Book 7: ‘It’s all in your head’ by Suzanne O’Sullivan




A single word is enough to summarise all I feel after reading this book by Suzanne O’ Sullivan: ‘phenomenal’. Suzanne O’ Sullivan is a Neurologist by profession working in the UK with specific interest in evaluation of epilepsy. In this book she has given a truthful account of some of her patients diagnosed with dissociative seizures or somatisation disorders. The pragmatic statistics of psychosomatic disease burden,morbidity and economic health burden presented in this book is an eye opener to medical professionals as well as public with limited medical knowledge. I admire and appreciate her ardent truthful narration. She never hesitated to divulge her own short comings in understanding patients with psychosomatic illness.

I have personal experience of this phenomena both as a clinician and as a patient. As a clinician, I have come across numerous people suffering from this phenomenon. Inspite of my own suffering from which I have been fortunate enough to recover, I cannot pat myself on my back and rest assured that I have demonstrated enough empathy to these patients all these days. Of course, my attitude and approach towards these patients from my early medical school days till date has evolved quite a lot. But I feel I could have been more proactive to convince patients about the real nature of their disease. I pity myself for writing an article a few months ago about people who suffer from this illness where my tone of accusation was evident.  This book has changed my outlook towards human beings who endure unspeakable and unmeasurable pain due to this phenomenon. Many a times the terminology ‘psychosomatic disease’ is not acceptable to the patient and it is a herculean task to convince such patients. If people can believe in God without the existence of any proof, they should be able to believe in the existence of psychosomatic illness. The power of subconscious (read as ‘neurones in your brain’) to cause physical experience or symptoms is unimaginable.

Dr Sullivan has given an account of the history of ‘hysteria’. I was surprised to learn that Jean Martin Charcot, who described Charcot-Marie -Tooth disease, which I encounter in my day to day practise, was actually a French Neurologist who had done pioneering work in understanding neuroses and was rightly named as the Napoleon of neuroses. Charcot, Janet and Sigmond Freud were physicians who made tremendous efforts in understanding and curing  this phenomenon. It is disturbing to discern that even in the 21st century ,with all the progress attained in medicine, the stigma associated with these disorders still prevails.

I hold a high opinion of the efforts taken by Dr Sullivan in writing this book with an appeal to the public to change their attitude towards psychosomatic illness. It calls for a better understanding and a lot of empathy that would perhaps be the only way by which this disorder can be curbed. Patients are not able to accept the psychological cause because they fear abandonment,harassment and trivialisation of their symptoms. The suffering is real even though the cause is non organic. The concluding chapter about ‘Laughter’  deserves special mention. ‘ Laughter’, the author says , ‘is the ultimate psychosomatic symptom’. If we believe in the highly complicated phenomenon of laughter, we have to believe in psychosomatic nature of illnesses. This book is highly recommended for anyone interested in neurology, psychiatry or in understanding human suffering and the power of human mind.


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