IS IT ALL IN YOUR HEAD?

Feeling out of sorts? Take two imaginary aspirin and call us in the morning.

Trained in both neurology and clinical neurophysiology, British doctor O’Sullivan sometimes strays from both fields to enter the realm of psychology and the within-mind processes that can make an otherwise healthy person feel very sick indeed. As she writes, her early experiences came in a study of people with epilepsy who were not responding to standard treatments—not responding, it turns out, because 70 percent of them were not really suffering from epilepsy but instead from psychological troubles. “And each person I encountered had a story to tell,” she writes, “and too often that story was one of a journey through the hospital system that led them to no satisfactory understanding of what was wrong.” In all this, long-ignored standards become relevant anew, and diagnosis by way of analysis becomes ever more critical, since, as the author notes, people themselves are rather untrustworthy witnesses to and interpreters of their own experience—and “distressed, frightened people are more unreliable still.” Blending well-spun anecdote with a gently worn survey of the current medical art, O’Sullivan examines the strengths and weaknesses of approaches to psychosomatic disorders (which “are noteworthy for how little respect they have for any single part of the body”) and stress-related neuroses and illnesses, some of them rare, some of them so commonplace that we scarcely notice whether someone has them or not; some “somatic symptom disorders” happen as a result of readily identifiable trauma, but some are not obvious and even secretive. As a result, the author concludes, just as there is no single cause of psychosomatic illness, neither is there a single cure. “To look for one,” she notes, “is akin to looking for the cure for unhappiness.”

An intriguing look at how mental processes affect and alter our views—and feelings—of health and illness.