This was a book I needed to read.
Daniel is twenty-three. He’s never been seriously ill, and he’s perfectly fit and well, but an acquaintance of his has just died of a brain haemorrhage and suddenly the mild-but-niggling headache at the back of his skull has taken on a far more sinister meaning. He hasn’t realised it yet, but his adamancy that he needs an MRI scan – just to make him feel better, just in case – could be the beginning of a very slippery slope into a terrifying world where every twinge is menacing, every blemish needs careful observance, and where something as commonplace as tiredness signals the potentially fatal. Daniel is suffering, but not at the way he thinks he is. His consultant, the author of this book, does not share his concern about his headaches. They are benign, harmless, with none of the warning signs of serious medical issues. Instead, she recommends he seeks treatment for the anxiety that has already begun to worm its way into his every waking moment. It was after reading the four or so pages that discussed Daniel’s plight, nestled in the middle of this already captivating book, that I broke down in tears. Recognising myself so entirely in the words and experiences of a stranger was not an experience I was prepared for.
There’s a huge difference between something originating in one’s mind, and actively making something up. That, essentially, is the message of this book. Daniel’s case is almost a side note. He is a hypochondriac, only really suffering from anxiety, not physically impaired by the symptoms making him worry so much. The rest of the book tells the tales of patients whose bodies really have been disabled. Matthew cannot move his legs. Camilla suffers from frequent seizures. Shahina’s dominant hand is painfully contorted. Yvonne has gone blind. O’Sullivan does not doubt the real-ness of their impairments. But, as a consultant in neurology, it is her job to tell her patients that their test results are normal, and that their ailments don’t have an organic cause. Instead of giving them the medical diagnosis they seek, she must face the inevitable backlash of denial, of frustration, of anger, sometimes, and deliver her diagnosis: “it’s all in your head”.
Our bodies do funny things when our minds are under pressure. A bride and groom sign their marriage certificates, hands shaking. A candidate waits for a job interview with butterflies in their stomach. A particularly tense moment of a film makes our hearts start pounding, and we wipe away sweat drops from our foreheads. Physical reactions like this are things that most of us take completely for granted. We don’t need a doctor to confirm that these are the workings of stress, and nothing more sinister. It shouldn’t be surprising, then, that such reactions can be more extreme, more varied, than those we call normal. O’Sullivan’s diagnosis is never intended as an accusation, but, sadly, it is often received as one. Somewhere, muddled among the implications of lying, and the negative stigma attached to mental health issues, the reality of psychosomatic disorders has been buried. And if, as O’Sullivan describes, the complex possibilities of such issues are little more than a footnote in a medical textbook, leaving even senior consultants confusing them with the results of imagination and deceit, it is hardly surprising that the common patient has such difficulty accepting them.
Writing about ‘science’ for non-scientists requires a delicate balance that O’Sullivan achieves masterfully. Admittedly, this book might be more about what we don’t know than what we know – after all, a diagnosis of a psychosomatic disease is only really made by ruling out possible organic causes – but I was certainly left feeling as though I understood a little more about the incredible and often underestimated connection between mind and body. Interjected with eloquent explanations of medical fact and psychological theory, O’Sullivan intimately recounts stories of patients and their plights. Perhaps what is most striking is the extent of her own involvement: a psychosomatic disorder can only be treated with understanding, and we share her determination to help even those who do not believe she can help them.
I wish I’d seen a consultant as switched on as O’Sullivan when my headaches started in October. It’s All in Your Head was fascinating and completely gripping, with characters painted vividly and a real sense of interest and urgency. For me, it was also incredibly reassuring. I may still be baffled by the human mind and body, but I’m learning to trust it to do its thing.
Disclaimer: I’ve never written a book review before. Is this even a review? Is it okay?