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Summary

Winner of the Wellcome Book Prize 2016

Pauline first became ill when she was 15. What seemed to be a urinary infection became joint pain, then life-threatening appendicitis. After a routine operation, Pauline lost all the strength in her legs. Shortly afterwards, convulsions started. But Pauline's tests are normal: her symptoms seem to have no physical cause whatsoever.

This may be an extreme case, but Pauline is not alone. As many as a third of people visiting their GPs have symptoms that are medically unexplained. In most an emotional root is suspected, which is often the last thing a patient wants to hear and a doctor to say.

We accept our hearts can flutter with excitement and our brows can sweat with nerves, but on this journey into the very real world of psychosomatic illness, Suzanne O'Sullivan finds the secrets we are all capable of keeping from ourselves.

©2016 Susan O'Sullivan (P)2016 Audible, Ltd

Critic reviews

"Doctors' tales of their patients' weirder afflictions have been popular since Oliver Sacks.... Few of them, however, are as bizarre or unsettling, as those described in this extraordinary and extraordinarily compassionate book." (James McConnachie, Sunday Times)
"A fascinating glimpse into the human condition...a forceful call for society to be more open about such suffering." (Ian Birrell, Daily Mail)

What listeners say about It's All in Your Head

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  • Overall
    3 out of 5 stars

OK content, but message and impact lost by very poor structure.

Narration was wonderful.

Book? Meh.

This book has all the facts, but it's totally confused by the poor structure and order, so that important points are spread out chapters apart or hidden confusingly amidst personal commentary.

I am unsurprised this author appears to have so many people dispute her diagnosis, or that there are so many negative reviews from CFS sufferers... Indeed, it takes her until the final chapter and conclusion to give an obvious, and understandable to almost everybody , example of psychosomatism (contagious laughter).

Imagine that you have ten lessons in which to teach someone to drive, you have vital information to share, but don't bother explaining the importance of the key and how it turns the engine on until the end. The rest of the lessons being filled out with personal stories of bad drivers you know as examples. Maybe you cover high and low gears in lesson one, but don't explain how to use the gear lever to engage the gears until lesson seven.

That is why this book has to be given an average three stars.

I am sure that this structure made perfect sense to her, based on her pre-existing understanding of simple medical facts that she skims over, (Certain emotions can trigger your body to automatically produce certain chemicals that then has a knock on physical affect for example.) Or her career path maybe led the structure, but it's one heck of a mine field for those who haven't dealt with the subject before and who might be trying to understand any illness they might have.

I personally came to this book after a recommendation from a GP during a routine pregnancy check up at 20 weeks. I had been having to explain once again why I couldn't tell if my very first baby was moving or not;

"I have multiple sclerosis, and whilst I have plenty of scans that show lesions on my brain and spinal cord, the last time I had a relapse they sent me for an MRI. At that time, I was having REAL symptoms and was losing control and feeling in my body down my left hand side, only the scan told me I was wrong.
I wasn't having an actual relapse, part of my unconscious brain was just trying to tell me that it wasn't coping with the stress of a house move.
Because I know I can't be sure now if a symptom is MS or emotional, I cope by ignoring all of my symptoms, after all, if they are caused by MS, I'll find out soon enough. As a result, I'm not sure if any movements in my tum are baby or gas, but I'm happy that baby will let me know for sure soon enough"

(She has :) )

After a brief discussion about how I think the brain it's an amazing and wierd place, she recommended the book.

To be honest, with the exception of personal experiences and stories of patients, there was nothing here that I wasn't already aware of, but this is what to myself made this book so frustrating.

I was wandering about the house listening to the audio and couldn't stop making comments aloud. 'So you're saying you said THAT to a patient, and they couldn't understand or accept it? Well duhrr' and just waiting for her to touch on some aspects that took her forever to mention.

If you are publishing a book intended for inexperienced general consumption, you really ought to ensure that you tailor it to the lowest common denominator.

Make it simple, at least to begin with, build the foundations of understanding in one spot before running off to tell us about someone you once knew.
If readers \ listeners have more of an understanding, they can be happy at having their own prior understanding confirmed.

If, like myself, you ARE frustrated by the lack of importance that some medical professionals place on mental health issues, then, yes, attitudes need to change, but you do that by summing up the facts in a simple, easy to understand, impossible to refute way, NOT by confusing and clouding the subject.

I really, really would suggest to the author that this book is restructured, it's got good content, but the organisation of content is dire.

Until the presentation is simplified, most people are likely to walk away with nothing more than the understanding and prejudices they came in with.

15 people found this helpful

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    5 out of 5 stars
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    5 out of 5 stars

Life-Changing

In a time when so many are attempting to de-stigmatise mental illness, this book is a must-read. For years, I've been attributing my stress and depression to my illnesses and my body's lack of health to pull my mind through. This book has turned my ideas on their heads: it's likely my stress and depression which leads to my illnesses (which have never been diagnosed despite a multitude of tests) which exacerbates my stress and depression. What a refreshing insight.

Whilst I understand the stigma behind being told that your illness "is all in your head" can be humiliating, I feel liberated by finally getting an answer and the possibility of a cure.

A great book with fascinating real-life stories and gripping accounts of patients' responses to their diagnoses. Thank you for this book!

33 people found this helpful

  • Overall
    4 out of 5 stars
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    4 out of 5 stars

Might now have a phobia of getting hypochondria!

What did you like best about this story?

Perhaps because of the nature of the patients involved it was important to get to know them in a little depth, personally, which gives you more of an investment in the outcome of their treatment when compared to some other books which take a drier and less personal look at their case studies.

Was there a moment in the book that particularly moved you?

None of the patients had simple lives, each having to endure their illnesses to different extents but refreshing throughout was the care that the author had for those she treated, even extending to one patient who did not even need her help at all. It was good to see her response to this was not one of disdain or cruelty, as is often seen by the public. She clearly thrives in this work.

Any additional comments?

The only issue, which the author herself acknowledges, is that in her line of work she doesn't necessarily see the cases all the way through to the end, given how difficult it can be to convince her patients of the nature of their problems. Many walk away, others are moved on to other people. It would be nice to know what happened to every patient, though for obvious reasons, that isn't possible.

8 people found this helpful

  • Overall
    4 out of 5 stars
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    5 out of 5 stars
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    5 out of 5 stars

fascinating stuff but ultimately a bit depressing!

a fascinating insight into 'imagined 'illnesses which turn out to not be rhat really......imagined implies deliberate and the book aims to dispel that impression to show it is the subconscious affecting the bodily symptoms. For a book that overall aims to be sympathetic and understanding to sufferers- there were times when I felt some contempt slipping through. The book suffers from having almost nil follow up to the case studies and leaves you with the impression that these sufferers are rarely treated/cured meaning they are condemned to a life of misery and suffering. the standard line was 'i asked if I could refer them to a psychiatrist' and that was the end of their story! it also only mentioned one mistaken diagnosis whereas I suspect there is a much higher incident of mistakes than admitted. The author specialises in epilepsy and therefore most of the case studies are of dissociative seizures. she breifly touches upon CFS/ME and gives history and background to her belief of it being psychosomatic whereas recent studies are revealing physiological causes. overall although a good book,- it does little to alter or improve the stigma surrounding somatic disorders.

7 people found this helpful

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    5 out of 5 stars
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    5 out of 5 stars

Must read for health professionals

Anyone in a clinical profession should make time to read this. Definite eye opener for me!

6 people found this helpful

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    2 out of 5 stars
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    2 out of 5 stars

Narration & attitude clouded any information over

I've never written a review before but felt I had to this time. I was interested in it because I'd been experiencing chronic pain for the last 2 years with no answers.

I was quite shocked and saddened to discover the tone that the narrator used for every patient (except 1) seemed either snobby, rude or ignorant. While I understand that some patients were disingenuine and faking their illness, I think it was very unfair and actually upsetting to think that genuine people going through a horrible time and experiencing real pain saw this woman for help, and as a result, had now been portrayed as impassive, bratty people in this audiobook. In some of the stories, you can tell from her choice of words that she believed some patients were overreacting and over-the-top from her perspective (like the guy with the symptom journal). Considering I had seen over 14 doctors at the time I started this book and had not gotten one answer towards what my pain could've been from, I felt for that guy making his own journal. Sure, he may not have experienced it for so long, but I thought 'good on him for taking that initiative for himself.' He was scared. As any human experiencing unanswered health issues would be.

While listening to this book I found out that I have Stage 4 Endometriosis. While I was relieved to finally get an answer, it made me even more sadder listening to the rest of this book because after all the doctors in my experience who didn't believe me + listening to the stories from the author's perspective and the added filter of that narration, I felt like she would've been one of them.

Were some interesting bits of info but was overshadowed by narration.

5 people found this helpful

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    1 out of 5 stars
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    1 out of 5 stars

The book title is as condescending as the rest.

The journey of a Writer who replaced her absolution of caring, if the tests she did had no answers - to a condescending writer on a high horse. It seems the only person that needed convincing of the suffering was the doctor not the patients.

The tone and language ( even accents) used to describe patient reactions from the position of reflection and education was eye opening. It is very easy to see why nobody wanted to listen to her.

Even as she admits she was willing to push someone out the door, who she later found to have a brain tumor.

There is no doubt to me psychosomatic problems affect people. However this book will not do any good to help any patient. Stop guessing. This is a good way to turn people suicidal.

4 people found this helpful

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    5 out of 5 stars
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    3 out of 5 stars
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    5 out of 5 stars

Great book about a difficult topic!

I'm a GP trainee and have seen conversion / psychosomatic / somatising disorders several times, but it is difficult to understand and explain. The author have succeeded in conveying the subject in a light, but still interesting way and with many learning points for professionals.

A must read for GPs and other interested readers.

4 people found this helpful

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    5 out of 5 stars
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    5 out of 5 stars
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    4 out of 5 stars

Very Interesting

What did you like most about It's All in Your Head?

Interesting stories, good background about the patients, narration was really good. It was refreshing knowing that the author went to great depths to investigate her patients illnesses.

Which scene did you most enjoy?

Overall I very much enjoyed the book, although it is a bit frustrating at times that it only reports what happened with the patients, rather than offering possible treatments besides following it up with psychiatrists.

Did you have an emotional reaction to this book? Did it make you laugh or cry?

The story about Camilla and baby Henry was heartbreaking. Have a tissue at hand.

Any additional comments?

I'm glad I gave it a go.

3 people found this helpful

  • Overall
    4 out of 5 stars
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    3 out of 5 stars
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    4 out of 5 stars

A mixed bag

Very interesting stories and on the side of progress regarding mental health but... riddled with outdated Cartesian dualism as it tries to navigate the mind-body system. It really shouldn't have to be so difficult to prove that the mind effects the body and this is a worthy cause indeed. However, it does not include any of the accepted data available on how psychological trauma creates chronic disease over time. The narrative still wrestles with the false dichotomy between mind and body, tying itself in knots, failing to acknowledge the multi-systemic, interconnectedness of the brain and body via the immune and endocrine system. It also skirts over the shocking statistics about women being repeatedly turned away by health professionals when suffering with life threatening illness, creating unnecessary delays and sometimes loss of life (all because of perceived hysteria). I'd recommend Gabor Matè's work 'When the Body Says No' for hard science and more up-to-date understanding of how our emotional worlds and environmental shapes our health.

2 people found this helpful