A nonfiction book on psychosomatic illnesses, written by a neurologist. I've always been fascinated by the power of the mind over the body – the placebo effect, for example – so I was interested to read a whole book on the topic.

O'Sullivan is an expert on treating and diagnosing seizures, and she began to encounter a large number of patients who did not improve under treatment for epilepsy. Under closer examination (monitoring heart rates and using an EEG to trace brain electrical activity), the seizures themselves turned out to be very different from epileptic seizures. She learned they were dissociative seizures, ones caused by trauma or other psychological problems. O'Sullivan also has treated paralyzed patients whose MRIs reveal distinct differences from those paralyzed by physical causes. Though they also show distinct differences from experimental volunteers asked to pretend to be paralyzed! In fact, O'Sullivan makes that point repeatedly and thoroughly in the book: these people aren't faking or merely worried, but have real, disabling, life-destroying diseases that they can't 'get over'. It's just that their illnesses originate in the mind rather than body. (I don't know what's up with the subtitle; presumably it was a marketing decision made by someone else.)

All of this fine so far. Unfortunately, the book overall wasn't great. O'Sullivan illustrates her general principles through case studies of patients, but because she's a neurologist and not a psychiatrist, her interaction with them generally ends at the point of diagnosis. We never see if these people recover, or how they go about doing so. What is the treatment of dissociative seizures? I read this entire book and still don't know, other than a vague gesture toward 'therapy, I guess?'. Related to this, O'Sullivan spends a large portion of the book talking about the history of what was often called "hysteria", but never gets past Freud. I realize that Plato, Galen, and Charcot are still influential today, but surely there's some modern psychatriatic theories on psychogenic illnesses that might be important to mention?

I also felt that O'Sullivan generalized from her experience with seizures and paralysis – which seem to be fairly objectively testable – to medical problems like fatigue, pain, muscle spasm, and sensory issues which simply can't be measured in any objective way (at least, not yet) and which are much, much harder to distinguish between physical and psychogenic origins. She seemed fairly blase about allowing the diagnosis of psychogenic illness solely on (known) physical causes being ruled out, but that seemed too simplistic to me. Just because it's not A doesn't mean it's necessarily B. There's a lot of other letters out there. Finally, I worried about the possibility of patients being lost in the cracks of the medical system when O'Sullivan sent them off with a recommendation to see a therapist but with no followup or consistent medical team; she does briefly mention this as a possibility, but I didn't feel like she treated it with the seriousness the issue deserves.

All that said, I did appreciate O'Sullivan's advocation for psychogenic illnesses: that they're real, that they they're not uncommon, that they deserve respect from society and not to be treated as dismissal diagnoses by doctors who think they're a synonym for 'bored housewife'. I can agree with all of that, even if I wish the rest of the book was better-written and more thorough.

https://www.goodreads.com/review/show/2521794242

The brain is an amazing organ. I recall reading books as a child on the brain that amazed me, at what it could be made to control. So when I saw this book, I knew it was something I needed to read. Psychosomatic illnesses are interesting and I can recall a couple from when I was young that have since proven to have physical causes, actual diseases. Still this was an interesting read. Anyone interested in the human brain might find it fascinating.

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.

Neurologist Suzanne O’Sullivan began her career treating general neurology cases, but over time, noting the number of psychosomatic related neurological disorders she was seeing, began to specialize in such treatments. In Is It All in Your Head, she charts her own progress and experiences in the field, each chapter centering on a specific patient case file or files and the issues present in them.

Though O’Sullivan admits there is a tendency in her field towards dismissing those neurological cases with a psychological basis, she argues strongly against it. She charts her own slow realizations as to the fact that a psychological cause does not make these conditions any less impairing, however it markedly influences the way the patients are treated by society, their employers and even doctors. Providing examples of diagnoses and case files throughout history from highly influential neurologists like Jean-Martin Charcot, who has thus far defined more neurological diseases than any other doctor. Sullivan charts the history and name changes of such psychogenic diseases from hysteria to neurasthenia to the multiple prevailing terms today including: psychogenic and psychosomatic disorders. Throughout, she provides a fascinating and highly readable collection of cases and medical history of such conditions. A highly readable and informative book that will appeal to lovers of psychology, medical literature, or those who just love to learn something new.

Disclaimer: I received an ARC of this book from the publisher in exchange for an honest review.