Review of reviews: Books
Book of the week
Is It All in Your Head? True Stories of Imaginary Illness
(Other Press, $27)
Suzanne O’Sullivan is an unusually good listener, said James McConnachie in The Sunday Times (U.K.). In her “extraordinary” and “extraordinarily compassionate” new book, the London-based neurologist shares numerous tales of patients she’s treated whose paralysis, seizures, or withered limbs were no less real because they had no physical cause. One patient, a woman she refers to as “Yvonne,” went blind one day even though her eyes, as doctors could see, never stopped tracking moving objects. What Yvonne and the others taught O’Sullivan is that a psychosomatic illness is not a fake illness: It’s a sometimes debilitating physical expression of the subconscious, treatable only by doctors ready to recognize that the sufferers need appropriate therapy, not scorn. O’Sullivan’s book, aimed at a general audience, “tries to awaken that humane response in all of us.”
“Her findings are striking,” said Jerome Groopman in The New York Review of Books. Early in her career, O’Sullivan studied epilepsy patients who weren’t responding to standard treatment and discovered that the seizures of fully 70 percent of them were solely attributable to psychological causes. And psychosomatic illness appears to be widespread: Surveys show that a quarter of all people who seek medical care complain of symptoms for which caregivers can find no physical basis. Doctors and patients alike resist labeling illnesses “ psychosomatic”—the patients because they consider it another name for crazy, and the doctors because they fear they may have overlooked a physical cause. But “medicine is an inexact science,” and it’s better for doctors to be open to a psychosomatic cause than to subject a patient to unnecessary surgeries or drug treatments.
“This is a wise book, but one with few happy endings,” said William Bynum in The Wall Street Journal. Because O’Sullivan is not a psychologist herself, she frequently has nothing to report about what happened to her patients who accepted a psychosomatic diagnosis and began therapy. We do learn that Yvonne fully regained her sight after six months of counseling that relieved emotional stress generated by circumstances at home. Her example—as well as the finding that psychosomatic illness is more common among victims of childhood sexual abuse—suggests that therapy might work wonders for other patients too. Whatever the outcomes for these individuals, their stories remind us that emotions play a role in the manifestation of every illness. “In the end, all disease is psychosomatic—disease of both body and mind.”