(Is It All in Your Head? True Stories of Imaginary Illness. New York, NY: Other Press, 2017)
Justine had fibromyalgia – or so that’s what she told me. No matter how much she slept, she was always tired. Her joints hurt. On some days, walking from her car to the office could be a challenge. She struggled daily to keep up with work, and occasionally she had to stay home. Simply thinking about everything she needed to accomplish overwhelmed her. However, there were stretches of time, two days, sometimes an entire week when she felt fine. Energetic, she ran errands, went out with friends, and commenced new projects. Neither she nor her doctor could find a pattern, nor could they predict when she might next experience these moments of reprieve. Once, I made the mistake of asking if perhaps her difficulties were more psychological than physical. Appalled by my suggestion, she scoffed at me. How dare I think she was making it up? Her suffering was real. How could I not see that?
Then one Sunday morning after church, her congregation, having her heard about her illness, laid hands on her. They lifted their prayers to God, and she, a devout Christian, trusted in His goodwill. The following morning, she woke up to discover that her pain and fatigue had vanished in the night. Her congregation, with God’s help, had cured her. A follow-up appointment with her doctor confirmed this to be true. When she told me, I congratulated her on her improved health. What I kept to myself was the fact that this seemed to give credence to my opinion. God didn’t cure her – a change in attitude did.
While reading Is It All in Your Head? True Stories of Imaginary Illness by Suzanne O’Sullivan, I thought frequently about Justine, wondering if my initial understanding of her illness was correct. Throughout the book, O’Sullivan explores psychosomatic disorders – illnesses that are rooted in the mind but are manifested physically. She concentrates specifically on dissociative seizures – seizures that often lead to a misdiagnosis of epilepsy – but also discusses chronic fatigue syndrome, fibromyalgia, hypochondria, and Munchausen Syndrome. These illnesses are no less “real” and cause people no less suffering than their physical counterparts.
Although certainly very “real”, they can’t be diagnosed with tests. Blood work and MRIs will appear normal, which at first might puzzle the doctor. Only after every other possibility has been explored will a doctor suggest that the illness is probably seeded in the mind: “In the case of psychosomatic disorders the diagnosis often rests on the lack of evidence. The diagnosis is made when disease is sought but not found.”
These illnesses are treatable, but often the men and women experiencing them are reluctant to accept the diagnosis. Medication will not help them. To get better requires working with a psychiatrist, an option that many find unappealing or even degrading. Friends, colleagues, and employers understand and are sympathetic of debilitating illnesses that are physical in nature. Ailments of the mind are harder to explain and harder for society to comprehend:
Telling somebody that their disability has a psychological cause creates in them a feeling that they are being accused of something; they are being told that they are lying, faking or imagining their symptoms.
Throughout the book, O’Sullivan makes a concerted effort to convey the fact that psychosomatic disorders should not be brushed aside, ignored, or taken less seriously than other more tangible maladies. Hers is an attempt to give them validity by confronting myths regarding hysteria and demonstrating to the reader that illness located in the mind is not an act of fantasy or an attempt to willfully mislead others. Those who experience illness that is influenced by the mind have often experienced something traumatic in their lives, something so painful that seizures, fatigue, or muscle impairment become a way for the person to subconsciously cope: “Almost any symptom we can imagine can become real when we are in distress – tremor, fatigue, speech impairments, numbness. Anything.” Psychiatrists help patients uncover the underlying issue, and once it is exposed, the physical problems often disappear.
The medical terms O’Sullivan uses can be rather dense for a reader not schooled in medicine, but that does not detract from the effectiveness of the stories she tells. The book is broken up into nine chapters, seven of which are titled by the first names of people whose illnesses have influenced her work. The essays read like stories, bringing the reader directly into other people’s lives, building sympathy for their struggles, and slowly removing judgement from our thoughts. There is an element of mystery infused in the work. O’Sullivan conveys the narrative of what brought her patients in to seek help. Then she sets out to uncover the underlying cause, the trauma masked by the physical disability.
One of the strengths of the book is O’Sullivan’s meandering into the history of hysteria and the doctors – going back to the days of Ancient Greece – who studied it. These doctors include Hippocrates, Jean-Martin Charcot, Pierre Janet, George Beard and Sigmund Freud. It is fascinating to see the way they have interpreted psychosomatic disorders, how they have experimented with those who suffer, and the conclusions they have drawn. It is equally interesting to learn how society has fluctuated in its acceptance of psychosomatic disorders.
Having read Is It All in Your Head? True Stories of Imaginary Illness, I realize I did my friend, Justine, a disservice. While my suspicions that much of what she experienced was lodged in her mind might have been accurate, my response was inappropriate. O’Sullivan cautions,
Telling someone that their symptoms do not have an organic cause is not always met by the relief a doctor expects. To the patient the diagnosis may feel like a dismissal. And why not? We live in a world where disability that occurs for psychological reasons is considered as less deserving than other forms of disability.
What Justine needed from me was sympathy, and for me to have a degree of faith in what she shared. The next time a friend comes to me with what I might suspect is a psychosomatic disorder, I will not be so quick to roll my eyes in frustration.
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Elizabeth Jaeger has recently earned an MFA degree in creative writing from Fairleigh Dickinson University. Her essays and fiction have been published in Boston Accent Lit, Damfino, Inside the Bell Jar, Blue Planet Journal, Italian Americana, Yellow Chair Review, Drowing Gull, Icarus Down Review, Linden Avenue Literary Journal, Atticus Review, and Literary Explorer.