Written by a consultant neurologist, 'It's All in Your Head' explores the complex and misunderstood subject of psychosomatic illness with a combination of compassion, pragmatism and professional experience. Throughout her working life, Dr O'Sullivan has encountered patients suffering symptoms with no clear biological cause. They have often endured countless invasive and comprehensive tests and spent decades taking heavy duty medication, yet their lives have been destroyed by apparently incurable illness. Visiting a neurologist can be the last step on a journey that includes everything from debilitating headaches to epileptic-type seizures to complete blindness to chronic fatigue. But once all the tests have been done, the results analysed and every physical cause ruled out, is it really possible it could all be in your head?
This book was absolutely fascinating. Dr O'Sullivan's expert deployment of case studies to illustrate her points made the book both readable and humane, In this economic climate, it would have been very easy for someone to go on a political rant and use this as a platform for blaming clearly ill people for wasting money and destroying the NHS. Even the reviews I read used it as a stick to beat people with ME/Chronic Fatigue Syndrome because there is one paragraph in which the writer sticks her neck out and suggests that psychological factors may contribute to the prolonging of some cases of ME/CFS. She's a scientist for crying out loud, she's looked at the research and evidence and drawn a logical conclusion. She freely admits she could be wrong, but she's made a judgement on what information is currently available and in no way belittles the suffering of others. Whether influenced by psychology or not, these patients are clearly suffering through no conscious choice of their own and need help, support and understanding, not blame.
Reading the heart rending stories of different patients, sometimes angry, sometimes pitiful, always relatable, made it easy to understand the subject and recognise how serious the consequences of stress and trauma can be for certain people. According to Dr O'Sullivan, at the root of all psychosomatic symptoms lies some undealt with and unrecognised cause, buried away in the mind but making itself felt in the most terrifying way.
Doctors are frightened to diagnose such psychological causes for physical illnesses because they might have missed something or a new test in the future could prove them wrong or the patient might simply get angry (a common and understandable response). Meanwhile the patient thinks they're being called a liar, a faker or a fantasist. And all this in the context of a society that has so firmly separated the mind from the body that mental health is neglected and everyday twinges are over medicalised. It's a toxic cocktail that lets many people down.
My only complaint about this book is its subtitle; 'True Stories of Imaginary Illnesses'. In the very least, the jury is still out on that. These patients are clearly suffering from something, their symptoms are involuntary and do exist. The cause may be in the mind, but 'imaginary' suggests a stereotype that the author clearly wanted to undermine, that of the patient who is making it all up.
Before jumping to conclusions, I encourage you to read this book. Whether right or wrong, it is genuinely fascinating and full of ideas that could really change your mind.
Now, what next...?
