually on a subconscious level, allegedly).

In my adult years, I have witnessed this process in the use of Prozac to validate depression. If someone takes a chemical (Prozac) that successfully treats depression, then that depression is considered chemical in nature (not imaginary or a moral failing).

The final chapter, offering suggestions to everyone from neurologists to the government to insurance companies to drug companies to celebrities about how "to improve the quality of life of patients with chronic pain--those who account for the leading cause of adult disability in the United States" is very useful. But I was so tired by the time I finally got to it that I couldn't absorb it properly.

Like so many books, it would be better if it were shorter.

The world needs more and better editors.

[Jennifer Lizcano · Rating 3 out of 5]

I picked this up because I didn't want to pay the price for the new hardback Atul Gawande book.
I don't get headaches, nor do I know anyone who does (or at least admits it to me) so I figured it would be good to try and see the affliction from a sufferer's perspective. I'm sure I will have a patient suffering migraine or cluster headaches eventually.
This woman is a hilarious wit...but I think this book would have been better off with 150 fewer pages.

The last 100 were a bear to get through. But I've finally done it, thank God I can move on to other things! Overall it's a well-research informative book with some entertaining humor to help move this serious subject along, but the condescending ending basically undid all the goodwill I'd built up for the author over the course of 400 pages.
She basically condescends everyone involved in the medical profession except for a single internist she had a connection with, and advised ridiculous remedies like "insurance companies, pay for needed medications. be reasonable" and "neurologists, don't just blindly hand out drugs" and "big pharma, spend more money to find a cure for chronic daily headache".

I understand her frustration and the source of her anger...but this oversimplification of a world whose workings she obviously has no intellectual command over left a bitter taste in my mouth. My visceral response was Paula Kamen, don't mouth off on things you don't understand.

[Sam Bennett · Rating 4 out of 5]

Excellent story about chronic pain, esp for folks with migraines. This book is written from the author/patients perspective and experience as she goes through the multitudes of therapies people try for managing chronic pain.

In doing so she writes about the history of medical issues, the way the medical establishment discriminates against women and why they have done that historically. She also lays out the last 50 years of feminist theory and how that has affected women and their medical care.

I highly recommend this book for folks like me, who have chronic pain, but anyone will get valuable information out of it for understanding our health care approach.

All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable, and Only Slightly Enlightening Headache

[Jessica · Rating 4 out of 5]

I really enjoyed this memoir - a little bit of a slower read. The book is a memoir written by a journalist, Paula Kamen, who one day gets a headache. And it stays. For at least 15 years and counting. This is her chronicle of searching for a cure to her pain, and then her story of learning to accept that the pain may continue to be a constant. Along the way she delves into all sorts of research on Chronic Daily Headache, tries all sorts of conventional and non-conventional remedies, and begins interviewing other "Tired Girls" like herself. I would recommend this to anyone with an interest in chronic illness, chronic pain, migraines, feminist studies, public health or biography and memoir. For those with chronic pain of their own - this lady "gets it".

[Sue Nitz]

This book was just to hard for me to read, I cried every time I picked it up, to say I related to much to what she has been through would be a gross understatement. Unfortunately because of that I was not able to continue, it was just too hard for me, as our paths our too similar. I even tried skimming it but it was still to close to home. I give her all the credit in the world for writing it and battling this horrible illness.

[Silk]

My sister said this includes a commentary about modern medicine in america, and I'm always interested in that, probably more than I should be. If nothing else, I'd like to know if and how the headache was fixed.

[Lis Wheaton · Rating 4 out of 5]

Useful if you can't stop beating yourself up for having issues your doctor can't figure out. Also contains a useful way of looking at and dealing with major fatigue issues and chronic pain.

[Martin Cooper · Rating 5 out of 5]

Holy crap, this book. If you've ever Googled what causes headaches at 3 AM while massaging your temples, Paula Kamen gets you. I mean, REALLY gets you.

I bought this expecting another medical memoir, but got something way better - part detective story, part dark comedy, and 100% relatable for anyone whose brain likes to torture them. Kamen doesn't just describe her years-long headache ordeal - she takes you along for every frustrating doctor visit, every failed treatment, every "but you look fine" moment.

What made me nod violently:

The raw honesty about how chronic pain messes with your identity

The infuriating (but hilarious) parade of well-meaning but clueless suggestions ("Have you tried yoga?")

The deep dive into what causes headaches (spoiler: it's complicated)

This isn't a pity party though - it's strangely empowering. Like watching someone take back control from an invisible enemy. I finished it feeling less alone in my own headache struggles.

Perfect for:

People whose "invisible illness" gets eye rolls

Anyone who's been told their pain is "all in their head" (duh, that's where headaches live)

Those who appreciate humor as a survival tactic

Warning: May cause outbursts of "YES! THIS!" in public reading spaces. Also might make you side-eye anyone who suggests essential oils as a cure.

P.S. The chapter about "headache economics" (time/money/energy spent chasing relief) should be required reading for every doctor.

[Amy · Rating 5 out of 5]

A must-read for anyone, especially women, suffering from chronic headache or migraine. This review is written to those women:

It’s like she was in my head, articulating experiences, thoughts, and emotions better than I ever could myself. A life of chronic pain in your head, the part of your body that processes everything you experience, is at (many) times isolating and defeating beyond belief. This book chronicles something I thought I was completely alone in…I can’t describe what a relief that has been. But take it with a grain of salt. You will not find the magical drug that cured her in this book. Do not expect the answer that will give you your pain-free life back. That life was a gift, and you may never get it back. This book is about learning to live a different kind of life with the pain, about how to try to manage the pain instead of cure it, and to keep going…because that’s really all we can do.

[Heydi Smith · Rating 3 out of 5]

I have read probably ten of these types of books now. Obviously, I realize there's going to be a long journey with not a lot of resolution at the end. This book was exactly that.

It was well written and well researched but like the others, don't get your hopes up. As she will explain through years of trial and error, there just isn't a cure.

I enjoyed her insights and her ups and downs. I applaud her for sharing them with the world so openly.

After three years of being a chronic pain sufferer myself, I keep reading these books, not for cures but for a reminder that I am not alone.

Also, that the many drugs I could try will have copious side effects and possibly cause long-term harm. That can be hard to remember when doctors start offering them like candy.

[Jenny · Rating 5 out of 5]

Hang in there with it

This book had a very weak start (that never-ending, not that interesting elementary school story), and I kept starting and stopping this book for years. Finally I was able to get over a weak beginning and really get into it, and, omg, I'm glad I did. It is a fantastic book! By the end, I was so upset that it was ending because I was so into it. If you like medical memoirs (for whatever crazy reason), this one is like the best one out there. Just delicious. I don't think I could read it again because it's dense- this is an intellectual writing so don't expect kitchen-table talk. And it's long. But, wow, a beautiful book.
One person found this helpful

[Laura · Rating 5 out of 5]

Really important read if you struggle with headaches on a regular basis. Some of the new science isn't included (the book is 13 years old), but the old science is still with us and this book explains it and lays down a well-rounded understanding of chronic pain and how doctors, therapists, friends and the general public treat you if you have an invisible disability.

[Diane DeSousa · Rating 5 out of 5]

So much research went into this book, so many facts, but it is so honest and compassionate for fellow sufferers. I have had migraines for most of my life, and the book makes me feel as if she is my sister who is also a warrior in a quest to change society's attitudes towards migraines and get more research into their cause and treatment.

[Ann · Rating 3 out of 5]

3.5/5

[Emily · Rating 4 out of 5]

This book is a memoir by Paula Kamen, a woman in her thirties who has suffered from a chronic headache since her early twenties. In this book, she chronicles the treatments she pursued in the quest to cure her headache, ranging from the traditional (painkillers, antidepressants, surgery) to the downright weird (craniosacral adjustments, guided visualization, strange diets) and everything inbetween (biofeedback, massage, chiropractic). Nothing cures her, although some things do seem to help a bit.

Interspersed with Kamen's own story are facts and statistics about chronic pain and its sufferers. I found that information fascinating. Kamen calls them the "Tired Girls" because chronic pain sufferers who have pain that is not from an obvious cause tend to be young-ish women with fibromyalgia, chronic headache or migraines, lupus, chronic fatigue syndrome, and so on. All of those disorders cause chronic, disabling pain and fatigue, but without any outward symptoms or foolproof diagnostic signs. So the people who have those disorders end up seeming like they are just lazy and wimpy, and that their problems are "all in their heads".

Even as someone who is sympathetic to the "Tired Girls" - my closest friend in college had fibromyalgia, and I never doubted that she was genuinely suffering, even though I couldn't see the source of her pain - I was taken aback by the callousness that the Western medical establishment, and Western society at large, show toward them. We would never say to a person with chest pain from heart disease, "Oh, quit your whining, if you stop thinking about the pain it will go away" or "if you just weren't so emotionally uptight you wouldn't be sick." Also, I think our medical culture still doesn't give enough consideration to the effects of chronic pain - it's demoralizing and depressing to be in constant pain, especially if you're told by your doctors that you're imagining it!

Finally, Kamen is a witty and funny writer, and really captures the absurdity of her situation. I didn't expect to laugh at a book about a headache, but I did.

[Kelley · Rating 4 out of 5]

I had to order this book online because it’s apparently not available in-store anywhere. I wanted to read it so that I could learn about the struggles Kamen went through to cure her headache. Though her experience isn’t the same thing that I have been going through, I thought it could lend some guidance, or at least some insight into the realms of headaches. Starting off, I was pretty astonished to find that my experience with the neurologist seemed to mirror Kamen’s pretty significantly. We had been treated very similarly, and put on several the same drugs in the beginning (and her story started almost 20 years ago). What this made me realize more than anything was that my neurologist seemed to very much be focusing on my intermittent head pain instead of my symptoms at large. It was a disappointing, although not really very surprising, revelation. As I read further into this book, I really began to feel frustrated for and with Kamen, as her problems never seemed to get better, and her quest for resolve never seemed to end. In the end, I am left feeling two things: slightly disheartened that my chronic problems may never be solved, and grateful that I am not suffering what poor Paula Kamen has been dealing with for close to 20 years.

[Michelle Wilkes · Rating 4 out of 5]

Excellent book, which I got as I also have Chronic Daily Headache (otherwise known as "The Headache" as it doesn't actually go away at all) with episodic migraine. I thought the book was very well written, but some chapters were a bit heavy in places and possibly un-neccessary to include (hence only four stars). I found it correlated so much with how I feel, and I have only been suffering for about 3 years now. Written for the American market, I did have to look up some of the medication names (we have different names in the UK) but I found reading about the helpfulness of some of the "alternative" or now known as "Complementary" therapy has finally gave me the push to try massage, aromatherapy, reflexology, reiki, magnesium supplements and magnesium oil/bath flakes with some very positive results so far.

edited to add that as the book was written 10 years ago, I am very interrested to know how Paula Kamen has done over the last 10 years and whether anything has changed and if she still has "The Headache" though I expect she has.

[Trish · Rating 5 out of 5]

Although this book is over a decade old, unfortunately it is still highly relevant today.

As a fellow migraine warrior, Kamen reflected many of my own experiences back to me in a way that was wonderfully validating, so reading this book was extremely cathartic for me.

"All in My Head", made me feel less alone and freakish and gave me excellent metaphors to describe to people what it is like to live with daily pain (marbles, driving with the parking break on, etc,). Kamen so thoroughly covered all aspects of chronic pain from the isolation, guilt, and depression to the crazy medications, treatments, doctors, as well as its effects on our interpersonal relationships and the people who just don't believe that you can be in pain all the time. I am so profoundly grateful that Kamen wrote this book and shared her story with such intelligence and humour.

[Shameem · Rating 5 out of 5]

If you have any kind of chronic illness, you'll relate to Kamen throughout this entire book, in a way you'll really benefit from. But this book goes beyond being beneficial for chronic pain patients. It's a necessary read for anyone in pharmaceuticals, any medical practitioner, people involved in healthcare policy, and of course, the loved ones of people who suffer from chronic illness. I wish I had more words to explain why Kamen's writing is so powerful, but I'm coming up dry. I hate to lay on a guilt-trip, but honestly, if you truly care about the well-being of those you treat/work to help/love, you'll read this.

[Heather · Rating 4 out of 5]

This book was smarter, but probably a little less fun than the other chronic headache book I read (Chocolate and Vicodin), although I did appreciate the dark humor. As a journalist, she was thorough in her explorations of just what happens to a person who has a headache that just won't go away. It was relatable (unfortunately for us!) and also educational (which was a definite plus for someone who has already read plenty about this disorder). I especially liked her conclusion and plea for more research to be done on this. She is a survivor and an activist. I hope my poor little chronic migraineur ends up as enlightened.

[Erica · Rating 4 out of 5]

Journey through dealing with medical issues, unexpectedly funny, over the course of a decade + long headache, the author really does try everything, and is realistic but desperate. The idea of this awful lingering headache is difficult to think about, and I end up with a headache each time I read a section. Spoiler - there is no magical cure. The author introduces the idea of 'sick girls', women who have disproportionate occurances of pain, auto immune and other illnesses and get little or no help from tradional and non traditional medicine.

[Kimberlie · Rating 2 out of 5]

The subtitle of this book caught my eye--and is why I read it. Turns out this book was only as slightly enlightening as my headache is. Lots of the author's experiences mirrored mine, I just don't really blame the still present headache on gender issues (most people with daily chronic headache are women, and Paula says that's why no one bothers to find a cure) and the pharmaceutical companies (she calls Big Pharm) as much as she does. Some parts were funny, but lots of it was just okay to me.

[LynAnne Smucker · Rating 4 out of 5]

I thought that her combination of personal memoir, with her insightful and witty perspective on both modern medicine and alternative medicine made for a really understandable and interesting book to read. Much of what she has to say resonated with things I had learned when I took my anthropology of reproduction class. The other thing I gained from her book is a greater understanding of what life with a chronic debilitating medical condition is like. Glad to have read this.

[Seddon · Rating 5 out of 5]

This book really goes into detail about the frustrations and challenges of chronic pain. After my own personal experiences with the medical system and back pain, I found myself amused and happy to find someone else had this experience. Plus as a woman it's important to understand the history going back to Freud in relation to medical views on women's chronic pain.

[Monica · Rating 4 out of 5]

I learned so much about what my friend is going through, and that there are so many others like her out there dealing with chronic migraines. It was witty, quick, and a very interesting read. It touched on a lot of very personal topics related to the US healthcare system and western medicine in general.

[Teresa Mobley · Rating 5 out of 5]

THE best book I have ever read on he subject. Accurate, funny, self deprecation at its best. Pity party and motivation kept to a minimum. An excellent balance. Reads like a fictional novel. Great paired with Laurie Notaro!!! As someone who has dealt with her own unrelenting and unreasonable headache for years, this book was written for me.

[Alexandra · Rating 4 out of 5]

As a migraine sufferer this was kind of entertaining but also a real eye-opener. Have I really taken lots of these drugs too....yes, and only been seriously addicted to one but that was enough.

It is brilliantly written and as with headache conventions that I have attended - makes me realise that I am pretty lucky.

[Misha Fredericks · Rating 3 out of 5]

As a migraine sufferer, I found this book both helpful and overwhelming. Helpful because of her meticulous reporting of her path with all she learned that helped or hindered her pain and others. Overwhelming because she often was too wordy and went on and on. The book easily could be condensed by 100 pages and made easier to read and assimilate.